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Sample records for 64-slice ct angiography

  1. Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan

    Marini, Davide; Agnoletti, Gabriella [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Brunelle, Francis [University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France); Sidi, Daniel; Bonnet, Damien [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Ou, Phalla [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France)], E-mail: phalla.ou@nck.aphp.fr

    2009-09-15

    Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery. Population and methods: Fifteen consecutive children (8 male and 7 female; age 9.2 {+-} 6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8 {+-} 3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard. Results: CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography. Conclusion: In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surge0008.

  2. Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan

    Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery. Population and methods: Fifteen consecutive children (8 male and 7 female; age 9.2 ± 6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8 ± 3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard. Results: CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography. Conclusion: In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surgery.

  3. Optimizing 64-slice spiral CT angiography in lower extremity arterial disease with individualized injection protocol

    Objective: To explore the optimal protocol of the 64-slice spiral CT angiography (CTA) in lower extremity arterial disease. Methods: Forty -eight patients with clinically suspected lower extremity arterial disease underwent GE LightSpeed VCT using individual and traditional injection protocols. The clinical value of CTA was evaluated using DSA as the standard reference. Results: Satisfactory images were obtained from 47 of 48 cases. Images fulfilling clinical diagnostic requirements after appropriate post -procession on workstation were obtained from 1 case. The image quality of the group with the individualized injection protocol was significantly superior to that of the group with the traditional image protocol. The sensitivity and specificity of CTA in detecting middle-grade and severe arterial stenosis were 86.1% and 86.6%, respectively. Conclusion: 64-slice spiral CT angiography is a reliable method for evaluating the lower extremity arterial disease, and is a more ideal method if using individualized injection protocol. (authors)

  4. The value of 64-slice CT angiography in diagnosing spinal vascular malformations

    Objective: To evaluate 64-slice CT angiography in diagnosing spinal vascular malformations. Methods: Fifteen patients, who were suggestive of spinal vascular malformations by clinical manifestation and MRI, underwent CT angiography with a 64-slice spiral CT (GE lightspeed VCT). DSA were performed later within 1 week in all the patients and four of them were treated with operation as well. We evaluated CTA images in displaying the lesions according to the following aspects: the type of malformation, lesion range, feeding artery, draining vein and possible fistula, and compared those details with DSA and operation findings. Results: All 15 patients acquired their final diagnosis by DSA and operation, which were intramedullary artefiovenous malformation in 6 cases, perimedullary artefiovenous fistula in 2, spinal dural arteriovenous fistula in 3 and Cobb syndrome in 4 cases. CTA was consistent with DSA in the classification of lesions and in the determination of the involved regions and it revealed the main feeding arteries and draining veins in all patients. CTA showed four arteriovenous fistulae confirmed by DSA, but it failed in a complex arteriovenous fistula. In Cobb syndrome patients, not only the intramedullary but also paravertebral and subcutenous vascular malformation could be clearly seen on CTA images. Conclusion: 64-slice CT angiography can be a preliminary method in spinal vascular malformation because it can determine the classification and reveal almost all the main lesions quickly, atraumatically. (authors)

  5. Diagnostic value of 64-slice CT angiography in coronary artery disease: A systematic review

    Purpose: To perform a systematic review of the diagnostic value of 64-multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography. Materials and methods: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 64-slice MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analysed at segment-, vessel- and patient-based assessment. Results: Fifteen studies met selection criteria and were included for analysis. Pooled sensitivity, specificity, positive predictive value and negative predictive value as well as 95% confidence interval (CI) were 97% (94 and 99%), 88% (79 and 97%), 94% (91 and 97%), and 95% (90 and 99%) for patient-based assessment; 92% (85 and 99%), 92% (85 and 99%), 78% (66 and 91%) and 98% (96 and 99%) for vessel-based assessment; 90% (85 and 94%), 96% (95 and 97%), 75%(68 and 82%) and 98% (98 and 99%) for segment-based assessment, respectively. No significant difference was found in the diagnostic accuracy of 64-slice CT in the detection of CAD when comparison was performed either among four main coronary arteries, or between proximal and middle or distal segments (p > 0.05). Conclusion: Our results showed that 64-slice CT angiography has a high-diagnostic value in the detection of CAD. Severe coronary artery calcification seems to be the major factor affecting the visualisation and assessment

  6. Preliminary evaluation of 64-slice spiral CT coronary angiography in patients with coronary artery disease

    Objective: To investigate the image quality and diagnostic accuracy using 64-slice spiral computed tomography (64-CTA) scanner in patients with suspected coronary artery disease. Methods: Sixty eight patients with chest pain or post PTCA underwent CT coronary angiography (CTA) and selected coronary angiography (SCA). The SCA results were served as 'gold standard' to evaluate the diagnostic accuracy of CTA, while the sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated, respectively. Results: 64-slice spiral CT could clearly demonstrate the coronary arterial trunk and branchs with stenosis, calcifications abnormal orifise origination and bridge vascular disease; especially with high accuracy in revealing calcification and even with quantification. The sensitivity, specificity, PPV and NPV of the degree of stenosis more than 75% for coronary artery segments evaluated by CTA were significantly higher than those of the degree of stenosis less than 50% for coronary artery segments (P<0.01). Conclusion: CTA is a safe, simple and reliable noninvasive method for screening coronary artery disease in patients with chest pain. Moreover, 64-slice spiral CT could demonstrate not only the more delicate delineation of coronary arterial changes with 3D reconstruction and volume renderting but also the presence and quantity of calcium deposited on the vascular wall. (authors)

  7. Adolescent Kawasaki disease: usefulness of 64-slice CT coronary angiography for follow-up investigation

    Carbone, Iacopo; Cannata, David; Algeri, Emanuela; Galea, Nicola; Napoli, Alessandro; Catalano, Carlo; Passariello, Roberto; Francone, Marco [Sapienza University of Rome, Department of Radiological, Onchological and Anatomopathological Sciences, Policlinico Umberto I, Rome (Italy); De Zorzi, Andrea [Bambino Gesu Hospital, Cardiology Division, Rome (Italy); Bosco, Giovanna; D' Agostino, Rita [Sapienza University of Rome, Unit of Paediatric Cardiology, Policlinico Umberto I, Rome (Italy); Menezes, Leon [University College of London, Institute of Nuclear Medicine, London (United Kingdom)

    2011-09-15

    Kawasaki disease (KD) is a systemic vasculitis that mainly affects coronary arteries in children, and requires regular follow-up from the time of diagnosis. To evaluate the feasibility of 64-slice CT angiography (CTA) for follow-up of patients with KD using previously performed invasive catheter coronary angiography (CCA) as reference standard. The study group comprised 12 patients (age 17.6 {+-} 2.9 years, mean{+-}SD) with a diagnosis of KD and a previously performed CCA (interval, 32.6 {+-} 13.5 months) who underwent 64-slice cardiac CTA. The quality of the images for establishing the presence of coronary abnormalities was determined by two observers. The CTA findings were compared with those from the prior CCA. Adequate image quality was obtained in all patients. Mean effective dose for CTA was 6.56 {+-} 0.95 mSv. CTA allowed accurate identification, characterization and measurement of all coronary aneurysms (n = 32), stenoses (n = 3) and occlusions (n = 9) previously demonstrated by CCA. One patient with disease progression went on to have percutaneous coronary intervention. Coronary lesions were reliably evaluated by 64-slice CTA in the follow-up of compliant patients with KD, reducing the need for repeated diagnostic invasive CCA. Hence, in an adequately selected patient population, the role of CCA could be limited almost only to therapeutic procedures. (orig.)

  8. Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography

    Cademartiri, Filippo [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Azienda Ospedaliero-Universitaria di Parma, Non-invasive Cardiovascular Imaging Unit, Department of Radiology, Parma (Italy); Maffei, Erica; Aldrovandi, Annachiara; Fusaro, Michele; Vignali, Luigi; Menozzi, Alberto [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Palumbo, Anselmo A. [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Malago, Roberto [University of Verona, Department of Radiology, Verona (Italy); La Grutta, Ludovico; Midiri, Massimo [University of Palermo, Department of Radiology, Palermo (Italy); Meiijboom, W.B.; Mollet, Nico R.A.; Krestin, Gabriel P. [Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Brambilla, Valerio; Coruzzi, Paolo [Don Gnocchi ONLUS, Cardiovascular Rehabilitation Unit, Parma (Italy); Kirchin, Miles A. [Bracco Imaging SpA, Worldwide Medical and Regulatory Affairs, Milan (Italy)

    2008-03-15

    We assessed the effect of intra-coronary attenuation on diagnostic accuracy using 64-slice computed tomography coronary angiography (CT-CA). We enrolled 170 patients with suspected coronary artery disease who underwent conventional coronary angiography (CA) and 64-slice CT-CA (100 ml of Iomeprol 400 mg I/ml at 4 ml/s). The study population was divided into two groups (85 patients each based on median attenuation of 326 HU) based on mean arterial attenuation; group 1 with low attenuation and group 2 with high attenuation. Diagnostic accuracy for the detection of significant coronary artery stenosis was determined for both groups using CA as reference standard. Overall, 163 significant stenoses were detected in 1,030 assessable coronary artery segments in group 1 compared with 160 significant stenoses in 1,020 assessable segments in group 2. The average intra-coronary attenuation was significantly (P < 0.05) higher for group 2 (388 {+-} 46 HU) compared with group 1 (291 {+-} 33 HU). The corresponding sensitivity and specificity values for detection of significant coronary artery stenosis were higher for group 2 (96.3% and 97.6%, respectively) than for group 1 (82.8% and 93.2%, respectively) and were more marked in distal coronary segments than in proximal segments. Higher intra-coronary attenuation on CT-CA results in greater diagnostic accuracy for detection of coronary artery stenosis. (orig.)

  9. Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography

    We assessed the effect of intra-coronary attenuation on diagnostic accuracy using 64-slice computed tomography coronary angiography (CT-CA). We enrolled 170 patients with suspected coronary artery disease who underwent conventional coronary angiography (CA) and 64-slice CT-CA (100 ml of Iomeprol 400 mg I/ml at 4 ml/s). The study population was divided into two groups (85 patients each based on median attenuation of 326 HU) based on mean arterial attenuation; group 1 with low attenuation and group 2 with high attenuation. Diagnostic accuracy for the detection of significant coronary artery stenosis was determined for both groups using CA as reference standard. Overall, 163 significant stenoses were detected in 1,030 assessable coronary artery segments in group 1 compared with 160 significant stenoses in 1,020 assessable segments in group 2. The average intra-coronary attenuation was significantly (P < 0.05) higher for group 2 (388 ± 46 HU) compared with group 1 (291 ± 33 HU). The corresponding sensitivity and specificity values for detection of significant coronary artery stenosis were higher for group 2 (96.3% and 97.6%, respectively) than for group 1 (82.8% and 93.2%, respectively) and were more marked in distal coronary segments than in proximal segments. Higher intra-coronary attenuation on CT-CA results in greater diagnostic accuracy for detection of coronary artery stenosis. (orig.)

  10. The clinical application of 64-slice spiral CT angiography in carotid artery bifurcation disease

    Objective: To explore the clinical value of 64-slice spiral CT angiography (CTA) in carotid stenosis and atherosclerotic plaque. Methods: 40 patients (80 carotid arteries) underwent CTA and DSA. These two examinations within one week. The results of CTA were compared with that of DSA, the sensitivity and specificity of CTA and DSA were figured out. Results: CTA performed well in the detection of mild (0% to 29%) carotid stenosis, as well as carotid occlusion, with values for sensitivity and specificity both near 100%. In determining that a stenosis was >50% by DSA measurement, CTA with a sensitivity, specificity of 89% and 91% respectively. While CTA was quite specific in identifying degrees of stenoses in either the 50% to 69% or the 70% to 99% ranges, in this task it was much less sensitive: 65% and 73% respectively. CTA can detect all kinds of ulcers while DSA can not. Conclusions: 64-slice CTA and DSA were correctly identified in detecting carotid stenosis. CTA could demonstrate ulcers associated with the carotid stenosis, hut DSA only show stenosis. (authors)

  11. 64-slice multidetector coronary CT angiography: in vitro evaluation of 68 different stents

    Maintz, David; Seifarth, Harald; Rink, Michael; Oezguen, Murat; Heindel, Walter; Fischbach, Roman [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Raupach, Rainer; Flohr, Thomas [Siemens Medical Solutions, Forchheim (Germany); Sommer, Torsten [University of Bonn, Department of Radiology, Bonn (Germany)

    2006-04-15

    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 sharp, 0.6. To evaluate visualization characteristics of of the stent, the lumen diameter, intraluminal density and noise were measured. The high-resolution kernel offered significantly better average lumen visualization (57% {+-}10%) and more realistic lumen attenuation (222 HU {+-}66 HU) at the expense of increased noise (15.3 HU {+-}3.7 HU) compared with the soft and medium-soft CT angiography (CTA) protocol (p<0.001 for all). Stents with a lumen visibility of more than 66% were: Arthos pico, Driver, Flex, Nexus2, S7, Tenax complete, Vision (all 67%), Symbiot, Teneo (70%), and Radius (73%). Only ten stents showed a lumen visibility of less than 50%. Stent lumen visibility largely varies depending on the stent type. Even with the improved spatial resolution of 64-slice CT, a stent-optimized kernel remains beneficial for stent visualization when compared with the standard medium-soft CTA protocol. Using 64-slice CT and high-resolution kernel, the majority of stent products show a lumen visibility of more than 50% of the stent

  12. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris

    Pugliese, Francesca; Krestin, Gabriel P. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Mollet, Nico R.A.; deFeyter, Pim J. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Runza, Giuseppe [University of Palermo, Department of Radiology, Palermo (Italy); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy); Mieghem, Carlos van; Meijboom, Willem B.; Baks, Timo [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Malagutti, Patrizia [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); University of Ferrara, Department of Cardiology, Ferrara (Italy); Cademartiri, Filippo [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy)

    2006-03-15

    Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as {>=} 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures. (orig.)

  13. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris

    Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as ≥ 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures. (orig.)

  14. Evaluation of peripheral artery stent with 64-slice multi-detector row CT angiography: Prospective comparison with digital subtraction angiography

    Li Xiaoming, E-mail: lixiaoming55@hotmail.co [Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433 (China); Department of Radiology, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092 (China); Li Yuhua, E-mail: liyuhua2000@hotmail.co [Department of Radiology, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092 (China); Tian Jianming, E-mail: tianjianming1952@hotmail.co [Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433 (China); Xiao Yi, E-mail: xiaoyi@188.co [Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433 (China); Lu Jianping, E-mail: lujianping2000@hotmail.co [Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433 (China); Jing Zaiping, E-mail: jingzaiping@hotmail.co [Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433 (China); Sheng Jing, E-mail: shengjing1997@hotmail.co [Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433 (China); Edwin, Angela, E-mail: angiedwin@yahoo.co [Department of Emergency, 34 Military Hospital, Wilberforce Barracks, Republic of Sierra Leone Armed Forces, Freetown (Sierra Leone); Wu Fanghong, E-mail: fanghong.wu@siemens.co [Medical Solutions, Shanghai Branch, Siemens Ltd. (China)

    2010-07-15

    Purpose: To assess the accuracy of 64-slice multi-detector row computed tomography (MDCT) angiography in the evaluation of peripheral artery in-stent or peristent restenosis, with conventional digital subtraction angiography (DSA) as the reference standard. Materials and methods: Forty-one patients (30 men, 11 women; mean age, 69.8 {+-} 9.2 years) with symptomatic peripheral arterial occlusive disease after peripheral artery stenting (81 stented lesions) underwent both conventional DSA and 64-slice MDCT angiography. Each stent was classified as evaluable or unevaluable, and every stent was divided into three segments (proximal stent, stent body, and distal stent), resulting in 243 segments. For evaluation, stenosis was graded as follows: 1, none or slight stenosis (<25%); 2, mild stenosis (25-49%); 3, moderate stenosis (50-74%); 4, severe stenosis or total occlusion ({>=}75%). Two readers evaluated all CT angiograms with regard to narrowing of in-stent or peristent restenosis by consensus. Results were compared with findings of the DSA. Results: Of 81 stents, 62 (76.5%) were determined to be assessable. The metal artifact of the gold marker and motion artifact increased uninterpretability of the images of stents. Overall, 24 of 28 in-stent restenosis and 38 of 53 persistent restenosis were correctly detected by MDCT (85.7% and 71.7% sensitivity). In evaluable stents, 21 of 22 in-stent restenoses and 27 of 28 persistent restenosis were correctly detected (95.4% and 96.4% sensitivity). Additionally, as the grade of stenosis increases, the mean level of CT values in the stent lumina decreases linearly accordingly. Conclusion: 64-Slice MDCT has a high accuracy for the detection of significant in-stent or peristent restenosis of assessable stents in patients with peripheral artery stent implantation and therefore can be considered as a valuable noninvasive technique for stent surveillance.

  15. Evaluation of peripheral artery stent with 64-slice multi-detector row CT angiography: Prospective comparison with digital subtraction angiography

    Purpose: To assess the accuracy of 64-slice multi-detector row computed tomography (MDCT) angiography in the evaluation of peripheral artery in-stent or peristent restenosis, with conventional digital subtraction angiography (DSA) as the reference standard. Materials and methods: Forty-one patients (30 men, 11 women; mean age, 69.8 ± 9.2 years) with symptomatic peripheral arterial occlusive disease after peripheral artery stenting (81 stented lesions) underwent both conventional DSA and 64-slice MDCT angiography. Each stent was classified as evaluable or unevaluable, and every stent was divided into three segments (proximal stent, stent body, and distal stent), resulting in 243 segments. For evaluation, stenosis was graded as follows: 1, none or slight stenosis (<25%); 2, mild stenosis (25-49%); 3, moderate stenosis (50-74%); 4, severe stenosis or total occlusion (≥75%). Two readers evaluated all CT angiograms with regard to narrowing of in-stent or peristent restenosis by consensus. Results were compared with findings of the DSA. Results: Of 81 stents, 62 (76.5%) were determined to be assessable. The metal artifact of the gold marker and motion artifact increased uninterpretability of the images of stents. Overall, 24 of 28 in-stent restenosis and 38 of 53 persistent restenosis were correctly detected by MDCT (85.7% and 71.7% sensitivity). In evaluable stents, 21 of 22 in-stent restenoses and 27 of 28 persistent restenosis were correctly detected (95.4% and 96.4% sensitivity). Additionally, as the grade of stenosis increases, the mean level of CT values in the stent lumina decreases linearly accordingly. Conclusion: 64-Slice MDCT has a high accuracy for the detection of significant in-stent or peristent restenosis of assessable stents in patients with peripheral artery stent implantation and therefore can be considered as a valuable noninvasive technique for stent surveillance.

  16. The comparative study of 64-slices spiral CT angiography with DSA in lower extremity arterial occlusive diseases

    Objective: To study the clinical value of 64-slices spiral CTA with DSA comparatively in diagnosis of lower extremity arterial occlusive diseases. Methods: 31 patients with lower extremity arterial occlusive diseases underwent 64-slice spiral CT angiography of lower extremity arteries and they also underwent digital subtraction angiography (DSA)two weeks later. Reconstruction by maximum intensity projection (MIP), volume render (VR)and multiplanar reformatting (MPR)in working-station was undertaken comparing with the bolus chase DSA and traditional DSA for diagnostic accuracy. Results: The 216 arterial segments of lower extremity were selected, including 157 segments with consistent results in demonstrating degree of stenosis by both examinations. On CT angiography, 5 segmental stenosis were overestimated and 9 were underestimated. When stenosis of detected segments is more than 50%, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CTA were 98.21%, 96.15%, 97.22%, 96.49%, and 98.04%, respectively. Conclusion: 64-slices spiral CT angiography is an effective and reliable method for evaluating the lower extremity arterial occlusive diseases and may provide precious information for planning interventional therapy. (authors)

  17. The value of 64-slice spiral CT angiography based on pre-contrasted raw data in diagnosing pulmonary arteriovenous fistula

    Objective: To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula. Methods: 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula, pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively, including maximum intensity projection (MIP), shaded-surface display (SSD), and volume rendering (VR). According to the results of angiocardiography and surgical findings, comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images. Results: 8 of the 16 PAVF cases were single lesion, 8 cases were multi-lesions. 30 PAVF lesions were found in all the patients. MIP, SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20, 14, and 22, respectively. The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions. MIP, SSD, and VR based on post-contrast raw data displayed PAVF lesions in 24, 18, and 30, respectively. The combination of the 3 methods based on post-contrast raw data could show 30 PAVF lesions. Conclusion: 64-slice spiral CT angiography based on pre-contrasted raw data can clearly show the position, number, and shape of PAVF lesions, which is of great value in diagnosing PAVF. (authors)

  18. 64-Slice CT Angiography in the Detection of Intracranial Aneurysms: Comparison with DSA and Surgical Findings.

    Milošević Medenica, S; V Vućković, V; Prstojević, B

    2010-03-01

    The overall results of CT angiography on 64-slice MSCT published in the last five years are very close to results of DSA which is still a gold standard in the diagnosis of intracranial aneurysms. The aim of this study is to contribute to the confidence in reliability of this method and to try to answer the question of whether CTA should be used as the first diagnostic modality in patients with suspect intracranial aneurysms. In the period from October 2008 to August 2009 we diagnosed 118 aneurysms in 73 patients. We included in this study only those patients who underwent either DSA, surgical treatment or both after MSCTA, and the remainder of the above patients were not treated and are followed up, or died before treatment. So our group comprised 47 patients who were divided into two groups. The first group of 22 patients underwent DSA after MSCTA. We found 36 aneurysms in this group. One aneurysm was falsely positive compared to DSA, while 35 were in concordance with DSA. DSA revealed five aneurysms smaller than 4 mm not disclosed by MSCTA. The second group comprised 25 patients who were operated according to MSCTA findings only. There were 33 aneurysms in this group: 25 aneurysms were operated and surgical findings agreed with MSCTA. Eight aneurysms smaller than 4 mm were not operated and we do not have confirmation for them. In all false positive and false negative cases the misdiagnosed aneurysms were in fact 1-1.5 mm outpouchings that were not responsible for SAH. According to the available literature and our results, MSCTA has proved a very reliable method, simple and safe, competent to be used as a diagnostic modality of choice in the patients with SAH or suspect unruptured aneurysm. DSA should be used in cases of negative or uncertain findings on MSCTA, excluding cases of perimesencephalic SAH with negative MSCTA. The relative disadvantage of this method is its lower sensitivity in the detection of tiny outpouchings, especially in the infraclionid region

  19. Prevalence of anatomical variants and coronary anomalies in 543 consecutive patients studied with 64-slice CT coronary angiography

    Cademartiri, Filippo; La Grutta, Ludovico; Malagò, Roberto; Alberghina, Filippo; Meijboom, Willem B.; Pugliese, Francesca; Maffei, Erica; Palumbo, Anselmo Alessandro; Aldrovandi, Annachiara; Fusaro, Michele; Brambilla, Valerio; Coruzzi, Paolo; Midiri, Massimo; Mollet, Nico R. A.; Krestin, Gabriel P

    2008-01-01

    The aim of our study was to assess the prevalence of variants and anomalies of the coronary artery tree in patients who underwent 64-slice computed tomography coronary angiography (CT-CA) for suspected or known coronary artery disease. A total of 543 patients (389 male, mean age 60.5 ± 10.9) were reviewed for coronary artery variants and anomalies including post-processing tools. The majority of segments were identified according to the American Heart Association scheme. The coronary dominanc...

  20. Acute subarachnoid hemorrhage: using 64-slice multidetector CT angiography to ''triage'' patients' treatment

    Agid, R.; Lee, S.K.; Willinsky, R.A.; Farb, R.I.; TerBrugge, K.G. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario (Canada)

    2006-11-15

    To evaluate the clinical role of CT angiography (CTA) in patients with acute subarachnoid hemorrhage (SAH) for treatment decision-making. Consecutive patients with acute SAH had CTA using a 64-slice scanner for initial clinical decision-making. Image processing included multiplanar volume reformatted (MPVR) maximum intensity projections (MIP) and 3D volume-rendered reconstructions. CTAs were used for (1) evaluating the cause of SAH, and (2) triaging aneurysm-bearing patients to the more appropriate management, either surgical clipping or endovascular coiling. CTA findings were confirmed by neurosurgical exploration or catheter angiography (digital subtraction angiography, DSA). Successful coiling provided evidence that triaging to endovascular treatment was correct. Included in the study were 73 patients. CTA findings were confirmed by DSA or neurosurgical operation in 65 patients, and of these 65, 47 had aneurysmal SAH, 3 had vasculitis, 1 had arterial dissection and 14 had no underlying arterial abnormality. The cause of SAH was detected with CTA in 62 out of the 65 patients (95.4%, sensitivity 94%, specificity 100%). CTA revealed the aneurysm in 46 of 47 patients (98%, sensitivity 98%, specificity 100%, positive predictive value 100%, negative predictive value 82.3%), 1 of 3 vasculitides and 1 of 1 dissection. Of the 46 patients with aneurysm, 44 (95.7%) were referred for treatment based on CTA. In 2 patients (2 of 46, 4.4%) CTA was not informative enough to choose treatment requiring DSA. Of the 44 patients, 27 (61.4%) were referred to endovascular treatment and successful coiling was achieved in 25 (25 of 27, 92.6%). CTA using a 64-slice scanner is an accurate tool for detecting and characterizing aneurysms in acute SAH. CTA is useful in the decision process whether to coil or clip an aneurysm. (orig.)

  1. Optimal scanning protocols of 64-slice CT angiography in coronary artery stents: An in vitro phantom study

    Almutairi, Abdulrahman Marzouq [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Sun Zhonghua [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia)], E-mail: z.sun@curtin.edu.au; Ng, Curtise [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Al-Safran, Zakariya A.; Al-Mulla, Abeer A.; Al-Jamaan, Abdulaziz I. [Department of Medical Imaging, King Fahad Specialist Hospital, Dammam (Saudi Arabia)

    2010-04-15

    Purpose: The purpose of the study was to investigate the optimal scanning protocol of 64-slice CT angiography for assessment of coronary artery stents based on a phantom study. Materials and methods: Coronary stents with a diameter of 2.5 mm was implanted in thin plastic tubes with an inner diameter of 3.0 mm to simulate a coronary artery. The tubes were filled with iodinated contrast medium diluted to 178 HU, closed at both ends and positioned in a plastic container filled with vegetable oil (-70 to -100 HU). A series of scans were performed with a 64-slice CT scanner with the following protocols: section thickness: 0.67 mm, 1.0 mm, 1.5 mm, 2.0 mm, pitch value: 0.2, 0.3, 0.5 and reconstruction interval of 50% overlap of the section thickness. 2D axial and multiplanar reformatted images were generated to assess the visibility of stent lumen, while virtual intravascular endoscopy (VIE) was reconstructed to evaluate the artery wall and stent surface. Results: Our results showed that a scanning protocol of 1.0 mm slice thickness with a pitch of 0.3 produced acceptable images with best demonstration of the intrastent lumen and stent surface with minimal image noise or artifacts. In contrast, submillimeter scans with 0.67 mm resulted in moderate artifacts which affected visualization of the coronary lumen, in addition to the increased noise. When the section thickness increased to 1.5 mm and 2.0 mm, visualization of the artery wall and stent surface was compromised, although the intrastent lumen was still visible. Conclusion: Our in vitro study suggested that a scanning protocol of 1.0 mm section thickness with pitch of 0.3 is the optimal protocol for evaluation of coronary artery stents as it allows generation of acceptable images with better visualization of stent lumen, stent surface and coronary artery wall.

  2. Optimal scanning protocols of 64-slice CT angiography in coronary artery stents: An in vitro phantom study

    Purpose: The purpose of the study was to investigate the optimal scanning protocol of 64-slice CT angiography for assessment of coronary artery stents based on a phantom study. Materials and methods: Coronary stents with a diameter of 2.5 mm was implanted in thin plastic tubes with an inner diameter of 3.0 mm to simulate a coronary artery. The tubes were filled with iodinated contrast medium diluted to 178 HU, closed at both ends and positioned in a plastic container filled with vegetable oil (-70 to -100 HU). A series of scans were performed with a 64-slice CT scanner with the following protocols: section thickness: 0.67 mm, 1.0 mm, 1.5 mm, 2.0 mm, pitch value: 0.2, 0.3, 0.5 and reconstruction interval of 50% overlap of the section thickness. 2D axial and multiplanar reformatted images were generated to assess the visibility of stent lumen, while virtual intravascular endoscopy (VIE) was reconstructed to evaluate the artery wall and stent surface. Results: Our results showed that a scanning protocol of 1.0 mm slice thickness with a pitch of 0.3 produced acceptable images with best demonstration of the intrastent lumen and stent surface with minimal image noise or artifacts. In contrast, submillimeter scans with 0.67 mm resulted in moderate artifacts which affected visualization of the coronary lumen, in addition to the increased noise. When the section thickness increased to 1.5 mm and 2.0 mm, visualization of the artery wall and stent surface was compromised, although the intrastent lumen was still visible. Conclusion: Our in vitro study suggested that a scanning protocol of 1.0 mm section thickness with pitch of 0.3 is the optimal protocol for evaluation of coronary artery stents as it allows generation of acceptable images with better visualization of stent lumen, stent surface and coronary artery wall.

  3. Bone Subtraction 3-Dimension CT Angiography Using 64-Slice Multidetector CT for the Evaluation of Steno-Occlusive Intra- and Extracranial Vascular Diseases: Comparison with Digital Subtraction Angiography

    Park, Sung Eun; Choi, Dae Seob; Shin, Hwa Seon; You, Jin Jong; Park, Mi Jung; Cho, Jae Min; Choi, Ho Cheol; Son, Seung Nam [Gyeongsang National University School of Medicine, Jinju (Korea, Republic of); Ryu, Jae Wook [Dept. of Radiology, Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2012-09-15

    To investigate the efficacy of bone subtraction CT angiography (BSCTA) for the evaluation of steno-occlusive intra- and extracranial vascular diseases. Fifty-six patients were examined using 64-slice multidetector CT and digital subtraction angiography (DSA). For BSCTA, both nonenhanced CT and enhanced CT angiography (CTA) data sets were obtained. The stenotic degree of each vascular segment was assessed and classified into 5 grades. With DSA as the standard, CTA images were compared. For the evaluation of the extracranial vessels, 370 arterial segments were analyzed, and the stenotic degree revealed by CTA and DSA agreed in 359 (97.0%). There was a significant correlation between CTA and DSA (Rs = 0.974). For depiction of {>=} 50% stenosis, the sensitivity, specificity, and diagnostic accuracy of BSCTA were 100%, 98.2%, and 98.6%, respectively. For the intracranial arteries, 1029 segments were analyzed, and CTA agreed with DSA in 966 (93.9%). There was a significant correlation between CTA and DSA for stenotic degree (Rs = 0.880). For the depiction of {>=} 50% stenosis, the sensitivity, specificity, and diagnostic accuracy of CTA were 100%, 95.8%, and 96.0%, respectively. In all 74 segments of disagreement, the degree of stenosis was overestimated on CTA. BSCTA is comparable to DSA for the evaluation of steno-occlusive intra- and extracranial vascular diseases. However, the stenotic degree tends to be overestimated on BSCTA, especially in cases of wall calcifications.

  4. Preliminary Reports on the Accuracy of Coronary CT-Angiography Using 64-slice Multi-slice Spiral CT (MSCT in Iran

    "A. Arjmand Shabestari

    2005-08-01

    Full Text Available Introduction & Background: Coronary artery disease (CAD is the leading cause of death in many western countries. Its prevalence and incidence among Irani-ans particularly in the urban areas are increasing. Ac-cording to the newest Tehran annual mortality re-port, the most common cause of death in Tehran is cardiovascular disease. Diagnostic gold standard in CAD is fluoroscopic coronary angiography (FCA us-ing catheterization. Nevertheless, it is an invasive method and in recent years, some non-invasive or less-invasive imaging modalities such as MRI and CT scans have been used to investigate CAD. One of the most attractive new methods in this regard is Coro-nary CT-Angiography (CCTA, which has gained considerable attention. Multi-slice spiral CT (MSCT scanners with simultaneous acquisition of multiple (up to 64 slices in less than half a second of gantry rotation time (in our study, 0.33 second, have be-come available, resulting in minimally-invasive coro-nary artery imaging. The purpose of this study is to determine the diagnostic accuracy of a new 64-slice MSCT scanner in the diagnosis of coronary artery and/or bypass grafts occlusion or hemodynamically significant stenosis. Parients & Methods: This investigation is underway in patients undergoing elective FCA. A 64-channel per rotation MSCT scanner (Somatom Sensation 64, Siemens Medical Systems, Forchheim, Germany, with 0.6 mm collimation, 0.33 second gantry rotation time and 120 KVp was used to perform CCTA. Ap-proximately 70-90 mL of a nonionic contrast medium was injected intravenously. All coronary artery seg-ments, according to American Heart Association (AHA classification & nomenclature system were analyzed. Patients who had undergone previous coronary artery bypass grafts (CABGs, or used coro-nary stents were enrolled in the study, as well. MSCT scans were carried out within 10 days of catheteriza-tion, and the most dramatically stenotic lesions were analyzed in CCTA by a semi

  5. Assessment of Grafts and Coronary Arteries with 64-slice Computer Tomography(CT) Angiography after Coronary Artery Bypass Surgery - our experiences

    Veljanovska, Lidija; Sokolov, V.; Milev, Ivan; Idrizi, Spend; Mitrev, Zan

    2008-01-01

    The use of 64 slice CT (GE Light-Speed VCT) in evaluation of pathway and patency of the grafts, distal anastomosis and native vascular net in patients (pts) after coronary artery bypass grafting (CABG).

  6. Optimisation of contrast medium volume and injection-related factors in CT pulmonary angiography: 64-slice CT study

    Uysal Ramadan, Selma [Ankara Training and Research Hospital, Department of Radiology, Ankara (Turkey); Ankara Training and Research Hospital, Cebeci, Ankara (Turkey); Kosar, Pinar; Sonmez, Iclal; Kosar, Ugur [Ankara Training and Research Hospital, Department of Radiology, Ankara (Turkey); Karahan, Sevilay [Hacettepe University, Department of Biostatistics, Faculty of Medicine, Ankara (Turkey)

    2010-09-15

    To compare the image quality of computed tomography pulmonary angiography (CTPA) obtained with the injection of various low doses of contrast medium (CM) with different injection-related factors. A total of 90 patients (42 females, 48 males; 54.3 {+-} 18.6 years) undergoing CTPA were included. Three CM protocols, each containing 30 patients, were created. Protocols 1, 2 and 3 consisted of a CM of 60 ml, 55 ml and 50 ml, and a bolus trigger level of 120 HU, 90 HU and 75 HU, respectively. Injection was uniphasic for protocols 1 and 2 (flow rate 5 ml/s), and biphasic for protocol 3 (flow rates 5 and 4 ml/s); with saline flushing afterwards. Enhancement was measured in three central and six peripheral pulmonary arteries. The mean attenuation value for pulmonary arteries was over 250 HU for all protocols. There was no difference between the attenuation levels with the protocols (p > 0.05). The percentage of pulmonary arteries exceeding optimal attenuation ({>=}250 HU) showed that protocols 2 and 3 were 90-100% successful (p < 0.05). The use of proper injection-related factors during CTPA, such as a low trigger level and a high flow rate with saline injection following a decreased CM volume (55 ml or 50 ml), will enable adequate pulmonary artery contrast enhancement. (orig.)

  7. Diagnostic Value of 64-Slice Dual-Source CT Coronary Angiography in Patients with Atrial Fibrillation: Comparison with Invasive Coronary Angiography

    We wanted to evaluate the image quality and diagnostic value of 64-slice dual-source computed tomography (DSCT) coronary angiography in patients with atrial fibrillation (Afib). The coronary arteries of 22 Afib patients seen on DSCT were classified into 15 segments and the imaging quality (excellent, good, moderate and poor) and significant stenoses (≥ 50%) were evaluated by two radiologists who were blinded to the conventional coronary angiography (CAG) results. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting important coronary artery stenosis were calculated. McNemar test was used to determine any significant difference between DSCT and CAG, and Cohen's Kappa statistics were calculated for the intermodality and interobserver agreement. The mean heart rate was 89 ± 8.3 bpm (range: 80-118 bpm). A range from 250 msec to 300 msec within the RR interval was the optimal reconstruction interval for the patients with Afib. The respective overall sensitivity, specificity, PPV and NPV values were 74%, 97%, 81% and 96% for reader 1 and 72%, 98%, 85% and 96% for reader 2. No significant difference between DSCT and CAG was found for detecting a significant stenosis (reader 1, p = 1.0; reader 2, p = 0.727). Cohen's Kappa statistics demonstrated good intermodality and interobserver agreement. 64-slice DSCT coronary angiography provides good image quality in patients with atrial fibrillation without the need for controlling the heart rate. DSCT can be used for ruling out significant stenosis in patients with atrial fibrillation with its high NPV for detecting in important stenosis.

  8. Diagnostic Value of 64-Slice Dual-Source CT Coronary Angiography in Patients with Atrial Fibrillation: Comparison with Invasive Coronary Angiography

    Zhang, Jian Jun; Liu, Tie; Feng, Yue; Wu, Wei Feng; Mou, Cai Yun; Zhai, Li Hao [Zhejiang Hospital, Hangzhou (China)

    2011-08-15

    We wanted to evaluate the image quality and diagnostic value of 64-slice dual-source computed tomography (DSCT) coronary angiography in patients with atrial fibrillation (Afib). The coronary arteries of 22 Afib patients seen on DSCT were classified into 15 segments and the imaging quality (excellent, good, moderate and poor) and significant stenoses ({>=} 50%) were evaluated by two radiologists who were blinded to the conventional coronary angiography (CAG) results. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting important coronary artery stenosis were calculated. McNemar test was used to determine any significant difference between DSCT and CAG, and Cohen's Kappa statistics were calculated for the intermodality and interobserver agreement. The mean heart rate was 89 {+-} 8.3 bpm (range: 80-118 bpm). A range from 250 msec to 300 msec within the RR interval was the optimal reconstruction interval for the patients with Afib. The respective overall sensitivity, specificity, PPV and NPV values were 74%, 97%, 81% and 96% for reader 1 and 72%, 98%, 85% and 96% for reader 2. No significant difference between DSCT and CAG was found for detecting a significant stenosis (reader 1, p = 1.0; reader 2, p = 0.727). Cohen's Kappa statistics demonstrated good intermodality and interobserver agreement. 64-slice DSCT coronary angiography provides good image quality in patients with atrial fibrillation without the need for controlling the heart rate. DSCT can be used for ruling out significant stenosis in patients with atrial fibrillation with its high NPV for detecting in important stenosis.

  9. The application of the reduced dosage of the contrast medium with saline flush in cerebral and carotid angiography with 64-slice spiral CT

    Objective: To utilize the reduced contrast dose with saline flush in cerebral and carotid angiography with 64-slice spiral CT. Methods: According to the contrast dose, 40 patients undergoing cerebral and carotid CTA examination were randomly divided into 2 groups, one group was treated with 50 ml contrast agent and 20 ml saline flush, the other group was administrated with 70 ml contrast agent. With double blindness method, the data were respectively evaluated and analyzed by two radiologists independently. Results: For the two radiologists, on the manifestation of carotid and cerebral arteries, the venous artefact and the CT value measurement aspects, the Kappa value was respectively 0.895, 0.814, 0.702, 0.836. By rank sum test, on the manifestation of carotid arteries aspect, the grading score of the two groups of radiologist A was respectively 1.3, l.2; and that of radiologist B was respectively 1.4, 1.2; the differences between the two groups of the two radiologists have no statistical significance(U=173, P>0.05; U=128, P>0.05). And on the manifestation of cerebral arteries aspect, the grading score of the two groups of radiologist A was respectively 1.4, l.2; and that of radiologist B was respectively 1.2, 1.2; the differences between two groups of the two radiologists both have no statistical significance (U=160, P>0.05; U=106, P>0.05). And on the artefacts produced by the high contrast densities in the right subclavian vein, brachiocephalic vein and vena cava, the grading score of the two groups of radiologist A was respectively 1.3, 2.1; and that of radiologist B was respectively 1.2, 1.9; the differences between the two groups of the two radiologists both have statistical significance (U=75, P0.05). The CT value of the arteries of the two groups from radiologist B was respectively 337.3, 329.5, 239.2, 192.8, 345.6, 341.2, 247.1, 210.5 HU; and the difference between the two groups has no statistical significance (t=0.233, P>0.05). Conclusion: On the CTA

  10. Validation of a new cardiac image fusion software for three-dimensional integration of myocardial perfusion SPECT and stand-alone 64-slice CT angiography

    Combining the functional information of SPECT myocardial perfusion imaging (SPECT-MPI) and the morphological information of coronary CT angiography (CTA) may allow easier evaluation of the spatial relationship between coronary stenoses and perfusion defects. The aim of the present study was the validation of a novel software solution for three-dimensional (3D) image fusion of SPECT-MPI and CTA. SPECT-MPI with adenosine stress/rest 99mTc-tetrofosmin was fused with 64-slice CTA in 15 consecutive patients with a single perfusion defect and a single significant coronary artery stenosis (≥50% diameter stenosis). 3D fused SPECT/CT images were analysed by two independent observers with regard to superposition of the stenosed vessel onto the myocardial perfusion defect. Interobserver variability was assessed by recording the X, Y, Z coordinates for the origin of the stenosed coronary artery and the centre of the perfusion defect and measuring the distance between the two landmarks. SPECT-MPI revealed a fixed defect in seven patients, a reversible defect in five patients and a mixed defect in three patients and CTA documented a significant stenosis in the respective subtending coronary artery. 3D fused SPECT/CT images showed a match of coronary lesion and perfusion defect in each patient and the fusion process took less than 15 min. Interobserver variability was excellent for landmark detection (r = 1.00 and r = 0.99, p < 0.0001) and very good for the 3D distance between the two landmarks (r = 0.94, p < 0.001). 3D SPECT/CT image fusion is feasible, reproducible and allows correct superposition of SPECT segments onto cardiac CT anatomy. (orig.)

  11. 64层螺旋CT冠状动脉成像影响因素分析%Analysis of Influential Factors of 64-slice Spiral CT Coronary Angiography

    刘伟宾

    2011-01-01

    目的 探讨64层螺旋CT冠状动脉成像的质量影响因素.方法 回顾性分析514例行64层螺旋CT冠状动脉成像的影像资料.结果 根据图像评价方法,本组优321例,占62.5%;良138例,26.8%;差55例,占10.7%,认定为检查失败.127例ECG前瞻式门控扫描检查失败21例,占16.5%;387例回顾式门控扫描检查失败34例,占8.8%.检查时心率波动≤5/min 313例,7例失败,占2.2%;6~10/min 175例,23例检查失败,占13.1%;10~20/min 26例,25例检查失败,占96.2%.检查过程中37例屏气不好,32例检查失败,占86.5%;3例扫描过程中未能控制呛咳、呃逆,检查失败;53例冠状动脉搭桥术后复查者,1例因扫描范围不足而检查失败;3例过于肥胖,1例扫描参数过低而导致检查失败.结论 充分认识64层螺旋CT冠状动脉成像检查中影响成像质量的因素,争取患者最佳配合状态,方能获得更好的图像质量,提高诊断准确性.%Objective To discuss the influential factors of image quality of 64-slice spiral CT coronary angiography (CTCA). Methods The imaging data of 514 patients with coronary artery disease were retrospectively analyzed. Results According to image evaluation method, the results were excellent in 321 patients(62.5% ), good in 138 ( 26. 8% ) , and poor and regarded as failures in 55( 10.7% ). 127 patients underwent prospective electrocardiographic (ECG) gating, but failed in 21 patients (16.5%) ; 387 patients underwent retrospective ECG gating, and failed in 34 patients (8.8%). 313 patients had heart rate fluctuation ≤5 beats per minute( BPM), among whom, 7 (2.2%) failed in examination; 175 patients had heart rate from 6 BPM to 10 BPM, among whom, 23 (13.1%) failed in examination; 26 patients had heart rate from 10 BPM to 20 BPM,among whom, 25 failed in examination; 37 patients had poor breathholding, among whom, 32(86.5% )failed in examination.3 failed in examination due to incontrollable bucking and hiccup during the

  12. 64-slice CT imaging in a case of total anomalous pulmonary venous circulation

    For long, catheter angiography has been the investigation of choice for the diagnosis of congenital anomalies of the heart such as total anomalous pulmonary venous circulation (TAPVC). In the last few years, MRI and multislice CT scan have also been introduced for this purpose. We report a case where 64-slice CT scan was found very useful in the evaluation of TAPVC

  13. 64-slice spiral CT in the diagnosis of Caroli disease

    Objective: To investigate the value of 64-slice spiral CT in the diagnosis of Caroli disease. Methods: 64-slice spiral CT of 15 patients with histologically proven Caroli disease was reviewed. Results: All cases were polycystic or multi-tubular hypodensities in the livers communicating with intrahepatic bile ducts. There was no contrast enhancement. The central dot sign was detected on 2 patients. Of 12 patients with type I disease, ancillary findings included multiple hemangiomas and small cysts in the liver (2), bile duct stones (4), pneumobilia (3), and cholangitis (1). Of the remaining 3 patients with type II disease, two had liver cirrhosis and the other cholangitis with periportal fibrosis. Conclusion: 64 slice spiral CT with multiplanar reconstruction allows clear depiction of cystic liver lesions and their relationship with intrahepatic bile ducts. It is valuable in the diagnosis of Caroli disease. (authors)

  14. Infant Cardiac CT Angiography with 64-Slice and 256-Slice CT: Comparison of Radiation Dose and Image Quality Using a Pediatric Phantom

    Lee, Yi-Wei; Yang, Ching-Ching; Mok, Greta S. P.; Wu, Tung-Hsin

    2012-01-01

    Background The aims of this study were to investigate the image quality and radiation exposure of pediatric protocols for cardiac CT angiography (CTA) in infants under one year of age. Methodology/Principal Findings Cardiac CTA examinations were performed using an anthropomorphic phantom representing a 1-year-old child scanned with non-electrocardiogram-gated (NG), retrospectively electrocardiogram-gated helical (RGH) and prospectively electrocardiogram-gated axial (PGA) techniques in 64-slic...

  15. A study on the application of CT perfusion and CT angiography with 64-slice spiral CT in the evaluation of internal carotid artery and middle cerebral artery stenosis and occlusion

    Objective: To evaluate clinical application of combined cerebral CT perfusion (CTP) with head and neck CT angiography (CTA) using 64-slice spiral CT on the cerebral ischemia caused by the stenosis or occlusion of internal carotid artery (ICA) and middle cerebral artery (MCA). Methods: The sixty nine patients with unilateral or bilateral ICA and MCA stenosis or occlusion confirmed by digital subtraction angiography underwent head plain CT scan, cerebral CTP, and head and neck CTA using 64-slice spiral CT. Ten normal adults served as control. To discriminate the ischemic foci, the parameter maps of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTF) and time to peak (TTP) were obtained. Results: Among the patients with unilateral ICA stenosis or occlusion diagnosed by CTA, abnormal perfusion was found only in the watershed zone in 5 cases, both the MCA territory and the watershed zone were involved in 10 cases. Of 12 patients with severe unilateral ICA stenosis and occlusion, CBF values of the watershed zone in nonsymptmatic and symptomatic sides were(41±9) and (38±8) ml· 100 g-1·min-1 respectively (t=2.08, P>0.05), the MTT values were (5.2±1.1) and (10.9±2.6) s, respectively (t=7.24, P<0.01). Thirteen patients with severe bilateral ICA stenosis or occlusion diagnosed by CTA had perfusion abnormalities in the both the MCA territory and the watershed zone. Of 25 patients with unilateral MCA stenosis, 4 patients were normal in CT perfusion, 17 patients had perfusion abnormalities in MCA territory, and 4 patients had perfusion abnormalities in both MCA territory and the watershed zone. Twelve patients with severe bilateral MCA stenosis diagnosed by CTA had perfusion abnormalities in both the MCA territory and the watershed zone. Compared to normal control, the MTF and TTP were increased, the CBF was decreased, and the CBV in MCA territory and the watershed zone at the symptomatic side was increased. Conclusion: The combined examination

  16. Application of 64 slice spiral CT in evaluating the patency of coronary artery after stent implantation

    Yong-Shu Gao; Xing-Can Ma

    2015-01-01

    Objective:To explore the feasibility and effectiveness of 64 slice spiral CT in evaluating the patency of coronary artery after stent implantation.Methods:The 64 slice spiral CT image data of 125 patients after coronary artery stent implantation were collected, meanwhile, the image data of 25 patients underwent coronary angiography were also collected. The feasibility and accuracy of 64 slice spiral CT coronary artery stent imaging were comparatively analyzed. Results: The 64 slice spiral CT imaging quality with a stent diameter greater than 3.00 mm was significantly superior to that with a diameter of 2.25-3.00 mm. The CT imaging quality in the left main coronary artery and anterior descending artery was significantly higher than that in the left circumflex coronary artery. The CT imaging quality in the left main coronary artery was significantly higher than that in the right coronary artery. The CT reconstruction imaging quality in the drug coating stent was significantly superior to that in the bare metal stent. The sensitivity of 64 slice spiral CT was 100.00%, and the accuracy was 100.00%. In detecting the coronary artery with occlusion and stenosis (stent stenosis greater than 50%), the sensitivity was 90.00%, the false negative rate was 10.00%, and the positive predicative value was 100.00%.Conclusions:The effect of 64 slice spiral CT coronary imaging in evaluating the patency of coronary artery after stent implantation is highly consistent with that by coronary angiography, with a simple operation, less risk, and low cost, and thus, it can be completely taken as the imaging method in evaluating the patency of coronary artery after stent implantation.

  17. Application of 64 slice spiral CT angiography in subarachnoid hemorrhage%64层螺旋 CT 血管成像在自发性蛛网膜下腔出血中的应用

    韩璐璐; 张锡海; 张爱霞; 王俊英; 董乐

    2015-01-01

    目的:为了进一步提高临床对自发性蛛网膜下腔出血(SAH)的治疗效果,分析和探讨64层螺旋 CT血管成像在自发性 SAH 中的应用价值。方法按照随机双盲的原则抽取2014年1月-2015年1月治疗的38例考虑自发性 SAH 的患者作为研究对象,所有入组的患者均常规给予64层螺旋 CT 血管成像(CTA)及数字减影脑血管造影(DSA)检查,其中 CT 血管成像均应用最大密度投影(MIP)、容积再现技术(VR),通过和 DSA 结果对比分析 CTA 在发现自发性 SAH 中的病因诊断中的应用价值和意义。结果以 DSA 诊断结果作为评价标准,CTA 的诊断结果准确率和 DSA 相比较,差异亦无统计学意义(P ﹥0.05);而 CTA 组在诊断血管瘤大小方面和 DSA 诊断结果准确率和 DSA相比较示,差异无统计学意义(P ﹥0.05)。结论临床上在诊断自发性 SAH 的过程中应用64层螺旋 CT 血管成像,不仅简单、快捷和方便,而且有利于发现病因和提高诊断准确率,值得推广。%Objective To further improve the effectiveness of our hospital in terms of t spontaneous subarachnoid hemorrhage(SAH)and to reduce and prevent the occurrence probability of a variety of adverse events,analysis and discussion of the meaning and value of 64-slice CT angiography(CTA). Methods Selected 38 cases of patients with spontaneous sub-arachnoid hemorrhage(SAH)in our hospital from January 2014 to January 2015 according to the randomized double blind controlled principles as a study object,all patients with acute SAH underwent 64-slice CTA and digital subtraction angiography (DSA). Three-dimensional post-processing techniques including volume rendering( VR),maximum intensity projection (MIP),curved planar reformation(CPR)and multi-planar reconstruction(MPR)were underwent. Results Taking the DSA result as the standard,CTA diagnosis accuracy compared with DSA the difference between the two groups weren

  18. Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients

    D' Agostino, A.G.; Remy-Jardin, M.; Khalil, C.; Remy, J. [University Center of Lille, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Delannoy-Deken, V.; Duhamel, A. [University of Lille, Department of Medical Statistics, Lille (France); Flohr, T. [Siemens Medical, Research and Development Department, CT Division, Forchheim (Germany)

    2006-10-15

    interpolation artefacts was significantly linked to a low heart rate in affected patients. The overall image quality of CT scans was rated as diagnostic in 94 patients (89.5%) while 11 examinations (10.5%) were found to be partially nondiagnostic owing to the cyclic presence of severe interpolation artefacts, which can be compensated for by additional reconstructions at a different temporal window. In these cases, interpolation artefacts could have been avoided by reducing the pitch from 0.3 to 0.2 at the expense of increased patient dose. Low-dose ECG-gated CT angiograms of the chest can be obtained in routine clinical practice with 64-slice CT technology without altering the diagnostic value of CT scans. (orig.)

  19. The comparison of imaging quality between bolus-triggering and test-bolus technique used in 64-slice spiral CT angiography of lower extremity arteries

    Objective: To investigate the clinical value of multi-slice CT angiography (MSCTA) of lower limbs in patients with peripheral arterial occlusive disease (PAOD) using the test-bolus technique. Methods: Forty-four patients with PAOD were enrolled consecutively in the study. In group 1, 18 subjects underwent CTA by bolus triggering method and in group 2, 26 subjects underwent CTA by test-bolus technique. During scanning procedure in group 2 subjects, the bolus transit time to aorta (TAO), popliteal arteries (TPOP) and aorto-popliteal bolus transit time (Tt) were calculated through dynamic acquisition at their respective level and the delay time were immediately set as TAO and scan time as double Tt. Two independent senior attending physicians with training experience in interpreting CTA determined the quality of each arterial segment visualization based on 5 parameters (1. visible farthest branch, 2. clarity of vessels border, 3. presence of venous contamination, 4. grading of stenosis, 5. CT value at 4 arterial segments). Inter-observer agreement on imaging quality between readers was evaluated using Cohen's k statistic by calculating K values. χ2 test and t test were used to compare the quality of images in both groups. Results: In group 2 patients, a larger individual variation in transit time of the contrast to reach aorta was obserued [TAO=(17.1±2.6) s with a range of 12.0-22.0 s] and aorto-popliteal transit time [Tt=(14.8±5.5) s with a range of 8.0-24.0 s]. CTA of group 2 patients demonstrated better quality over group 1 patients' CTA, especifically in the infra-popliteal and foot area arteries. There was an excellent inter-observer agreement for group 2 patients (K>0.80) whereas in group 1 agreement in infra-popliteal segments for venous contamination (K value 0.60) and stenosis degree (K value 0.50) were not satisfactory enough. Group 1 patients were reported to have more severe stenosis in infra-popliteal and foot arteries (χ2=30.55 and 22.41, P<0

  20. Coronary artery imaging with 64-slice spiral CT in atrial fibrillation patients: initial experience

    Objective: To discuss the clinical value of coronary artery imaging using 64-slice spiral CT in patient with atrial fibrillation. Methods: The images of 31 patients with atrial fibrillation who underwent contrast-enhanced CT coronary angiography were evaluated. The presence of stenosis on each segment of coronary arteries was recorded and their degree of stenosis was measured using the vessel analysis software. Ten patients additionally underwent conventional coronary angiography. The results of conventional coronary angiography were compared with CT coronary angiography of the 10 patients. Results: Image reconstruction was based on absolute timing. The image quality of 364 coronary vessel segments on the images from 31 patients was evaluated and defined as excellent, fine, moderate or poor. The image quality was excellent, fine, moderate and poor in 85, 41, 5, and 8 vessel segments respectively in patient group with heart rate between 47 beat per minent (bpm) and 69 bpm; and in 63, 16, 13, and 15 vessel segments respectively in patent group with heart rate between 70 bpm and 79 bpm;and in 46, 25, 23, and 24 vessel segments in patient group with heart rate between 80 bpm and 105 bpm. There was significant difference among the three patient groups (H=22.08, P<0.01). Comparison was carried out between CT angiographic findings and conventional angiographic findings of the 125 segments of the coronary arteries in the 10 patients who underwent conventional coronary angiography. The sensitivity and specificity of CT angiography for diagnosing vessel with significant coronary stenosis (≥50% narrowing) was 85.0% (17/20) and 95.2% (100/105), respectively. Positive predictive value was 77.3% (17/22), and negative predictive value was 97.1% (100/103). Coronary CTA underestimated the lesions of 3 vessel segments and overestimated the lesions of 5 vessel segments. Conclusion: Coronary artery imaging with 64-slice row CT had clinical value for patients with atrial fibrillation

  1. Detection of Postcoronary Stent Complication: Utility of 64-Slice Multidetector CT

    Alpa Bharati

    2012-01-01

    Full Text Available Coronary stent fracture is a known complication of coronary arterial stent placements. Multiple long-term risks are also associated with drug eluting stents. 64-slice multidetector CT (MDCT coronary angiography has been shown to detect poststent complications such as instent stenosis, thrombosis, stent migration and stent fractures. We report a case of stent fracture in a patient who underwent RCA stenting with associated RCA perforation and almost complete thrombosis of the RCA and peristent fibrinoid collection. This is a rare case of stent fracture with perforation of the RCA. The paper highlights the role of 64-row multidetector computed tomography (MDCT in evaluation of such poststent placement complications.

  2. 64排CT血管造影在动脉瘤性蛛网膜下腔出血的临床研究%Clinical research of 64-slice CT angiography in aneurysmal subarachnoid hemorrhage

    陈立朝; 许民辉; 邹咏文; 杨东虹; 张云东; 徐伦山; 张溢华

    2011-01-01

    目的:评估CT血管造影(CTA)在动脉瘤性蛛网膜下腔出血(SAH)病人中选择治疗策略的作用.方法:对231例动脉瘤性SAH病人行64排CTA检查.选择临床治疗方案,并通过DSA或外科手术验证CTA检查的准确性.结果:CTA检查与DSA或术中探查一致228例,CTA信息不充分2例,CTA漏诊1例;CTA检查的敏感性98.7%,特异性100%.根据CTA检查确定治疗方案228例(98.7%),其中采用血管内栓塞治疗141例,夹闭术87例;根据DSA检查,采用血管内栓塞治疗3例.结论:64排CTA能准确检测颅内动脉瘤及其特征,有助于选择治疗策略.%Objective To evaluate the clinical application of CT angiography (CTA) in making therapeutic strategy for patients with aneurysmal subarachnoid hemorrhage (SAH). Methods The 64-slice CTA examination was performed in 231 patients with aneurysmal SAH to select appropriate treatment strategies. CTA findings should be confirmed by DSA or surgical exploration. Results CTA findings were coincident with the findings by DSA or surgical exploration in 228 cases, CTA findings were insufficient in 2 cases, and missed diagnosis by CTA in 1 case. The sensitivity of CTA examination was 98.7% and specificity was 100%. The therapeutic measures were decided based on CTA in 228 cases (98.7%), including endovascular treatment in 141 cases, clipping of aneurysm in 87. Endovascular treatment was adopted based on DSA in 3 cases. Conclusions The 64-slice CTA as an accurate tool for detecting intracranial aneurysms is useful to decide therapeutic strategy.

  3. Influence of coronary calcification on the diagnostic accuracy of 64-slice computed tomography coronary angiography

    Abdulla, Jawdat; Pedersen, Kasper; Budoff, Matthew;

    2012-01-01

    To determine via meta-analysis the diagnostic accuracy of 64-slice computed tomography coronary angiography (CTA) for assessment of significant obstructive coronary artery stenosis at different coronary artery calcium score (CACS) levels. Data of 12,053 versus 5,890 segments, 906 versus 758 arter...

  4. Clinical application of 64-slice spiral CT in the diagnosis of the Tetralogy of Fallot

    Wang Ximing [Tianjin Medical University, Tianjin City (China) and Shandong Medical Imaging Research Institute, Jinan City, Shandong Province 250021 (China)], E-mail: wxming369@163.com.cn; Wu Lebin [Shandong Medical Imaging Research Institute, Jinan City, Shandong Province 250021 (China); Sun Cong [Shandong Medical Imaging Research Institute, Jinan City, Shandong Province 250021 (China); Shandong University Medical College, Shandong Jinan 250012 (China); Liu Cheng [Shandong Medical Imaging Research Institute, Jinan City, Shandong Province 250021 (China); Chao, Bao-Ting [Shandong University Medical College, Shandong Jinan 250012 (China); Han Bo [Shandong Provincial Hospital Pediatric Department, Shandong, Jinan 250021 (China); Zhang Yunting [Tianjin Medical University, General Hospital MR Department, Tianjin City (China); Chen Haisong [Shandong Medical Imaging Research Institute, Jinan City, Shandong Province 250021 (China); Shandong University Medical College, Shandong Jinan 250012 (China); Li Zhenjia [Shandong Medical Imaging Research Institute, Jinan City, Shandong Province 250021 (China)

    2007-11-15

    Objective: To explore the clinical application of 64-slice spiral CT in the diagnosis of the Tetralogy of Fallot. Methods: Eighteen patients with diagnosed Tetralogy of Fallot underwent cardiac CT angiography with 64-slice CT (CTA). Two- and three-dimensional images were used for diagnosing in all cases by means of MPR (coronal, sagital and oblique), cMPR, MIP and VRT. Results: All patients had ventricular septal defect, pulmonary stenosis and hypertrophy of right ventricle. The morphologic features of Tetralogy of Fallot were equal to echocardiography. Patent ductus arteriosus (PDA) were detected on eight patients. Main coronary artery branches and partial sub-branches were visualized in all patients. Abnormal coronary arteries were found in seven cases: both left and right main coronary artery arising from the right aortic sinus one case, right main coronary artery and circumflex (CX) arising from the right aortic sinus one case, left anterior descending (LAD) and CX arising from left aortic sinus directly one case, left and right coronary artery arising from back and front of the aortic sinus, respectively, three cases. Pulmonary artery branch stenosis was found in 12 cases and branch pulmonary artery dilation noticed in 1 case. Double superior vena cava was also found in one case. According to the surgery the diagnostic accuracy of CT and Echocardiography was 95.45 and 83.33%, respectively. Conclusion: Two- and three-dimensional 64-slice CTA not only show the overall anatomical structure of the heart, but also show coronary and pulmonary arteries. With these results, evaluation of coronary anomalies and pulmonary artery stenosis with 64-MSCT is extremely valuable for planning the operative procedure on the patients with Tetralogy of Fallot.

  5. Clinical application of 64-slice spiral CT in the diagnosis of the Tetralogy of Fallot

    Objective: To explore the clinical application of 64-slice spiral CT in the diagnosis of the Tetralogy of Fallot. Methods: Eighteen patients with diagnosed Tetralogy of Fallot underwent cardiac CT angiography with 64-slice CT (CTA). Two- and three-dimensional images were used for diagnosing in all cases by means of MPR (coronal, sagital and oblique), cMPR, MIP and VRT. Results: All patients had ventricular septal defect, pulmonary stenosis and hypertrophy of right ventricle. The morphologic features of Tetralogy of Fallot were equal to echocardiography. Patent ductus arteriosus (PDA) were detected on eight patients. Main coronary artery branches and partial sub-branches were visualized in all patients. Abnormal coronary arteries were found in seven cases: both left and right main coronary artery arising from the right aortic sinus one case, right main coronary artery and circumflex (CX) arising from the right aortic sinus one case, left anterior descending (LAD) and CX arising from left aortic sinus directly one case, left and right coronary artery arising from back and front of the aortic sinus, respectively, three cases. Pulmonary artery branch stenosis was found in 12 cases and branch pulmonary artery dilation noticed in 1 case. Double superior vena cava was also found in one case. According to the surgery the diagnostic accuracy of CT and Echocardiography was 95.45 and 83.33%, respectively. Conclusion: Two- and three-dimensional 64-slice CTA not only show the overall anatomical structure of the heart, but also show coronary and pulmonary arteries. With these results, evaluation of coronary anomalies and pulmonary artery stenosis with 64-MSCT is extremely valuable for planning the operative procedure on the patients with Tetralogy of Fallot

  6. 64层螺旋CT血管成像诊断大脑中动脉成窗变异%CT Angiography Features of Fenestration Variation in the Middle Cerebral Artery Using 64-slice Multidetector Spiral CT

    袁飞; 刘银社; 常爱华; 赵军; 顾欣; 冯凯琳

    2011-01-01

    目的 探讨大脑中动脉成窗变异的发生率及CT血管成像(CTA)特征,提高对该血管变异的认识.资料与方法 2007年11月至2010年1月本院共有2734例患者行头颈联合64层CTA检查,其中14例确诊为大脑中动脉成窗.回顾性分析大脑中动脉成窗的发生率、部位、形态等CTA特征及其合并症.结果 (1)14例患者共15个大脑中动脉成窗,发生率为0.51%(14/2734).M1段近端成窗12个,占80%;M1段远端成窗2个,占13.3%,均由一支桥血管与M1段远端及M2段近端构成;M1段中部成窗1个,占6.7%.M1段近端成窗中,9个成窗位于大脑中动脉起始部,3个成窗由一支桥血管与M1和A1近端三支血管组成.(2)2个"窗"径较小者(<2 mm)呈孔状,13个"窗"径较大者中,10个分支粗细不等呈"OK"手势样,3个分支粗细大致相同呈"凸透镜"样.(3)1例合并基底动脉成窗,1例合并大脑后动脉成窗,1例合并永久三叉动脉,3例合并颅内其他动脉的动脉瘤.结论 CTA能快速、直观、准确地判断大脑中动脉成窗及其合并症,熟悉其CTA特征有助于指导临床制定合理的治疗方案,提高相应治疗中的安全性.%Objective To analyze the incidence and CT angiography(CTA) features of the fenestrations variation of middie eerebral artery, and to improve dignesis. Materials and Methods The imaging data of 2734 patients peeformed 64 slice CTA of the cranio cervical arteries in our hospital between November,2007 and January 2010 were evaluated retrospectively,and 14 of them were diagnosed as the fenestration variation of middle cerebral arteries. The incidence,location,morpholngical characteristics of the fenestration of middle cerebral artery and its coexisting abnormalities were analyzed. Results ( 1 ) 15 fenestrations variation of middle cerebral arteries in 14 patients were found,withh the incidence of 0.51% ( 14/2734 ). 80%( 12 fenestrations) were located at the proximal Mi segments,13.3% (2 fenestrations) at the distal

  7. Prognostic value of absence or presence of coronary artery disease determined by 64-slice computed tomography coronary angiography A systematic review and meta-analysis

    Abdulla, Jawdat; Asferg, Camilla Lundegaard; Kofoed, Klaus Fuglsang

    2011-01-01

    To determine via a meta-analysis the prognostic value of 64-slice computed tomography angiography (CTA) by quantifying risk of major adverse cardiac events (MACE) in different patient groups classified according to CT angiographic findings. A systematic literature search and meta-analyses was con...

  8. Application of 64-slice spiral CT angiography in the diagnosis of tetralogy of fallot%64层螺旋CT血管造影在法洛四联症诊断中的应用

    陈红; 曹成瑛; 朱友义; 王生元; 罗焕; 周署泉

    2011-01-01

    目的:探讨64层螺旋CT血管造影(64-SCTA)诊断法洛四联症(tetralogy of Fallot,TOF)的应用价值.方法:回顾性分析23例TOF患者的64-SCTA诊断结果,并与心脏超声(UCG)和手术进行对比.结果:23例TOF患者经64-SCTA和UCG都能发现和准确诊断TOF的4种主要畸形,室间隔缺损大小、主动脉骑跨程度、右室流出道狭窄、右室前壁厚度以及主肺动脉内径的测量结果与手术结果比较均差异无统计学意义(均P>0.05);64-SCTA检出体肺侧支动脉血管6例,UCG仅检出1例,二者比较,差异有统计学意义(P<0.01).结论:64-SCTA能客观清晰地显示TOF的4种畸形,在心外大血管畸形诊断方面较UCG有明显的优势,是准确诊断TOF无创性检查的理想选择.%Objective!To evaluate the advantage and limitation of 64-slice spiral CT angiography (64-SCTA) in diagnosing tetralogy of fallot (TOF). Method:64-SCTA findings of 23 patients with TOF were retrospectively ana-lyzed comparatively with cardiac ultrasound and surgery. Result:Four major malformations of TOF could be accu-rately diagnosed by both 64-SCTA and cardiac ultrasound. There was no significant statistically difference (P> 0. 05) compared with that of surgery in evaluating the ventricular septal defect size, degree of aortic cross-riding, stenosis of right ventricular outflow, as well as internal diameter of main pulmonary, left and right pulmonary ar-tery, the right ventricular wall thickness were no significant statistically difference (P>0. 05) measured by 64-SC-TA and cardiac ultrasound, but 64-SCTA had more advantages than cardiac ultrasound in diagnosing the extracar-diac malformation (P<0. 01) , for the detection of lung body collateral arteries by 64-SCTA in 6cases, while only lease by cardiac ultrasound. Conclusion: Four major malformations of TOF could be objectively and clearly diag-nosed by 64-SCTA. In diagnosis of great extracardiac vessel malformations, 64-SCTA is significantly superior to UCG. 64

  9. Coronary artery imaging with 64-slice CT in atrial fibrillation patients: scanning method and post-processing techniques

    Objective: To discuss the clinical value of coronary artery imaging using 64-slice CT in patient with atrial fibrillation. Methods: All the cardiac volume data of 31 patients with atrial fibrillation were reconstructed using absolute time method. The images of 12 patients. The images of 31 patients who undeiwent contrast-enhanced CT coronary angiography were evaluated. The presence of stenosis on each segment of coronary arteries was recorded and their degree of stenosis was measured using the vessel analysis software.. The results of conventional coronary angiography (CAG) of the 10 patients were compared with CT coronary angiography. Results: The image quality of 364 coronary vessel segments on the images from 31 patients was evaluated and defined as excellent, fine, moderate or poor. The image quality was excellent, fine, moderate and poor in 194(53.3%), 82(22.5%), 41(11.3%) and 47(12.9%) vessel segments. Comparison was carried out between CTA findings and CAG findings of the 125 segments of the coronary arteries in the 10 patients who underwent CAG. The sensitivity and specificity of CTA for diagnosing vessel with stenosis (≥ 50% narrowing) was 85%(17/20) and 95.2% (100/105). Conclusion: Coronary artery imaging using 64-slice CT is useful in patient with atrial fibrillation. (authors)

  10. Quantitative parameters of image quality in 64-slice computed tomography angiography of the coronary arteries

    We explored quantitative parameters of image quality in consecutive patients undergoing 64-slice multi-detector computed tomography (MDCT) coronary angiography for clinical reasons. Forty-two patients (36 men, mean age 61 ± 11 years, mean heart rate 63 ± 10 bpm) underwent contrast-enhanced MDCT coronary angiography with a 64-slice scanner (Siemens Sensation 64, 64 mmx 0.6 mm collimation, 330 ms tube rotation, 850 mAs, 120 kV). Two independent observers measured the overall visualized vessel length and the length of the coronary arteries visualized without motion artifacts in curved multiplanar reformatted images. Contrast-to-noise ratio was measured in the proximal and distal segments of the coronary arteries. The mean length of visualized coronary arteries was: left main 12 ± 6 mm, left anterior descending 149 ± 25 mm, left circumflex 89 ± 30 mm, and right coronary artery 161 ± 38 mm. On average, 97 ± 5% of the total visualized vessel length was depicted without motion artifacts (left main 100 ± 0%, left anterior descending 97 ± 6%, left circumflex 98 ± 5%, and right coronary artery 95 ± 6%). In 27 patients with a heart rate ≤65 bpm, 98 ± 4% of the overall visualized vessel length was imaged without motion artifacts, whereas 96 ± 6% of the overall visualized vessel length was imaged without motion artifacts in 15 patients with a heart rate >65 bpm (p < 0.001). The mean contrast-to-noise ratio in all measured coronary arteries was 14.6 ± 4.7 (proximal coronary segments: range 15.1 ± 4.4 to 16.1 ± 5.0, distal coronary segments: range 11.4 ± 4.2 to 15.9 ± 4.9). In conclusion, 64-slice MDCT permits reliable visualization of the coronary arteries with minimal motion artifacts and high CNR in consecutive patients referred for non-invasive MDCT coronary angiography. Low heart rate is an important prerequisite for excellent image quality

  11. Diagnostic accuracy of 64-slice multidetector CT for detection of in-stent restenosis in an unselected, consecutive patient population

    Haraldsdottir, Sigurdis, E-mail: sigurdisha@gmail.com [Boston Medical Center, 72 East Concord Street (Evans 124), Boston, MA, 02118 (United States); Gudnason, Thorarinn, E-mail: thorgudn@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Sigurdsson, Axel F., E-mail: axelfsig@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Gudjonsdottir, Jonina, E-mail: jonina@rd.is [Rontgen Domus Medica, Egilsgata 3, 101 Reykjavik (Iceland); Lehman, Sam J., E-mail: slehman@partners.org [Massachusetts General Hospital, 165 Cambridge Street, Suite 400, Boston, MA 02114 (United States); Eyjolfsson, Kristjan, E-mail: kristey@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Scheving, Sigurpall S., E-mail: sigurpal@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Gibson, C. Michael, E-mail: mgibson@perfuse.org [Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115 (United States); Hoffmann, Udo, E-mail: uhoffmann@partners.org [Massachusetts General Hospital, 165 Cambridge Street, Suite 400, Boston, MA 02114 (United States); Jonsdottir, Birna, E-mail: birna@rd.is [Rontgen Domus Medica, Egilsgata 3, 101 Reykjavik (Iceland); Andersen, Karl, E-mail: andersen@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland)

    2010-11-15

    Objectives: To investigate the diagnostic accuracy of 64-slice multidetector computed tomography (64-CT) for detection of in-stent restenosis (ISR) in an unselected, consecutive patient population. Background: Detection of in-stent restenosis by cardiac CT would be a major advance for the evaluation of patients suspected of having ISR. However, the diagnostic accuracy of current generation 64-CT in this context is not fully established. Methods: We conducted a prospective study on patients with stable angina or acute coronary syndrome with no prior history of coronary artery disease. Six months after percutaneous coronary intervention (PCI) with stent placement they underwent a 64-CT scan (Toshiba Multi-Slice Aquilion 64) and consequently a repeat coronary angiography for comparison. Cardiac CT data sets were analyzed for the presence of in-stent restenosis by two independent expert readers blinded to the coronary angiographic data. Results: Ninety-three patients with a total of 140 stents were evaluated. Males comprised 82% of the study group and the mean age was 63 {+-} 10 years. The mean time from PCI to the repeat coronary angiography was 208 {+-} 37 days and the mean time from 64-CT to repeat coronary angiography was 3.7 {+-} 4.9 days. The restenosis rate according to coronary angiography was 26%. Stent diameter, strut thickness, heart rate and body mass index (BMI) significantly affected image quality. The sensitivity, specificity, positive and negative predictive values of 64-CT for detection of in-stent restenosis were 27%, 95%, 67% and 78%, respectively. Conclusions: Current generation, 64-slice CT, remains limited in its ability to accurately detect in-stent restenosis.

  12. Assessment of extracranial-intracranial bypass patency with 64-slice multidetector computerized tomography angiography

    Extracranial-intracranial (EC/IC) bypass is a useful procedure for the treatment of cerebral vascular insufficiency or complex aneurysms. We explored the role of multidetector computed tomography angiography (MDCTA), instead of digital subtraction angiography (DSA), for the postoperative assessment of EC/IC bypass patency. We retrospectively analyzed a consecutive series of 21 MDCTAs from 17 patients that underwent 25 direct or indirect EC/IC bypass procedures between April 2003 and November 2007. Conventional DSA was available for comparison in 13 cases. MDCTA used a 64-slice MDCT scanner (Aquilion 64, Toshiba). The proximal and distal patencies were analyzed independently on MDCTA and DSA by a neuroradiologist and a neurosurgeon. The bypass was considered patent when the entire donor vessel was opacified without discontinuity from proximal to distal ends and was visibly in contact with the recipient vessel. MDCTA depicted the patency status in every patient. Bypasses were patent in 22 cases, stenosed in one, and occluded in two. DSA always confirmed the results of the MDCTA (sensitivity = 100%, 95% CI = 0.655-1.0; specificity 100%, 95% CI = 0.05-1.0). MDCTA is a non-invasive and accurate exam to assess the postoperative EC/IC bypass patency and is a promising technique in routine follow-up. (orig.)

  13. Radiation dose and cancer risk from pediatric CT examinations on 64-slice CT: A phantom study

    Objective: To measure the radiation dose from CT scans in an anthropomorphic phantom using a 64-slice MDCT, and to estimate the associated cancer risk. Materials and methods: Organ doses were measured with a 5-year-old phantom and thermoluminescent dosimeters. Four protocols; head CT, thorax CT, abdomen CT and pelvis CT were studied. Cancer risks, in the form of lifetime attributable risk (LAR) of cancer incidence, were estimated by linear extrapolation using the organ radiation doses and the LAR data. Results: The effective doses for head, thorax, abdomen and pelvis CT, were 0.7 mSv, 3.5 mSv, 3.0 mSv, 1.3 mSv respectively. The organs with the highest dose were; for head CT, salivary gland (22.33 mGy); for thorax CT, breast (7.89 mGy); for abdomen CT, colon (6.62 mGy); for pelvis CT, bladder (4.28 mGy). The corresponding LARs for boys and girls were 0.015-0.053% and 0.034-0.155% respectively. The organs with highest LARs were; for head CT, thyroid gland (0.003% for boys, 0.015% for girls); for thorax CT, lung for boys (0.014%) and breast for girls (0.069%); for abdomen CT, colon for boys (0.017%) and lung for girls (0.016%); for pelvis CT, bladder for both boys and girls (0.008%). Conclusion: The effective doses from these common pediatric CT examinations ranged from 0.7 mSv to 3.5 mSv and the associated lifetime cancer risks were found to be up to 0.16%, with some organs of higher radiosensitivity including breast, thyroid gland, colon and lungs.

  14. Clinical value of 64-slice spiral CT for classification of femoral neck fracture

    Objective: To evaluate the clinical application of 64-slice spiral CT for classification of femoral neck fracture. Methods: The survey was comprised of 46 patients with femoral neck fractures detected with plain radiographs and CT images. Cases were randomly presented in 2 formats: plain radiographs and CT. Garden classification was queried. Modification of garden classification (nondisplaced vs displaced) was taken to compare with plain radiographs and CT in the study. Results: The results of classification for plain radiographs were 2 cases of Garden Ⅰ, 10 cases of Ⅱ, 22 cases of Ⅲ, and 12 cases of Ⅳ. Those for CT were 1 cases of Garden Ⅰ, 4 cases of Ⅱ, 26 cases of Ⅲ, and 15 cases of Ⅳ. CT improved the accuracy of Garden Classification (P<0.05). Conclusion: Garden classification using CT images shows good conformation with results of surgery. 64-Slic CT is better plain radiographs for Garden classification of femoral neck fracture. (authors)

  15. 64排螺旋CT冠状动脉成像与冠状动脉造影对心肌桥诊断的比较研究%Diagnosis Comparison of Myocardial Bridge by 64-slice CT Coronary Angiography and Conventional Coronary Angiography

    施斌斌; 吴晶涛; 征锦; 叶靖; 王守安

    2012-01-01

    目的:比较64排螺旋CT冠状动脉成像(64 SCTCA)和冠状动脉造影(CAG)对心肌桥(MB)的诊断价值.方法:832例患者分别行64SCTCA扫描及CAG,观察有无MB及测量MB的长度、厚度、壁冠状动脉(MCA)狭窄程度等,并对结果进行对比研究.结果:64 SCTCA MB检出率为18.3%,CAG MB检出率为10.2%,两者比较差异有统计学意义(P<0.05).64 SCTCA与CAG对MB的狭窄程度及长度比较,差异也有统计学意义(P<0.05).结论:与CAG相比,64SCTCA对MB有较高的检出率,并能准确显示壁冠状动脉与心肌的解剖关系.%Objective To compare the clinical significance of 64-slice coronary CT angiography(64 SCTA) and conventional coronary angiography(CAG) for identification of myocardial bridge. Methods Eight hundred and thirty —two patients with suspected coronary artery disease underwent multi-detector row CT and conventional coronary angiography respectively.The prevalence, precise location, length, depth and concomitant atheromatous changes were evaluated. Results One hundred and sixty-five sites of MB were found in 152(18.3%, 152/832) of 832 patients with 64 SCTA, with MB detection rate of 10.2% by CAG, and the difference was statistically significant(P<0.05). There was also significant difference between 64 SCTCA and CAG for the degree and length of stenosis of the MB. Conclusion Compared with CAG, 64 SCTCA has a higher detection rate for MB, and can accurately show the relationship between mural coronary arteries and myocardial.

  16. Coronary ostial involvement in acute aortic dissection: detection with 64-slice cardiac CT.

    Ryan, E Ronan

    2012-02-01

    A 41-year-old man collapsed after lifting weights at a gym. Following admission to the emergency department, a 64-slice cardiac computed tomography (CT) revealed a Stanford Type A aortic dissection arising from a previous coarctation repair. Multiphasic reconstructions demonstrated an unstable, highly mobile aortic dissection flap that extended proximally to involve the right coronary artery ostium. Our case is an example of the application of electrocardiogram-gated cardiac CT in directly visualizing involvement of the coronary ostia in acute aortic dissection, which may influence surgical management.

  17. Coronary calcium score as gatekeeper for 64-slice computed tomography coronary angiography in patients with chest pain: per-segment and per-patient analysis

    Palumbo, Anselmo Alessandro; Cademartiri, Filippo [Azienda Ospedaliero-Universitaria di Parma, Non-Invasive Cardiovascular Imaging, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Maffei, Erica; Martini, Chiara [Azienda Ospedaliero-Universitaria di Parma, Non-Invasive Cardiovascular Imaging, Department of Radiology and Cardiology, Parma (Italy); Tarantini, Giuseppe [University of Padua, Department of Cardiology, Padua (Italy); Di Tanna, Gian Luca; Berti, Elena; Grilli, Roberto [Regional Health Agency, Regione Emilia Romagna, Bologna (Italy); Casolo, Giancarlo [Ospedale Versilia, Department of Cardiology, Viareggio (Italy); Brambilla, Valerio [Don Gnocchi ONLUS, Cardiovascular Rehabilitation Unit, Parma (Italy); Cerrato, Marcella; Rotondo, Antonio [University of Naples, Department of Radiology, Naples (Italy); Weustink, Annick C.; Mollet, Nico R.A. [Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands)

    2009-09-15

    We sought to investigate the performance of 64-slice CT in symptomatic patients with different coronary calcium scores. Two hundred patients undergoing 64-slice CT coronary angiography for suspected coronary artery disease were enrolled into five groups based on Agatston calcium score using the Mayo Clinic risk stratification: group 1: score 0, group 2: score 1-10, group 3: score 11-100, group 4: score 101-400, and group 5: score > 401. Diagnostic accuracy for the detection of significant ({>=}50% lumen reduction) coronary artery stenosis was assessed on a per-segment and per-patient base using quantitative coronary angiography as the gold standard. For groups 1 through 5, sensitivity was 97, 96, 91, 90, 92%, and specificity was 99, 98, 96, 88, 90%, respectively, on a per-segment basis. On a per-patient basis, the best diagnostic performance was obtained in group 1 (sensitivity 100% and specificity 100%) and group 5 (sensitivity 95% and specificity 100%). Progressively higher coronary calcium levels affect diagnostic accuracy of CT coronary angiography, decreasing sensitivity and specificity on a per-segment base. On a per-patient base, the best results in terms of diagnostic accuracy were obtained in the populations with very low and very high cardiovascular risk. (orig.)

  18. Coronary calcium score as gatekeeper for 64-slice computed tomography coronary angiography in patients with chest pain: per-segment and per-patient analysis

    We sought to investigate the performance of 64-slice CT in symptomatic patients with different coronary calcium scores. Two hundred patients undergoing 64-slice CT coronary angiography for suspected coronary artery disease were enrolled into five groups based on Agatston calcium score using the Mayo Clinic risk stratification: group 1: score 0, group 2: score 1-10, group 3: score 11-100, group 4: score 101-400, and group 5: score > 401. Diagnostic accuracy for the detection of significant (≥50% lumen reduction) coronary artery stenosis was assessed on a per-segment and per-patient base using quantitative coronary angiography as the gold standard. For groups 1 through 5, sensitivity was 97, 96, 91, 90, 92%, and specificity was 99, 98, 96, 88, 90%, respectively, on a per-segment basis. On a per-patient basis, the best diagnostic performance was obtained in group 1 (sensitivity 100% and specificity 100%) and group 5 (sensitivity 95% and specificity 100%). Progressively higher coronary calcium levels affect diagnostic accuracy of CT coronary angiography, decreasing sensitivity and specificity on a per-segment base. On a per-patient base, the best results in terms of diagnostic accuracy were obtained in the populations with very low and very high cardiovascular risk. (orig.)

  19. The value of multiplanar reconstruction using 64-slice CT myelography in cervical nerve root injury

    Objective: To study the diagnostic value of multi-direction adjusted multiplanar reconstruction (MPR) by 64-slice CT myelography (CTM) in diagnosing cervical nerve injury, and the possibility of the MPR to replace conventional myelography and CT direct-scanning axial images. Methods: Twenty-six patients with cervical nerve root injury were examined by conventional myelography and 64-slice CT using isotropic parameters. Then multi-direction MPR were performed to display nerve roots on coronal and sagittal planes besides axial images. Twenty-six patients were performed surgical operations and diagnosis were obtained. The coincident diagnosing rate with surgical operations results were compared statistically among multi-direction MPR, direct-scanning axial CT images, conventional myelography. The numbers of images were also compared between axial MPR and direct scanning axial CT images. Results: Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in 64-slice CT, which was found in 31 nerve roots. Indirect signs included: (1) Traumatic pseudomeningocele: 29 nerve roots showed the leak of Isovist into nerve root sheath, and extended into foramina; (2) Arachnoid cyst: 26 nerve roots clearly displays cystic distension in nerve root, which has low-density fine clew form septation from subarachnoid cavity and no nerve root in the cyst; (3) Deformity of the subarachnoid space: deformity of thecal sac, partially lack of Isovist into arachnoid space, which was found in 17 nerve roots. The coincident diagnosing rate of cervical nerve root injury by multi-direction adjusted coronal MPR imaging was 92.6% (50/54), which was higher than by axial CT (77.8%, 42/54) and conventional myelography (68.5%, 37/54), There was significant difference between the conventional myelography, direct-scanning axial CT, multi-direction MPR images (Kappa=0.686, 0.772, 0.920, respectively, P<0.05), the coronal MPR imaging was significantly

  20. The study of temporal bone scanning at low-dose with 64-slice spiral CT

    Objective: To study the rationality and possibility of 64 slice spiral CT in the examination of the temporal bone at low dose. Methods: The same CT technique and temporal bone mode as those for clinical CT were used, two cranium specimens (four ears) were scanned with Somatom Sensation 64-slice spiral CT at different mA (380, 300, 200, 160, 120, 80), and multi-planar reformation was performed. The CT dose index at different mA groups were measured by 10 em pencil ionization chamber and head dose phantom. Four anatomic structures on axial images (subarcuate fossa, tendon of tensor tympani, facial recess, etc), four anatomic structures on coronal images (scute, crista transversa, fenestra cochleae, etc) and six anatomic structures on double oblique images (malleus, incus, stirrup bone, upper bony semicircular, etc) were chosen to evaluate and grade the reformation images among different mA groups, and to determine the minimum mA value. Ten ears of five patients were used to test the validity of the minimum mA value. Results: CT radiation dose was significantly reduced flora (47.8 ± 2.7) to (20.1 ± 2.0) mGy (P<0.01) when mA decreased from 380 mA to 160 mA. No significant difference in displaying anatomic structures between the two mA protocols. Conclusion: it is a feasible borne temporal scanning method to decrease the radiation dose by decreasing mA appropriately. (authors)

  1. Comparison of digitally reconstructed radiographs (DRRs) generated from 4-slice and 64-slice helical CT scanners, a phantom study

    Full text: Digitally reconstructed radiographs (DRRs) are generated from CT data sets and playa vital role for verifying patient position for many radiotherapy treatments. The present study aimed to investigate the impact on the image quality of DRRs due to changes in the original CT data acquisition; specifically a 4-slice CT scanner and a 64-slice CT scanner have been considered. A specifically designed CT simulation phantom (Nuclear Associates Model 76--417) with test patterns to measure low contrast and modulation transfer function (MTF) was used to evaluate DRR characteristics for Siemens Somatom Sensation 4 and Sensation 64 CT scanners. The phantom was scanned as described in the manufacturer's manual, using the departmental protocol for head CT. The CT images were obtained with 120 kV, 300 mAs, a scanning and reconstruction pitch of I and collimation of I mm. Each of the test patterns from the DRRs was compared for the 4-slice and the 64-slice helical scans. Results The calculated relative MTF (RMTF) showed higher spatial resolution for DRRs generated from 64-slice scans compared with 4-slice scans, Fig. 1. The low contrast values for hole diameter patterns on the DRRs ranged from 0.01-8.04% for 64 slice scans and 0.06-6.15% for 4 slice scans.

  2. Downstream resource utilization following hybrid cardiac imaging with an integrated cadmium-zinc-telluride/64-slice CT device

    Low yield of invasive coronary angiography and unnecessary coronary interventions have been identified as key cost drivers in cardiology for evaluation of coronary artery disease (CAD). This has fuelled the search for noninvasive techniques providing comprehensive functional and anatomical information on coronary lesions. We have evaluated the impact of implementation of a novel hybrid cadmium-zinc-telluride (CZT)/64-slice CT camera into the daily clinical routine on downstream resource utilization. Sixty-two patients with known or suspected CAD were referred for same-day single-session hybrid evaluation with CZT myocardial perfusion imaging (MPI) and coronary CT angiography (CCTA). Hybrid MPI/CCTA images from the integrated CZT/CT camera served for decision-making towards conservative versus invasive management. Based on the hybrid images patients were classified into those with and those without matched findings. Matched findings were defined as the combination of MPI defect with a stenosis by CCTA in the coronary artery subtending the respective territory. All patients with normal MPI and CCTA as well as those with isolated MPI or CCTA finding or combined but unmatched findings were categorized as ''no match''. All 23 patients with a matched finding underwent invasive coronary angiography and 21 (91%) were revascularized. Of the 39 patients with no match, 5 (13%, p < 0.001 vs matched) underwent catheterization and 3 (8%, p < 0.001 vs matched) were revascularized. Cardiac hybrid imaging in CAD evaluation has a profound impact on patient management and may contribute to optimal downstream resource utilization. (orig.)

  3. Downstream resource utilization following hybrid cardiac imaging with an integrated cadmium-zinc-telluride/64-slice CT device

    Fiechter, Michael; Kaufmann, Philipp A. [University Hospital Zurich, Department of Radiology, Cardiac Imaging, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland); Ghadri, Jelena R.; Wolfrum, Mathias; Kuest, Silke M.; Pazhenkottil, Aju P.; Nkoulou, Rene N.; Herzog, Bernhard A.; Gebhard, Catherine; Fuchs, Tobias A.; Gaemperli, Oliver [University Hospital Zurich, Department of Radiology, Cardiac Imaging, Zurich (Switzerland)

    2012-03-15

    Low yield of invasive coronary angiography and unnecessary coronary interventions have been identified as key cost drivers in cardiology for evaluation of coronary artery disease (CAD). This has fuelled the search for noninvasive techniques providing comprehensive functional and anatomical information on coronary lesions. We have evaluated the impact of implementation of a novel hybrid cadmium-zinc-telluride (CZT)/64-slice CT camera into the daily clinical routine on downstream resource utilization. Sixty-two patients with known or suspected CAD were referred for same-day single-session hybrid evaluation with CZT myocardial perfusion imaging (MPI) and coronary CT angiography (CCTA). Hybrid MPI/CCTA images from the integrated CZT/CT camera served for decision-making towards conservative versus invasive management. Based on the hybrid images patients were classified into those with and those without matched findings. Matched findings were defined as the combination of MPI defect with a stenosis by CCTA in the coronary artery subtending the respective territory. All patients with normal MPI and CCTA as well as those with isolated MPI or CCTA finding or combined but unmatched findings were categorized as ''no match''. All 23 patients with a matched finding underwent invasive coronary angiography and 21 (91%) were revascularized. Of the 39 patients with no match, 5 (13%, p < 0.001 vs matched) underwent catheterization and 3 (8%, p < 0.001 vs matched) were revascularized. Cardiac hybrid imaging in CAD evaluation has a profound impact on patient management and may contribute to optimal downstream resource utilization. (orig.)

  4. In vitro imaging of coronary artery stents: Are there differences between 16- and 64-slice CT scanners?

    Purpose: To compare the performance of 64-slice with 16-slice CT scanners for the in vitro evaluation of coronary artery stents. Methods and materials: Twelve different coronary artery stents were placed in the drillings of a combined heart and chest phantom, which was scanned with a 16- and 64-slice CT scanner. Coronal reformations were evaluated for artificial lumen narrowing, intraluminal attenuation values, and false widening of the outer stent diameter as an indicator of artifacts outside the stent. Results: Mean artificial lumen narrowing was not significantly different between the 16- and 64-slice CT scanner (44% versus 39%; p = 0.408). The differences between the Hounsfield Units (HU) measurements inside and outside the stents were significantly lower (p = 0.001) with 64- compared to 16-slice CT. The standard deviation of the HU measurements inside the stents was significantly (p = 0.002) lower with 64- than with 16-slice CT. Artifacts outside the stents were not significantly different between the scanners (p = 0.866). Conclusion: Visualization of the in-stent lumen is improved with 64-slice CT when compared with 16-slice CT as quantified by significantly lesser intraluminal image noise and less artificial rise in intraluminal HU measurement, which is the most important parameter for the evaluation of stent patency in vivo

  5. Comparison of 64-slice computed tomography angiography and coronary angiography for the detection and assessment of coronary artery disease in patients with angina: A systematic review

    Background: Coronary artery disease (CAD) is the leading cause of death in Western countries. It presents itself in various ways, the commonest being angina. According to the Royal College of Radiologist referral guidelines, Coronary Angiography (CA) is currently the gold standard for diagnosis and evaluation of CAD. However, due to the invasive nature and expense of CA there is a perceived need for a primary non-invasive imaging modality to supersede it. Computed tomography angiography (CTA), utilising 64-slice technology, may be a less invasive alternative to CA. Aim: To consider the research evidence for the current gold standard diagnostic test for CAD. Specifically, which is more sensitive and specific for detecting CAD in patients with angina; 64-slice CTA or CA? Inclusion Criteria: Prospective, non-randomised control trials and diagnostic accuracy studies comparing 64-slice CTA and CA were included. Participants were adults with angina with suspected or known CAD. Method: An electronic search of the databases; AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE and Science Direct, was conducted between January 2004 and April 2012. Secondary hand-searching of grey literature was undertaken. Two reviewers independently determined studies for inclusion, assessed quality, using SIGN50, and extracted data. Diagnostic value of 64-slice CTA and CA was compared and analysed at patient and segment level. Results: Ten studies were included in the critical review enrolling 1188 patients. At patient level sensitivity for 64-slice CTA ranged from 88% to 100%, specificity 64–92%, PPV 86–97% and NPV 76.9–100%. At segment level sensitivity for 64-slice CTA ranged from 73% to 100%, specificity 83–98%, PPV 47–90% and NPV 89–100% Conclusion: At both patient and segment level, 64-slice CTA is a highly sensitive and specific non-invasive alternative to CA for diagnosis of significant stenosis in patients with angina. For standalone diagnosis of CAD current research would

  6. Integrated cardio-thoracic imaging with ECG-Gated 64-slice multidetector-row CT: initial findings in 133 patients

    Salem, Randa; Remy-Jardin, Martine; Delhaye, Damien; Khalil, Chadi; Teisseire, Antoine; Remy, Jacques [Hospital Calmette, University Center of Lille, Department of Thoracic Imaging, LILLE cedex (France); Delannoy-Deken, Valerie; Duhamel, Alain [University of Lille, Place de Verdun, Department of Medical Statistics, LILLE cedex (France)

    2006-09-15

    The purpose of this study was to investigate the possibility of assessing the underlying respiratory disease as well as cardiac function during ECG-gated CT angiography of the chest with 64-slice multidetector-row CT (MDCT). One hundred thirty-three consecutive patients in sinus rhythm with known or suspected ventricular dysfunction underwent an ECG-gated CT angiographic examination of the chest without {beta}-blockers using the following parameters: (1) collimation: 32 x 0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.6-mm slices (Sensation 64; Siemens); rotation time: 0.33 s; pitch: 0.3; 120 kV; 200 mAs; ECG-controlled dose modulation (ECG-pulsing) and (2) 120 ml of a 35% contrast agent. Data were reconstructed: (1) to evaluate the underlying respiratory disease (1-mm thick lung and mediastinal scans reconstructed at 55% of the R-R interval; i.e., ''morphologic scans'') and (2) to determine right (RVEF) and left (LVEF) ventricular ejection fractions (short-axis systolic and diastolic images; Argus software; i.e., ''functional scans''). The mean heart rate was 73 bpm (range: 42-120) and the mean scan time was 18.11{+-}2.67 s (range: 10-27). A total of 123 examinations (92%) had both lung and mediastinal images rated as diagnostic scans, whereas 10 examinations (8%) had non-diagnostic images altered by the presence of respiratory-motion artifacts (n=4) or cyclic artifacts related to the use of a pitch value of 0.3 in patients with a very low heart rate during data acquisition (n=6). Assessment of right and left ventricular function was achievable in 124 patients (93%, 95% CI: 88-97%). For these 124 examinations, the mean RVEF was 46.10% ({+-}9.5; range: 20-72) and the mean LVEF was 58.23% ({+-}10.88; range: 20-83). In the remaining nine patients, an imprecise segmentation of the right and left ventricular cavities was considered as a limiting factor for precise calculation of end-systolic and end

  7. Accessory left atrial diverticulae: contractile properties depicted with 64-slice cine-cardiac CT.

    Killeen, Ronan P

    2012-02-01

    To assess the contractility of accessory left atrial appendages (LAAs) using multiphasic cardiac CT. We retrospectively analyzed the presence, location, size and contractile properties of accessory LAAs using multiphasic cardiac 64-slice CT in 102 consecutive patients (63 males, 39 females, mean age 57). Multiplanar reformats were used to create image planes in axial oblique, sagittal oblique and coronal oblique planes. For all appendages with an orifice diameter >or= 10 mm, axial and sagittal diameters and appendage volumes were recorded in atrial diastole and systole. Regression analysis was performed to assess which imaging appearances best predicted accessory appendage contractility. Twenty-three (23%) patients demonstrated an accessory LAA, all identified along the anterior LA wall. Dimensions for axial oblique (AOD) and sagittal oblique (SOD) diameters and sagittal oblique length (SOL) were 6.3-19, 3.4-20 and 5-21 mm, respectively. All appendages (>or=10 mm) demonstrated significant contraction during atrial systole (greatest diameter reduction was AOD [3.8 mm, 27%]). Significant correlations were noted between AOD-contraction and AOD (R = 0.57, P < 0.05) and SOD-contraction and AOD, SOD and SOL (R = 0.6, P < 0.05). Mean diverticulum volume in atrial diastole was 468.4 +\\/- 493 mm(3) and in systole was 171.2 +\\/- 122 mm(3), indicating a mean change in volume of 297.2 +\\/- 390 mm(3), P < 0.0001. Stepwise multiple regression analysis revealed SOL to be the strongest independent predictor of appendage contractility (R(2) = 0.86, P < 0.0001) followed by SOD (R(2) = 0.91, P < 0.0001). Accessory LAAs show significant contractile properties on cardiac CT. Those accessory LAAs with a large sagittal height or depth should be evaluated for contractile properties, and if present should be examined for ectopic activity during electrophysiological studies.

  8. Measurement of scattered radiation in a volumetric 64-slice CT scanner using three experimental techniques

    Akbarzadeh, A; Ay, M R; Sarkar, S [Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Ghadiri, H [Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Zaidi, H [Division of Nuclear Medicine, Geneva University Hospital, CH-1211 Geneva (Switzerland)], E-mail: mohammadreza_ay@tums.ac.ir

    2010-04-21

    Compton scatter poses a significant threat to volumetric x-ray computed tomography, bringing cupping and streak artefacts thus impacting qualitative and quantitative imaging procedures. To perform appropriate scatter compensation, it is necessary to estimate the magnitude and spatial distribution of x-ray scatter. The aim of this study is to compare three experimental methods for measurement of the scattered radiation profile in a 64-slice CT scanner. The explored techniques involve the use of collimator shadow, a single blocker (a lead bar that suppresses the primary radiation) and an array blocker. The latter was recently proposed and validated by our group. The collimator shadow technique was used as reference for comparison since it established itself as the most accurate experimental procedure available today. The mean relative error of measurements in all tube voltages was 3.9 {+-} 5.5% (with a maximum value of 20%) for the single blocker method whereas it was 1.4 {+-} 1.1% (with a maximum value of 5%) for the proposed blocker array method. The calculated scatter-to-primary ratio (SPR) using the blocker array method for the tube voltages of 140 kVp and 80 kVp was 0.148 and 1.034, respectively. For a larger polypropylene phantom, the maximum SPR achieved was 0.803 and 6.458 at 140 kVp and 80 kVp, respectively. Although the three compared methods present a reasonable accuracy for calculation of the scattered profile in the region corresponding to the object, the collimator shadow method is by far the most accurate empirical technique. Nevertheless, the blocker array method is relatively straightforward for scatter estimation providing minor additional radiation exposure to the patient.

  9. 造影剂注射速率对64层螺旋CT冠状动脉血管成像质量的影响%Effect of contrast injection rates on immaging quality of coronary angiography taken by 64-slice spiral CT

    沈栋; 潘昌杰

    2011-01-01

    目的 研究造影剂注射速率对64层螺旋CT冠状动脉血管成像质量的影响.方法 120 例冠状动脉血管造影患者随机均分成三组,分别用4.5、5或5.5ml/s的速率注射等量造影剂.应用64层螺旋CT进行扫描;采用团注实验测定延迟时间;分别在左冠发出层面横断面图像选择感兴趣区测量升、降主动脉衰减值(HU),利用多平面重建技术(MPR)于离出口约1cm处的正交横断面图像测量心脏血管(左主干、前降支、回旋支及右冠状动脉)的衰减值.结果 升、降主动脉及心脏血管三组间对比衰减均有统计学意义(P<0.01).心脏血管对比衰减与体重(r=-0.722)、体重指数(BMI)(r=-0.599)明显相关(P<0.05).以5ml/s速率注射造影剂获得的图像质量优于其它两组(P<0.01).结论 在心脏CT血管造影(CTA)中在扫描条件及造影剂的碘浓度一致情况下,以5ml/s注射速率给予造影剂可以获得良好的血管增强效果.%Objective To study the effect of contrast injection rates on immaging quality of coronary angiography taken by 64-slice spiral CT (64-MSCT). Methods A total of 120 patients undergoing coronary angiography was equally randomized to 3 groups, in which the contrast injection was performed at the flow rates of 4. 5, 5, and 5. 5 ml/s, respectively. The 64-MSCT scanner and scanning protocols were the same for each group. The scanning delay of CT was determined with a bolus test technique. The attenuation in Hounsfield units(HU) achieved after each injection rate was determined at regions of interest(ROIs) placed at the 1 cm origin of coronary arteries measured by multiplanar reconstructions (MPR), which included the left main artery (LMA), left anterior descending artery(LAD), left circumfiex artery(LCX) and right coronary artery(RCA). All data were analyzed with one way ANOVA. The quality of the coronary artery images was evaluated and compared. Results The mean attenuation achieved at each aortic site was

  10. Calcium scoring using 64-slice MDCT, dual source CT and EBT : a comparative phantom study

    Groen, Jaap M.; Greuter, Marcel J. W.; Vliegenthart, R.; Suess, C.; Schmidt, B.; Zijlstra, F.; Oudkerk, M.

    2008-01-01

    Purpose Assessment of calcium scoring (Ca-scoring) on a 64-slice multi-detector computed tomography (MDCT) scanner, a dual-source computed tomography (DSCT) scanner and an electron beam tomography (EBT) scanner with a moving cardiac phantom as a function of heart rate, slice thickness and calcium de

  11. Optimization of individualized abdominal scan protocol with 64-slice CT scanner

    Objective: To explore an individualized abdominal scan protocol with a 64-slice CT scanner. Methods: From Sep. 2010 to Nov. 2010, one hundred consecutive patients, who underwent twice non-contrast-enhanced abdominal CT scans within 3 months, were enrolled in this study. For each patient, the tube current of 274 eff. mAs and 207 eff. mAs were applied respectively in the first and second abdominal scan. The imaging qualities of the two scans were evaluated retrospectively by 3 reviewers. All the individual variants,including height, weight, body mass index (BMI), the maximum transverse diameter, the anteroposterior diameter and the average maximum diameter of abdomen were recorded. A five-point scale was used for grading the image noise of eight organs, including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex and renal medulla. Diagnostic acceptability of CT images at three anatomic levels,including porta hepatis, pancreas and the upper pole of renal, was also evaluated by using a five-point scale. The noise value of abdominal aorta was defined as the standard deviation (SD) of CT values of aorta at the level of porta hepatis. Scatter diagram and Pearson correlation analysis were used for evaluating the linear relationship between the individual variants and the noise value of abdominal aorta, and multivariate linear regression analysis was used for evaluating the relevance between the individual variants and the noise value of aorta. Results: In this patients group, the average height was (164.6 ± 7.5) cm,the average weight was (64.3 ± 11.0) kg, the BMI was (23.7 ±3.3) kg/m2, the maximum transverse diameter of abdomen was (29.8 ± 2.3) cm, the anteroposterior diameter of abdomen was (23.1 ± 2.9) cm, and the average maximum diameter of abdomen was (26.5 ± 2.5) cm. Pearson correlation analysis showed significant positive linear correlation between the noise value of abdominal aorta (1 1.7 ± 3.0) and patients' weight (r=0

  12. Calcium scoring using 64-slice MDCT, dual source CT and EBT: a comparative phantom study

    Groen, Jaap M.; Greuter, Marcel J. W.; Vliegenthart, R.; Suess, C.; Schmidt, B.; Zijlstra, F.; Oudkerk, M.

    2007-01-01

    Purpose Assessment of calcium scoring (Ca-scoring) on a 64-slice multi-detector computed tomography (MDCT) scanner, a dual-source computed tomography (DSCT) scanner and an electron beam tomography (EBT) scanner with a moving cardiac phantom as a function of heart rate, slice thickness and calcium density. Methods and materials Three artificial arteries with inserted calcifications of different sizes and densities were scanned at rest (0 beats per minute) and at 50–110 beats per minute (bpm) w...

  13. Bouveret’s Syndrome: 64-Slice CT Diagnosis and Surgical Management—A Case Report

    Dinesh Sharma

    2012-01-01

    Full Text Available Gastric outlet obstruction caused by duodenal impaction of a large gallstone migrated through a cholecystoduodenal fistula has been referred to as Bouveret’s syndrome. We present a case of gallstone-induced duodenal obstruction in an elderly female patient, diagnosed on a 64-slice MDCT scanner. One-stage surgery, that is, stone removal and cholecystectomy, was performed resulting in relief of obstruction and complete cure. Clinical features, multidetector computed tomography (MDCT findings, and surgical management are discussed.

  14. Congenital anomalies of coronary arteries: Diagnosis with 64 slice multidetector CT

    Objective: Congenital coronary artery anomalies are generally incidental, uncommon and asymptomatic. Some can cause severe potentially life threatening symptoms. The common mode of studying the coronary arteries is Conventional Coronary Angiogram. ECG-gated-multidetector CT is a non invasive modality. The objective of our study was to identify rare congenital coronary artery anomalies and discuss their clinical significance. Material and methods: A total number of 900 MDCT coronary angiograms were carried out at our institution between the period of April 2006 and October 2010. Patients with coronary artery anomaly constituted the subject of study. Results: The incidence of anomalous anatomical origin and course of the coronary arteries in our study was 1.55%. Hemodynamical significance was seen in five patients. 3 cases of single coronary artery originating from right coronary sinus were seen. 1 case of anomalous left coronary artery arising from main pulmonary artery was seen. 4 cases of anomalous RCA arising from left aortic cusp, 6 cases of absent LMCA with separate origin of LAD and LCX were seen. Conclusion: Multidetector row CT is a noninvasive modality in cardiac imaging. It provides superior resolution of coronary tree and its variant. No projectional vascular overlap is seen. Various postprocessing techniques outclass catheter angiography imaging. Definition of ostia and proximal course of the coronary arteries by Multidetector CT is better than catheter angiography.

  15. Diagnostic performance of prospectively ECG triggered versus retrospectively ECG gated 64-slice computed tomography coronary angiography in a heterogeneous patient population

    Lehmkuhl, Lukas, E-mail: lukas.lehmkuhl@med.uni-leipzig.de [University of Leipzig - Heart Center, Department of Diagnostic and Interventional Radiology, Struempellstrasse 39, D-04289 Leipzig (Germany); Herz, Franziska; Foldyna, Borek [University of Leipzig - Heart Center, Department of Diagnostic and Interventional Radiology, Struempellstrasse 39, D-04289 Leipzig (Germany); Nagel, Hans Dieter [Dr. HD Nagel - Science and Technology for Radiology, Buchholz (Germany); Grothoff, Matthias; Nitzsche, Stefan [University of Leipzig - Heart Center, Department of Diagnostic and Interventional Radiology, Struempellstrasse 39, D-04289 Leipzig (Germany); Thiele, Holger [University of Leipzig - Heart Center, Department for Cardiology (Germany); Mohr, Friedrich-Wilhelm [University of Leipzig - Heart Center, Department for Cardiovascular Surgery (Germany); Hindricks, Gerhard [University of Leipzig - Heart Center, Department for Cardiology (Germany); Gutberlet, Matthias [University of Leipzig - Heart Center, Department of Diagnostic and Interventional Radiology, Struempellstrasse 39, D-04289 Leipzig (Germany)

    2011-11-15

    Objective: To compare diagnostic performance and applicability of prospectively versus retrospectively gated 64-slice computed tomography coronary angiography (pro-CTCA vs. retro-CTCA) in a heterogeneous patient population compared to invasive coronary angiography. Methods: 77 patients referred to an ECG-gated-CT of the chest were retrospectively included. Pro-CTCA was applied, whenever possible, alternatively retro-CTCA was performed. All coronary artery segments {>=}1.5 mm were analysed and image quality was assessed. Results: In 39 patients retro-CTCA and in 38 patients pro-CTCA was applied, mean heart rate (HR) was 69.5 {+-} 9.1 min{sup -1} and 62.8 {+-} 5.9, respectively. For a stenosis {>=}50% segment-based (patient-based) analysis revealed a sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of 97%, 98%, 71%, 100% (91%, 82%, 67%, 96%) using retro-CTCA and 94%, 97%, 75%, 99% (93%, 96%, 93%, 96%) using pro-CTCA. Sensitivity and NPV increased in the pro-CTCA group in patients with a HR < 65. Vessel-based analysis showed lower diagnostic performance for the right coronary artery (RCA) using pro-CTCA, which increased when HR < 65. Image quality did not differ significantly in both groups. Conclusions: Prospectively triggered CTCA in a heterogeneous patient group has a very high diagnostic accuracy and image quality, when used in HR {<=} 65. A low HR is of special importance for the evaluation of the RCA.

  16. Coronary artery imaging during preoperative CT staging: preliminary experience with 64-slice multidetector CT in 99 consecutive patients

    Delhaye, Damien; Remy-Jardin, Martine; Rozel, Celine; Remy, Jacques [University Center of Lille, Boulevard Jules Leclerc, Department of Thoracic Imaging, Hospital Calmette, Lille cedex (France); Dusson, Catherine; Wurtz, Alain [University Center of Lille, Department of Thoracic Surgery, Hospital Calmette, Lille cedex (France); Delannoy-Deken, Valerie; Duhamel, Alain [University of Lille, Department of Medical Statistics, Lille cedex (France)

    2007-03-15

    The purpose of this study was to evaluate the clinical feasibility of coronary artery imaging during routine preoperative 64-slice MDCT scans of the chest. Ninety-nine consecutive patients in sinus rhythm underwent a biphasic multidetector-row spiral CT examination of the chest without the administration of beta-blockers, including an ECG-gated acquisition over the cardiac cavities, followed by a non-gated examination of the upper third of the thorax. Data were reconstructed to evaluate coronary arteries and to obtain presurgical staging of the underlying disease. The percentage of assessable segments ranged from 65.4% (972/1,485) when considering all coronary artery segments to 88% (613/693) for the proximal and mid segments, reaching 98% (387/396) for proximal coronary artery segments. The 387 interpretable proximal segments included 97 (97%) LM, 99 (100%) LAD, 96 (97%) LCX and 95 (96%) RCA with a mean attenuation of 280.70{+-}52.93 HU. The mean percentage of assessable segments was significantly higher in patients with a heart rate {<=}80 bpm (n=48) than in patients with a heart rate greater than 80 bpm (n=35) (80{+-}11% vs. 72{+-}13%; P=0.0008). Diagnostic image quality was achieved in all patients for preoperative staging of the underlying disorder. The mean estimated effective dose was 12.06{+-}3.25 mSv for ECG-gated scans and 13.88{+-}3.49 mSv for complete chest examinations. Proximal and mid-coronary artery segments can be adequately evaluated during presurgical CT examinations of the chest obtained with 64-slice MDCT without the administration of {beta}-blockers. (orig.)

  17. Assessments of Coronary Artery Visibility and Radiation Dose in Infants with Congenital Heart Disease on Cardiac 128-slice CT and on Cardiac 64-slice CT.

    Cui, Y; Huang, M; Zheng, J; Li, J; Liu, H; Liang, C

    2016-01-01

    The aim of this study was to compare the coronary artery visibility and radiation dose in infants with CHD on cardiac 128-slice CT and on cardiac 64-slice CT. The images of 200 patients were analyzed in this study, 100 patients were selected randomly from a group of 789 infants (ECG-triggered axial scan, and 100 were selected randomly from 911 infants with CHD undergoing 64-slice CT retrospective ECG-gated spiral scan. The visibility of coronary artery segments was graded on a four-point scale. The coronary arteries were considered to be detected or visible when grade was 2 or higher. The visibility of the coronary artery segments and the radiation dose was compared between the two groups. Except for the rate of LM (96 vs. 99%), the detection rates of the total, LAD, LCX, RCA, and the proximal segment of the RCA in the 256-slice CT group were significantly higher than those in the 64-slice CT group (51.7, 53.33, 33.67, 53.33, and 99 vs. 34.8, 34.33, 18, 30.67, and 75%, respectively). The counts of visibility score (4/3/2/1) for the LM and the proximal segment of the RCA were 62/22/12/4 and 56/20/17/7, respectively, in the 128-slice CT group and 17/42/30/1 and 9/30/38/25, respectively, in the 64-slice CT group. There were significant differences, especially for score 4 and 3, between the two groups. The radiation dose in the 128-slice CT group was significantly decreased than those in the 64-slice CT group (CTDIvol 1.88 ± 0.51 vs. 5.61 ± 0.63 mGy; SSDE 4.48 ± 1.15 vs. 13.97 ± 1.52 mGy; effective radiation dose 1.36 ± 0.44 vs. 4.06 ± 0.7 mSv). With reduced radiation dose, the visibility of the coronary artery in infants with CHD via prospective ECG-triggered mode on a 128-slice CT is superior to that of the 64-slice CT using retrospective ECG-gated spiral mode. PMID:26271472

  18. Diagnostic Accuracy of 64-Slice MDCT Coronary Angiography for the Assessment of Coronary Artery Disease in Korean Patients with Type 2 Diabetes

    Jun Sung Moon

    2013-02-01

    Full Text Available BackgroundA 64-slice multidetector computed tomography (MDCT is well known to be a useful noninvasive form of angiography for the general population, but not for certain patients with diabetes. The aim of this study was to investigate the diagnostic accuracy and usefulness of 64-slice MDCT coronary angiography for detecting coronary artery disease in Korean patients with type 2 diabetes mellitus (T2DM.MethodsA total of 240 patients were included, 74 of whom had type 2 diabetes (M:F=40:33; 41.8±9.5 years. We compared significant coronary stenosis (>50% luminal narrowing in MDCT with invasive coronary angiography (ICA by segment, artery, and patient. We also evaluated the influence of obesity and coronary calcium score on MDCT accuracy.ResultsOf the 4,064 coronary segments studied, 4,062 segments (T2DM=1,109 were assessed quantitatively by both MDCT and ICA, and 706 segments (T2DM=226 were detected as a significant lesion by ICA in all patients. Sensitivity, specificity, as well as positive and negative predictive values for the presence of significant stenosis in T2DM were: by segment, 89.4%, 96.4%, 85.8%, and 97.4%, respectively; by artery (n=222, 95.1%, 92.9%, 94.4%, and 93.8%, respectively; by patients (n=74, 98.4%, 100.0%, 98.4%, and 90.0%, respectively. Regardless of presence of diabetes, there was no significant difference in diagnostic accuracy. Obesity (≥25 kg/m2 and coronary calcium score did not also affect the diagnostic accuracy of MDCT.ConclusionThe 64-slice MDCT coronary angiography was found to have similar diagnostic accuracy with ICA, regardless of diabetes. These results suggest MDCT may be helpful to reduce unnecessary invasive studies for patients with diabetes.

  19. Relationship between Willis circle variation and the occurrence of anterior and posterior communicaring artery aneurysms investigated by 64-slice CT angiography%CT血管成像评价颅内Willis环变异与前后交通动脉动脉瘤发生的关系

    王洪生; 徐新文; 王辉; 杨昭伟; 王鹏; 赵佩林; 王阳春

    2011-01-01

    目的 探讨大脑前动脉水平段(A1段)发育异常和胚胎型大脑后动脉与颅内前、后交通动脉动脉瘤形成的关系. 方法 回顾性分析216例64排CT血管成像(CTA)的资料.①将216例中CTA发现有前后交通动脉动脉瘤的126例,分为前交通动脉动脉瘤(ACoAA)组69例和后交通动脉动脉瘤(PCoAA)组57例,其余CTA检查无动脉瘤,但有头痛、头晕的90例患者,作为对照组.②分析动脉瘤的有无,动脉瘤的部位、形态、大小和瘤颈的宽度、瘤顶指向及瘤体与周围结构的关系等.③将判定结果与手术结果进行对照.④同时观察大脑前动脉A1段是否存在发育不良或缺如,是否存在胚胎型大脑后动脉. 结果 ①64排CTA共检出前、后交通动脉动脉瘤126例,其中ACoAA 69例,PCoAA57例,以DSA和手术为判断标准,64排CTA检出动脉瘤的敏感性和特异性均为100%.②ACoAA组中一侧A1段发育不良或缺如达81.7%,明显高于PCoAA组和对照组(P <0.05);PCoAA组中胚胎型大脑后动脉达56.1%,明显高于ACoAA组和对照组(P<0.05).结论 (1)64排CTA检出动脉瘤具有较高的敏感性和特异性;②一侧大脑前动脉Al段发育不良或缺如及胚胎型大脑后动脉与前、后交通动脉动脉瘤的发生密切相关.%Objective To investigate the relationship between the dysplasia of horizontal segment ( A1 segment) of anterior cerebral artery and the formation of anterior and posterior communicating artery aneurysms. Methods The data of 64-slice computed tomography angiography (CTA) of 216 patients were analyzed retrospectively. Of the 216 patients, CTA found 126 patients with aneurysm. They were di-vided into anterior communicating artery aneurysm ( ACoAA) group (n =69) and posterior communicating artery aneurysm (PCoAA)group (re =57). The other patients without aneurysm revealed by CTA but with headache and dizziness (n =90) were used as a control group. The presence or absence of aneurysm

  20. Clinical evaluation of 64-slice CT assessment of global left ventricular function using automated cardiac phase selection

    Left ventricular (LV) function provides prognostic information regarding the morbidity and mortality of patients. An automated cardiac phase selection algorithm has the potential to support the assessment of LV function with computed tomography (CT). This algorithm is clinically evaluated for 64-slice cardiac CT. Examinations of twenty consecutive patients were selected. Electrocardiogram gated contrast-enhanced CT was performed. Reconstructions were performed using an automated and a manual method, followed by the determination of the global LV function. Significances were tested using 2-sided Student's t-tests. Reduction in post processing time and storage capacity were estimated. A slightly smaller mean end-systolic volume was found with the automated method (52±18 ml vs 54±17 ml, p=0.02, r=0.99). The mean LV ejection fraction was slightly larger with the automated method (65±8% vs 64±8%, p=0.004, r=0.99). The estimated reduction in post processing time was maximal 5 min per patient with a potential 80% data storage reduction. Results of the automated phase selection algorithm are similar to the manual method. The automated tool reduces post processing time, reconstruction time and transfer time. (author)

  1. Radiation Exposure of Ovarian Cancer Patients: Contribution of CT Examinations Performed on Different MDCT (16 and 64 Slices) Scanners and Image Quality Evaluation

    Rizzo, S; D. Origgi; Brambilla, S.; Maria, F.; Foà, R; Raimondi, S; N. Colombo; Bellomi, M.

    2015-01-01

    Abstract The objective of this study is to compare radiation doses given to ovarian cancer patients by different computed tomographies (CTs) and to evaluate association between doses and subjective and objective image quality. CT examinations included were performed either on a 16-slice CT, equipped with automatic z-axis tube current modulation, or on a 64-slice CT, equipped with z-axis, xy-axis modulation, and adaptive statistical iterative algorithm (ASIR). Evaluation of dose included the f...

  2. Clinical application of 64-slice spiral CT for apical hypertrophic cardiomyopathy

    Objective: To evaluate the clinical application values of 64-row MSCT for apical hypertrophic cardiomyopathy (AHCM). Methods: Twenty-one patients with AHCM were included in this study, 14 patients were diagnosed by echocardiography (UCG), and 7 patients were diagnosed by MRI. All patients underwent MSCT exam, and 5 patients also had ventriculography and coronary angiography. The left ventricular wall thickness in end-systole and end-diastole phases were measured at MSCT workstation, the left ventricular apex thickening rate (LVAT) and the ratio of maximum wall thickness of the left ventricular apex (LVA) to the left ventrieular posterior wall thickness (LVA/LVPW) in end-diastole phase were calculated. The left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were quantitatively evaluated with cardiac functional analysis software. The results were compared with the measurement results from the normal control group (30 volunteers). The independent-samples t test was used for the statistics. At the same time, the coronary stenosis was measured. Results: Diffuse or partial thickening of the LV apical myocardium were found in the four-chamber view and two-chamber view of MSCT images, which leaded to the deformation of the left ventricle chamber. The LVEDV were (82.6± 11.4) and (108.5±10.6) ml in the AHCM group and the control group, respectively; the LVA were (20.6±3.4) and (9.9±1.5) mm; LVA/LVPW were 2.1±0.5 and 1.1±0.2; the LVAT were (25.6± 4.7)% and (81.5±8.5)%. There were significant differences in LYEDV, LVA, LVA/LVPW and LVAT between the two groups (t=8.32 and 15.29, P 0.05). Five patients had myocardium bridging and 4 patients had coronary stenosis. Conclusion: AHCM can be diagnosed accurately with MSCT, and the cardiac anatomy, function and coronary artery are also assessed simultaneously. (authors)

  3. Comparison of myocardial perfusion SPECT with 64-slice multi-slice computed tomography angiography in cardiac screening of asymptomatic diabetic patients

    Lim, Il Han; Lee, Won Woo; Chang, Hyuck Jae; Choi, Sang II; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Asymptomatic diabetic patients may suffer silent ischemia. However, the question that what is the optimal screening tool for detection of cardiac disease in asymptomatic diabetic patients has not been addressed. We prospectively recruited diabetic patients who had not complained chest pain, and obtained myocardial perfusion SPECT (MPS) and cardiac CT angiography (CTA). We compared perfusion status on MPS with findings on CTA. A total of 110 diabetic patients (Age range 41-84, mean age 61.6{+-}7.74; gender, M: F 66:44) without cardiac symptom underwent both MPS and CTA. The MPS protocol was one-day single isotope study, adenosine stress Tc-99m MIBI/rest Tc-99m MIBI. CTA was conducted using 64-slice multi-slice CT (Brillance64, Philips Medical Systems). Perfusion status on MPS was assessed by summed-stress score (SSS) using 20-segment model, and SSS of {>=}4 was considered abnormal. Coronary stenosis of more than 50% luminal narrowing in CTA was considered significant, and coronary artery calcium scoring (CACS) was graded as: < or =10, 11-100, 101-400, or >400. MPS found abnormal perfusion in 11.8% (13/110) and CTA significant coronary stenosis in 20.9% (23/110). Five patients showed both abnormal perfusion and significant coronary stenosis. CACS (n=103 patients) were measured as; < or =10 in 45.6%, 11-100 in 28.1%, 101-400 in 19.4%, and >400 in 6.8%. The patient proportion of abnormal MPS in each CACS group were; 10.6% with < or = 10, 17.2% with 11-100, 5% with 101-400, and 0% with >400. The patient proportion of significant coronary stenosis on CTA in each CACS group were; 2.13% with < or =10, 27.6% with 11-100, 35% with 101-400, and 57.1% with >400. In asymptomatic diabetic patients, coronary stenosis by CTA showed correlation with coronary artery calcium scoring, but myocardial perfusion status by MPS did not. Long-term evaluation is essential for determination of prognostic significance of MPS and cardiac CTA.

  4. Radiation exposure of ovarian cancer patients: contribution of CT examinations performed on different MDCT (16 and 64 slices) scanners and image quality evaluation: an observational study.

    Rizzo, Stefania; Origgi, Daniela; Brambilla, Sarah; De Maria, Federica; Foà, Riccardo; Raimondi, Sara; Colombo, Nicoletta; Bellomi, Massimo

    2015-05-01

    The objective of this study is to compare radiation doses given to ovarian cancer patients by different computed tomographies (CTs) and to evaluate association between doses and subjective and objective image quality.CT examinations included were performed either on a 16-slice CT, equipped with automatic z-axis tube current modulation, or on a 64-slice CT, equipped with z-axis, xy-axis modulation, and adaptive statistical iterative algorithm (ASIR). Evaluation of dose included the following dose descriptors: volumetric CT dose index (CTDIvol), dose length product (DLP), and effective dose (E). Objective image noise was evaluated in abdominal aorta and liver. Subjective image quality was evaluated by assessment of image noise, spatial resolution and diagnostic acceptability.Mean and median CTDIvol, DLP, and E; correlation between CTDIvol and DLP and patients' weight; comparison of objective noise for the 2 scanners; association between dose descriptors and subjective image quality.The 64-slice CT delivered to patients 24.5% lower dose (P descriptors (CTDIvol, DLP, E) and weight (P descriptors and image noise for the 64-slice CT, and between dose descriptors and spatial resolution for the 16-slice CT.Current dose reduction systems may reduce radiation dose without significantly affecting image quality and diagnostic acceptability of CT exams. PMID:25929914

  5. Preliminary study of X-ray dosage reduction using post-processing filter in 64-slice spiral CT cardiac examination

    Objective: To evaluate the adaptive post-processing filter (C2) on reducing X-ray dosage in 64-slice CT cardiac examinations. Methods: The study was divided into two steps: (1) On 30 consecutive patients (group A) prescribed for cardiac scans on 64-slice CT, the scan protocol was 120 kV, 640 mA, 0.35 s/r, 0.625 mm slice thickness, 0.22-0.24 pitch and large body bowtie. For each patients, cardiac images were reconstructed with and without C2 filter to create two image sets (C2 and NC2, respectively). The image quality was blindly evaluated between C2 and NC2. Image noises were also measured and their means and standard deviations calculated for the two sets. Statistical t-test analysis was performed on the quality scores and the noise between the two data sets. (2) On the 30 consecutive cardiac patients in another group (group B), the protocol was kept the same as in group A except for decreasing the tube current 450 mA based on the results from group A. Images were reconstructed using post-processing filter C2 to create 2C2 image set. Statistical t-test was performed between image sets of 2C2 and NC2 in step 1. (3) CTDIvol values from the 2C2 and NC2 (C2) groups were converted into effective dose (ED) and the ED values of the two groups were compared. Results: (1) The image quality scores for the C2 and NC2 sets were 3.71±0.31 and 3.72±0.29, respectively, with t-test of P>0.05, indicating no significant statistical difference (P>0.05). The noise of C2 and NC2 sets were 22±4, 27±5, respectively, indicating the difference was statistically significant (P2 filter had 18% noise reduction compared to those without C2 filter. (2) The image quality scores for the 2C2 and NC2 sets were 3.67± 0.34, 3.72±0.29, indicating no significant statistical difference (P>0.05). The noise of 2C2 and NC2 sets were 26±3, 27±5, indicating no significant statistical difference (P>0.05). (3) The average CTDIvol values were 60±5 mGy, 88±10 mGy for 2C2 and NC2 (C2) groups

  6. Quantitative evaluation of benign meningioma and hemangiopericytoma with peritumoral brain edema by 64-slice CT perfusion imaging

    REN Guang; CHEN Shuang; WANG Yin; ZHU Rui-jiang; GENG Dao-ying; FENG Xiao-yuan

    2010-01-01

    Background Hemangiopericytomas (HPCs) have a relentless tendency for local recurrence and metastases,differentiating between benign meningiomas and HPCs before surgery is important for both treatment planning and the prognosis appraisal.The purpose of this study was to evaluate the correlations between CT perfusion parameters and microvessel density (MVD) in extra-axial tumors and the possible role of CT perfusion imaging in preoperatively differentiating benign meningiomas and HPCs.Methods Seventeen patients with benign meningiomas and peritumoral edema, 12 patients with HPCs and peritumoral edema underwent 64-slice CT perfusion imaging pre-operation.Perfusion was calculated using the Patlak method.The quantitative parameters, include cerebral blood volume (CBV), permeability surface (PS) of parenchyma, peritumoral edema among benign meningiomas and HPCs were compared respectively.CBV and PS in parenchyma, peritumoral edema of benign meningiomas and HPCs were also compared to that of the contrallateral normal white matter respectively.The correlations between CBV, PS of tumoral parenchyma and MVD were examined.Results The value of CBV and PS in parenchyma of HPCs were significantly higher than that of benign meningiomas (P<0.05), while the values of CBV and PS in peritumoral edema of benign meningiomas and HPCs were not significantly different (P >0.05).MVD in parenchyma of HPCs were significantly higher than that of benign meningiomas (P<0.05).There were positive correlations between CBV and MVD (r=0.648, P<0.05), PS and MVD (r=0.541, P<0.05) respectively.Furthermore, the value of CBV and PS in parenchyma of benign meningiomas and HPCs were significantly higher than that of contrallateral normal white matter (P<0.05), the value of CBV in peritumoral edema of benign meningiomas and HPCs were significantly lower than that of contrallateral normal white matter (P<0.05), while the value of PS in peritumoral edema of benign meningiomas and HPCs were not

  7. Bicuspid aortic valves: Diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT

    Objectives: To assess the diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves. Materials and methods: The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly analyzed for (i) the appearance of the valve cusps, (ii) the largest aortic sinus area, (iii) the longest aortic cusp length, (iv) the thickest aortic valve cusp and (v) valve calcification. A second blinded reader independently analyzed the appearance of the valve cusps. Forty-two age- and sex-matched patients with known tricuspid aortic valves were used as controls. Retrospectively ECG-gated cardiac CT multiphase reconstructions of the aortic valve were used as the gold-standard. Results: Fourteen (21%) scans were scored as unevaluable (7 bicuspid, 7 tricuspid). Of the remainder, there were 13 evaluable bicuspid valves, ten of which showed an aortic valve line sign, while the remaining three showed a normal Mercedes-Benz appearance owing to fused valve cusps. The 35 evaluable tricuspid aortic valves all showed a normal Mercedes-Benz appearance (P = 0.001). Kappa analysis = 0.62 indicating good interobserver agreement for the aortic valve cusp appearance. Aortic sinus areas, aortic cusp lengths and aortic cusp thicknesses of ≥3.8 cm2, 3.2 cm and 1.6 mm respectively on standard axial chest CT best distinguished bicuspid from tricuspid aortic valves (P < 0.0001 for all). Of evaluable scans, the sensitivity, specificity, positive and negative predictive values of standard axial chest CT in diagnosing bicuspid aortic valves was 77% (CI 0.54–1.0), 100%, 100% and 70% respectively. Conclusion: The aortic valve is evaluable in approximately 80% of standard chest 64-slice CT scans. Bicuspid aortic valves may be diagnosed on evaluable scans with good diagnostic accuracy. An aortic valve line sign, enlarged aortic sinuses and elongated, thickened valve cusps are specific CT

  8. Quantitative parameters to compare image quality of non-invasive coronary angiography with 16-slice, 64-slice and dual-source computed tomography.

    Burgstahler, Christof; Reimann, Anja; Brodoefel, Harald; Daferner, Ulrike; Herberts, Tina; Tsiflikas, Ilias; Thomas, Christoph; Drosch, Tanja; Schroeder, Stephen; Heuschmid, Martin

    2009-03-01

    Multi-slice computed tomography (MSCT) is a non-invasive modality to visualize coronary arteries with an overall good image quality. Improved spatial and temporal resolution of 64-slice and dual-source computed tomography (DSCT) scanners are supposed to have a positive impact on diagnostic accuracy and image quality. However, quantitative parameters to compare image quality of 16-slice, 64-slice MSCT and DSCT are missing. A total of 256 CT examinations were evaluated (Siemens, Sensation 16: n = 90; Siemens Sensation 64: n = 91; Siemens Definition: n = 75). Mean Hounsfield units (HU) were measured in the cavum of the left ventricle (LV), the ascending aorta (Ao), the left ventricular myocardium (My) and the proximal part of the left main (LM), the left anterior descending artery (LAD), the right coronary artery (RCA) and the circumflex artery (CX). Moreover, the ratio of intraluminal attenuation (HU) to myocardial attenuation was assessed for all coronary arteries. Clinical data [body mass index (BMI), gender, heart rate] were accessible for all patients. Mean attenuation (CA) of the coronary arteries was significantly higher for DSCT in comparison to 64- and 16-slice MSCT within the RCA [347 +/- 13 vs. 254 +/- 14 (64-MSCT) vs. 233 +/- 11 (16-MSCT) HU], LM (362 +/- 11/275 +/- 12/262 +/- 9), LAD (332 +/- 17/248 +/- 19/219 +/- 14) and LCX (310 +/- 12/210 +/- 13/221 +/- 10, all p < 0.05), whereas there was no significant difference between DSCT and 64-MSCT for the LV, the Ao and My. Heart rate had a significant impact on CA ratio in 16-slice and 64-slice CT only (p < 0.05). BMI had no impact on the CA ratio in DSCT only (p < 0.001). Improved spatial and temporal resolution of dual-source CT is associated with better opacification of the coronary arteries and a better contrast with the myocardium, which is independent of heart rate. In comparison to MSCT, opacification of the coronary arteries at DSCT is not affected by BMI. The main advantage of DSCT lies with the

  9. Quantitative parameters to compare image quality of non-invasive coronary angiography with 16-slice, 64-slice and dual-source computed tomography

    Burgstahler, Christof [University Hospital Tuebingen, Department of Cardiology, Tuebingen (Germany)]|[Eberhard-Karls-University Tuebingen, Department of Internal Medicine III-Cardiology, Tuebingen (Germany); Reimann, Anja; Brodoefel, Harald; Tsiflikas, Ilias; Thomas, Christoph; Heuschmid, Martin [University Hospital Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany); Daferner, Ulrike; Drosch, Tanja; Schroeder, Stephen [University Hospital Tuebingen, Department of Cardiology, Tuebingen (Germany); Herberts, Tina [University of Tuebingen, Department of Medical Biometry, Tuebingen (Germany)

    2009-03-15

    Multi-slice computed tomography (MSCT) is a non-invasive modality to visualize coronary arteries with an overall good image quality. Improved spatial and temporal resolution of 64-slice and dual-source computed tomography (DSCT) scanners are supposed to have a positive impact on diagnostic accuracy and image quality. However, quantitative parameters to compare image quality of 16-slice, 64-slice MSCT and DSCT are missing. A total of 256 CT examinations were evaluated (Siemens, Sensation 16: n=90; Siemens Sensation 64: n=91; Siemens Definition: n=75). Mean Hounsfield units (HU) were measured in the cavum of the left ventricle (LV), the ascending aorta (Ao), the left ventricular myocardium (My) and the proximal part of the left main (LM), the left anterior descending artery (LAD), the right coronary artery (RCA) and the circumflex artery (CX). Moreover, the ratio of intraluminal attenuation (HU) to myocardial attenuation was assessed for all coronary arteries. Clinical data [body mass index (BMI), gender, heart rate] were accessible for all patients. Mean attenuation (CA) of the coronary arteries was significantly higher for DSCT in comparison to 64- and 16-slice MSCT within the RCA [347{+-}13 vs. 254{+-}14 (64-MSCT) vs. 233{+-}11 (16-MSCT) HU], LM (362{+-}11/275 {+-} 12/262{+-}9), LAD (332{+-}17/248{+-}19/219{+-}14) and LCX (310{+-}12/210{+-}13/221{+-}10, all p<0.05), whereas there was no significant difference between DSCT and 64-MSCT for the LV, the Ao and My. Heart rate had a significant impact on CA ratio in 16-slice and 64-slice CT only (p<0.05). BMI had no impact on the CA ratio in DSCT only (p<0.001). Improved spatial and temporal resolution of dual-source CT is associated with better opacification of the coronary arteries and a better contrast with the myocardium, which is independent of heart rate. In comparison to MSCT, opacification of the coronary arteries at DSCT is not affected by BMI. The main advantage of DSCT lies with the heart rate independency

  10. Quantitative parameters to compare image quality of non-invasive coronary angiography with 16-slice, 64-slice and dual-source computed tomography

    Multi-slice computed tomography (MSCT) is a non-invasive modality to visualize coronary arteries with an overall good image quality. Improved spatial and temporal resolution of 64-slice and dual-source computed tomography (DSCT) scanners are supposed to have a positive impact on diagnostic accuracy and image quality. However, quantitative parameters to compare image quality of 16-slice, 64-slice MSCT and DSCT are missing. A total of 256 CT examinations were evaluated (Siemens, Sensation 16: n=90; Siemens Sensation 64: n=91; Siemens Definition: n=75). Mean Hounsfield units (HU) were measured in the cavum of the left ventricle (LV), the ascending aorta (Ao), the left ventricular myocardium (My) and the proximal part of the left main (LM), the left anterior descending artery (LAD), the right coronary artery (RCA) and the circumflex artery (CX). Moreover, the ratio of intraluminal attenuation (HU) to myocardial attenuation was assessed for all coronary arteries. Clinical data [body mass index (BMI), gender, heart rate] were accessible for all patients. Mean attenuation (CA) of the coronary arteries was significantly higher for DSCT in comparison to 64- and 16-slice MSCT within the RCA [347±13 vs. 254±14 (64-MSCT) vs. 233±11 (16-MSCT) HU], LM (362±11/275 ± 12/262±9), LAD (332±17/248±19/219±14) and LCX (310±12/210±13/221±10, all p<0.05), whereas there was no significant difference between DSCT and 64-MSCT for the LV, the Ao and My. Heart rate had a significant impact on CA ratio in 16-slice and 64-slice CT only (p<0.05). BMI had no impact on the CA ratio in DSCT only (p<0.001). Improved spatial and temporal resolution of dual-source CT is associated with better opacification of the coronary arteries and a better contrast with the myocardium, which is independent of heart rate. In comparison to MSCT, opacification of the coronary arteries at DSCT is not affected by BMI. The main advantage of DSCT lies with the heart rate independency, which might have a

  11. Left coronary to right ventricle fistula in a child: management strategy based on cardiac-gated 64-slice CT

    Congenital coronary fistulae are a diagnostic challenge. A prerequisite for best management is accurate anatomical evaluation, traditionally provided by invasive catheter angiography. Multislice CT (MSCT) is an emerging noninvasive technique for coronary artery evaluation. We present a 3-year-old boy and highlight the clinical usefulness of new-generation MSCT to study coronary artery fistulae in children. Multiplanar and 3-D reconstruction offer invaluable information to plan the best therapeutic strategy in this setting. We provide evidence for the expanding clinical role of MSCT for coronary artery imaging in children. (orig.)

  12. Bicuspid aortic valves: Diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT

    Murphy, David J., E-mail: david.murphy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); McEvoy, Sinead H., E-mail: s.mcevoy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); Iyengar, Sri, E-mail: sri.iyengar@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Feuchtner, Gudrun, E-mail: Gudrun.Feuchtner@i-med.ac.at [Department of Radiology, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck (Austria); Cury, Ricardo C., E-mail: r.cury@baptisthealth.net [Department of Radiology, Baptist Cardiac and Vascular Institute, 8900 North Kendall Drive, Miami, FL 33176 (United States); Roobottom, Carl, E-mail: carl.roobottom@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Plymouth University Peninsula Schools of Medicine and Dentistry (United Kingdom); Baumueller, Stephan, E-mail: Hatem.Alkadhi@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Alkadhi, Hatem, E-mail: stephan.baumueller@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Dodd, Jonathan D., E-mail: jonniedodd@gmail.com [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland)

    2014-08-15

    Objectives: To assess the diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves. Materials and methods: The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly analyzed for (i) the appearance of the valve cusps, (ii) the largest aortic sinus area, (iii) the longest aortic cusp length, (iv) the thickest aortic valve cusp and (v) valve calcification. A second blinded reader independently analyzed the appearance of the valve cusps. Forty-two age- and sex-matched patients with known tricuspid aortic valves were used as controls. Retrospectively ECG-gated cardiac CT multiphase reconstructions of the aortic valve were used as the gold-standard. Results: Fourteen (21%) scans were scored as unevaluable (7 bicuspid, 7 tricuspid). Of the remainder, there were 13 evaluable bicuspid valves, ten of which showed an aortic valve line sign, while the remaining three showed a normal Mercedes-Benz appearance owing to fused valve cusps. The 35 evaluable tricuspid aortic valves all showed a normal Mercedes-Benz appearance (P = 0.001). Kappa analysis = 0.62 indicating good interobserver agreement for the aortic valve cusp appearance. Aortic sinus areas, aortic cusp lengths and aortic cusp thicknesses of ≥3.8 cm{sup 2}, 3.2 cm and 1.6 mm respectively on standard axial chest CT best distinguished bicuspid from tricuspid aortic valves (P < 0.0001 for all). Of evaluable scans, the sensitivity, specificity, positive and negative predictive values of standard axial chest CT in diagnosing bicuspid aortic valves was 77% (CI 0.54–1.0), 100%, 100% and 70% respectively. Conclusion: The aortic valve is evaluable in approximately 80% of standard chest 64-slice CT scans. Bicuspid aortic valves may be diagnosed on evaluable scans with good diagnostic accuracy. An aortic valve line sign, enlarged aortic sinuses and elongated, thickened valve cusps are specific CT

  13. Influence of heart rate on image quality of 64-slice spiral computed coronary angiography and optimization on reconstruction of phase window

    Objective: To evaluate the influence of heart rate on the image quality of 64-slice spiral computed coronary angiography (MSCTCA) and optimize the image reconstruction window. Methods: According to the heart rate, 86 patients were classified into 5 groups: group A, the heart rate ≤60 beat per minute(BMP); group B,61-70BMP, group C,71-80BMP, and group D>80BMP. The image quality of MSCTCA was scored 5 grades from 1-5 according to heart motion artifact. The influences of heart rate and reconstruction phase on the image quality of MSCTCA were evaluated. Results: Average heart rate was 64.4 ±10.1BMP. Diagnostic image quality (score>3) was attained in 277 of 344 segments at the best reconstruction interval. There was a significant corxelation between average heart rate and image quality, but there was no difference between relative delay (%) reconstruction and absolute delay (ms) reconstruction on the image quality. Conclusion: Reducing average heart rate is beneficial for improving the image quality. (authors)

  14. Coronary imaging quality in routine ECG-gated multidetector CT examinations of the entire thorax: preliminary experience with a 64-slice CT system in 133 patients

    Delhaye, Damien; Remy-Jardin, Martine; Salem, Randa; Teisseire, Antoine; Khalil, Chadi; Remy, Jacques [Hospital Calmette, University Center of Lille, Department of Thoracic Imaging, Lille Cedex (France); Delannoy-Deken, Valerie; Duhamel, Alain [University of Lille, Department of Medical Statistics, Lille Cedex (France)

    2007-04-15

    To evaluate image quality in the assessment of the coronary arteries during routine ECG-gated multidetector CT (MDCT) of the chest. One hundred and thirty three patients in sinus rhythm underwent an ECG-gated CT angiographic examination of the entire chest without {beta}-blockers with a 64-slice CT system. In 127 patients (95%), it was possible to assess the coronary arteries partially or totally; coronary artery imaging failed in six patients (5%), leading to a detailed description of the coronary arteries in 127 patients. Considering ten coronary artery segments per patient, 75% of coronary segments were assessable (948/1270 segments). When the distal segments were excluded from the analysis (i.e., seven coronary segments evaluated per patient), the percentage of assessable segments was 86% (768/889 proximal and mid coronary segments) and reached 93% (474/508) when assessing proximal segments exclusively. The mean number of assessable segments was significantly higher in patients with a heart rate {<=}80 bpm (n=95) than in patients with a heart rate >80 bpm (n=38) (p<0.002). Proximal and mid-coronary segments can be adequately assessed during a whole-chest ECG-gated CT angiographic examination without administration of {beta}-blockers in patients with a heart rate below 80 bpm. (orig.)

  15. Volumetric evaluation of dual-energy perfusion CT by the presence of intrapulmonary clots using a 64-slice dual-source CT

    Okada, Munemasa; Nakashima, Yoshiteru; Kunihiro, Yoshie; Nakao, Sei; Matsunaga, Naofumi [Dept. of Radiology, Yamaguchi Univ. Graduate School of Medicine, Yamaguchi (Japan)], e-mail: radokada@yamaguchi-u.ac.jp; Morikage, Noriyasu [Medical Bioregulation Dept. of Organ Regulatory Surgery, Yamaguchi Univ. Graduate School of Medicine, Yamaguchi (Japan); Sano, Yuichi [Dept. of Radiology, Yamaguchi Univ. Hospital, Yamaguchi (Japan); Suga, Kazuyoshi [Dept. of Radiology, St Hills Hospital, Yamaguchi (Japan)

    2013-07-15

    Background: Dual-energy perfusion CT (DE{sub p}CT) directly represents the iodine distribution in lung parenchyma and low perfusion areas caused by intrapulmonary clots (IPCs) are visualized as low attenuation areas. Purpose: To evaluate if volumetric evaluation of DE{sub p}CT can be used as a predictor of right heart strain by the presence of IPCs. Material and Methods: One hundred and ninety-six patients suspected of having acute pulmonary embolism (PE) underwent DE{sub p}CT using a 64-slice dual-source CT. DE{sub p}CT images were three-dimensionally reconstructed with four threshold ranges: 1-120 HU (V{sub 120}), 1-15 HU (V{sub 15}), 1-10 HU (V{sub 10}), and 1-5 HU (V{sub 5}). Each relative ratio per V{sub 120} was expressed as the %V{sub 15}, %V{sub 10}, and %V{sub 5}. Volumetric data-sets were compared with D-dimer, pulmonary arterial (PA) pressure, right ventricular (RV) diameter, RV/left ventricular (RV/LV) diameter ratio, PA diameter, and PA/aorta (PA/Ao) diameter ratio. The areas under the ROC curves (AUCs) were examined for their relationship to the presence of IPCs. This study was approved by the local ethics committee. Results: PA pressure and D-dimer were significantly higher in the patients who had IPCs. In the patients with IPCs, V{sub 15}, V{sub 10}, V{sub 5}, %V{sub 15}, %V{sub 10}, and %V{sub 5} were also significantly higher than those without IPC (P = 0.001). %V{sub 5} had a better correlation with D-dimer (r = 0.30, P < 0.001) and RV/LV diameter ratio (r = 0.27, P < 0.001), and showed a higher AUC (0.73) than the other CT measurements. Conclusion: The volumetric evaluation by DE{sub p}CT had a correlation with D-dimer and RV/LV diameter ratio, and the relative ratio of volumetric CT measurements with a lower attenuation threshold might be recommended for the analysis of acute PE.

  16. CT coronary angiography vs. invasive coronary angiography in CHD

    Anja Hagen

    2012-04-01

    Full Text Available Scientific background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive computed tomography (CT coronary angiography are used in the diagnosis of coronary heart disease (CHD. Research questions: The present report aims to evaluate the clinical efficacy, diagnostic accuracy, prognostic value cost-effectiveness as well as the ethical, social and legal implications of CT coronary angiography versus invasive coronary angiography in the diagnosis of CHD. Methods: A systematic literature search was conducted in electronic data bases (MEDLINE, EMBASE etc. in October 2010 and was completed with a manual search. The literature search was restricted to articles published from 2006 in German or English. Two independent reviewers were involved in the selection of the relevant publications. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography as the reference standard and on diagnostic studies with intracoronary pressure measurement as the reference standard. Study results were combined in a meta-analysis with 95 % confidence intervals (CI. Additionally, data on radiation doses from current non-systematic reviews were taken into account. A health economic evaluation was performed by modelling from the social perspective with clinical assumptions derived from the meta-analysis and economic assumptions derived from contemporary German sources. Data on special indications (bypass or in-stent-restenosis were not included in the evaluation. Only data obtained using CT scanners with at least 64 slices were considered. Results: No studies were found regarding the clinical efficacy or prognostic value of CT coronary angiography versus conventional invasive coronary angiography in the diagnosis of CHD. Overall, 15 systematic reviews with data from 44 diagnostic studies using invasive coronary angiography as the reference standard (identification of obstructive

  17. 64排螺旋CT泌尿系三维成像患者的护理%Nursing of patients undergoing 64-slice CT urography

    高丽; 张金玲; 赵云霞; 申秀芬

    2009-01-01

    目的 探讨护理工作在64排螺旋CT泌尿系三维成像(MSCTU)中的价值.方法 240例患者应用64排螺旋CT进行泌尿系三维成像检查,检查前询问病史及碘过敏史,关注患者的心理状态,做好碘预试验;检查中认真观察患者,对可能出现的任何不良反应进行预判,并制订相应的措施;检查后对症处理出现的各种情况,并做好护理指导.结果 239例患者顺利完成检查,1例在扫描过程中出现药物外渗,扫描失败,经过重新扫描,获得满意图像.结论 利用64排螺旋CT行泌尿系三维成像检查,作为一种无创伤、费用相对较低、安全性高的检查技术,护理操作应贯穿检查的每一步.有效的护理措施直接影响检查结果的准确性,熟练的护理操作及耐心细致的心理护理是MSCTU检查中的重要环节.%Objective To discuss the value of nursing work in 64-slice CT urography. Methods 240 patients participated in the 64-slice CT urography, inquiring medical history and iodine allergic history, paying attention to their psychological state and finishing iodine preliminary test before examination, ob-serving patients carefully, pre-judging any possible adverse effect and formulating corresponding measures during the examination, giving expectant treatment according to the various condition and nursing instruc-tion. Results 239 patients passed through the examination smoothly, agents exosmosis happened in one case and led to failure, but satisfactory image was obtained after rescanning. Conclusions Nursing oper-ation penetrates every step of 64-slice CT urography, which is a non-traumatic, low-expense and high-safety examination. Effect nursing directly influences the accuracy of the results, proficient nursing opera-tion and patient psychological nursing is the important part of it.

  18. Non-invasive detection of aortic and coronary atherosclerosis in homozygous familial hypercholesterolemia by 64 slice multi-detector row computed tomography angiography

    Homozygous familial hypercholesterolemia (HoFH) is a rare disorder characterized by the early onset of atherosclerosis, often at the ostia of coronary arteries. In this study we document for the first time that aortic and coronary atherosclerosis can be detected using 64 slice multiple detector row ...

  19. Non-invasive Detection of Aortic and Coronary Atherosclerosis in Homozygous Familial Hypercholesterolemia by 64 Slice Multi-detector Row Computed Tomography Angiography

    Homozygous familial hypercholesterolemia (HoFH) is a rare disorder characterized by the early onset of atherosclerosis, often at the ostia of coronary arteries. In this study we document for the first time that aortic and coronary atherosclerosis can be detected using 64 slice multiple detector-row ...

  20. Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

    Yi, Ji Sook; Cha, Jang Gyu [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Han, Jong Kyu [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kim, Hyun Joo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2015-08-15

    To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

  1. Effect of Heart Rate and Body Mass Index on the Interscan and Interobserver Variability of Coronary Artery Calcium Scoring at Prospective ECG-Triggered 64-Slice CT

    To test the effects of heart rate, body mass index (BMI) and noise level on interscan and interobserver variability of coronary artery calcium (CAC) scoring on a prospective electrocardiogram (ECG)-triggered 64-slice CT. One hundred and ten patients (76 patients with CAC) were scanned twice on prospective ECG-triggered scans. The scan parameters included 120 kV, 82 mAs, a 2.5 mm thickness, and an acquisition center at 45% of the RR interval. The interscan and interobserver variability on the CAC scores (Agatston, volume, and mass) was calculated. The factors affecting the variability were determined by plotting it against heart rate, BMI, and noise level (defined as the standard deviation: SD). The estimated effective dose was 1.5 ± 0.2 mSv. The mean heart rate was 63 ± 12 bpm (range, 44-101 bpm). The patient BMIs were 24.5 ± 4.5 kg/m2 (range, 15.5-42.3 kg/m2). The mean and median interscan variabilities were 11% and 6%, respectively by volume, and 11% and 6%, respectively, by mass. Moreover, the mean and median of the algorithms were lower than the Agatston algorithm (16% and 9%, respectively). The mean and median interobserver variability was 10% and 4%, respectively (average of algorithms). The mean noise levels were 15 ± 4 Hounsfield unit (HU) (range, 8-25 HU). The interscan and interobserver variability was not correlated with heart rate, BMI, or noise level. The interscan and interobserver variability of CAC on a prospective ECG-triggered 64-slice CT with high image quality and 45% of RR acquisition is not significantly affected by heart rate, BMI, or noise level. The volume or mass algorithms show reduced interscan variability compared to the Agatston scoring (p < 0.05).

  2. Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

    To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI

  3. Non-invasive assessment of congenital pulmonary vein stenosis in children using cardiac-non-gated CT with 64-slice technology

    Background: Management of congenital pulmonary vein stenosis is a diagnostic challenge. Echocardiography may be insufficient and thus cardiac catheterization remains the reference standard in this setting. The aim of the study was to investigate the accuracy of cardiac-non-gated CT using 64-slice technology in detecting congenital pulmonary vein stenosis in children. Materials and methods: CT examinations were consecutively performed from May 2005 to December 2006 in 13 children aged 1.5-12 months (median 5 months) for suspected congenital pulmonary vein stenosis. Cardiac-non-gated CT acquisitions were performed after the peripheral injection of contrast agent. Pulmonary veins were evaluated for their pattern of connectivity from the lung to the left atrium and for the presence of stenosis. CT findings of pulmonary vein stenosis were compared with combined findings available from echocardiography, catheterization and surgery. Results: Pulmonary veins from the right lung (n = 29) and left lung (n = 26) were evaluated as separate structures (N = 55). Of the 55 structures, 32 had surgical and/or catheterization data and 45 had echocardiography for comparison. CT visualized 100% (55/55) of the investigated structures, while echocardiography visualized 82% (45/55). In the 13 subjects CT identified 10 stenotic pulmonary veins. CT confirmed the echocardiography suspicion of pulmonary vein stenosis in 100% (7/7) and established a new diagnosis in 3 other patients. CT agreed with surgery/catheterization in 100% (10/10) of the available comparisons. Conclusion: Cardiac-non-gated CT assessed the pulmonary veins more completely than echocardiography and should be considered as a viable alternative for invasive pulmonary venography for detecting pulmonary vein stenosis in children.

  4. Evaluation of organ doses and specific k effective dose of 64-slice CT thorax examination using an adult anthropomorphic phantom

    Hashim, S.; Karim, M. K. A.; Bakar, K. A.; Sabarudin, A.; Chin, A. W.; Saripan, M. I.; Bradley, D. A.

    2016-09-01

    The magnitude of radiation dose in computed tomography (CT) depends on the scan acquisition parameters, investigated herein using an anthropomorphic phantom (RANDO®) and thermoluminescence dosimeters (TLD). Specific interest was in the organ doses resulting from CT thorax examination, the specific k coefficient for effective dose estimation for particular protocols also being determined. For measurement of doses representing five main organs (thyroid, lung, liver, esophagus and skin), TLD-100 (LiF:Mg, Ti) were inserted into selected holes in a phantom slab. Five CT thorax protocols were investigated, one routine (R1) and four that were modified protocols (R2 to R5). Organ doses were ranked from greatest to least, found to lie in the order: thyroid>skin>lung>liver>breast. The greatest dose, for thyroid at 25 mGy, was that in use of R1 while the lowest, at 8.8 mGy, was in breast tissue using R3. Effective dose (E) was estimated using three standard methods: the International Commission on Radiological Protection (ICRP)-103 recommendation (E103), the computational phantom CT-EXPO (E(CTEXPO)) method, and the dose-length product (DLP) based approach. E103 k factors were constant for all protocols, ~8% less than that of the universal k factor. Due to inconsistency in tube potential and pitch factor the k factors from CTEXPO were found to vary between 0.015 and 0.010 for protocols R3 and R5. With considerable variation between scan acquisition parameters and organ doses, optimization of practice is necessary in order to reduce patient organ dose.

  5. Comparison of 64-slice multi-detector computed tomography coronary angiography between asymptomatic, type 2 diabetes mellitus and impaired glucose tolerance patients

    Cardiovascular disease is the most frequent cause of death and disability for diabetic patients, and patients with diabetes are more likely to have silent ischemia. Multi-detector computed tomography (MDCT) allows non-invasive assessment of coronary artery stenosis and plaque properties. In this study, we investigated whether 64-slice MDCT can non-invasively identify significant coronary artery stenosis in asymptomatic, type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT) patients. The study population consisted of 154 consecutive asymptomatic patients [IGT (n=93), T2DM (n=61)]. All patients underwent contrast-enhanced 64-slice MDCT. The number of diseased coronary segments was classified as showing obstructive (≥50% luminal narrowing) disease or not. Significant coronary stenosis was detected in 43 (27.9%) of 154 enrolled patients. Patients with T2DM showed significantly more coronary stenosis than patients with IGT (41% vs. 19.4%; p<0.01). Twenty-three patients [14.9%; IGT (n=9), T2DM (n=14)] underwent percutaneous coronary intervention (PCI) for severe stenosis. Patients with T2DM showed significantly more calcified plaque than IGT (47.5% vs. 29%; p<0.05), but not significantly more soft plaque (19.7% vs. 15.1%; ns), or significantly different remodeling index (1.05±0.18 vs. 1.04±0.21; ns), respectively. 64-Slice MDCT can non-invasively identify significant coronary artery stenosis in asymptomatic, T2DM and IGT patients. (author)

  6. Impact of 64-slice coronary CT on the management of patients presenting with acute chest pain: results of a prospective two-centre study

    Our two-centre prospective study evaluates the usefulness of 64-slice coronary computed tomography (CCT) to rule out significant coronary artery stenosis in patients admitted in emergency departments (ED) for acute coronary syndromes (ACS) with low-to-intermediate risk score. Patients (175) admitted for acute chest pain (ACP), unmodified electrocardiogram and first troponin measurement within normal ranges were included. A second troponin measurement and a 64-slice CCT within 24 h were performed. Major adverse cardiac events (MACE) were recorded during follow-up (6 months ± 2). 64-slice CCT was either normal or showed non-significant coronary stenosis in the majority of patients (78%). 64-slice CCT depicted significant stenosis (>50% diameter) in 22% of patient whereas initial clinical and biological evaluation was reassuring. For negative CCTs, elevated troponin at second measurement did not modify the strategy or treatment of patients. No MACEs were noted during follow up. In 12% of patients CCT identified unsuspected non-coronary abnormalities. Our study confirms 64-slice CCT utility to rule out significant coronary artery stenosis in 8/10 patients admitted in ED with ACP or ACS with low-to-intermediate risk score. Early discharge with a negative 64-slice CCT is associated with very low risk of cardiac events at 6 months. (orig.)

  7. The optimization of low-dose scanning protocols of 64-slice spiral CT in the adult chest: a multicenter study

    Objective: To compare the image quality of chest low dose CT (LDCT) using automatic exposure control (AEC) and constant current. control (CCC) and explore a more reasonable scanning protocol. Methods: Two hundred and eighty participants were examined with 64 CT scanner at 7 centers in China. All were divided into 4 groups. Two groups underwent LDCT using AEC with standard deviation set at 25 (Al) and 30 (A2) respectively and the tube current ranged from 10 mA to 80 mA. The other two groups underwent LDCT using CCC with tube current set at 40 mA (Cl) and 50 mA (C2) respectively. The axial and MPR images were evaluated by two radiologists who were blinded to the scanning protocols. The radiation dose, noise and the image quality of the 4 groups were compared and analyzed statistically. Differences of radiation dose and noise among groups were determined with variance analysis and t test, image quality with Mann- Whitney test and the consistency of diagnosis with Kappa test. Results: There was a significant lower DLP in AEC group than in CCC group [(82.62±40.31) vs (110.81±18.21) mGy · cm (F=56.88, P 0.05]. The noisy of AEC group was higher than that of CCC group both on lung window (41.50±9.58 vs 40.86±7.03) and mediastinum window (41.19±7.83 vs 40.92±9.89), but there was no significant difference (Flung=0.835, P=0.476, Fwediastinum=1.910, P=0.128). The quality score of axial image in AEC group was higher than that in CCC group (superior margin of the brachiocephalic vein level: 4.49± 0.56 vs 4.38±0.64, superior margin of the aortic arch: 4.86±0.23 vs 4.81±0.32, the right superior lobar bronchus Level: 4.87±0.27 vs 4.84±0.22, the right middle lobar bronchus Level: 4.90±0.25 vs 4.88±0.21) except on the right inferior pulmonary vein level (4.92±0.25 vs 4.93±0.17) and superior margin of the left diaphragmatic dome level (4.91±0.27 vs 4.93±0.22) on lung window, but no significant differences (F=0.076-1.748, P>0.05) were observed. A significant higher

  8. Biological behavior and disease pattern of carcinoma gallbladder shown on 64-slice CT scanner: A hospital-based retrospective observational study and our experience

    AND Dwivedi

    2012-01-01

    Full Text Available Purpose: The aim of this diagnostic observational study was to assess the spread and biological behavior of gallbladder cancer using 64-slice computerized tomography (CT scanner in this particular geographic belt (eastern Uttar Pradesh, western Bihar, and northern Madhya Pradesh provinces of North India. Indians are ethnically and culturally different from their Western counterparts among whom the incidence of this disease is comparatively low. Subjects and Methods: After systemic examination, all patients (87 were subjected to ultrasonographic examination. All cases were histopathologically proven. Confirmed cases were subjected to volumetric CT examination of abdomen and pelvis, plain, post contrast and delayed phase. Results: Majority of the cases were adenocarcinoma. There was female preponderance with majority belonging to fifth and sixth decades. Commonest presentation was diffuse, irregular, enhancing wall thickening in 49.4%. Majority had invasion of liver parenchyma (74.7%. Cholelithiasis was seen in 48.3% cases. Invasion of biliary radicals was high (13.8-18.4%. Eleven cases had invasion of portal vein and tumor thrombus, with hepatic artery invasion in one case. In two cases, both hepatic artery and portal vein invasion was seen. Portal and peripancreatic nodal metastasis was seen in 58.5%. Distant metastasis was reported. Conclusion: Few studies involving the Indian population have attempted to use multi-row detector CT to define the biological behavior of carcinoma gallbladder. The opinion whether the pathology is operable or non-operable can reasonably be given. This large-scale, single-center study gives insight about the epidemiology and biological behavior of carcinoma gallbladder.

  9. Radiation Dose to the Thyroid and Gonads in Patients Undergoing Cardiac CT Angiography

    Behroozi, Hamid; Davoodi, Mohammad; Aghasi, Shahriar

    2015-01-01

    Background: The present data show a global increase in the rate of cardiovascular disease. Cardiac CT angiography has developed as a fast and non-invasive cardiac imaging modality following the introduction of multi-slice computed tomogaraphy. Objectives: The aim of this study was to measure the radiation dose to the thyroid and pelvis regions in patients undergoing cardiac CT angiography using the Care Dose 4D method of 64-slice scanner. Patients and Methods: Eighty-one patients (41 males an...

  10. Evaluation of coronary calcifications with 64-slice CT - variability of the scores and the influence of the reconstruction interval; Bestimmung des koronaren Kalzium-Scores mittels 64-Zeilen-CT - Variabilitaet der Scores und Einfluss des Rekonstruktionszeitpunktes

    Weininger, M.; Ritter, C.O.; Beer, M.; Hahn, D.; Beissert, M. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Wuerzburg (Germany)

    2007-09-15

    Purpose: To evaluate the variability of coronary calcium scores depending on the image reconstruction interval using a 64-slice CT scanner. Materials and Methods: 30 patients (18 male, 12 female; mean age 57 {+-} 9 yrs; mean heart rate 66 {+-} 10 bpm) underwent coronary calcium scoring using a 64-slice CT scanner (Somatom Sensation 64, Siemens Medical Solutions, Erlangen) and a standardized scanning protocol. Oral {beta}-blockers were administered to 12 patients with a baseline heart rate > 70 bpm. Images were reconstructed in 10 % increments from 10 - 100 % of the RR interval. Two blinded experienced observers independently calculated Agatston (AS), calcium mass (MS) and volume scores (VS) for every reconstructed image series. The results were compared to similar studies for 16-slice CT scanners. Results: The mean values and mean coefficients of variation among all patients were as follows: AS, 397 {+-} 829, 109 % MS, 88 {+-} 225, 154 % VS, 335 {+-} 669, 100 %. Regarding the reconstruction intervals, the mean coefficients of variation were as follows: 107 % (AS), 97 % (VS), 116 % (MS). No specific image reconstruction interval with statistically significant lower variability for each score could be identified. High inter-observer agreement was achieved (K = 0.98). With statistical significance (p < 0.05) 10/30 patients (pts) were able to be allocated to more than one risk group (RG): 6 pts = 2 RG; 3 pts = 3 RG; 1 pts = 4 RG. The scores for 5/30 patients were zero for at least one reconstruction interval, but further reconstructions revealed calcifications. The number of patients assignable to different risk groups was significantly lower compared to published data using a 16-slice scanner (p < 0.05). Conclusion: Coronary calcium scores determined using a 64-slice scanner display a wide range of variability depending on the image reconstruction interval as already described for 16-slice CT scanners. However, compared to previous studies, our data indicate that this

  11. Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan

    The potential impact of dual-source ECG-triggered sequential CT scan on coronary artery visibility has not been evaluated in free-breathing young children. To compare coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT between dual-source ECG-triggered sequential (DSET) scan and single-source non-ECG-synchronized spiral (SSNE) scan. In 93 young children, 108 cardiac 64-slice CT examinations were performed during free-breathing. Visibility of coronary arteries and side branches was compared between SSNE and DSET scans. Heart rates and trigger delays for DSET scan were recorded. Effective dose of each scan technique was calculated. Visual grades were significantly higher (P < 0.001 or =0.011) on DSET scan than on SSNE scan except for the distal left anterior descending artery. Coronary arteries were traceable in 79.3% on DSET scan and 54.3% on SSNE scan in the overlapped scan range (P < 0.0001), and 97.1% and 71.9% for the origins and proximal segments (P < 0.0001). Visibility of side branches was improved on DSET scan by a factor of 2.0. Heart rates and trigger delays for DSET scan were 131 ± 24 beats per min and 199 ± 44 ms, respectively. Effective doses of DSET and SSNE scans were 0.36 ± 0.12 mSv and 0.99 ± 0.23 mSv, respectively. DSET scan improves visibility of coronary arteries on cardiac 64-slice CT in free-breathing young children with congenital heart disease, compared with SSNE scan. (orig.)

  12. Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan

    Goo, Hyun Woo; Yang, Dong Hyun [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

    2010-10-15

    The potential impact of dual-source ECG-triggered sequential CT scan on coronary artery visibility has not been evaluated in free-breathing young children. To compare coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT between dual-source ECG-triggered sequential (DSET) scan and single-source non-ECG-synchronized spiral (SSNE) scan. In 93 young children, 108 cardiac 64-slice CT examinations were performed during free-breathing. Visibility of coronary arteries and side branches was compared between SSNE and DSET scans. Heart rates and trigger delays for DSET scan were recorded. Effective dose of each scan technique was calculated. Visual grades were significantly higher (P < 0.001 or =0.011) on DSET scan than on SSNE scan except for the distal left anterior descending artery. Coronary arteries were traceable in 79.3% on DSET scan and 54.3% on SSNE scan in the overlapped scan range (P < 0.0001), and 97.1% and 71.9% for the origins and proximal segments (P < 0.0001). Visibility of side branches was improved on DSET scan by a factor of 2.0. Heart rates and trigger delays for DSET scan were 131 {+-} 24 beats per min and 199 {+-} 44 ms, respectively. Effective doses of DSET and SSNE scans were 0.36 {+-} 0.12 mSv and 0.99 {+-} 0.23 mSv, respectively. DSET scan improves visibility of coronary arteries on cardiac 64-slice CT in free-breathing young children with congenital heart disease, compared with SSNE scan. (orig.)

  13. Diagnostic Accuracy of 64-Slice Multislice Computed Tomography in Assessment of Coronary Artery Bypass Grafts

    A. Arjmand Shabestari

    2007-05-01

    Full Text Available Background and Objective: Nowadays 64-slice mul-tislice computed tomography (MSCT has gained a wide acceptance as a non-invasive diagnostic imaging modality in native coronary arteries. This study was performed to determine the diagnostic accuracy of 64-slice MSCT in assessment of coronary artery by-pass grafting (CABG patency. Materials and Methods: 73 patients underwent both coronary CT-angiography (CTA using 64-slice MSCT scanner and quantitative coronary angiography (QCA were studied. Arterial and venous CABG patency was graded as: a-normal, b-patent with non-significant (<50% diameter reduction stenosis, c-patent with significant (≥50% diameter reduction stenosis or d-totally occluded. The results of CTA and QCA were compared. Results: Totally, 236 CABG were assessed, including 49 arterial and 187 venous grafts. Sensitivity, specific-ity, positive predictive value (PPV and negative pre-dictive value (NPV in detecting normal patency of arterial grafts were 100%, 85%, 95% and 100%, re-spectively and those in finding normal patency of ve-nous grafts all were 100%. The above-mentioned fig-ures for non-significant stenosis were 67% (2 out of 3 patients, 100%, 100% and 98% in arterial and 95%, 100%, 100% and 99% in venous grafts, respectively. Regarding to the significant stenosis, the results were 67% (2 out of 3 patients, 100%, 100% and 98% in arterial and 100%, 99%, 94% and 100% in venous grafts, respectively. All of these numerals were meas-ured being 100% for total occlusion of both arterial and venous grafts. Conclusion: Diagnostic accuracy of 64-slice MSCT in detecting normal patency, non-significant stenosis, significant stenosis and total occlusion of arterial and particularly venous CABG is extremely high so that QCA may be eventually substituted by CTA in a near future.

  14. CT Angiography of the Coronary Arteries

    H.Ghanaati

    2005-08-01

    Full Text Available Introduction & Background: Cardiac imaging is currently one the most rapidly advancing fields in clinical cardiology. Continuing technical innovations are expanding the applicability and usefulness of non-invasive imaging modalities such as ultrasound, nuclear imaging, positron emis-sion tomography Magnetic Resonance Imaging and most recently computed tomography (CT. In 1998, the 4-slice spiral CT scanners were introduced with a rotation time of 500ms a collimated detector width varying from 0.5 to 1.25mm. In 2002, the 16-slice spiral CT scanners were first used for coronary imag-ing. The rotation time and some of these scanners is now less than 400ms, the slice thickness varies be-tween 0.5 and 0.75mm, and a complete cardiac scan can be performed in less than 20s. In 2004, 64-slice spiral CT released into the market. Imaging of the heart requires acquisition or image reconstruction that is synchronized to the motion of the heart. Nie-man et al, irrespectively of the image quality, evalu-ated all branches with a minimal luminal diameter of 2.0mm and sensitivity and specificity of 95% and 86% respectively in comparison to angiography.

  15. Diagnostic Significance of Lumbar Spine Bone Metastases by 64 Slice Spiral CT and Whole Body Bone Imaging%64层螺旋CT与全身骨显像对腰椎骨转移瘤的诊断意义

    宋世祥

    2014-01-01

    目的:探讨64层螺旋CT与99Tcm-MDP全身骨显像对腰椎骨转移瘤的诊断意义。方法回顾性分析临床确诊腰椎骨转移瘤且资料完整的住院诊治27例患者49处腰椎骨转移瘤,总结分析27例患者的64层螺旋CT与99Tcm-MDP全身骨显像检查结果。比较两种检查结果的灵敏度及特异性。结果经64层螺旋CT检查示,27例患者有41处腰椎锥体破坏;经99Tcm-MDP全身骨显像检查示,23例患者有31处腰椎椎体放射性异常浓集,27例患者发现椎体外多发放射性异常浓集。64层螺旋CT检查的灵敏度为83.6%,特异性为98.6%;99Tcm-MDP全身骨显像检查的灵敏度为63.2%,特异性为96.7%。经64层螺旋CT检查示,有17例明确诊断为腰椎转移瘤,10例可疑为腰椎转移瘤;经99Tcm-MDP全身骨显像检查示,有20例明确诊断为腰椎转移瘤,7例可疑为腰椎转移瘤。结论64层螺旋CT对腰椎骨转移瘤的诊断较99Tcm-MDP全身骨显像具有更高的灵敏度,但多数患者经99Tcm-MDP全身骨显像可获得较为明确的诊断。%Objective To investigate the diagnostic significance of lumbar spine bone metastases by 64 slice spiral CT and 99Tcm-MDP whole body bone imaging. Methods 27 cases of lumbar spine bone metastases with 49 places by clinical diagnosis and with complete hospitalization data were retrospectively analyzed, and the examination results of 27 cases with 64 slice spiral CT and 99Tcm-MDP whole body bone imaging were summarized and analyzed. The sensitivity and specificity of two kinds of examination results were compared. Results The examination result of 64 slice spiral CT showed that 41 vertebrae were damaged in 27 patients, the sensitivity was 83.6%, 17 cases of lumbar spine bone metastases were confirmed by 64 slice spiral CT, 10 patients were suspected. The examination result of 99Tcm-MDP whole body bone imaging showed that 31 vertebrae had radioactive anomaly concentration in 27 patients, the

  16. Conventional and CT angiography in children: dosimetry and dose comparisons

    Tremendous advances have been made in imaging in children with both congenital and acquired heart disease. These include technical advances in cardiac catheterization and conventional angiography, especially with advancements in interventional procedures, as well as noninvasive imaging with MR and CT angiography. With rapid advances in multidetector CT (MDCT) technology, most recently 64-detector array systems (64-slice MDCT), have come a number of advantages over MR. However, both conventional and CT angiography impart radiation dose to children. Although the presence of radiation exposure to children has long been recognized, it is apparent that our ability to assess this dose, particularly in light of the rapid advancements, has been limited. Traditional methods of dosimetry for both conventional and CT angiography are somewhat cumbersome or involve a potential for substantial uncertainty. Recent developments in dosimetry, including metal oxide semiconductor field effect transistors (MOSFET) and the availability of anthropomorphic, tissue-equivalent phantoms have provided new opportunities for dosimetric assessments. Recent work with this technology in state-of-the-art cardiac angiography suites as well as with MDCT have offered direct comparisons of doses in infants and children undergoing diagnostic cardiac evaluation. It is with these dose data that assessment of risks, and ultimately the assessment of risk-benefit, can be better achieved. (orig.)

  17. 64-slice Computed Tomography Assessment of Coronary Artery Stents: a Phantom Study

    Mahnken, A.H.; Muehlenbruch, G.; Seyfarth, T.; Flohr, T.; Stanzel, S.; Wildberger, J.E.; Guenther, R.W.; Kuettner, A. [Aachen Univ. of Technology (Germany). Dept. of Diagnostic Radiology

    2006-02-15

    Purpose: To compare the use of a new 64-slice computed tomography (CT) scanner with 16-slice CT in the visualization of coronary artery stent lumen. Material and Methods: Eight different coronary artery stents, each with a diameter of 3 mm, were placed in a static chest phantom. The phantom was positioned in the CT gantry at an angle of 0 deg and 45 deg towards the z-axis and examined with both a 64-slice and a 16-slice CT scanner. Effective slice thickness was 0.6 mm with 64-slice CT and 1 mm with 16-slice CT. A reconstruction increment of 0.3 mm was applied in both scanners. Image quality was assessed visually using a 5-point grading scale. Stent diameters were measured and compared using paired Wilcoxon tests. Results: Artificial lumen reduction was significantly less with 64-slice than with 16-slice CT. Average visible stent lumen was 53.4% using 64-slice CT and 47.5% with 16-slice MSCT. Most severe artifacts were seen in stents with radiopaque markers. Using 64-slice CT, image noise increased by approximately 30% due to thinner slice thickness. Conclusion: Improved spatial resolution of 64-slice CT resulted in superior assessment of coronary artery stent lumen compared to 16-slice CT. However, a relevant part of the stent lumen is still not assessable with multi-slice CT.

  18. 急性阑尾炎超声与64排螺旋 CT 检查对比分析%The comparative analysis between ultrasound and 64-slice spiral CT examination in acute appendicitis

    王振芳; 岳学旺; 毕言刚; 李飞; 张仕状

    2014-01-01

    目的:探讨超声与64排螺旋 CT 平扫检查在诊断急性阑尾炎中的应用价值。方法收集经手术、病理证实或经保守治疗好转确诊急性阑尾炎的患者65例,术前或治疗前均做了 B 超和 CT 检查,对急性阑尾炎病理改变的显示情况及诊断符合率进行对比分析。结果65例阑尾炎病变,在 CT 图像上正确诊断58例,诊断符合率为89.23%,超声图像正确诊断48例,诊断符合率为73.85%,2种检查方法诊断符合率具有统计学差异(χ2=5.11,P =0.024)。结论多排螺旋 CT 与超声相比在诊断急性阑尾炎方面有较高的诊断符合率。%Objective To investigate the application of ultrasound and 64-slice spiral CT in the diagnosis of acute appendicitis. Methods Sixty-five patients with pathologically or clinally confirmed acute appendicitis were underwent ultrasound and CT examina-tion before operation or conservative treatment.Compared with pathology,the accuracy of CT and B-ultrasound imaging were ana-lyzed.Results Fifty-eight cases were correctly diagnosed by CT and 48 cases were correctly diagnosed by ultrasound,the accuracy was 89.23% (58/65)and 73.85% (48/65),respectively.There was a statistically significant difference between two groups (χ2 =5.1 1,P =0.024).Conclusion The accuracy of multi-slice spiral CT is higher than ultrasound in the diagnosis of acute appendicitis.

  19. Comparison of findings of spontaneous splenorenal shunt in color Doppler sonography with multislice CT scan (64 slices) in liver transplant candidates

    Background: Liver transplantation is the only definite treatment for end stage liver disease and it has high costs for the medical system so decreasing its complication and increasing its effectiveness is crucial. One of the factors that affect liver transplantation is the presence of spontaneous splenorenal shunt. Its diagnosis is mainly overlooked in pre-liver transplant patients. Main modality for its diagnosis is multislice CT scan however this is more expensive than sonography. Also, it exposes the patients to ionizing radiation. Considering the advantages of color Doppler ultrasound, studies to determine the sensitivity and specificity for detection of spontaneous splenorenal shunt is essential. Materials and methods: In our study 70 cirrhotic patients who were referred by liver transplant surgeons for evaluation of abdomen by CT and sonograhy were assessed for presence of spontaneous splenorenal shunt, left adrenal varix and left renal vein diameter and velocity and sensitivity and specificity of both modalities were checked. Patients in whom left renal vein could not evaluated by sonography and patients with splenectomy and nutcracker syndrome were excluded. Results: In the point of 10 mm diameter of left renal vein in CT scan there was 78.6% sensitivity and 67.9% specificity for the presence of spontaneous splenorenal shunt. Left adrenal varix in CT had sensitivity of 71.4%, specificity of 100%, and positive predictive value of 100% and negative predictive value of 70% and varix below spleen in CT had sensitivity of 54.8%, specificity of 96.4%, and positive predictive value of 95.8% and negative predictive value of 58.7% for the presence of spontaneous splenorenal shunt. In the point of 8 mm diameter of left renal vein in sonography there was 66.7% sensitivity and 85.7% specificity for the presence of spontaneous splenorenal shunt. For the velocity of more than 35 cm/s of left renal vein in sonography there was 61.9% sensitivity and 82.1% specificity for

  20. Comparison of findings of spontaneous splenorenal shunt in color Doppler sonography with multislice CT scan (64 slices) in liver transplant candidates

    Bagheri, Mohammadhadi, E-mail: Bagherimh@gmail.com [Department of Radiology, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz (Iran, Islamic Republic of); Hajati, Azadeh, E-mail: azadeh.hajati@gmail.com [Department of Radiology, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz (Iran, Islamic Republic of); Hosseini, Mohammadkazem, E-mail: hosseiniaslm@sums.ac.ir [Department of Radiology, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz (Iran, Islamic Republic of); Ostad, Seyed Pouria, E-mail: Pouria.Ostad@gmail.com [Department of Radiology, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz (Iran, Islamic Republic of)

    2012-09-15

    Background: Liver transplantation is the only definite treatment for end stage liver disease and it has high costs for the medical system so decreasing its complication and increasing its effectiveness is crucial. One of the factors that affect liver transplantation is the presence of spontaneous splenorenal shunt. Its diagnosis is mainly overlooked in pre-liver transplant patients. Main modality for its diagnosis is multislice CT scan however this is more expensive than sonography. Also, it exposes the patients to ionizing radiation. Considering the advantages of color Doppler ultrasound, studies to determine the sensitivity and specificity for detection of spontaneous splenorenal shunt is essential. Materials and methods: In our study 70 cirrhotic patients who were referred by liver transplant surgeons for evaluation of abdomen by CT and sonograhy were assessed for presence of spontaneous splenorenal shunt, left adrenal varix and left renal vein diameter and velocity and sensitivity and specificity of both modalities were checked. Patients in whom left renal vein could not evaluated by sonography and patients with splenectomy and nutcracker syndrome were excluded. Results: In the point of 10 mm diameter of left renal vein in CT scan there was 78.6% sensitivity and 67.9% specificity for the presence of spontaneous splenorenal shunt. Left adrenal varix in CT had sensitivity of 71.4%, specificity of 100%, and positive predictive value of 100% and negative predictive value of 70% and varix below spleen in CT had sensitivity of 54.8%, specificity of 96.4%, and positive predictive value of 95.8% and negative predictive value of 58.7% for the presence of spontaneous splenorenal shunt. In the point of 8 mm diameter of left renal vein in sonography there was 66.7% sensitivity and 85.7% specificity for the presence of spontaneous splenorenal shunt. For the velocity of more than 35 cm/s of left renal vein in sonography there was 61.9% sensitivity and 82.1% specificity for

  1. Experimental assessment of the influence of beam hardening filters on image quality and patient dose in volumetric 64-slice X-ray CT scanners

    Ay, Mohammad Reza; Mehranian, Abolfazi; Maleki, Asghar; Ghadiri, Hossien; Ghafarian, Pardis; Zaidi, Habib

    2013-01-01

    Beam hardening filters have long been employed in X-ray Computed Tomography (CT) to preferentially absorb soft and low-energy X-rays having no or little contribution to image formation, thus allowing the reduction of patient dose and beam hardening artefacts. In this work, we studied the influence o

  2. 64层螺旋CT低剂量扫描在新生儿气胸诊断中的应用%Low dose scanning of 64 slice spiral CT in the diagnosis of pneumothorax in neonates

    武军; 李彦杰

    2015-01-01

    Objective Application of low dose of 64 row spiral CT scanning in the diagnosis of pneumothorax in neonatal pneumothorax, analysis CT charac-teristics, in order to improve the diagnostic level of understanding and CT on neonatal pneumothorax. Methods Twenty-three patients with clinically suspected of pneumothorax in neonates of low voltage, low current and increasing pitch were scanned by 64 slice spiral CT. And the image analysis. Results Patients with CT showed different types, such as lateral lung chest,medial mediastinum side pneumothorax, diaphrag-matic surface and near the front of pneumothorax. Conclusion Neonatal lung chest clinic and CT features, the timely detection of pneumothorax in neonates, for clinical diagnosis and timely treatment is meaningful.%目的:探讨64层螺旋CT低剂量扫描在新生儿气胸诊断中的应用,分析新生儿气胸的CT表现特点,以提高对新生儿气胸的认识及CT的诊断水平。方法用64层螺旋CT对23例临床可疑新生儿气胸进行低电压、低电流和增大螺距进行扫描,并对图像进行分析。结果患儿有不同类型的CT表现,如外侧肺气胸、内侧纵隔旁气胸、膈面附近及胸前部气胸等。结论新生儿肺气胸有一定的临床CT特征,对及时发现新生儿气胸,对临床诊断并及时处理有重要意义。

  3. The application value of 64-slice spiral CT in the diagnosis of occult rib fracture%64层螺旋CT在隐匿性肋骨骨折诊断中的应用价值

    迟宝权; 刘亚静; 康洁

    2011-01-01

    Objective To evaluate the diagnostic value of 64-slice spiral CT and post-reconstruction technique in the diagnosis of occult rib fracture. Methods 42 patients with suspected chest trauma and occult rib fracture were examined by 64-slice spiral CT scan. All the original images were transferred to workstation to be post-processed to obtain volume rendering ( VR ) , maximum intensity projection ( MIP), multiplanar reformation (MPR) ,curved planar reformation(CPR) images in order to reveal occult rib fractures clearly. The abilities in displaying occult rib fractures were compared among VR, MIP, MPR, and CPR. Results The comprehensive application of various reconstruction techniques could show clearly the different parts and different types of occult rib fractures. The CPR reconstruction was the best one of them in displaying occult rib fractures,as compared with MPR and VR. A total of 59 parts of occult rib fracture were diagnosed in 42 patients with chest trauma. Conclusion The 64-slice spiral CT and post-reconstruction technique to treat the images can show clearly occult rib fracture, and can meet the positioning and qualitative analysis for occult fracture ribs,so which is the preferred method for detecting occult rib fracture.%目的 探讨64层螺旋CT及其后重建技术在隐匿性肋骨骨折诊断中的临床应用价值.方法 对42例胸部外伤考虑隐匿性肋骨骨折患者,进行64层螺旋CT平扫,将所得原始数据经工作站进行图像后处理,获得容积再现(VR),最大密度投影(MIP),多平面重组(MPR)、曲面重建(CPR)图像.并比较各种重建图像对隐匿性骨折的显示能力.结果 综合运用各种后重建技术,可清晰显示不同部位、不同类型肋骨隐匿性骨折.重建以CPR技术显示效果最佳,MPR、VR次之.42例胸部外伤患者共确诊59处肋骨隐匿性骨折.结论 64层螺旋CT及其后重建技术图像显示清晰,满足对肋骨隐匿性骨折进行定位、定性分析,是肋骨隐匿性骨折检查首选方法.

  4. 64排螺旋CT在泌尿系三维成像检查中的影响%Effects of 64 slice spiral CT 3D imaging in urinary system

    王强

    2013-01-01

    Objective To investigate the clinical value of 3D imaging exams after 64-slice spiral CT scan.Methods Conventional thin plain scan and arterial phase,venous phase,delayed phase scans to 50 patients with urinary tract diseases were performed respectively by applicating 64-slice spiral CT,then,the data were transferred to the imaging workstation for MPR,VR and MIP and other 3D reconstruction,ifnally,a comprehensive analysis was made to all image data.Results kidney or ureteral stones in 33 cases,occupying of kidney,ureter or bladder in 8 cases,inflammation in 6 cases,congenital malformations in 2 cases,ureteral clot in 1 case.Conclusion 3D imaging exams after 64-slice spiral CT scan has a reliable value to the diagnosis of urinary tract disease,it can not only get a clear kidneys,ureter and bladder dimensional reconstructed images,but also accurately display the urological global and local ifne structure,shape,extending direction and its relationship with the surrounding tissue.In addition,the image can be made rotation,cutting,ampliifcation and other post-processing.%目的:探讨64排螺旋CT在泌尿系三维成像检查中的临床应用价值。方法抽取来我院就诊的泌尿系疾病患者50例,应用64排螺旋CT分别行常规薄层平扫及动脉期、静脉期、延迟期扫描,并将所得数据传输至影像工作站进行MPR、VR及MIP等三维重建,对其影像资料进行综合分析。结果肾或输尿管结石33例,肾、输尿管或膀胱占位8例,炎症6例,先天性畸形2例,输尿管内血块1例。结论64排螺旋CT三维成像检查不仅能够获得清晰的双肾、输尿管及膀胱的三维重建图像,而且能够准确地显示出泌尿系统整体和局部的细微结构、形状、走形及其与周围组织关系,还可对图像进行旋转、切割、放大等后处理操作,对于临床诊断泌尿系统疾病具有可靠价值。

  5. Evaluation of the Correlation Between Myocardial Bridging and Atherosclerotic Changes in Coronary Artery Segment Proximal to the Bridge by 64-Slice Multidetector CT Scan

    Safa Hoodeshenas; Abbas Arjmand Shabestari

    2011-01-01

    Background/Objective: The aim of this study was"nto evaluate the prevalance and characteristics of myocardial bridging (MB) and to assess the correlation"nbetween atherosclerosis and MB."nMaterials and Methods: Retrospective evaluation"nof 2790 coronary angiograms were obtained by 64-"nslice multidetector CT. The prevalance, length, depth,"nprecise of MB location and concomitant atherosclerosis"nproximal to tunneled segment were evaluated. The"ngroup of...

  6. Application of low-dose 64-slice spiral CT scanning technology in adenoidal hypertrophy in children%64层CT对儿童腺样体肥大低剂量扫描的应用

    黄冰; 杨玲; 桂绍高

    2014-01-01

    Objective To investigate clinical application value of low-dose 64-slice spiral CT scanning technology in the ade-noidal hypertrophy of children. Methods 100 cases of children with adenoidal hypertrophy underwent low-dose(group A)and con-ventional-dose (group B)64-slice spiral CT scanning. The A/N ratio,Dand radiation dose in two groups were compared. Results The A/N ratio (P=0.981) and D (P=0.199) showed no significant difference between low-dose CT scanning and conventional-dose CT scanning (P=0.981). The CTDIvol of low-dose CT scanning was 6.93mGy and the CTDIvol of conventional-doses was 27. 92mGy. The CTDIvol of low-dose CT scanning decreased about 75%as compared with those of conventional dose scanning. Con-clusion The diagnostic result of image of low dose CT scanning is the same as that of conventional dose scanning,and the low-dose spiral CT scanning in children with adenoidal hypertrophy can substitute the conventional-dose spiral CT scanning.%目的:探讨低剂量64层螺旋CT扫描技术在儿童腺样体肥大中的应用。方法对100例临床疑似腺样体肥大儿童行64层螺旋CT低剂量和常规剂量扫描,将其随机分为两组,对比两种剂量扫描的鼻咽气腔前后径A/N比值和鼻咽气腔有效气道的前后径(D值)及患者的辐射剂量。结果64层螺旋CT低剂量扫描与常规剂量扫描之间鼻咽气腔前后径A/N比值无统计学差异(P=0.981);低剂量组与常规剂量组鼻咽气腔有效气道的前后径(D值)无统计学差异(P=0.199)。低剂量CT扫描显示儿童鼻咽部容积CT剂量指数CTDIvol为6.93mGy,常规剂量CTDIvol为27.92mGy。低剂量与常规剂量相比,其CTDIvol降低了约75%的辐射剂量。结论64层螺旋CT低剂量扫描对腺样体肥大的诊断结果与常规剂量均相同,故64层螺旋CT低剂量扫描临床疑似腺样体肥大的患者,完全能替代常规剂量的64层螺旋CT扫描。

  7. Evaluation of the Correlation Between Myocardial Bridging and Atherosclerotic Changes in Coronary Artery Segment Proximal to the Bridge by 64-Slice Multidetector CT Scan

    Safa Hoodeshenas

    2011-05-01

    Full Text Available Background/Objective: The aim of this study was"nto evaluate the prevalance and characteristics of myocardial bridging (MB and to assess the correlation"nbetween atherosclerosis and MB."nMaterials and Methods: Retrospective evaluation"nof 2790 coronary angiograms were obtained by 64-"nslice multidetector CT. The prevalance, length, depth,"nprecise of MB location and concomitant atherosclerosis"nproximal to tunneled segment were evaluated. The"ngroup of subjects with MB was compared with the"ncontrol group (subjects without MB."nResults: Of the 2790 subjects, 548 (19.64% were"nfound to have MB. MB was present equally in men"nand women. The tunneled segment was intact in"nall subjects. A negative significant correlation was"nfound between the presence of MB and severity of"natherosclerosis in the proximal segment of the coronary"nartery (p<0.001; df=2×2=42.75. The mid LAD was the"nmost common coronary artery involved. The severity"nof atherosclerosis in the part proximal to the tunneled"nsegment correlated with the thickness of bridge"n(p=0.035, but no significant correlation was found"nwith the length of the bridged segment (p=0.431."nConclusion: The myocardial bridge not only does not"npredispose to the development of atherosclerosis in"nthe coronary artery segment proximal to the bridge,"nbut may also be a protective factor.

  8. Correlation of 64-slices CT Features with Vascular Endothelial Growth Factor Expression in Brain Astrocytoma%VEGF在脑星形细胞瘤中的表达与64排CT征象的关系

    蔡胜艳; 孙妍; 胡嘉航

    2012-01-01

    目的:探讨脑星形细胞瘤64排CT征象与VEGF表达之间的关系.方法:搜集经手术证实的脑星形细胞瘤30例,分析其CT表现,术后对肿瘤组织标本进行免疫组化染色,分析其VEGF表达的程度与CT征象之间的关系.结果:星形细胞瘤的VEGF表达程度与肿瘤的分级、瘤周水肿的范围及肿瘤的强化程度有相关性.结论:星形细胞瘤的CT表现可以反映VEGF的表达程度,能对临床治疗方案的选择和患者预后的评估起到重要作用.%Objective To study the correlation of 64-slices CT features with vascular endolhelial growth factor(VEGF) expression in brain astrocytoma. Methods CT findings in 30 cases with surgically and pathologically proved astrocytoma were retrospectively analyzed. VEGF was stained with immuno- histochemical technique, and VEGF expression levels were compared with CTfeatures. Results VEGF expression levels were with correlated with pathological grade, the extent of per tumor edema and the degree of contrast enhancement. Conclusion CT features of astrocytoma can reflect VEGF expression levels. It is important for the choice of clinical treatment and prognostic evaluation of patients. [Chinese Medical Equipment Journal,2012,33(6):67-68

  9. 混合性生殖细胞瘤的64层螺旋CT诊断及病理表现%Diagnosis of mixed germ cell tumor by 64-slice spiral CT and pathological manifestations

    朱刚明; 谭琦碹; 钟胜; 李兆勇; 付东

    2011-01-01

    目的:探讨64层螺旋CT对混合性生殖细胞瘤的诊断价值.方法:回顾性分析7例经病理证实的混合性生殖细胞瘤的CT平扫及两期增强表现、病理标本及切片特征.结果:7例病灶3例位于卵巢,3例位于前纵隔.1例位于睾丸;其中3例边界清楚;各病灶密度不均匀,内见囊变、坏死区,1例可见脂肪及钙化:增强扫描静脉期较动脉期强化明显,均呈不均匀强化.病理结果2例卵黄囊瘤与成熟畸胎瘸混合型.2例卵黄囊瘤与未成熟畸胎瘤混合型.1例卵黄囊瘤、胚胎性癌、畸胎瘤混合型,1例绒癌与无性细胞癌混合型,1例精原细胞瘤、胚胎性癌、滋养细胞成分混合型.结论:64层螺旋CT对混合性生殖细胞瘤的诊断虽无特异性,但在一定程度上为肿瘤良恶性判断、临床分期提供十分重要的依据.%Objective:To investigate the diagnostic value of mixed germ cell tumor by 64 -slice spiral CT. Methods: The plain CT and two-phase enhanced CT scanning and pathological specimens of 7 cases of the tumor confirmed by pathology were retrospectively studied. Results: 3 cases were found in ovarian and 3 cases in anterior mediastinum and 1 case in testis. 3 lesions were clear boundary, with fat and calcification in 1 lesion. All the lesions were uneven density and the cystic or necrotic area could be found. Venous phase enhancement was significantly higher than other phase, showed inhomogc-neous enhance. Pathological findings: induded 2 cases of yolk sac tumor and mature teratoma mixed. 2 cases of yolk sac tumor and immature teratoma mixed, 1 case of yolk sac tumor embryonal carcinoma and teratoma mixed. 1 case of chorio-carcinoma and asexual cell carcinoma mixed, and 1 case of seminoma embryonal carcinoma and trophoblastic ingredients mixed. Conclusion: Although there is no specific by 64-slice spiral CT. To a certain degree.it can determine the benign or malignant tumor and give the important prop for clinical staging.

  10. The initial clinical application of multi-detector CT on spinal angiography

    Objective: To explore the value of Multi-detector CT in spinal cord angiography. Methods: Ten patients with initial MR and clinical findings suggestive of spinal cord vessel disease were performed CT spinal cord angiography. Among these, 7 patients were performed DSA later within 1 week, and 4 patients were therapy by operation. CT protocol: Toshiba Aquilion 64 slice CT scanner, 0.5 mm thickness, 0.5/r, 120 kV, 350 mA, choose aortic arch level as inspection position, and use 'surestart' technique with CT threshold 180 HU. Contrast medium was Iohexol (370 mg I/ml), with injection velocity of 6 ml/s. The total volume was 80 ml. The CT spinal cord angiography images were analyzed according to disease model, disease range, feeding artery, fistula, draining veins, and were compared with DSA and operation results. Results: All CT spinal cord angiography images displayed spinal vessel malformation. Among these, 3 patients were inner-medullary arteriovenous malformation; 2 patients were peri-medullary arteriovenous fistula; 5 patients were spinal dural arteriovenous fistula. All cases showed disease range, and draining veins clearly, one patient had two vessels that were false positive, and all the other cases showed feeding arteries clearly, which were confirmed by DSA. Conclusion: There are great values for CT spinal angiography in diagnosing spinal vessel disease, it can be a screening exam before DSA. (authors)

  11. 低仟伏64层MSCT扫描对泌尿系结石检出的研究%Low kilovotage 64-slice spiral CT in the detection of urinary calculus:an experimental study

    王秋霞; 陈亮; 黄文华; 胡道予

    2011-01-01

    目的:探讨低仟伏值(kV)低辐射量MSCT扫描对泌尿系结石的检出率及对图像质量的影响.方法:将4种单一成分的泌尿系结石108粒放入猪里脊肉内制成结石模型,应用64层螺旋CT对模型进行扫描,扫描的管电压分别为120 kV、100 kV和80 kV,并与不同的管电流进行组合,层厚为5 mm,层间距为5 mm,螺距为0.984.扫描后的原始数据(5mm层厚)重建成1.25mm层厚,使用GE ADW4.3工作站对数据进行处理.测量图像质量的噪声水平,记录X线辐射剂量指标CTDIvol.结果:与对照组120kV-250mAs相比,实验组80kV-150mAs及100kV-50mAs组的噪声SD值仅分别升高7.60%和8.62%,主观评分均为合格,结石检出率为100%,而辐射剂量降低率分别达到81.40%和87.60%.结论:合适的低kV-mAs组合对泌尿系结石的检出率可以达到100%,且明显降低辐射剂量.%Objective : To investigate the detectability of urinary calculi undergoing 64-slice CT scanning with reducing kV and to evaluate the image quality,so as to obtain the optimal scanning program. Methods : The calculi model was made by inserting 108 granules of urinary calculus containing four kinds of simple constituent into pork loin,and then scanned by 64-slice CT. The scanning parameters were as follows : three different dose-groups were chosen according to the fixed kV set 120kV, 100kV , 80kV : slice thickness and interval 5mm ; the pitch is 0.984; the raw data were reconstructed into 1.25mm ; all the reconstructed images were transferred to GE ADW4.3 workstation. To evaluate image quality according to different dose-groups and counted the number of detected calculus respectively. The standard deviation (SD) and signal to noise ratio (SNR) of the images were measured. CT dose index volume (CTDIvol) was obtained automatically. Results: 120kV~250mAs was set to be the control group. Compared with the control group,80kV-150mAs,100kV~50mAs and 120kV~30mAs noise SD values were only increased by 7.60 %,8

  12. Contrast-enhanced 64-slice computed tomography in detection and evaluation of anomalous coronary arteries

    Anomalous coronary artery (ACA) has either an unusual origin or different anatomical course and is associated with sudden cardiac death. The absence or nonspecific symptoms of ACA make its diagnosis difficult. Mostly, ACA is diagnosed coincidentally during invasive coronary angiogram (ICA). A conventional computed tomography (CT) cannot provide detailed images of coronary arteries of the moving heart, but 64-slice CT, with its short acquisition time, can provide detailed anatomy of coronary arteries non-invasively. In this study, we assessed the validity of contrast-enhanced 64-slice CT in the evaluation of ACA. ICA was performed in 7,574 patients for the diagnosis or evaluation of occlusive coronary artery disease and detected coronary anomalies in 56 patients (0.7%). We then performed 64-slice CT in 53 patients out of the 56 patients with demonstrated or suspected coronary anomaly, showing the origin and the course of the ACA along with stenosis, except for one patient who could not be evaluated due to image distortion artifacts. Contrast-enhanced 64-slice CT was also performed in 374 patients with vague signs and symptoms, detecting coronary anomalies in 7 patients (1.2%). Thus, in the total of 59 patients undergone 64-slice CT, we were able to visualize the entire abnormal coronary tree with a high diagnostic image quality. This is the first study to demonstrate the utility of 64-slice CT in a large series of ACA. Contrast-enhanced 64-slice CT is superior to ICA to identify the presence and course of ACA and should be the first line diagnostic tool in the evaluation of ACA. (author)

  13. Multislice CT angiography

    The introduction of multislice CT into clinical radiology constitutes a quantum leap that significantly widens the scope of vascular CT imaging. The advances over conventional spiral CT have been quantitative, mainly in terms of increased image acquisition speed which provides unprecedented volume coverage and spatial resolution. Moreover, significant technical innovations, such as cardiac scanning capabilities, have brought about a qualitative shift towards applications that were thought to be beyond the scope of CT imaging. This way multislice CT offers a wealth of new opportunities for quickly and accurately diagnosing suspected vascular disease in all organ systems; however, as we move towards faster and faster image acquisition techniques, we are also facing new challenges that require development of novel strategies in order to take full advantage of the increased capabilities of multislice CT in its current form and future generations of CT scanners. (orig.)

  14. Preliminary study of the optimization of abdominal CT scanning parameters on 64-slice spiral CT%64层螺旋CT腹部扫描参数优化的初步研究

    胡敏霞; 赵心明; 宋俊峰; 周纯武; 赵红枫

    2011-01-01

    Objective To investigate the appropriate low tube current of abdominal CT on a 64-slice spiral CT. Methods (1) Phantom study:The phantom Catphan500R was scanned with a fixed 120 kVp,and 450,400,380,360,340,320,300,280 mA, respectively. 15, 9, 8, 7, 6 mm diameter low-contrast objects with 1% contrast were scanned for evaluating image quality. CT images were graded in terms of lowcontrast conspicuity by using a five-point scale. Statistical analyses were performed to determine the appropriate tube current and the interval leading to the qualitative change. (2) Clinical study: 3 groups of 45 patients who had 2 examinations of non-enhanced abdominal CT within 3 months were enrolled. All patients were scanned with 450 mA at first scanning. For the second scanning, group-1 was scanned with optimal tube current, group-2 was scanned with optimal tube current plus interval, group-3 was scanned with optimal tube current sinus interval. CT images were graded in terms of the diagnostic acceptability at three anatomic levels including porta hepatis, pancreas and the upper pole kidney, and the image noises of eight organs including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex, renal medulla were graded by using a five-point scale. The image quality was compared with non-parametric rank sum test,and the individual factors of the patients were compared with the A VONA. Results (1) The optimal tube current and interval leading to the qualitative change were 340 mA and 40 mA respectively. (2) There were no significant differences in image quality between 340 mA and 450 mA in group-1, between 380 mA and 450 mA in group-2 (P > 0. 05). There was significant difference in image quality between 300 mA and 450 mA in group-3 (the mean scores for 300 mA were 2. 92 ± 0. 62,2.92 ± 0. 62,2.64 ± 0. 84,2. 72 ±0.82,2.63 ±0.71,2.51 ±0.84,3.04 ±0.72,3.04 ±0.72,2.63 ±0.71,2.52 ±0.73,2.93 ±0.81respectively; for 450 mA were 3.93 ± 0. 72,3.94 ± 0. 72

  15. 64-slice coronary computed tomography angiography using low tube voltage of 80 kV in subjects with normal body mass indices: comparative study using 120 kV

    Background. The radiation dose of coronary computed tomography (CT) angiography (CCTA) is generally higher than that of CT scans of other parts of the body, and there is concern that the high radiation dose may result in increased cancer risk. Although various techniques have recently been introduced to lower the radiation dose of CCTA, there has been no direct comparison between protocols with 80 and 120 kV. Purpose. To assess the image quality and radiation dose of 80-kV electrocardiography (ECG)-gated CCTA in subjects with a normal body mass index (BMI), compared to 120-kV ECG-gated CCTA. Material and Methods. This retrospective study was approved by our local ethics board, and the requirement of written informed consent was waived. We analyzed the CCTA images of 100 subjects with BMIs <25 kg/m2. Fifty subjects underwent 120-kV CCTA, and the other 50 subjects underwent 80-kV CCTA. Two blinded observers independently evaluated the subjective image quality of the coronary arteries. The objective image quality (signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) and radiation dose were also measured in each group. Results. Although the objective image quality of the 80-kV protocol images was significantly poorer than that of 120-kV protocol images (mean SNR, 14.9 ± 4.7 vs. 19.8 ± 4.4, P < 0.0001; mean CNR, 15.2 ± 4.8 vs. 21.6 ± 4.7, P < 0.0001), there was no significant difference in the subjective image quality between the two groups (mean image score, 4.7 ± 1.1 vs. 4.5 ± 0.7 for radiologist 1, P 0.273; 5.0 ± 1.0 vs. 4.8 ± 1.0 for radiologist 2, P = 0.197). The radiation dose was reduced by 70% with the 80-kV protocol and by 88% with the 80-kV and ECG-based tube current modulation than with the 120-kV protocol (3.42 ± 1.16 and 2.9 ± 0.8 vs. 11.49 ± 3.62 mSv, P < 0.0001). Conclusion. The low tube voltage CCTA protocol using 80 kV allows significant reduction of the radiation dose without impairing the subjective image quality in subjects with

  16. Diagnostic value of CT angiography in myocardial bridge and mural coronary artery

    Objective: To discuss the clinical value of CT angiography (CTA) in diagnosis of myocardial bridge and mural coronary artery. Methods: Three hundred twenty-seven patients were performed 64 slices CT angiography to observe myocardial bridge, and evaluate the stenosis of mural coronary artery.All cases with myocardial bridge received coronary arteriongraphy and comparison. Results: Fifty-seven cases with 66 myocardial bridge segments were found, with mean length (4.72 ± 0.93) mm, mean thickness (2.04 ± 0.62) mm, the mean stenosis of mural coronary artery was (33 ± 20)%. Twenty-nine cases with 35 myocardial bridge segments were found by coronary arteriongraphy, the difference between them has statistical significance (P<0.05). Conclusion: CTA can clearly show myocardial bridge and mural coronary artery, and it has important significance in clinical diagnosis compared with traditional coronary arteriongraphy. (authors)

  17. Assessment of carotid arteri calcification using 3D-CT angiography

    The aim of this study was to evaluate carotid arteri calcifications using 3D-CT angiography. We performed a retrospective review of 181 patients referred for 64-slice multi-detector row computed tomography. Using curved multiplanar reformation (curved MPR) images of ZIOSOFT M900 QUADRA, we evaluated the distribution of calcifications around the carotid bifurcation. Among the 181 patients, 66 patients (36%) had arterial calcifications. The present study found that almost arterial calcifications localized at the carotid bifurcation. Furthermore, in the group with carotid arterial stenosis, we found arterial calcifications localized not only at the carotid bifurcation, but also at the distal side of internal carotid artery. Curved MPR imaging using 3D-CT angiography is a helpful tool for evaluating calcification of carotid arteries. (author)

  18. [Spiral CT angiography in practice].

    Pavcec, Zlatko; Zokalj, Ivan; Rumboldt, Zoran; Pal, Andrej; Saghir, Hussein; Ozretić, David; Latin, Branko; Perhoć, Zeljka; Marotti, Miljenko

    2005-01-01

    Incidence of vascular diseases and development of new radiologic techniques in the last three decades has given strong impuls for introduction of non-invasive vascular diagnostic methods. Thanks to the introduction of Doppler ultrasound, new types of computed tomography (CT) and magnetic resonance (MR) scanners, non-invasive vascular diagnostic methods are replacing conventional invasive (catheter) angiographic methods. Computed tomographic angiography (CTA) is a noninvasive vascular diagnostic method based on continuous scanning with CT scanner during intravenous application of contrast material. Performing of CTA is possible after introduction of spiral CT technique whose characteristics are short imaging time and volumetric data acquisition. The main goal of this article, based on our experiences, is to review the role of CTA, performed on single-slice CT scanner, in managment of patients with vascular pathology. PMID:16145870

  19. Noninvasive coronary angiography using 64-slice spiral computed tomography in an unselected patient collective: Effect of heart rate, heart rate variability and coronary calcifications on image quality and diagnostic accuracy

    Objective: The aim of this study was to assess the impact of heart rate, heart rate variability and calcification on image quality and diagnostic accuracy in an unselected patient collective. Subjects and methods: One hundred and two consecutive patients with known or suspected coronary artery disease underwent both 64-MSCT and invasive coronary angiography. Image quality (IQ) was assessed by independent observers using a 4-point scale from excellent (1) to non-diagnostic (4). Accuracy of MSCT regarding detection or exclusion of significant stenosis (>50%) was evaluated on a per segment basis in a modified AHA 13-segment model. Effects of heart rate, heart rate variability, calcification and body mass index (BMI) on IQ and accuracy were evaluated by multivariate regression. IQ and accuracy were further analysed in subgroups of significant predictor variables and simple regression performed to calculate thresholds for adequate IQ. Results: Mean heart rate was 68.2 ± 13.3 bpm, mean heart rate variability 11.5 ± 16.0 beats per CT-examination (bpct) and median Agatston score 226.5. Average IQ score was 2 ± 0.6 whilst diagnostic quality was obtained in 89% of segments. Overall sensitivity, specificity, PPV or NPV was 91.2%, 99.2%, 95.3% or 98.3%. According to multivariate regression, overall IQ was significantly related to heart rate and calcification (P = 0.0038; P < 0.0001). The effect of heart rate variability was limited to IQ of RCA segments (P = 0.018); BMI was not related to IQ (P = 0.52). Calcification was the only predictor variable with significant effect on the number of non-diagnostic segments (P < 0.0001). In a multivariate regression, calcification was also the single factor with impact on diagnostic accuracy (P = 0.0049). Conclusion: Whilst heart rate, heart rate variability and calcification all show an inverse correlation to IQ, severe calcium burden remains the single factor with translation of such effect into decrease of diagnostic accuracy

  20. Introduction to coronary imaging with 64-slice Computed Tomography

    The aim of this article is to illustrate the main technical improvements in the last generation of 64-row CT scanners and the possible applications in coronary angiography. In particular, we describe the new physical components (X-ray tube-detectors system) and the general scan and reconstruction parameters. We then define the scan protocols for coronary angiography with the new generation of 64-row CT scanners to enable radiologists to perform a CT study on the basis of the diagnostic possibilities

  1. Persistent hypoglossal artery and its variants diagnosed by CT and MR angiography

    Persistent hypoglossal artery (PHA) is the second most common anastomosis between the carotid and vertebrobasilar systems and demonstrates some variations. We evaluated the prevalence of PHA on computed tomography (CT) angiography. We also evaluated characteristic features of PHA and its variants on magnetic resonance (MR) angiography. We retrospectively reviewed our database of 2,074 CT angiographic images obtained using either of two 64-slice multidetector CT scanners. We also reviewed our database of 7,646 MR angiographic images obtained using either of two 1.5-T or one 3.0-T imager. We could not determine the exact number of patients whose MR angiography included the hypoglossal canal. Most patients had or were suspected of having cerebrovascular diseases. We found six usual PHAs arising from the cervical internal carotid artery on CT angiography among 2,074 patients. On MR angiography, we also found six additional usual PHAs (total 12, right/left = 6/6, male/female = 3/9), three right PHAs originating from the external carotid artery (ECA), and two posterior inferior cerebellar arteries (PICAs) arising from the ECA without connection to the vertebral artery. The prevalence of usual PHA diagnosed by CT angiography was 0.29 %, slightly higher than that reported for angiography and may be due to selection bias in the examined patients. We propose naming usual PHA ''type 1 PHA''; PHA originating from the ECA, of which we found three, ''type 2 PHA''; and PICA arising from the ECA, of which we found two, ''type 2 PHA variant''. (orig.)

  2. CT angiography in carotid stenosis; CT-Angiographie bei Karotisstenosen

    Mildenberger, P.; Kauczor, H.U.; Ehrhard, K.; Thelen, M. [Johannes Gutenberg-Universitaet Mainz (Germany). Klinik und Poliklinik fuer Radiologie; Schmiedt, W. [Johannes Gutenberg-Universitaet Mainz (Germany). Klinik fuer Herz-, Thorax- und Gefaesschirurgie

    1997-11-01

    Purpose: Prospective evaluation of the accuracy CT angiography (CTA) with different postprocessing for extracranial carotid artery in comparison with DSA. Method: one hundred patients were studied with standarized CTA. For postprocessing, MPR, MIP, and 3D reconstruction based on segmentation with upper and lower threshold were used. Intravascular density profiles were considered. All CTA studies were correlated with intra-arterial angiography. The degree and classification of stenoses was determined using the guidelines established by the NASCET collaborators. Results: Measurement of stenosis was possible by MPR in 82.5%, by MIP in 85%, and 3D in 100%. Correct classification was found in 65.5% for MPR, 66% for MIP and 88.5% for 3D. The sensitivity for severe stenoses was 74% for MPR, 82% for MIP, and 93% for 3D. The specificity of these methods was 98%, 96%, and 97%, respectively. All carotid occlusions were correctly identified, no carotid artery was wrongly classified as occluded. (orig./AJ) [Deutsch] In einer prospektiven Untersuchung sollte die Genauigkeit verschiedener Nachverarbeitungsmethoden der CT-Angiographie (CTA) der extrakraniellen Karotis im Vergleich zur DSA untersucht werden. 100 Patienten wurden mit einer standardisierten CTA untersucht. Zur Nachverarbeitung wurden MPR, MIP und 3D-Rekonstruktion nach Segmentation mit doppeltem Schwellenwert eingesetzt. Fuer die Durchmesserbestimmung wurden die intravasalen Dichteprofile beruecksichtigt. Alle CTA-Untersuchungen wurden mit intraarteriellen DSA-Untersuchungen korreliert. Die Bestimmung des Stenosegrades und die Klassifizierung erfolgte nach den NASCET-Kriterien. Die Auswertung der CTA war mit MPR in 82,5% mit MIP in 85% und mit der 3D in 100% moeglich. Die Uebereinstimmung zwischen DSA und CTA in der Klassifikation der Stenosegrade betrug fuer MPR 65,5%, fuer die MIP 66% und fuer die 3D-Rekonstruktion 88,5%. Die Sensitivitaet im Nachweis relevanter Karotisstenosen ist fuer die MPR 74%, fuer die MIP 82

  3. CT angiography in carotid stenosis

    Purpose: Prospective evaluation of the accuracy CT angiography (CTA) with different postprocessing for extracranial carotid artery in comparison with DSA. Method: one hundred patients were studied with standarized CTA. For postprocessing, MPR, MIP, and 3D reconstruction based on segmentation with upper and lower threshold were used. Intravascular density profiles were considered. All CTA studies were correlated with intra-arterial angiography. The degree and classification of stenoses was determined using the guidelines established by the NASCET collaborators. Results: Measurement of stenosis was possible by MPR in 82.5%, by MIP in 85%, and 3D in 100%. Correct classification was found in 65.5% for MPR, 66% for MIP and 88.5% for 3D. The sensitivity for severe stenoses was 74% for MPR, 82% for MIP, and 93% for 3D. The specificity of these methods was 98%, 96%, and 97%, respectively. All carotid occlusions were correctly identified, no carotid artery was wrongly classified as occluded. (orig./AJ)

  4. Coronary CT angiography and MR angiography of Kawasaki disease

    Although the incidence of coronary artery aneurysms has diminished in patients with Kawasaki disease, coronary artery involvement is still regarded as a major complication of the disease, significantly affecting morbidity and mortality. Recent technical advances in coronary CT angiography (CTA) and MR angiography (MRA) have led to the possibility of using these two imaging methods as minimally invasive alternatives to the more invasive diagnostic catheter angiography in evaluating coronary artery abnormalities, such as aneurysm, stenosis, and occlusion. In this article, we describe imaging techniques and findings of coronary CTA and MRA in Kawasaki disease. (orig.)

  5. 64层螺旋CT评价膝关节创伤后的隐匿病变及软组织损伤%Evaluation of the occult lesions and soft tissue injury after knee injury by 64-slice spiral CT

    钟俊; 杨法宝; 赵学航; 张丽; 李勤祥

    2012-01-01

    背景:膝关节创伤患者在行X射线检查后进一步选择64层螺旋CT检查时,根据伤情及重建需要选择何种后处理技术在临床上存在一定分歧.目的:探讨64层螺旋CT及后处理技术在膝关节创伤中的应用价值.方法:回顾性分析79例膝关节创伤患者的普通X射线片及64排螺旋CT影像学资料,采用多平面重组、容积显示和表面遮盖显示等后处理技术,结合原始骨窗及软组织窗图像,由2名以上有经验的放射科和骨科医生对图像进行双盲分析并与临床及图像重建结果对照.结果与结论:在79例膝关节创伤患者中,共计92处骨折.普通X射线片诊断68例82处骨折,1例假阳性,5例假阴性,检出率约为89%;经64层螺旋CT及三维重建后确诊79例共92处骨折,检出率100%.证实,和X射线检查相比,64层螺旋CT及多种图像重建是膝关节创伤的重要辅助检查手段,能进一步明确有无膝关节周围隐匿性骨折、微骨折及脱位及软组织损伤等.%BACKGROUND: The patients with knee trauma received the 64-slice spiral CT examination after the X-ray examination, and there still some differences on the choice of the post-processing technology in clinic according to the injury and reconstruction needs. OBJECTIVE: To investigate application value of 64-slice spiral CT and the post-processing technology in the knee injury. METHODS: The imaging data of the X-ray and 64-slice spiral CTofthe 79 patients with knee injury were retrospectively analyzed, the post-processing technology, such as the multiple planar reformation, volume rendering and shaded surface display were adopted and combined with the image of the original bone and soft tissue window, and the images were dealt by two or more experienced X-ray and orthopaedic surgeons with double-blind analysis and compared with the clinical and operation results . RESULTS AND CONCLUSION: In all the 79 patients with knee injury, there were a total of 92 fractures

  6. 64排螺旋CT血管成像诊断永存三叉动脉%Diagnosis of persistent trigeminal artery with 64-slice spiral CT angiography

    袁飞; 刘银社; 赵军; 谷鹏; 顾欣; 冯凯琳

    2010-01-01

    目的 观察64排螺旋CT血管成像(CTA)在诊断永存三叉动脉(PTA)中的价值,提高对该血管变异的认识.方法 回顾性分析2734例行头颈64排螺旋CTA检查中的5例PTA患者的影像学资料,分析PTA的发生率、起源、走行、后循环供血及合并其他血管畸形的情况.结果 ①PTA的发生率为0.18%(5/2734),其中3例位于右侧,2例位于左侧.②三叉动脉均起自颈内动脉海绵窦段,血管走行外侧型4例,内侧型1例;按Saltzman分型显示PTA后循环供血情况:Ⅰ型1例,Ⅱ型1例,Ⅲ型3例.③吻合点近端的基底动脉及双侧椎动脉发育不良3例,吻合点近端基底动脉完全萎缩1例;合并PTA的动脉瘤1例,合并对侧大脑中动脉成窗1例.结论 64排CTA能清晰、快速、无创、准确地显示PTA及其走行.在鞍区或鞍上区手术及介入治疗前,了解这种异常血管的有助于制定合理的手术和介入治疗方案,避免因操作不当所致的危险.

  7. 64排螺旋CT血管造影诊断颅内动脉瘤%DIAGNOSIS OF INTRACRANIAL ANEURYSM WITH 64-SLICE SPIRAL CT ANGIOGRAPHY

    钱惠农; 王有刚; 朱蕴杰; 姜峰

    2009-01-01

    [目的]评估64排螺旋CT血管造影(CTA)在颅内动脉瘤诊断中的作用.[方法]对48例自发性蛛网膜下腔出血(SAH)患者进行CTA检查,同期行数字减影血管造影(DSA),分析比较两种检查的结果.[结果]11例SAH患者其CTA和DSA均未见异常.37例CTA和DSA结果存在异常患者中,CTA发现37个动脉瘤,DSA发现38个(2例多发性动脉瘤),CTA遗漏2个动脉瘤,误诊1个动脉瘤.CTA诊断动脉瘤的灵敏度为94.7%,特异度为91.7%.[结论]64排螺旋CTA是诊断颅内动脉瘤的一种简单、快速、准确的方法,具有极高的临床价值.

  8. Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

    Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ''CORE-64'' trial (''Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors''). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows. (orig.)

  9. Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

    Miller, Julie M.; Vavere, Andrea L.; Arbab-Zadeh, Armin; Bush, David E.; Lardo, Albert C.; Texter, John; Brinker, Jeffery; Lima, Joao A.C. [Johns Hopkins Hospital, Johns Hopkins University, Department of Medicine, Division of Cardiology, Baltimore, MD (United States); Dewey, Marc [Charite - Universitaetsmedizin Berlin, Medical School, Humboldt-Universitaet und Freie Universitaet zu Berlin, Department of Radiology, Berlin, PO Box 10098 (Germany); Rochitte, Carlos E.; Lemos, Pedro A. [University of Sao Paulo Medical School, Heart Institute (InCor), Sao Paulo (Brazil); Niinuma, Hiroyuki [Iwate Medical University, Department of Cardiology, Morioka (Japan); Paul, Narinder [Toronto General Hospital, Department of Medical Imaging, Toronto (Canada); Hoe, John [Medi-Rad Associates Ltd, CT Centre, Mt Elizabeth Hospital, Singapore (Singapore); Roos, Albert de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Yoshioka, Kunihiro [Iwate Medical University, Department of Radiology, Morioka (Japan); Cox, Christopher [Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD (United States); Clouse, Melvin E. [Harvard University, Department of Radiology, Beth Israel Deaconess, Boston, MA (United States)

    2009-04-15

    Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ''CORE-64'' trial (''Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors''). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows. (orig.)

  10. Detection of pulmonary embolism using 64-slice multidetector-row computed tomography: accuracy and reproducibility on different image reconstruction parameters

    Jung, Jung Im; Ahn, Myeong Im; Park, Seog Hee (Dept. of Radiology, Seoul St Mary' s Hospital, College of Medicine, The Catholic Univ. of Korea (Korea, Republic of)), email: jijung@catholic.ac.kr; Kim, Ki Jun (Deparment of Radiology, Incheon St Mary' s Hospital, College of Medicine, The Catholic Univ. of Korea (Korea, Republic of)); Kim, Hyo Rim (Deparment of Radiology, Yeouido St Mary' s Hospital, College of Medicine, The Catholic Univ. of Korea (Korea, Republic of)); Park, Hyun Jin (Dept. of Radiology, St Vincent Hospital, College of Medicine, The Catholic Univ. of Korea (Korea, Republic of)); Jung, SeungHee; Lim, Hyeon Woo (Deparment of Preventive Medicine, College of Medicine, The Catholic Univ. of Korea (Korea, Republic of))

    2011-05-15

    Background Direct comparison of different image reconstruction parameters to detect pulmonary embolism (PE) using 64-slice multidetector-row computed tomography (MDCT) is absent and the most accurate image reconstruction parameters have not yet been proven. Purpose To compare different image reconstruction parameters for detecting PE using 64-slice MDCT in patients suspected of having an acute PE. Material and Methods Forty patients who underwent pulmonary CT angiography with 64-slice MDCT for a suspected PE were included. Different image reconstruction parameters were used for each patient: axial and coronal images with slice thicknesses of 0.625 mm, 1.3 mm, and 2.5 mm and axial maximum intensity projection (MIP) images with slab thicknesses of 1.3 mm, 2.5 mm, and 5 mm. Four experienced radiologists reviewed the images. The diagnosis of a PE was based on consensus review of axial 0.625 mm slice thickness images by two chest radiologists with allowing multiplanar reconstruction. Accuracy and reproducibility (kappa value) were evaluated. Results In 15 of 40 patients, a PE was diagnosed. For detecting lobar PEs, axial images with a slice thickness of 1.25 mm and all coronal re-formatted images showed comparable results to axial images with a slice thickness of 0.625 mm. For detecting segmental PEs, axial images with a slice thickness of 1.25 mm and coronal images with a slice thickness of 0.625 mm re-formatted images showed comparable results to axial images of a slice thickness of 0.625 mm. For detecting subsegmental PEs, axial images with a slice thickness of 0.625 mm showed the highest sensitivity. Better reproducibility was obtained when the thinner slice thickness reconstructions were in axial and coronal images. However, reproducibility of MIP images with slab thicknesses of 2.5 mm and 5 mm was similar for detecting segmental and subsegmental PEs. Conclusion Thin-slice reconstruction of less than 1 mm is mandatory for visualization of PE at the subsegmental

  11. Diagnostic accuracy of sixty four multi-slice CT angiography in assessment of arterial cut-off and run-off in comparison with surgical findings

    The accurate anatomic mapping and determination of the severity of arterial disease, an important health problem of the elderly, is of great significance. We aimed to determine the diagnostic value of 64-multislice CT angiography in run-off and cut-off sites of arterial disease. Patients and Methods: Throughout the study, multislice CT angiography followed by an operative intervention was carried out on a total of 38 patients with clinical signs and symptoms suggestive of arterial disease all of whom had the indication for vascular surgery. The mean age of patients was 34±15.86 (range, 23 to 93) years. Multislice CT angiography was executed using a 64-slice CT scanner, during the arterial phase of injecting the nonionic, contrast medium with a power injector at the rate of 5 ml/sec into the antecubital vein and exploration and revascularization of peripheral arterial disease was performed intraoperatively. Results: Atherosclerosis and arterial disease, the most common causes of vascular occlusion, were more common in the lower extremities. According to multislice CT angiography findings, the most frequent site of stenosis was the superficial femoral artery. Spear man's correlation coefficient showed a high degree of agreement amongst the raters. The sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of multislice CT angiography compared to surgery were 83.8%, 96%, 96.8%, 81.3% and 89%, respectively. Multislice CT angiography findings were compared with surgery as a standard of reference, which showed concordance in the majority of cases (81.6%). Cut-off sites were correctly identified by multislice CT angiography in 97.3% of the patients and the most common sites of discordance were the run-off sites (18.2%). Conclusion: multislice CT angiography angiography as a novel diagnostic modality may be a suitable alternative and a viable choice for routine clinical diagnosis.

  12. Post-mortem CT-coronary angiography

    Pøhlsgaard, Camilla; Leth, Peter Mygind

    2007-01-01

    post-mortem coronary angiography and computerized tomography.  We describe how to prepare and inject the contrast medium, and how to establish a CT-protocol that optimizes spatial resolution, low contrast resolution and noise level. Testing of the method on 6 hearts, showed that the lumen of the...

  13. Experimental measurement of the scatter fraction in skull and body CT for teams 64- slice computed tomography; Medida experimental de la fraccion de dispersion TC en craneo y cuerpo para equipo de tomografia computarizada de 64 cortes

    Sanchez, G.; Haro, G.; Herrador, M.

    2011-07-01

    Different formalisms for the calculation of shielding in Cf equipment, the proposed document 147 of NCRP are widely accepted. Of the three methods mentioned in the protocol, two involve the use of two independent factor a of equipment, called scatter fraction CT in skull and body. Interestingly, the experimental measurement of the same, especially in those models following the publication of the document, which are also coincides with the highest number of detector channels and overall a greater radiation beam in the z axis.

  14. Radiation Dose to the Thyroid and Gonads in Patients Undergoing Cardiac CT Angiography

    The present data show a global increase in the rate of cardiovascular disease. Cardiac CT angiography has developed as a fast and non-invasive cardiac imaging modality following the introduction of multi-slice computed tomogaraphy. The aim of this study was to measure the radiation dose to the thyroid and pelvis regions in patients undergoing cardiac CT angiography using the Care Dose 4D method of 64-slice scanner. Eighty-one patients (41 males and 40 females) who were diagnosed with suspected coronary artery disease and were referred to Golestan Hospital, Imaging Department were recruited. Inclusion criteria were based on the protocol of multi-slice CT coronary angiography. The radiation dose to the thyroid and pelvis regions was measured using thermo luminescent dosimeters (TLDs). The mean radiation dose to the thyroid in male and female subjects was 0.32 mSv and 0.41 mSv, respectively (P = 0.032) (total mean, 0.36 mSv). The mean radiation dose to the pelvis in male and female subjects was 81 μSv and 112 μSv, respectively (P = 0.026) (total mean, 96.5 μSv), The total mean radiation dose to the thyroid and gonads was 0.36 mSv, and 96.5 μSv, respectively for the subjects. These values were high for one organ in a single study. Gender can affect the radiation dose to the thyroid and gonads. This can be attributed to the anatomical characteristic differences of the male and female subjects

  15. Evaluation of the Optimal Image Reconstruction Interval for Coronary Artery Imaging Using 64-Slice Computed Tomography

    Background: Cardiac computed tomography (CT) has become an established complement in cardiac imaging. Thus, optimized image quality is diagnostically crucial. Purpose: To prospectively evaluate whether, by using 64-slice CT, a specific reconstruction interval can be identified providing best image quality for all coronary artery segments and each individual coronary artery. Material and Methods: 311 coronary segments of 14 men and seven women were analyzed using 64-slice CT. Data reconstruction was performed in 5% increments from 5-100% of the R-R interval. Four experienced observers independently evaluated image quality of the coronary arteries according to the AHA classification. A three-point ranking scale was applied: 1, very poor, no evaluation possible; 2, diagnostically sufficient quality; 3, highest image quality, no artifacts. Results: The best reconstruction point for all segments was found to be 65% of the R-R interval (mean value 2.4±0.5; P<0.05). On a per-artery basis, best image quality was again achieved at 65% of the R-R interval: RCA 2.2±0.4, LCA 2.4±0.5, LM 2.5±0.2, LAD 2.3±0.4, LCX 2.3±0.5. Conclusion: By using 64-slice CT, the need for adjusting the reconstruction point to each coronary segment might be overcome. Best image quality was achieved with image reconstruction at 65% of the R-R interval for all coronary segments as well as each coronary artery

  16. 64排CT与全景牙片在埋伏牙诊断中的应用%Diagnositic Value of 64-Slice CT and Intraoral Digital Dental Radiography Technique in Embedded Teeth

    陈殿森; 陈望; 滑炎卿

    2011-01-01

    目的:评价64排螺旋CT与口腔全景X线牙片对上颌前部埋伏牙诊断及定位的应用价值.方法:对42例全景X线牙片疑上颌埋伏牙患者行64排螺旋CT扫描,并应用64排螺旋CT图像后处理功能,做三维重建和多层面重建,获取相应牙体的任意平面、任意方位图像.结果:42例患者,38例为上颌前部埋伏牙,25例埋伏牙位于腭侧,9例埋伏牙位于唇侧,4例埋伏牙牙根位于腭侧,而牙冠位于唇侧,经手术证实,符合率100%.结论:多排螺旋CT对儿童上颌埋伏牙能做出精确定位,对上颌埋伏牙诊断及定位的价值优于全景数字X线牙片,可作为上颌埋伏牙临床外科治疗及正畸治疗前的重要检查方法.%Objective: To compare the clinic application of multirow spiral CT (MSCT) and intraoral digital dental radiography technique in location with embedded teeth of children. Methods: Forty-two children suspected for embedded teeth were examined by MSCT and intraoral digital dental radiography technique with multiplanar reformation (MPR) and three dimensional (3D) reconstruction of MSCT. Results: A total of 38 cases of embedded teeth were diagnosed, including 25 embedded teeth located in palate sides, 9 in lip sides, and 4 cases of which the teeth root located in palate sides, and the teeth crown located in lip sides. According to the resluts of surgery, the accurate rate was 100%. Conclusion; Multirow spiral CT can accurately locate embedded teeth of children, and have an obvious advantage over the intraoral digital dental radiography technique in diagnosis and locating of embedded teeth. It is an important method to be applied in examing embedded teeth in upper jaw.

  17. CT Angiography and MR Angiography of Carotid Arteries

    M Motevalli

    2009-01-01

    Full Text Available  CT angiography (CTA has revolutionized vascular imaging. Vessels smaller than 1mm in diameter can be visualized with single slice CTA and vessels 2 mm or more in diameter can be diagnostically evaluated. The acquisition of 3D data volumes makes it possible to generate "angiographic" views that facilitate anatomic orientation."nWith the advent of multi slice CTA, near isotropic resolution becomes available for most applications and allows evaluation of even smaller vessels."nMulti slice scanning makes CTA less technically challenging and more robust. It reduces scan time and the vulnerability to motion artifacts, and may be used to substantially decrease the required contrast material volume to as little as 50 ml in selected cases."nThe advantages of CTA over arterial angiography (DSA include substantially lower invasiveness, less cost, less radiation exposure, and better patient tolerance. Diagnostic advantages include simultaneous visualization of the vessel wall and lumen, and the ability to study vascular anatomy from arbitrary viewing angles using only one data acquisition."nCTA even allows projections (such as Caudocranial that cannot be obtained with conventional angiographic techniques."nAlthough CTA can replace diagnostic ultrasound with its various Doppler techniques, it may be preferred over CTA in regions that are easily accessible by sonography or when flow information is required. It also holds advantages whenever bedside imaging is to be preferred."nMagnetic resonance angiography (MRA has become the common place in the last few years. The improvements in pulse sequence design, hardware design, and post processing methods make it possible to acquire data in a short period with excellent vascular visualization in a variety of clinical applications."nContrast -enhanced magnetic resonance angiography (MRA offers competitive results to CTA, although spatial resolution is often lower than with multi slice CT scanning. The lack of

  18. Assessment of the right ventricular function in patients with chronic obstructive pulmonary disease and cor pulmonale using cardiac 64-slice spiral CT comparing with 1.7 T MRI

    cardiac CT were correlated well with that on cardiac MRI. The MM of the RV showed moderate correlation (r=0.82), RV volumes and RVEF significant correlation (r=0.98 and 0.97 for RV EDV and RV ESV, r=0.95 for RVEF, respectively). A strong correlation between MSCT and MRI for the assessment of RV function was also found using Bland-Altman plot. The correlation was excellent between the MSCT results and forced expiratory volume in 1 sec (r=0.781 for RVEF, r=-0.824 for RV MM) in COPD patients. Conclusions: Cardiac MSCT can accurately assess the RV size and function in comparison to MRL Patients with severe COPD have RV dysfunction. (authors)

  19. Usefulness of 64-slice MDCT for follow-up of young children with coronary artery aneurysm due to Kawasaki disease: Initial experience

    To evaluate the initial application and value of 64-slice multidetector computed tomography as an alternative diagnostic modality in the follow-up of young children with coronary artery aneurysm due to Kawasaki disease. Twelve boys (mean age 5.1 years, range 1.8-7.8 years) for follow-up (time range from 1.1 to 5.1 years) of known Kawasaki disease and coronary artery aneurysm underwent 64-slice MDCT ECG-gated coronary angiography. All data were acquired without breath holding. Two pediatric radiologists independently assessed image quality and the diameter of all coronary segments were measured for each patient. The number, position, shape and size of each coronary artery aneurysm were observed and compared with those of ECHO performed previously. A total of 118/156 segments permitted visualization with diagnostic image quality, the CT measurements showed good inter-observer and intra-observer reliability, coefficients were 0.93 and 0.88, respectively. A total of 30 coronary artery aneurysms were identified with measured mean of 7.5 ± 3.8 mm in diameter, and of 12.4 ± 9.1 mm in longitudinal lengths.10 tumors were small, 8 tumors were medium and 12 tumors were giant aneurysm. The affected segments included LM7/12(58.3%), 9/12(75%) of LAD1, 4/12(33.3%) of LAD2, 2/12(16.7%) of LCX1; 6/12(50%) of RCA1, 9/12(75%) of RCA2 and 4/12(33.3%) of RCA3, including affected two segments in 9 tumors and three segments in 1 tumor. Calcifications were found in 5 aneurysms and 3/5 with thrombosis; six stenotic segments were found. ECHO failed to detect 8 tumors with 2/8 in LAD, 1/8 in LCX and 5/8 in RCA, and those included 4 small aneurysms. The use of 64-slice MDCT angiography proved valuable for monitoring young children with Kawasaki disease. However, further study is necessary to specify the sensitivity and specificity of MDCT in the follow-up.

  20. Multidetector-row CT angiography of hepatic artery: comparison with conventional angiography

    To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MD-CT) for delineating the arterial anatomy of the liver. Hepatic arterial three-dimensional CT angiography was performed using MDCT (lightspeed Qx/I; GE medical systems, milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regrading a patient's hepatic arterial anatomy

  1. Müller状态下64排螺旋CT对阻塞性睡眠呼吸暂停低通气综合征诊断价值的研究%The study of the diagnostic value of 64-slice CT in obstructive sleep apnea hypopnea syndrome in Müller mameuver

    周旭; 王建中; 刘骏桢

    2013-01-01

    目的:通过对平静呼吸和Müller状态下的中重度OSAHS患者行CT扫描,了解Müller状态下上气道阻塞塌陷的具体部位、程度及累及范围,为手术治疗提供依据.方法:对30例经PSG确诊的中重度OSAHS患者分别行平静呼吸和Müller状态下64排VCT扫描,并经上气道三维重建和仿真内镜技术处理,比较2种状态下上气道各平面横截面积和各径线长度以及咽壁厚度、软腭悬雍垂长厚度、软硬腭角度、舌骨硬腭距离等指标.结果:平静呼吸时吸气末和Müller's动作吸气末各平面截面积和径线比较,舌根后区及会厌后区的前后径差异无统计学意义(P>0.05),其余所有气道径线的差异均有统计学意义(P<0.05).各平面软组织厚度比较,软腭后区、悬雍垂后区、舌根后区左右侧壁软组织厚度及软腭后区的后壁厚度、悬雍垂软腭长厚度比较差异均有统计学意义(P<0.05),软硬腭角度比较差异有统计学意义(P<0.05),舌骨的位置在Müller' s动作时有显著的下移.结论:通过64排CT上气道三维重建和仿真内镜技术,可推测中重度OSAHS患者打鼾时上气道塌陷阻塞的具体部位、程度、累及范围,以及上气道各平面软组织的变化情况,其临床应用价值大.%Objective:To examine the location,extent and cause of collapsed airway in Muller maneuver in OS-AHS patients with CT scan,and provide the evidence for surgery. Method:Thirty patients with moderate or severe OSAHS were measured with 64 slice CT in quiet breathing and in Muller maneuver. After three-dimensional reconstruction and virtual endoscope handing of the upper airway, we compare the cross-section area and the dimensions of five levels as well as the thickness of retropharyngeal and lateral pharyngeal tissue in two conditions. The evaluation values include the length and thickness of soft palate and uvula, soft-hard palate angle and hyoid hard palate distance. Result:The lateral distance

  2. Assessment of anemia during CT pulmonary angiography

    Jung, Caroline, E-mail: cjung@uke.de [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Groth, Michael; Bley, Thorsten A.; Henes, Frank O. [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Treszl, András [Department of Medical Biometry and Epidemiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Adam, Gerhard; Bannas, Peter [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany)

    2012-12-15

    Objectives: Anemia is associated with increased mortality in patients with acute symptomatic pulmonary embolism (PE). The purpose of this study was to evaluate the feasibility of Hounsfield unit (HU) measurements on the single unenhanced trigger slice of pulmonary CT angiography scans for diagnosis of anemia. Material and Methods: 150 consecutive patients (median age 64 ± 16 years) with suspected PE underwent pulmonary CT angiography. Two radiologists, blinded to laboratory results, performed HU measurements in the single unenhanced trigger scan independently by region-based analysis (ROI). HU values from ascending and descending aorta and the calculated mean of both were correlated with serum hemoglobin levels. Inter- and intraobserver variability was determined for HU measurements, and ROC analysis was performed for diagnosis of anemia. Calculated linear models were used to assess formulas for estimation of hemoglobin levels from HU measurements. Results: HU measurements revealed high intra- and interrater reliability (ICC > 0.981 and ICC > 0.965, respectively). Calculated mean HU values showed a strong correlation with serum hemoglobin levels (r = 0.734), which allowed generation of different formulas for calculation of hemoglobin levels from HU measurements. ROC analyses confirmed a high sensitivity (80.4 for men; 91.3 for women) and specificity (84.0 for men; 84.9 for women) for diagnosing anemia. Conclusion: Diagnosis of anemia and quantification of hemoglobin levels upon a single unenhanced trigger scan of pulmonary CT angiography is feasible. We suggest disclosing the anemic state in the radiological report, independent of the presence of PE, since anemia carries increased risks of morbidity and mortality.

  3. Assessment of anemia during CT pulmonary angiography

    Objectives: Anemia is associated with increased mortality in patients with acute symptomatic pulmonary embolism (PE). The purpose of this study was to evaluate the feasibility of Hounsfield unit (HU) measurements on the single unenhanced trigger slice of pulmonary CT angiography scans for diagnosis of anemia. Material and Methods: 150 consecutive patients (median age 64 ± 16 years) with suspected PE underwent pulmonary CT angiography. Two radiologists, blinded to laboratory results, performed HU measurements in the single unenhanced trigger scan independently by region-based analysis (ROI). HU values from ascending and descending aorta and the calculated mean of both were correlated with serum hemoglobin levels. Inter- and intraobserver variability was determined for HU measurements, and ROC analysis was performed for diagnosis of anemia. Calculated linear models were used to assess formulas for estimation of hemoglobin levels from HU measurements. Results: HU measurements revealed high intra- and interrater reliability (ICC > 0.981 and ICC > 0.965, respectively). Calculated mean HU values showed a strong correlation with serum hemoglobin levels (r = 0.734), which allowed generation of different formulas for calculation of hemoglobin levels from HU measurements. ROC analyses confirmed a high sensitivity (80.4 for men; 91.3 for women) and specificity (84.0 for men; 84.9 for women) for diagnosing anemia. Conclusion: Diagnosis of anemia and quantification of hemoglobin levels upon a single unenhanced trigger scan of pulmonary CT angiography is feasible. We suggest disclosing the anemic state in the radiological report, independent of the presence of PE, since anemia carries increased risks of morbidity and mortality.

  4. Usefulness of CT angiography for demonstrating cerebral aneurysm

    We report the usefulness of computed cerebral angiotomography (CT angiography) for demonstrating cerebral aneurysm and the clinical significance of CT angiography for ruptured cerebral aneurysm. Our modified method of CT angiography was easy and less time-consuming. Fifteen seconds after starting a single bolus injection, 1 ml/kg/25 seconds via cubital vein, of contrast medium (60 % urograffin), 5 serial 5 mm thick-CT slices were scanned in every 6.5 seconds including 2 seconds of interval, beginning from an axial level 20 mm above the orbitomeatal line and ending at a level 40 mm. A total of 103 patients were examined in this report, consisting of 70 unruptured asymptomatic, 8 unruptured symptomatic (oculomotor nerve palsy) and 25 subarachnoid hemorrhage (SAH). Seven unruptured aneurysms in 4 asymptomatic cases, 2 unruptured aneurysms in 2 symptomatic cases 27 aneurysms in 24 SAH cases were suspected by CT angiography. Of these 36 aneurysms suspected by CT angiography 32 aneurysms were confirmed by cerebral angiography. The detection rate of CT angiography in this report was 89 %, higher than those of previous reports. Thirteen aneurysms were located at internal carotidposterior communicating artery (ICPC) junction. 11 at anterior communicating artery (Acom), 7 at middle cerebral artery (MCA). CT angiography showed a false positive findings in 4 cases, which were all located at Acom. Four aneurysms were not detected in CT angiography, which were all located at MCA and were very small (2 - 3 mm) in diameter. There were no deteriorated cases during and after CT angiography. We suggest that CT angiography is a useful and safe method for predicting the location of not only unruptured but ruptured aneurysms. (author)

  5. Study on the three dimensional hepatic virtual operation based on the data of 64-slice helical CT scanning%基于64排螺旋CT扫描数据三维肝脏手术仿真的研究

    朱新勇; 方驰华; 鲍苏苏; 全显跃; 焦培峰; 钟世镇

    2008-01-01

    目的 研究基于64排螺旋CT扫描数据的三维肝脏虚拟手术的设计和仿真效果,以及基于自由设计模型系统(FreeForm Modeling System)的虚拟手术的可行性.方法 采集正常人肝脏64排薄层扫描数据集,利用医学三维重建软件(MIMICS软件)进行肝脏及其肝内血管三维重建,并将重建的肝脏及其管道模型、人工绘制肝脏肿瘤模拟物导入FreeForm Modeling System,利用力反馈设备(PHANToM),对肝脏模型进行手术切割.结果 通过旋转和放大目标物体,肿瘤与肝内血管的立体关系能清晰展示.根据手术原则,使用PHANToM操纵"手术刀",仿真左外叶切除,术中肝内管道结构容易识别,其过程基本符合临床肝脏肿瘤切除的手术过程并可调节目标物体的强度,感受切割时力反馈的大小.结论 利用FreeForm Modeling System虚拟手术系统仿真肝脏手术切割,可以制定合理的个体化手术方案,减少并发症发生,提高手术成功率.%Objective To study the surgery plan and simulation effect of the three dimensional(3D)hepatic virtual operation based on the data of 64-slice helical CT scanning and to probe the feasibility of the virtual operation based on the FreeFotin Modeling System.Methods The volunteer liver Was scanned to collect two dimensional(2D)DICOM data of 64-slice helical CT scanning and the 3D hepatic and intrahepatic vessels model were reconstructed by MIMICS software.The reconstructed liver,the intrahepatic vessels model and the artificial tumor models were outputted into the FreeForm Modeling System in the STL format.The device PHANToM with the characterization of dynamo-feedback was applied to make the operation on tlle 3D hepatic.Resuits The spatial relationship between the tumour and the intrahepatic vessels were clearly observed by rotation and enlargement of the target.According to the operation principle,the left lobe of liver resection was simulated by manipulating the device PHANToM.Through the

  6. Peripheral CT angiography for interventional treatment planning

    Lower extremity CT angiography (CTA) has evolved into a very effective, widely available and robust imaging modality for patients with peripheral arterial occlusive disease (PAOD). In this article we briefly review the acquisition and contrast administration techniques for 4- through 64-channel peripheral CTA. Visualization of atherosclerotic disease with CTA in general requires 'angiography-like' 3D images (such as volume rendered or maximum intensity projection images), but-notably in the presence of vessel wall calcifications and stents-cross-sectional views (such as curved planar reformations, CPR) are also required to accurately assess the flow lumen of the aorta down to the pedal arteries. Adequate visualization and mapping of atherosclerotic lesions in patients with PAOD is not only a prerequisite for generating a dictated report, but more importantly, standardized postprocessed images are the key to communicating the findings to the treating physician, and they also serve as a treatment planning tool. Treatment decisions (surgical versus transluminal revascularization, or conservative treatment), and percutaneous treatment planning (access site, antegrade versus retrograde puncture) can be made in the majority of patients with PAOD based on lower extremity CT angiograms. (orig.)

  7. Data acquisition for pediatric CT angiography: problems and solutions

    With appropriate attention to the technical aspects, excellent CT angiography can be obtained even in young infants. In this article, we will present the problems inherent with pediatric CT angiography and offer solutions that minimize or eliminate these difficulties. In addition, a literature review of specific pediatric applications is provided. (orig.)

  8. 64 slice-coronary computed tomography sensitivity and specificity in the evaluation of coronary artery bypass graft stenosis: A meta-analysis.

    Barbero, Umberto; Iannaccone, Mario; d'Ascenzo, Fabrizio; Barbero, Cristina; Mohamed, Abdirashid; Annone, Umberto; Benedetto, Sara; Celentani, Dario; Gagliardi, Marco; Moretti, Claudio; Gaita, Fiorenzo

    2016-08-01

    A non-invasive approach to define grafts patency and stenosis in the follow-up of coronary artery bypass graft (CABG) patients may be an interesting alternative to coronary angiography. 64-slice-coronary computed tomography is nowadays a diffused non-invasive method that permits an accurate evaluation of coronary stenosis, due to a high temporal and spatial resolution. However, its sensitivity and specificity in CABG evaluation has to be clearly defined, since published studies used different protocols and scanners. We collected all studies investigating patients with stable symptoms and previous CABG and reporting the comparison between diagnostic performances of invasive coronary angiography and 64-slice-coronary computed tomography. As a result, sensitivity and specificity of 64-slice-coronary computed tomography for CABG occlusion were 0.99 (95% CI 0.97-1.00) and 0.99 (95% CI: 0.99-1.00) with an area under the curve (AUC) of 0.99. 64-slice-coronary computed tomography sensitivity and specificity for the presence of any CABG stenosis >50% were 0.98 (95% CI: 0.97-0.99) and 0.98 (95% CI: 0.96-0.98), while AUC was 0.99. At meta-regression, neither the age nor the time from graft implantation had effect on sensitivity and specificity of 64-slice-coronary computed tomography detection of significant CABG stenosis or occlusion. In conclusion 64-slice-coronary computed tomography confirmed its high sensitivity and specificity in CABG stenosis or occlusion evaluation. PMID:27140337

  9. Comparative study of 64-slice CT angiography and digital subtraction angiography in spontaneous subarachnoid hemorrhage cases%自发性蛛网膜下腔出血的CTA与DSA对比研究

    薛波; 高国波; 李勇; 张立军; 李昌晓

    2013-01-01

    目的:探讨64层CTA与DSA对自发性蛛网膜下腔出血(spontaneous subarachnoid hemorrhage,s-SAH)的应用价值及其限度.方法:收集153例s-SAH患者的CTA及DSA检查资料,回顾性分析2种检查方法的图像质量(采取1~3分评分制),并比较2种方法在脑动脉瘤检出方面的灵敏度、特异度及准确度.结果:图像质量评分CTA为(2.63±0.262)分,DSA为(2.73±0.254)分,二者差异无统计学意义(P>0.05).CTA对脑动脉瘤的检出的灵敏度为96.2%,特异度为94.9%,准确度为95.9%;DSA灵敏度为97.7%,特异度为97.4%,准确度为97.6%,二者差异无统计学意义(P>0.05).结论:在s-SAH患者中,CTA与DSA均能准确检出动脉瘤所致破裂出血.相较于DSA,CTA能多方位显示病变,对血管壁及血管周围情况的显示更具价值.

  10. Radiation dose reduction by using 100-kV tube voltage in cardiac 64-slice computed tomography: A comparative study

    Objective: To evaluate a 100-kilovoltage (kV) tube voltage protocol regarding radiation dose and image quality, in comparison with the standard 120 kV setting in cardiac computed tomography angiography (CCTA). Methods: 103 patients undergoing retrospective ECG-gated helical 64-slice CCTA were enrolled (100 kV group: 51 patients; 120 kV group: 52 patients). Inclusion criteria were: (1) BMI 2; (2) weight 25 kg/m2). Conclusions: The 100 kV protocol significantly reduces the radiation dose in CCTA in patients with a low BMI 2 and a low calcium load while maintaining high image quality and the advantages of helical scan algorithm.

  11. Hybrid cardiac SPECT/64-slice CTA-derived LV function parameters: Correlation and reproducibility assessment

    The purpose of this study is to define the relationship between SPECT and CTA measured parameters of left ventricular (LV) function and volumes obtained in a single session using SPECT/64-slice CT hybrid imaging device, and in addition, to assess the reproducibility of LV parameters measured using 64-slice CTA. Materials and methods: Seventy-six patients with suspected or known coronary artery disease underwent cardiac CTA and GSPECT in one session using a hybrid SPECT/CT device. LV end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were measured on each component of the hybrid device. For the CTA component, these parameters were re-measured by the same investigator and by a second investigator with an interval of 3-54 weeks. Corresponding GSPECT and CTA measured parameters were compared. For CTA, intra-observer and inter-observer variability of LV function and volume measurements were calculated. Results: A very good correlation was found between the GSPECT and CTA measured LVEF (r = 0.81), ESV (r = 0.90) and EDV (r = 0.82). There was a small positive difference by CTA measured LVEF (3.9 ± 14.2%), and more prominent positive differences by CTA measured ESV and EDV (9.8 ± 14.8 and 44.9 ± 23.1 cm3, respectively). There was excellent reproducibility in the measurements of all parameters with very low intra- and inter-observer variability (r = 0.93 for EF and 0.98 for EDV and ESV). Conclusions: Although a good correlation was found between the EF measurements obtained from CTA and SPECT, interchangeable use of EF measurements between the two modalities should be done cautiously and interchangeable use of LV EDV and ESV should be avoided.

  12. Multidetector CT angiography in Takayasu arteritis

    Khandelwal, Niranjan; Kalra, Naveen [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Garg, Mandeep Kumar, E-mail: gargmandeep@hotmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Kang, Mandeep; Lal, Anupam [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Jain, Sanjay [Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Suri, Sudha [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India)

    2011-02-15

    Objective: To analyse the spectrum of Takayasu's arteritis (TA) on multidetector CT angiography (MDCTA). Materials and methods: A retrospective analysis of the MDCTA findings was performed on 15 patients clinically diagnosed as Takayasu's arteritis. The spectrum and incidence of imaging findings on CTA were compared to studies in literature on catheter angiography in Takayasu's arteritis. Laboratory parameters were available in nine patients. The disease was considered active if erythrocyte sedimentation rate (ESR) levels were elevated and 'C' reactive protein (CRP) was positive. An attempt was made to correlate disease activity with the imaging findings. Results: Ascending aorta, arch of aorta and descending thoracic aorta were involved in 14 out of 15 (93%) patients. The wall thickness varied between 1 and 10 mm with maximal involvement in arch and descending thoracic aorta. Major neck vessels were involved in 11 (73%) patients with most pronounced changes seen in the brachiocephalic trunk, left common carotid artery (CCA) and left subclavian artery (SCA). Abdominal aorta and its branches were involved in all the 11 (100%) patients in whom abdominal CTA was performed. Celiac axis and SMA were involved in 10 (91%) and seven (64%) patients, respectively while renal artery stenosis was present in five (45%) patients. In six patients, ESR was elevated and CRP was positive indicating active disease. All patients in whom the laboratory parameters were available showed mural thickening in the aorta and at least one of the neck vessels except for one patient with inactive disease who had aortic mural thickening only. Conclusion: MDCTA provides information about both the vessel wall and lumen in patients with Takayasu's disease.

  13. Multidetector CT angiography in Takayasu arteritis

    Objective: To analyse the spectrum of Takayasu's arteritis (TA) on multidetector CT angiography (MDCTA). Materials and methods: A retrospective analysis of the MDCTA findings was performed on 15 patients clinically diagnosed as Takayasu's arteritis. The spectrum and incidence of imaging findings on CTA were compared to studies in literature on catheter angiography in Takayasu's arteritis. Laboratory parameters were available in nine patients. The disease was considered active if erythrocyte sedimentation rate (ESR) levels were elevated and 'C' reactive protein (CRP) was positive. An attempt was made to correlate disease activity with the imaging findings. Results: Ascending aorta, arch of aorta and descending thoracic aorta were involved in 14 out of 15 (93%) patients. The wall thickness varied between 1 and 10 mm with maximal involvement in arch and descending thoracic aorta. Major neck vessels were involved in 11 (73%) patients with most pronounced changes seen in the brachiocephalic trunk, left common carotid artery (CCA) and left subclavian artery (SCA). Abdominal aorta and its branches were involved in all the 11 (100%) patients in whom abdominal CTA was performed. Celiac axis and SMA were involved in 10 (91%) and seven (64%) patients, respectively while renal artery stenosis was present in five (45%) patients. In six patients, ESR was elevated and CRP was positive indicating active disease. All patients in whom the laboratory parameters were available showed mural thickening in the aorta and at least one of the neck vessels except for one patient with inactive disease who had aortic mural thickening only. Conclusion: MDCTA provides information about both the vessel wall and lumen in patients with Takayasu's disease.

  14. Hybrid CT angiography and quantitative 15O-water PET for assessment of coronary artery disease: comparison with quantitative coronary angiography

    CT angiography (CTA) can rule out significant stenoses with a very high reliability, whereas its ability to confirm significant stenoses is suboptimal. In contrast, measurements of myocardial blood flow (MBF) provide information on the haemodynamic consequences of stenoses. Therefore, a combination of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by 15O-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses. The study group comprised 44 outpatients scheduled for invasive coronary angiography (ICA) with an intermediate pretest likelihood of coronary artery disease. The patients underwent 64-slice CTA and baseline and hyperaemic PET before ICA with quantitative coronary angiography analysis. On a per-patient basis, the negative predictive values (NPV; 95 % confidence intervals in parentheses) were 88 % (64 - 97 %) for CTA, 90 % (71 - 97%) for PET and 92 % (74 - 98%) for PET/CTA, and the positive predictive values (PPV) were 71 % (53 - 85%) for CTA, 87 % (68 - 95%) for PET and 100 % (84 - 100%) for PET/CTA. Similarly, on a per-vessel basis the NPVs (which were generally high) were 97 % (94 - 100%) for CTA, 95 % (90 - 99%) for PET and 97 % (95 - 100%) for PET/CTA, and the PPVs (which were lower, but higher with PET/CTA) were 53 % (39 - 66%) for CTA, 53 % (40 - 66%) for PET and 85 % (73 - 97%) for PET/CTA. In six patients, CTA analysis was hampered by the presence of severe calcifications. However, with the addition of the PET data, all six patients were correctly categorized. Cardiac quantitative hybrid PET/CTA imaging has better diagnostic accuracy than CTA alone and PET alone. CTA has a suboptimal PPV, suggesting that hybrid PET/CTA imaging should be used to assess the significance of coronary stenoses diagnosed by CTA. (orig.)

  15. Hybrid CT angiography and quantitative {sup 15}O-water PET for assessment of coronary artery disease: comparison with quantitative coronary angiography

    Thomassen, Anders; Petersen, Henrik; Johansen, Allan; Braad, Poul-Erik; Hoeilund-Carlsen, Mette M.; Hoeilund-Carlsen, Poul F. [OUH, Odense University Hospital, Department of Nuclear Medicine, Odense C (Denmark); Diederichsen, Axel C.P.; Mickley, Hans; Jensen, Lisette O.; Thayssen, Per [OUH, Odense University Hospital, Department of Cardiology, Odense (Denmark); Gerke, Oke [OUH, Odense University Hospital, Department of Nuclear Medicine, Odense C (Denmark); University of Southern Denmark, Centre of Health Economics Research, Odense (Denmark); Vach, Werner [University Medical Center Freiburg, Clinical Epidemiology, Institute of Medical Biometry and Medical Informatics, Freiburg (Germany); Knuuti, Juhani [Turku University Hospital and University of Turku, Turku (Finland)

    2013-12-15

    CT angiography (CTA) can rule out significant stenoses with a very high reliability, whereas its ability to confirm significant stenoses is suboptimal. In contrast, measurements of myocardial blood flow (MBF) provide information on the haemodynamic consequences of stenoses. Therefore, a combination of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by {sup 15}O-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses. The study group comprised 44 outpatients scheduled for invasive coronary angiography (ICA) with an intermediate pretest likelihood of coronary artery disease. The patients underwent 64-slice CTA and baseline and hyperaemic PET before ICA with quantitative coronary angiography analysis. On a per-patient basis, the negative predictive values (NPV; 95 % confidence intervals in parentheses) were 88 % (64 - 97 %) for CTA, 90 % (71 - 97%) for PET and 92 % (74 - 98%) for PET/CTA, and the positive predictive values (PPV) were 71 % (53 - 85%) for CTA, 87 % (68 - 95%) for PET and 100 % (84 - 100%) for PET/CTA. Similarly, on a per-vessel basis the NPVs (which were generally high) were 97 % (94 - 100%) for CTA, 95 % (90 - 99%) for PET and 97 % (95 - 100%) for PET/CTA, and the PPVs (which were lower, but higher with PET/CTA) were 53 % (39 - 66%) for CTA, 53 % (40 - 66%) for PET and 85 % (73 - 97%) for PET/CTA. In six patients, CTA analysis was hampered by the presence of severe calcifications. However, with the addition of the PET data, all six patients were correctly categorized. Cardiac quantitative hybrid PET/CTA imaging has better diagnostic accuracy than CTA alone and PET alone. CTA has a suboptimal PPV, suggesting that hybrid PET/CTA imaging should be used to assess the significance of coronary stenoses diagnosed by CTA. (orig.)

  16. CT Angiography in the Diagnosis of Brain Death

    Summary Brain death is defined as the irreversible cessation of functioning of the entire brain, including the brainstem. Brain death is principally established using clinical criteria including coma, absence of brainstem reflexes and loss of central drive to breathe assessed with apnea test. In situations in which clinical testing cannot be performed or when uncertainty exists about the reliability of its parts due to confounding conditions ancillary tests (i.a. imaging studies) may be useful. The objective of ancillary tests in the diagnosis of brain death is to demonstrate the absence of cerebral electrical activity (EEG and evoked potentials) or cerebral circulatory arrest. In clinical practice catheter cerebral angiography, perfusion scintigraphy, transcranial Doppler sonography, CT angiography and MR angiography are used. Other methods, like perfusion CT, xenon CT, MR spectroscopy, diffusion weighted MRI and functional MRI are being studied as potentially useful in the diagnosis of brain death. CT angiography has recently attracted attention as a promising alternative to catheter angiography – a reference test in the diagnosis of brain death. Since 1998 several major studies were published and national guidelines were introduced in several countries (e.g. in France, Austria, Switzerland, the Netherlands and Canada). This paper reviews technique, characteristic findings and criteria for the diagnosis of cerebral circulatory arrest in CT angiography

  17. Serial changes of coronary atherosclerotic plaque: Assessment with 64-slice multi-detector computed tomography

    Kim, Eun Young; Kang, Doo Kyoung; Sun, Joo Sung; Choi, So Yeon [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2013-12-15

    Evaluate the progression of coronary atherosclerotic plaque during follow-up, and its association with cardiovascular risk factors. Fifty-six atherosclerotic patients with plaque were enrolled in this retrospective study. Patient's plaque was detected on repeat 64-slice multidetector CT scans with a mean interval of 25 ± 10 months changes in calcified and non-calcified plaque volumes and cardiovascular risk factors were assessed over time. Absolute and relative changes in plaque volume were compared, and the association between rapid progression and cardiovascular risk factors was determined. Diameter of the stenosis, length, calcified and non-calcified lesion plaque volumes increased significantly on follow-up CT. Absolute and relative annual changes in plaque volumes were significantly greater in non-calcified plaque (median, 22.7 mm{sup 3}, 90.4%) than in calcified plaque (median, 0.7 mm{sup 3}, 0%). Obesity, smoking, hypertension, hypercholesterolemia, and low high-density lipoprotein were significant predictors of progression of non-calcified plaque. Progression of calcified plaque was not associated with any cardiovascular risk factors. Coronary plaque volume increased significantly on follow-up CT. The rate of progression is related to non-calcified plaque than to calcified plaque. Cardiovascular risk factors are independently associated with the rapid progression of non-calcified plaque volume, but not associated with the progression of calcified plaque.

  18. Serial changes of coronary atherosclerotic plaque: Assessment with 64-slice multi-detector computed tomography

    Evaluate the progression of coronary atherosclerotic plaque during follow-up, and its association with cardiovascular risk factors. Fifty-six atherosclerotic patients with plaque were enrolled in this retrospective study. Patient's plaque was detected on repeat 64-slice multidetector CT scans with a mean interval of 25 ± 10 months changes in calcified and non-calcified plaque volumes and cardiovascular risk factors were assessed over time. Absolute and relative changes in plaque volume were compared, and the association between rapid progression and cardiovascular risk factors was determined. Diameter of the stenosis, length, calcified and non-calcified lesion plaque volumes increased significantly on follow-up CT. Absolute and relative annual changes in plaque volumes were significantly greater in non-calcified plaque (median, 22.7 mm3, 90.4%) than in calcified plaque (median, 0.7 mm3, 0%). Obesity, smoking, hypertension, hypercholesterolemia, and low high-density lipoprotein were significant predictors of progression of non-calcified plaque. Progression of calcified plaque was not associated with any cardiovascular risk factors. Coronary plaque volume increased significantly on follow-up CT. The rate of progression is related to non-calcified plaque than to calcified plaque. Cardiovascular risk factors are independently associated with the rapid progression of non-calcified plaque volume, but not associated with the progression of calcified plaque.

  19. Value of automatic bone subtraction in cranial CT angiography: comparison of bone-subtracted vs. standard CT angiography in 100 patients

    Non-contrast-enhanced cranial computed tomography (NECT) and CT angiography (CTA) are the most frequently used modalities in the triage of patients with acute ischemic and hemorrhagic stroke. CTA bone removal can improve the delineation of vasculature closely adjacent to bony structures, which is sometimes limited in standard CTA. The aim of this study was the evaluation of the clinical benefit of bone subtraction (BS) regarding delineation of cerebral vasculature, reading time and depiction of vascular pathologies compared to standard CTA without BS. A total of 100 patients who underwent NECT and supraaortic CTA on a 64-slice CT system were retrospectively included in the study. Bone removal was performed by subtraction of the NECT data from the CTA data using a dedicated workstation. Standard and BS CTA of each patient was reviewed for delineation of cerebral vasculature (grading scale from 1 ''excellent delineation'' to 10 = ''hardly any delineation''), reading time and depiction of vascular pathologies (standardized catalog) by two blinded readers. For BS data sets, the quality of BS was rated by a combination of the criteria complete bone removal, depiction of vascular structures and sufficient quality for diagnostic evaluation. The use of BS significantly reduced reading time from 4.60 min to 3.49 min (p < 0.001). Performing BS, the quality of vascular delineation of the cerebral arteries, cerebral veins and cavernous segment of the ICA increased significantly as compared to standard CTA (1.70 vs. 2.70; 2.60 vs. 4.12; 2.35 vs. 4.40, all p < 0.001). Consensus reading showed 41 pathologies in 35 patients. Diagnosis was missed or wrong overall in 15 cases, with 3 missed aneurysms (CTA: 2 vs. BS: 1), 8 wrong stenotic findings (CTA: 3 vs. BS: 5) and 4 missed partial thromboses (CTA: 2 vs. BS: 2). Performing BS in supraaortic CTA for the evaluation of cerebral vasculature reduces reading time and improves delineation of vessels. Diagnostic accuracy in general is

  20. Value of automatic bone subtraction in cranial CT angiography: comparison of bone-subtracted vs. standard CT angiography in 100 patients

    Morhard, Dominik; Fink, Christian; Becker, Christoph; Reiser, Maximilian F.; Nikolaou, Konstantin [Ludwig-Maximilians-University of Munich, Institute of Clinical Radiology, Munich (Germany)

    2008-05-15

    Non-contrast-enhanced cranial computed tomography (NECT) and CT angiography (CTA) are the most frequently used modalities in the triage of patients with acute ischemic and hemorrhagic stroke. CTA bone removal can improve the delineation of vasculature closely adjacent to bony structures, which is sometimes limited in standard CTA. The aim of this study was the evaluation of the clinical benefit of bone subtraction (BS) regarding delineation of cerebral vasculature, reading time and depiction of vascular pathologies compared to standard CTA without BS. A total of 100 patients who underwent NECT and supraaortic CTA on a 64-slice CT system were retrospectively included in the study. Bone removal was performed by subtraction of the NECT data from the CTA data using a dedicated workstation. Standard and BS CTA of each patient was reviewed for delineation of cerebral vasculature (grading scale from 1 = 'excellent delineation' to 10 = 'hardly any delineation'), reading time and depiction of vascular pathologies (standardized catalog) by two blinded readers. For BS data sets, the quality of BS was rated by a combination of the criteria complete bone removal, depiction of vascular structures and sufficient quality for diagnostic evaluation. The use of BS significantly reduced reading time from 4.60 min to 3.49 min (p < 0.001). Performing BS, the quality of vascular delineation of the cerebral arteries, cerebral veins and cavernous segment of the ICA increased significantly as compared to standard CTA (1.70 vs. 2.70; 2.60 vs. 4.12; 2.35 vs. 4.40, all p < 0.001). Consensus reading showed 41 pathologies in 35 patients. Diagnosis was missed or wrong overall in 15 cases, with 3 missed aneurysms (CTA: 2 vs. BS: 1), 8 wrong stenotic findings (CTA: 3 vs. BS: 5) and 4 missed partial thromboses (CTA: 2 vs. BS: 2). Performing BS in supraaortic CTA for the evaluation of cerebral vasculature reduces reading time and improves delineation of vessels. Diagnostic

  1. Evaluation of effective dose received by patients undergoing Cardiac Angiography Computed Tomography (CT) and Conventional Angiography

    Cardiac Angiography is a field of studies that utilizes the energy of radiation to study the coronary arteries of the heart. Patients undergoing this procedure has a probability of receiving an over dose of radiation that may further cause stochastic effect. The main objective of this research is to compare and clarify an approach for minimal effective dose receive by patients between procedures of Cardiac Angiography Computerized Tomography (CT) and Conventional Angiography. Based on this study, the patients recorded are based in Hospital University Sains Malaysia, Kubang Kerian, Kelantan. The Dose-Length-Product (DLP) was extracted from the Computed Tomography Dose Index (CTDI); meanwhile the Dose-Area-Product (DAP) was extracted from the modalities console screen. These relevant data are the means to clarify the effective dose receive by patients. The result shows that patients who undergo Conventional Angiography had a mean effective dose of 8.50 ± 6.41 mSv. Meanwhile, as for Cardiac Angiography Computerized Tomography, the patients had a mean effective dose of 7.08 ± 2.42 mSv. A significant difference in effective dose was seen between the two procedures. Cardiac Angiography CT provides high accurate diagnostic information with less radiation dose to patients compared to Conventional Angiography. (author)

  2. Clinical utility of landiolol for use in coronary CT angiography

    Tomizawa N

    2015-11-01

    Full Text Available Nobuo Tomizawa,1 Yayoi Hayakawa,1 Shinichi Inoh,1 Takeshi Nojo,1 Sunao Nakamura2 1Department of Radiology, 2Department of Cardiology, New Tokyo Hospital, Matsudo, Chiba, Japan Abstract: Although remarkable advancement in computed tomography (CT has been achieved, heart rate control is important to maintain an optimal image quality in coronary CT angiography. Oral or intravenous β-blockers are used as premedication for this purpose. Landiolol was developed as a β-blocker with very high cardioselectivity (β1/β2 =255 and short half-life (4 minutes. In this review, we report the pharmacological features and usage of landiolol and also its effects on heart rate and image quality in coronary CT angiography. In addition, we discuss the safety of landiolol. Keywords: coronary computed tomography angiography, heart rate, image quality

  3. Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients with SAH and Comparison of the CTA Results with 2D-DSA and Intraoperative Findings

    Ergun, Elif; Haberal, Murat; Koşar, Pınar; Yılmaz, Ali; Koşar, Uğur

    2011-01-01

    Objective: To prospectively evaluate the diagnostic value of 64-slice CTA in detecting intracranial aneurysms and to compare it with 2D-DSA and/or intra-operative findings. Material and Methods: 37 cases with SAH according to unenhanced cranial CT were included in the study. A 64-slice CTA was performed to all cases immediately after the nonenhanced cranial CT. DSA was performed in 24-48 hours following CTA. CT images were reviewed by two radiologists experienced in CT vascular imag...

  4. Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients with SAH and Comparison of the CTA Results with 2D-DSA and Intraoperative Findings

    Elif Ergun; Murat Haberal; Pınar Koşar; Ali Yılmaz; Uğur Koşar

    2011-01-01

    Objective: To prospectively evaluate the diagnostic value of 64-slice CTA in detecting intracranial aneurysms and to compare it with 2D-DSA and/or intra-operative findings.Material and Methods: 37 cases with SAH according to unenhanced cranial CT were included in the study. A 64-slice CTA was performed to all cases immediately after the nonenhanced cranial CT. DSA was performed in 24-48 hours following CTA. CT images were reviewed by two radiologists experienced in CT vascular imaging. The ...

  5. Diagnostic accuracy of CT angiography in acute gastrointestinal bleeding

    Full text: The aim of the study was to carry out a systematic review determining the accuracy of CT angiography in the diagnosis of acute gastrointestinal bleeding. A search of published work in Medline and manual searching of reference lists of articles was conducted. Studies were included if they compared CT angiography to a reference standard of upper gastrointestinal endoscopy, colonoscopy, angiography or surgery in the diagnosis of acute gastrointestinal bleeding. Eight published studies evaluating 129 patients were included. Data were used to form 2x2 tables. Computed tomography angiography showed pooled sensitivity of 86% (95% confidence interval 78-92%) and specificity of 95% (95% confidence interval 76-100%), without showing significant heterogeneity (x2 = 3.5, P=0.6) and (x2 - 5.4, P = 0.6), respectively. Summary receiver operating characteristic analysis showed an area under the curve of 0.93. Computed tomography angiography is accurate in the diagnosis of acute gastrointestinal bleeding and can show the precise location and aetiology of bleeding, thereby directing further management. Strong recommendations for use of CT cannot be made from this review because of the methodological limitations and further large prospective studies are needed to define the role of CT in acute gastrointestinal bleeding.

  6. New abdominal CT angiography protocol on a 16 detector-row CT scanner - first results

    Purpose. Purpose of this study was the implementation of a new abdominal CT angiography protocol on a 16 detector-row CT scanner and the comparison to selective catheter angiography.Methods. 76 patients with various vascular disorders underwent abdominal CT angiography on a recently developed 16 detector-row CT scanner using submillimeter slice collimation (16 x 0.75 mm). Results were compared with mesenteric and/or hepatic angiography in 17 patients performed during tumor embolization. Opacification was provided using individually tailored contrast application with a test bolus setting. To evaluate the contrast injection protocol density measurements within the vessel lumen were performed.Results. Diagnostic image quality was achieved in all patients with angiographic comparison (n = 17). Within the hepatic and mesenteric vasculature up to 4th generation vessels could be identified. Compared to selctive angiography CT angiography provided equivalent morphologic information up to the detectable vessel generation. With the applied contrast application regimen there were no significant differences in vessel enhancement along the abdominal aorta and iliac arteries.Conclusion. 16 detector-row CT enables whole abdominal angiographic studies with submillimeter resolution in a single breath-hold. The improved spatial resolution enables for high quality 3D visualization. Compared to invasive angiography, 16 detector-row CT reveals equivalent morphologic information. (orig.)

  7. Effect of CT scan protocols on x-ray-induced DNA double-strand breaks in blood lymphocytes of patients undergoing coronary CT angiography

    To compare in vivo DNA lesions induced during helical and sequential coronary computed tomography angiography (CTA) and to evaluate the effect of CT parameters on double-strand break (DSB) levels. Thirty-six patients were examined with various CT protocols and modes (helical scan, n = 27; sequential scan, n = 9) either using a 64-slice dual-source or a 128-slice CT system. Blood samples were obtained before and 30 min after CT. Lymphocytes were isolated, stained against the phosphorylated histone variant γ-H2AX, and DSBs were visualised by using fluorescence microscopy. DSB yields 30 min after CTA ranged from 0.04 to 0.71 per cell and showed a significant correlation to DLP (ρ = 0.81, p < 0.00001). Median DSB yield and median DLP were significantly lower after sequential compared to helical CT examinations (0.11 vs. 0.37 DSBs/cell and 249 vs. 958 mGy cm, p < 0.00001). Additional calcium scoring led to an increase in DLP (p = 0.15) and DSB levels (p = 0.04). DSB levels normalised to the DLP showed a significant correlation to the attenuation of the blood (ρ = 0.53, p = 0.01) and a negative correlation to the body mass index of the patients (ρ = -0.37, p = 0.06). γ-H2AX immunofluorescence microscopy allows one to determine dose-related effects on x-ray-induced DSB levels and to consider individual factors which cannot be monitored by physical dose measurements. (orig.)

  8. Effect of CT scan protocols on x-ray-induced DNA double-strand breaks in blood lymphocytes of patients undergoing coronary CT angiography

    Kuefner, M.A.; Hamann, J.; Lell, Michael; Anders, K.; Schwab, S.A.; Uder, M. [University of Erlangen-Nuernberg, Department of Radiology, Erlangen (Germany); Grudzenski, S.; Loebrich, M. [Darmstadt University of Technology, Radiation Biology and DNA Repair, Darmstadt (Germany); Achenbach, S. [University of Erlangen-Nuernberg, Department of Cardiology, Erlangen (Germany); Haeberle, L. [University of Erlangen-Nuernberg, Department of Medical Informatics, Biometry and Epidemiology, Erlangen (Germany)

    2010-12-15

    To compare in vivo DNA lesions induced during helical and sequential coronary computed tomography angiography (CTA) and to evaluate the effect of CT parameters on double-strand break (DSB) levels. Thirty-six patients were examined with various CT protocols and modes (helical scan, n = 27; sequential scan, n = 9) either using a 64-slice dual-source or a 128-slice CT system. Blood samples were obtained before and 30 min after CT. Lymphocytes were isolated, stained against the phosphorylated histone variant {gamma}-H2AX, and DSBs were visualised by using fluorescence microscopy. DSB yields 30 min after CTA ranged from 0.04 to 0.71 per cell and showed a significant correlation to DLP ({rho} = 0.81, p < 0.00001). Median DSB yield and median DLP were significantly lower after sequential compared to helical CT examinations (0.11 vs. 0.37 DSBs/cell and 249 vs. 958 mGy cm, p < 0.00001). Additional calcium scoring led to an increase in DLP (p = 0.15) and DSB levels (p = 0.04). DSB levels normalised to the DLP showed a significant correlation to the attenuation of the blood ({rho} = 0.53, p = 0.01) and a negative correlation to the body mass index of the patients ({rho} = -0.37, p = 0.06). {gamma}-H2AX immunofluorescence microscopy allows one to determine dose-related effects on x-ray-induced DSB levels and to consider individual factors which cannot be monitored by physical dose measurements. (orig.)

  9. Vertebral angiography of cerebellar astrocytoma. Tumor stain, tumor circulation, CT and angiography in diagnosis

    Kitaoka, K.; Ito, T.; Tashiro, K.; Abe, H.; Tsuru, M.; Miyasaka, K. (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1982-05-01

    Thirteen cases of cerebellar astrocytoma were examined primarily for tumor stain and pathological tumor circulation by angiography and CT. Tumor stain was observed in only one case by cerebral angiogram. A tumor was demonstrated as an avascular mass in the remaining 12 cases. It is suggested that mural nodules of cystic lesions should have certain weight and sizes so that they could be demonstrated as tumor stain. In the supratentorial region, five of the 12 low-grade astrocytoma exhibited abnormal tumor stain and tumor circulation by cerebral angiogram. It is considered that supratentorial and posterior fossa astrocytoma must usually exhibit different pathological tumor circulation by cerebral angiogram, since each group has distinctive clinical and biological characteristics. CT was performed in 7 of 13 cases. It appeared to be more useful than cerebral angiography in the morphological diagnosis. Especially in cystic tumors, CT produced minute information concerning peritumoral edema, enhancement of margin of cystic astrocytoma after intravenous contrast medium, and marginal enhancement with layering in the dependent part of the cyst. Neuroradiological differential diagnosis of cerebellar astrocytoma and cerebellar hemagioblastoma by CT was difficult in the cases of tumors. However, both tumors were differentiated from each other with ease by tumor stain and tumor circulation in cerebral angiography. Thus, it is concluded that cerebral angiography is superior to CT in differential diagnosis between cerebellar astrocytoma and cerebellar hemangioblastoma.

  10. 64层螺旋CT血管造影在蛛网膜下腔出血诊断的临床运用%Clinical application of 64-slices spiral CT angiography in diagnosing subarachnoid haemorrhage

    苏海; 孙晓川; 朱继; 唐文渊

    2007-01-01

    目的:探讨64层螺旋CT血管造影(CTA)在蛛网膜下腔出血(SAH)病因诊断中的作用.方法:对2005年9月到2006年9月收治入院的89例SAH患者行64层螺旋CT血管造影检查,其中49例同时接受数字减影血管造影(DSA)检查.分析CTA检查结果并与DSA检查结果比较.结果:89例患者中CTA检出动脉瘤70例,动静脉畸形9例,静脉窦血栓2例,阴性8例;在同时接受DSA检查的49例患者中,发现动脉瘤41例,动静脉畸形4例,阴性4例,其中除1例CTA发现并经临床证实的动脉瘤DSA检查为阴性外,其余全部证实CTA诊断.CTA对SAH病因诊断中的敏感性和特异性都为100%,DSA分别为98%和100%.结论:64层螺旋CTA对SAH的病因诊断是一种无创、快速、便捷的影像学检查方法,可显示血管的空间立体结构及周边关系,有助于治疗方法的选择和难度的评估.

  11. The value in detection of acute nontraumatic subarachnoid hemorrhage with 64 slice multidetector CT angiography%64层CTA对急性非外伤性蛛网膜下腔出血的应用价值

    杜忆兵; 闫宇涛; 王晓辉; 陆利霞

    2009-01-01

    目的:用64层螺旋CTA评价急性非外伤性蛛网膜下腔出血(SAH)病因并选择治疗方法.方法:对68例急性非外伤性SAH患者发病7天内行CTA检查,明确病因,根据CTA结果选择治疗方法并评价疗效.图像处理采用MPVR、MIP及3DVR重建.结果:68例SAH患者均经DSA及外科手术证实.其中45例为动脉瘤破裂所致,1例血管炎,2例动脉硬化,1例夹层动脉瘤,19例动脉无明显异常.68例SAH中64例由CTA做出病因诊断(准确率94.1%、敏感性91.8%、特异性100%、阳性预测值100%、阴性预测值82.6%).CTA直接显示43例动脉瘤,1例血管炎及1例夹层动脉瘤.43例动脉瘤有42例根据CTA结果选择治疗(97.7%).其中栓塞29例,有26例(89.7%)栓塞满意.13例行外科手术钳闭.结论:64层CTA能准确评价SAH病因及动脉瘤的特征.对选择治疗方法十分有价值.

  12. Rarity of isolated pulmonary embolism and acute aortic syndrome occurring outside of the field of view of dedicated coronary CT angiography

    Background Although triple rule-out CT angiography (TRO) to simultaneously evaluate acute coronary syndrome (ACS), pulmonary embolism (PE), and acute aortic syndrome (AAS) is increasingly used in many institutions, TRO is inevitably associated with increased radiation exposure due to extended z-axis coverage compared with dedicated coronary CT angiography (DCTA). Purpose To determine the frequency of exclusion of findings of AAS, PE, and significant incidental non-cardiac pathology that may be the cause of acute chest pain when using a restricted DCTA field of view (FOV). Material and Methods We retrospectively reviewed CT images and charts of 103 patients with acute PE and 50 patients with AAS. Either non-ECG gated dedicated pulmonary or aortic CT angiography was performed using 16- or 64-slice multidetector CT (MDCT). We analyzed the incidence of isolated PE, AAS, or significant non-cardiac pathology outside of DCTA FOV (i.e. from tracheal carina to the base of heart). Results There were two cases of isolated PE (2/103, 1.9%) excluded from the FOV of DCTA. One case of PE was isolated to the subsegmental pulmonary artery in the posterior segment of the right upper lobe. In the second case, pulmonary embolism in the left main pulmonary artery was located out of the FOV of DCTA because the left main pulmonary artery was retracted upwardly by fibrotic scar in the left upper lobe due to prior tuberculosis. There was no case of AAS and significant non-cardiac pathology excluded from the FOV of DCTA. AAS (n = 50) consisted of penetrating atherosclerotic ulcer (n = 7), intramural hematoma (n = 5) and aortic dissection (n = 38). Conclusion As isolated PE, AAS, and significant non-cardiac pathology outside of the DCTA FOV rarely occur, DCTA may replace TRO in the evaluation of patients with non-specific acute chest pain and a low pre-test probability of PE or aortic dissection

  13. Rarity of isolated pulmonary embolism and acute aortic syndrome occurring outside of the field of view of dedicated coronary CT angiography

    Lee, Hwa Yeon; Song, In Sup (Dept. of Diagnostic Radiology Chung-Ang Univ. College of Medicine, Seoul (Korea, Republic of)); Yoo, Seung Min; Rho, Ji Young (Dept. of Diagnostic Radiology CHA Medical Univ. Hospital, Bundang (Korea, Republic of)), email: smyoo68@hanmail.net; Moon, Jae Youn; Kim, In Jai; Lim, Sang Wook; Sung, Jung Hoon; Cha, Dong Hun (Dept. of Cardiology CHA Medical Univ. Hospital, Bundang (Korea, Republic of)); White, Charles S. (Dept. of Diagnostic Radiology Univ. of Maryland, Baltimore (United States))

    2011-05-15

    Background Although triple rule-out CT angiography (TRO) to simultaneously evaluate acute coronary syndrome (ACS), pulmonary embolism (PE), and acute aortic syndrome (AAS) is increasingly used in many institutions, TRO is inevitably associated with increased radiation exposure due to extended z-axis coverage compared with dedicated coronary CT angiography (DCTA). Purpose To determine the frequency of exclusion of findings of AAS, PE, and significant incidental non-cardiac pathology that may be the cause of acute chest pain when using a restricted DCTA field of view (FOV). Material and Methods We retrospectively reviewed CT images and charts of 103 patients with acute PE and 50 patients with AAS. Either non-ECG gated dedicated pulmonary or aortic CT angiography was performed using 16- or 64-slice multidetector CT (MDCT). We analyzed the incidence of isolated PE, AAS, or significant non-cardiac pathology outside of DCTA FOV (i.e. from tracheal carina to the base of heart). Results There were two cases of isolated PE (2/103, 1.9%) excluded from the FOV of DCTA. One case of PE was isolated to the subsegmental pulmonary artery in the posterior segment of the right upper lobe. In the second case, pulmonary embolism in the left main pulmonary artery was located out of the FOV of DCTA because the left main pulmonary artery was retracted upwardly by fibrotic scar in the left upper lobe due to prior tuberculosis. There was no case of AAS and significant non-cardiac pathology excluded from the FOV of DCTA. AAS (n = 50) consisted of penetrating atherosclerotic ulcer (n = 7), intramural hematoma (n = 5) and aortic dissection (n = 38). Conclusion As isolated PE, AAS, and significant non-cardiac pathology outside of the DCTA FOV rarely occur, DCTA may replace TRO in the evaluation of patients with non-specific acute chest pain and a low pre-test probability of PE or aortic dissection

  14. Varices from portal hypertension: correlation of CT and angiography

    McCain, A.H.; Bernardino, M.E.; Sones, P.J. Jr.; Berkman, W.A.; Casarella, W.J.

    1985-01-01

    Two hundred abdominal CT and angiographic examinations were performed on 137 patients with portal hypertension. These patients were being evaluated before or after a distal splenorenal shunt. CT increased the detection of umbilical and retroperitoneal varices. Angiography better detected peripancreatic varices and cavernous transformation. Both modalities together added more information than either alone in identification of coronary and/or gastroesophageal, retrogastric, and perisplenic-mesenteric varices. This additional anatomic information helped in the patient's management pre- and postoperatively.

  15. Clinical utility of landiolol for use in coronary CT angiography

    Tomizawa N; Hayakawa Y; Inoh S; Nojo T; Nakamura S

    2015-01-01

    Nobuo Tomizawa,1 Yayoi Hayakawa,1 Shinichi Inoh,1 Takeshi Nojo,1 Sunao Nakamura2 1Department of Radiology, 2Department of Cardiology, New Tokyo Hospital, Matsudo, Chiba, Japan Abstract: Although remarkable advancement in computed tomography (CT) has been achieved, heart rate control is important to maintain an optimal image quality in coronary CT angiography. Oral or intravenous β-blockers are used as premedication for this purpose. Landiolol was developed as a β-blocker with very ...

  16. Clinical utility of landiolol for use in coronary CT angiography

    Tomizawa, Nobuo

    2015-01-01

    Nobuo Tomizawa,1 Yayoi Hayakawa,1 Shinichi Inoh,1 Takeshi Nojo,1 Sunao Nakamura2 1Department of Radiology, 2Department of Cardiology, New Tokyo Hospital, Matsudo, Chiba, Japan Abstract: Although remarkable advancement in computed tomography (CT) has been achieved, heart rate control is important to maintain an optimal image quality in coronary CT angiography. Oral or intravenous β-blockers are used as premedication for this purpose. Landiolol was developed as a β-blocker wi...

  17. Comparison of digital subtraction angiography, CT angiography, and ultrasonic doppler examination in the evaluation of penile arterial lesions

    CT angiography reconstructed by a multidetector-row helical CT scanner is a newly developed form of imaging. We compared CT angiography and ultrasonic Doppler examination with digital subtraction angiography (DSA) in the diagnosis of arterial lesion. Eighteen patients with arteriogenic erectile dysfunction (ED) underwent color Doppler study DSA, and CT angiography after providing informed consent. The CT angiography images were obtained by a multidetector-row helical CT scanner, Asteion TSX021A (TOSHIBA). We injected prostaglandin E1 into the penile cavernous body, and then rapidly infused nonionic contrast medium into the antecubital vein. DSA and CT angiography images of the bilateral internal pudendal arteries and cavernous arteries were examined for stenotic lesions or occlusion. We also compared the peak systolic blood flow velocity in the cavernous artery measured by color Doppler ultrasound with CT angiography and DSA. The CT anigography and color Doppler studies were performed on an outpatient basis, but DSA required hospitalization. In the 36 internal pudendal arteries, DSA represented 22 normal arteries and 14 stenosis or occlusions. CT angiography showed 15 normal arteries and 21 occlusions. For the diagnosis of stenosis or occlusion in the internal pudendal artery, the CT angiography image had a good agreement, with a sensitivity of 1.00, specificity of 0.68, and accuracy of 0.81. For diagnosis in the cavernous artery, CT angiography image also showed a good agreement with DSA; however, the quality of the images of fine arteries was better in the DSA images. The inferior view and internal view of the pelvis in CT angiography were helpful for visulaizing the internal pudendal artery, especially at the pubic bone. There was insufficient correlation between peak systolic blood flow velocity and DSA findings. There were no serious complications involved in either examination. CT angiography has not yet reached the same level as DSA in the evaluation of fine

  18. Comparison of digital subtraction angiography, CT angiography, and ultrasonic doppler examination in the evaluation of penile arterial lesions

    Kawanisi, Yasuo; Kimura, Kazunori; Lee, Kyong Soo; Koizumi, Takahiro; Nakatsuji, Hiroyoshi; Kojima, Keiji; Yamamoto, Akira; Numata, Akira [Takamatsu Red Cross Hospital (Japan)

    2001-11-01

    CT angiography reconstructed by a multidetector-row helical CT scanner is a newly developed form of imaging. We compared CT angiography and ultrasonic Doppler examination with digital subtraction angiography (DSA) in the diagnosis of arterial lesion. Eighteen patients with arteriogenic erectile dysfunction (ED) underwent color Doppler study DSA, and CT angiography after providing informed consent. The CT angiography images were obtained by a multidetector-row helical CT scanner, Asteion TSX021A (TOSHIBA). We injected prostaglandin E{sub 1} into the penile cavernous body, and then rapidly infused nonionic contrast medium into the antecubital vein. DSA and CT angiography images of the bilateral internal pudendal arteries and cavernous arteries were examined for stenotic lesions or occlusion. We also compared the peak systolic blood flow velocity in the cavernous artery measured by color Doppler ultrasound with CT angiography and DSA. The CT anigography and color Doppler studies were performed on an outpatient basis, but DSA required hospitalization. In the 36 internal pudendal arteries, DSA represented 22 normal arteries and 14 stenosis or occlusions. CT angiography showed 15 normal arteries and 21 occlusions. For the diagnosis of stenosis or occlusion in the internal pudendal artery, the CT angiography image had a good agreement, with a sensitivity of 1.00, specificity of 0.68, and accuracy of 0.81. For diagnosis in the cavernous artery, CT angiography image also showed a good agreement with DSA; however, the quality of the images of fine arteries was better in the DSA images. The inferior view and internal view of the pelvis in CT angiography were helpful for visulaizing the internal pudendal artery, especially at the pubic bone. There was insufficient correlation between peak systolic blood flow velocity and DSA findings. There were no serious complications involved in either examination. CT angiography has not yet reached the same level as DSA in the evaluation

  19. Radiation dose in cardiac CT angiography: Protocols and image quality

    This paper aims to evaluate the radiation dose exposure of patients submitted to cardiac computed tomography angiography. The effective dose was obtained from the product of dose-length product values and the conversion factor established in the European Working Group for Guidelines on Quality Criteria in CT. The image noise and contrast-and signal-to-noise ratios were obtained for all images. Sixty-four- and 256-slice CT angiographies were used in 211 (68.5 %) and 97 (31.5 %) patients, respectively. The calculated mean effective dose with prospective CT angiography was 6.0±1.0 mSv and the retrospective mode was 8.4±1.2 mSv. The mean image noise values were 38.5±9.5 and 21.4±5.3 for prospective and retrospective modes, respectively. It was observed that the image noise increased by 44.4 % using a prospective mode. Prospective CT angiography reduces radiation dose by ∼29 % compared with the retrospective mode, while maintaining diagnostic image quality and the ability to assess obstructions in patients. (authors)

  20. Coronary CT Angiography versus Conventional Cardiac Angiography for Therapeutic Decision Making in Patients with High Likelihood of Coronary Artery Disease

    Moscariello, Antonio; Vliegenthart, Rozemarijn; Schoepf, U. Joseph; Nance, John W.; Zwerner, Peter L.; Meyer, Mathias; Townsend, Jacob C.; Fernandes, Valerian; Steinberg, Daniel H.; Fink, Christian; Oudkerk, Matthijs; Bonomo, Lorenzo; O'Brien, Terrence X.; Henzler, Thomas

    2012-01-01

    Purpose: To assess the efficacy of coronary computed tomographic (CT) angiography for therapeutic decision making in patients with high likelihood of coronary artery disease (CAD)-specifically the ability of coronary CT angiography to help differentiate patients without and patients with a need for

  1. High-resolution ex vivo imaging of coronary artery stents using 64-slice computed tomography - initial experience

    Rist, Carsten; Nikolaou, Konstantin; Wintersperger, Bernd J.; Reiser, Maximilian F.; Becker, Christoph R. [Ludwig-Maximilians University, Department of Clinical Radiology, Munich (Germany); Flohr, Thomas [Siemens Medical Solutions, CT Division, Forchheim (Germany)

    2006-07-15

    The aim of the study was to evaluate the potential of new-generation multi-slice computed tomography (CT) scanner technology for the delineation of coronary artery stents in an ex vivo setting. Nine stents of various diameters (seven stents 3 mm, two stents 2.5 mm) were implanted into the coronary arteries of ex vivo porcine hearts and filled with a mixture of an iodine-containing contrast agent. Specimens were scanned with a 16-slice CT (16SCT) machine; (Somatom Sensation 16, Siemens Medical Solutions), slice thickness 0.75 mm, and a 64-slice CT (64SCT, Somatom Sensation 64), slice-thickness 0.6 mm. Stent diameters as well as contrast densities were measured, on both the 16SCT and 64SCT images. No significant differences of CT densities were observed between the 16SCT and 64SCT images outside the stent lumen: 265{+-}25HU and 254{+-}16HU (P=0.33), respectively. CT densities derived from the 64SCT images and 16SCT images within the stent lumen were 367{+-}36HU versus 402{+-}28HU, P<0.05, respectively. Inner and outer stent diameters as measured from 16SCT and 64SCT images were 2.68{+-}0.08 mm versus 2.81{+-}0.07 mm and 3.29{+-}0.06 mm versus 3.18{+-}0.07 mm (P<0.05), respectively. The new 64SCT scanner proved to be superior in the ex vivo assessment of coronary artery stents to the conventional 16SCT machine. Increased spatial resolution allows for improved assessment of the coronary artery stent lumen. (orig.)

  2. Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding:A meta-analysis

    2010-01-01

    AIM: To analyze the accuracy of computed tomography (CT) angiography in the diagnosis of acute gastrointestinal (GI) bleeding. METHODS: The MEDLINE, EMBASE, Cancerlit, Cochrane Library database, Sciencedirect, Springerlink and Scopus, from January 1995 to December 2009, were searched for studies evaluating the accuracy of CT angiography in diagnosing acute GI bleeding. Studies were included if the ycompared CT angiography to a reference standard of upper GI endoscopy, colonoscopy, angiography or surgery in ...

  3. Effects of Propranolol on the Left Ventricular Volume of Normal Subjects During CT Coronary Angiography

    The purpose of this study is to determine the effects of propranolol on the left ventricular (LV) volume during CT coronary angiography. The LV volume of 252 normal Chinese subjects (126 subjects with propranolol medication and 126 age- and gender-matched Chinese subjects without medication) was estimated using 64 slices multi-detector CT (MDCT). The heart rate difference was analyzed by the logistic linear regression model with variables that included gender, age, body height, body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the dosage of propranolol. The following global LV functional parameters were calculated: the real-end diastolic volume (EDV), the real-end systolic volume (ESV) and the real-ejection fraction (EF). The female subjects had a greater decrease of heart rate after taking propranolol. The difference of heart rate was negatively correlated with the dosage of propranolol. The real-EDV, the real-ESV and the real-EF ranged from 48.1 to 109 mL/m2, 6.1 to 57.1 mL/m2 and 41% to 88%, respectively. There was no significant difference in the SBP and DBP between the groups without and with propranolol medication (123 ± 17 and 80 ± 10 mmHg; 120 ± 14 and 80 ± 11 mmHg, respectively). The real-EDV showed no significant difference between these two groups, but the real-ESV and real-EF showed significant differences between these two groups (69.4 ± 9.3 and 70.6 ± 8.9 mL/m2; 23.5 ± 5.7 and 25.6 ± 3.7 mL/m2, 66.5 ± 5.1% and 63.5 ± 4.6%, respectively). The difference of heart rate is significantly influenced by gender and the dosage of propranolol. Propranolol will also increase the ESV, which contributes to a decreased EF, while the SBP, DBP and EDV are not statistically changed.

  4. Low dose coronary CT angiography with 256-slice helical CT

    Objective: To compare the image quality and patient radiation dose of coronary computed tomography angiography (CCTA) received by prospectively-gated step-and-shoot (SAS) technique with those obtained by retrospectively-gated spiral ( RGS) technique on a 256-slice CT scanner. Methods: A total of 200 patients were enrolled in this study. One hundred patients underwent CCTA with SAS mode were subdivided into two groups: (1) 50 patients with an average heart rate (HR) ≤ 70 bpm were scanned with a data acquisition time window centered at the 75% of the R-R cycle (group A) and (2) 50 patients with HR > 70 bpm were scanned with the data acquisition time window centered at the 45% of the R-R cycle, including a phase tolerance of ± 5% (group B). Other 100 patients underwent CCTA with RGS mode and ECG-based tube current modulation were also subdivided into two groups: (3) 50 patients with HR ≤ 70 bpm were scanned with cardiac dose right set to phase of 75% ( group C) and (4) 50 patients with HR > 70 bpm were scanned with cardiac ose Rdight set to phases of 45% and 75% (group D). All patients were grouped in randomized order. The image quality of CCTA were evaluated using a rank scale from 1 to 4 (1: excellent; 4: non-assessable). Radiation dose of the four groups received was also estimated. The image quality between groups was compared by Mann-Whitney U test. The radiation dose between groups was compared by t test. For the 100 patients received by prospective ECG-gated CCTA, the receiver operating characteristic curve (ROC) was used to analyze the CCTA image quality and average heart rate to determine the uppercutoff of HR for obtaining diagnostic coronary images with SAS mode. A Spearman correlation analysis was also performed to analyze the correlation of HR and image quality in patients underwent CCTA with SAS mode. Results: Of 2338 coronary artery segments, excellent or good image quality (score of 1 or 2) was achieved in 96.5% (585 of 606) in group A, 77.7% (445

  5. Multi-section CT angiography compared with digital subtraction angiography in diagnosing major arterial hemorrhage in inflammatory pancreatic disease

    Purpose: Major arterial hemorrhage is an uncommon but serious complication of pancreatitis with high morbidity and mortality. Digital subtraction angiography (DSA) has long been the gold standard for the detection of a visceral artery pseudoaneurysm or for the site of active bleeding in patients with pancreatitis. Multi-section CT angiography is a minimally invasive technique which can provide high-resolution and high-contrast images of the arterial lumen and wall, with a much lower risk of complication and morbidity compared to DSA. The aim of this study was to determine the accuracy of multi-section CT angiography for the diagnosis of arterial complications of inflammatory pancreatitic disease. Materials and methods: A retrospective analysis of all patients undergoing visceral angiography for major bleeding as a complication of pancreatitis between 1998 and 2004 was performed. Twenty-nine studies in 25 patients (20 males, 5 females) with a mean age of 50.9 years (range 11-67 years) were identified where multi-section CT angiography was performed in the 24 h preceding the digital subtraction angiogram. Results: Digital subtraction angiography detected a pseudoaneurysm or contrast extravasation in 19 studies and no bleeding was demonstrated in 9 studies. CT angiography correctly identified the site and type of bleeding in 18 of the 19 positive studies. CT angiography detected extravasation of contrast in one study that was not demonstrated on digital subtraction angiography. The sensitivity and specificity for multi-section CT angiography for the detection of major arterial bleeding on a background of pancreatitis were 0.947 and 0.900, respectively. Conclusion: Multi-section CT angiography is a sensitive and accurate technique for the detection of major arterial hemorrhage in inflammatory pancreatic disease and should be considered as the first investigation in the management of these patients

  6. Multi-section CT angiography compared with digital subtraction angiography in diagnosing major arterial hemorrhage in inflammatory pancreatic disease

    Hyare, Harpreet [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom)]. E-mail: hhyare@doctors.org.uk; Desigan, Sharmini [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Nicholl, Helen [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Guiney, Michael J. [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Brookes, Jocelyn A. [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Lees, William R. [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom)

    2006-08-15

    Purpose: Major arterial hemorrhage is an uncommon but serious complication of pancreatitis with high morbidity and mortality. Digital subtraction angiography (DSA) has long been the gold standard for the detection of a visceral artery pseudoaneurysm or for the site of active bleeding in patients with pancreatitis. Multi-section CT angiography is a minimally invasive technique which can provide high-resolution and high-contrast images of the arterial lumen and wall, with a much lower risk of complication and morbidity compared to DSA. The aim of this study was to determine the accuracy of multi-section CT angiography for the diagnosis of arterial complications of inflammatory pancreatitic disease. Materials and methods: A retrospective analysis of all patients undergoing visceral angiography for major bleeding as a complication of pancreatitis between 1998 and 2004 was performed. Twenty-nine studies in 25 patients (20 males, 5 females) with a mean age of 50.9 years (range 11-67 years) were identified where multi-section CT angiography was performed in the 24 h preceding the digital subtraction angiogram. Results: Digital subtraction angiography detected a pseudoaneurysm or contrast extravasation in 19 studies and no bleeding was demonstrated in 9 studies. CT angiography correctly identified the site and type of bleeding in 18 of the 19 positive studies. CT angiography detected extravasation of contrast in one study that was not demonstrated on digital subtraction angiography. The sensitivity and specificity for multi-section CT angiography for the detection of major arterial bleeding on a background of pancreatitis were 0.947 and 0.900, respectively. Conclusion: Multi-section CT angiography is a sensitive and accurate technique for the detection of major arterial hemorrhage in inflammatory pancreatic disease and should be considered as the first investigation in the management of these patients.

  7. Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Bone Subtraction and Standard CT Angiography with Digital Subtraction Angiography

    Lee, Yong Hee; You, Jin Jong; Choi, Ho Cheol; Kim, Ji Eun [Dept. of Radiology, Gyeongsang National University Hospital, Jinju (Korea, Republic of); Choi, Dae Seob [Gyeongsang Institue of Health Science, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of); Ryoo, Jae Wook [Dept. of Radiology, Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2011-10-15

    To evaluate the usefulness of multidetector-row CT angiography (MDCTA) for the diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) by comparison of digital subtraction angiography (DSA) and to compare the bone subtraction CT angiography (BS-CTA) and standard CT angiography (S-CTA). Thirty-three patients who were treated with intraarterial nimodipine infusion for the cerebral vasospasm after aneurysmal SAH were evaluated with MDCTA and DSA. BS-CTA images were reconstructed from the S-CTA and unenhanced CT source images. A total of 207 vascular segments were evaluated. A four-step scale for the degree of stenosis was applied for each segment. With DSA as the standard images, BS-CTA and S-CTA images were comparied. On DSA, 56 segments (27%) presented vasospasm. Concordance between the DSA and S-CTA and between DSA and BS-CTA were 94.7% and 82.1%, respectively. Overestimation for the degree of stenosis was shown in 37 segments on BS-CTA and in 8 segments on S-CTA, but underestimated segments were only shown on S-CTA (n = 4). MDCTA with standard technique seems to be a useful imaging tool for the evaluation of the cerebral vasospasm after aneurysmal SAH. However, BS-CTA is not needed because of additional radiation and overestimation of the degree of stenosis.

  8. Congenital anomalies of aortic arch: CT angiography

    Moon, Yung; Kim, Yang Min; Kim, Tae Hoon; Kim, Mi Young [Sejong General hospial, Seoul (Korea, Republic of); Lee, Jae Young [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Hyung Seok [Cheju Medical Center, Cheju (Korea, Republic of)

    2001-01-01

    Aortic arch anomalies result from the failure of an embryonic vascular structure to persists and regress in the usual manner during formation of the aortic arch. The anomalous aortic arch may encircle and compress the trachea and esophagus as a form of a vascular ring. The diagnosis of aortic arch anomaly and the recognition of airway compression are important because they are conditions which complicate the natural and surgical course of related diseases. CT can demonstrate the nature of anatomic structures such as thr treachea and esophagus not revealed by angiogrphy, simultaneosuly disclosing the relationship of stenotic airways and offending mediastinal vessels. Volumetric data acquisition by means of spiral CT enables three dimensional reconstruction, which can provide easy global understanding for the complex anatomy and spatial relationship of airway and cardiovascular structures. Three dimensional imaging is very useful for the physician and surgeon who are not accustomed to mentally reconstructing axial images, and can facilitate surgical planning.

  9. Hepatic arterial supply in 1297 CT-angiographies

    Analysis, evaluation and classification of hepatic arterial supply variants and determination of their frequency distribution in CT-angiographies. CT-angiographies of 1,568 patients were evaluated retrospectively for the period between January 1, 2010 and August 30, 2012. The hepatic arterial anatomy was assessed and categorized according to Michels's classification. So far unclassified variants were considered separately. Results: CT-angiographies of 1297 patients were included in the study. Type I according to Michels was seen in 937 cases (72.2%), followed by type V in 114 patients (8.8%) and type III in 83 patients (6.4%). Type X could not be found in any of the patients. Not yet classified variants were discovered in 26 patients. The most frequent variant in this connection was a right hepatic artery originating from the superior mesenteric artery with the left hepatic artery originating from the left gastric artery (n=10). Michels's classification could be largely confirmed on the basis of a radiologically examined patient population. Not yet classified variants were categorized into subgroups of the existing classification.

  10. CT angiography, MR angiography and rotational digital subtraction angiography for volumetric assessment of intracranial aneurysms. An experimental study

    The purpose of our experimental study was to assess the accuracy and precision of CT angiography (CTA), MR angiography (MRA) and rotational digital subtraction angiography (DSA) for measuring the volume of an in vitro aneurysm model. A rigid model of the anterior cerebral circulation harbouring an anterior communicating aneurysm was connected to a pulsatile circuit. It was studied using unenhanced 3D time-of-flight MRA, contrast-enhanced CTA and rotational DSA angiography. The source images were then postprocessed on dedicated workstations to calculate the volume of the aneurysm. CTA was more accurate than MRA (P=0.0019). Rotational DSA was more accurate than CTA, although the difference did not reach statistical significance (P=0.1605), and significantly more accurate than MRA (P<0.00001). CTA was more precise than MRA (P=0.12), although this did not reach statistical significance. Rotational DSA can be part of the diagnosis, treatment planning and support endovascular treatment of intracranial aneurysms. The emerging endovascular treatment techniques which consist of using liquid polymers as implants to exclude aneurysms from arterial circulation would certainly benefit from this precise measurement of the volume of aneurysms. (orig.)

  11. Cardiac CT angiography in children with congenital heart disease

    Siripornpitak, Suvipaporn, E-mail: ssiripornpitak@yahoo.com [Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Pornkul, Ratanaporn [Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Khowsathit, Pongsak [Pediatric Cardiac Unit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Layangool, Thanarat; Promphan, Worakan [Pediatric Cardiology Unit, Queen Sirikit National Institute of Child Health, Bangkok (Thailand); Pongpanich, Boonchob [Pediatric Cardiac Unit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand)

    2013-07-15

    Cardiac imaging plays an important role in both congenital and acquired heart diseases. Cardiac computed tomography (angiography) cCT(A) is a non-invasive, increasingly popular, complementary modality to echocardiography in evaluation of congenital heart diseases (CHD) in children. Despite radiation exposure, cCT(A) is now commonly used for evaluation of the complex CHD, giving information of both intra-cardiac and extra-cardiac anatomy, coronary arteries, and vascular structures. This review article will focus on the fundamentals and essentials for performing cCT(A) in children, including radiation dose awareness, basic techniques, and strengths and weaknesses of cCT(A) compared with cardiac magnetic resonance imaging (cMRI), and applications. The limitations of this modality will also be discussed, including the CHD for which cMRI may be substituted.

  12. Cardiac CT angiography in children with congenital heart disease

    Cardiac imaging plays an important role in both congenital and acquired heart diseases. Cardiac computed tomography (angiography) cCT(A) is a non-invasive, increasingly popular, complementary modality to echocardiography in evaluation of congenital heart diseases (CHD) in children. Despite radiation exposure, cCT(A) is now commonly used for evaluation of the complex CHD, giving information of both intra-cardiac and extra-cardiac anatomy, coronary arteries, and vascular structures. This review article will focus on the fundamentals and essentials for performing cCT(A) in children, including radiation dose awareness, basic techniques, and strengths and weaknesses of cCT(A) compared with cardiac magnetic resonance imaging (cMRI), and applications. The limitations of this modality will also be discussed, including the CHD for which cMRI may be substituted

  13. Preoperative cerebral aneurysm assessment by three-dimensional CT angiography. Feasibility of surgery without cerebral angiography

    The purpose of this study is to assess the capability of three-dimensional CT angiography (3D-CTA) to replace conventional catheter angiography as a preoperative examination for unruptured intracranial aneurysms. A prospective study was designed to evaluate 18 patients with 20 unruptured intracranial aneurysms (13 middle cerebral artery aneurysms, 6 anterior communicating artery aneurysms, and 1 internal carotid posterior communicating artery aneurysm) who underwent surgery. There were 12 women and 6 men with the average age of 63 years old. All patients were initially diagnosed as having intracranial aneurysms by MR angiography, followed by 3D-CTA and conventional catheter angiography for confirmation. Three experienced neurosurgeons were in charge of the operations. One of the neurosurgeons (surgeon 1) was provided with only 3D-CTA as the preoperative radiological evaluation, while the others (surgeon 2 and 3) were given through assessments with MRA, 3D-CTA, and conventional angiography. Surgeon 1 carried out the operations under careful observation by the surgeons 2 and 3. Problems encountered by the surgeon 1 during surgery were recorded. Neck clipping in 19 aneurysms and dome wrapping in 1 were successfully accomplished. All patients were discharged without complication. Surgeries went smoothly in 16 aneurysms with 3D-CTA alone. Discrepancies between the 3D-CTA findings and microsurgical anatomy were noted in 4 aneurysms: the size of the neck was overestimated in 3 aneurysms, the relationships to parent arteries were obscure in 2 aneurysms, and a perforating artery problematic to neck clipping was missed in 1 aneurysms by 3D-CTA. The results of this study support the notion that 3D-CTA can replace conventional catheter angiography as preoperative examination in the majority of regular-sized anterior circulation aneurysms. Nevertheless, surgeons should recognize and be prepared for the fact that 3D-CTA can give false impression about the aneurysm neck and

  14. Value of the CT angiography in the diagnosis of common carotid artery bifurcation disease: CT angiography versus digital subtraction angiography and color flow Doppler

    Objective: assessment of the degree of stenosis is the central point in the treatment of carotid stenosis. The purpose of our study was to assess whether invasive CT angiography (CTA) is a feasible alternative to the current invasive gold standard carotid digital subtraction angiography (DSA) and the current non-invasive gold standard color flow doppler. Subjects and methods: about 178 patients with cerebrovascular disease underwent digital subtraction angiography (DSA), CFD and CTA. CTA was performed on a Somatom plus 4 (Siemens, Erlangen Germany). CT was performed with 2/3/2 (collimation/table feed/reconstruction interval) or 2/3/1 mm, start delay 15-20 s, flow 2.5-3.0 ml/s, using 120 ml non-ionic contrast medium (300 mg J/ml). Quantification of degree of stenosis was based on the perfused area in the axial slices. Plaque morphology (soft and hard) and ulceration were evaluated. Results: CTA detected nine cases of significant stenosis, which had been underestimated by DSA. CTA failed in two cases of a membraneous stenosis, which were underestimated, and in two cases with teeth artifacts. Calcifications were more readily appreciated by CTA than in CFD. In this respect, both methods were superior to DSA. CFD, DSA and CTA had a sensitivity of 100% for occlusions, respectively. Conclusion: CT angiography is useful in case of inconclusive CFD in the pre- and postoperative phase, and as a third modality in case of disagreement between DSA and CFD

  15. Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography

    Feger, S.; Rief, M.; Zimmermann, E.; Richter, F.; Roehle, R. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Dewey, M. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Institut fuer Radiologie, Berlin (Germany); Schoenenberger, E. [Medizinische Hochschule Hannover, Department of Medicine, Hannover (Germany)

    2015-07-15

    To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA). Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire. Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016). All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination. (orig.)

  16. Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography

    To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA). Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire. Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016). All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination. (orig.)

  17. Multislice Cardiac CT-Angiography; A Review on Accepted Indications and Potentials for Other Applications Regarding the Newest Development

    M. Motevalli

    2007-05-01

    Full Text Available There were not any clear-cut criteria available for clinical use of cardiac CT-angiography (CCTA up to October 2006 in which the American College of Car-diology (ACC, American College of Radiology (ACR and six other medical institutions released a joint consensus on clinical indications of cardiac CT and MRI. A statement was released by the American Heart Association together with two other radiology and cardiology institutions in the same month on the same matter. An illustrated review will be presented on the newly accepted indications of cardiac CT, especially CCTA. Some prominent indications are as follow: 1. Evaluation of chest pain syndrome in patient with intermediate pretest probability of coronary artery disease (CAD when exercise test is not feasible. 2. Evaluation of acute chest pain in patient with in-termediate pretest probability of CAD and negative ECG and enzymes. 3. Uninterpretable or equivocal stress test (exercise, perfusion scan, or stress echo. 4. Evaluation of coronary arteries in patients with new onset heart failure. 5. Assessment of congenital coronary and cardiac anomalies. 6. Noninvasive coronary vein mapping prior to placement of biventricular pacemaker. 7. Noninvasive coronary arterial mapping, including internal mammary artery prior to repeat cardiac sur-gical revascularization. Some recent research indicated that CCTA is useful in some other specific situations too, like evaluating in-stent re-stenosis for stainless steel or cobalt stents more than 3mm in diameter and has also some roles in the evaluation of coronary bypass grafts, etc. Fi-nally, the newer progressions in the field of multislice CT are promising of even better performance which may widen the scope of its indications. Dual-source CT scanners have shown better performance com-pared with 64-slice CT scanners in the preliminary studies, namely slice-thickness of 0.25mm vs. 0.4mm, temporal resolution of 83ms vs.165ms, assessable segments of 98.6% vs. 97

  18. Cerebral CT angiography in the diagnosis of acute subarachnoid hemorrhage

    Purpose: To evaluate the usefulness of CT angiography (CTA) in the detection of intracranial aneurysms in patients with acute subarachnoid hemorrhage (SAH). Material and Methods: In 53 patients with nontraumatic SAH a helical contrast-enhanced CTA was performed. CTA data were reconstructed with maximum intensity projection (MIP). Each patient underwent selective arteriography of the cerebral vessels (as the gold standard). CTA (axial images and MIP reconstructions) and arteriography were evaluated separately and their diagnostic information was compared. Results: In 14 of the 53 patients neither CTA nor angiography showed a vascular malformation. In the remaining 39 patients, angiography demonstrated a total of 51 aneurysms ranging in size from 3 mm to 16 mm. CTA missed one of these aneurysms, which was located at the internal carotid artery. 3-D CT reconstruction was slightly superior to arteriography in the demonstration of the neck, shape and direction of the aneurysms. Partial thrombosis of 3 aneurysms was demonstrated only by CTA. Conclusion: Although CTA cannot replace cerebral arteriography in the diagnostic work-up of acute SAH, it proved to be helpful in demonstrating the topographic anatomy of cerebral aneurysms and surrounding structures. (orig.)

  19. Intracranial aneurysms: evaluation in 200 patients with spiral CT angiography

    The goal of this study was to assess the usefulness of spiral CT angiography (CTA) with three- dimensional reconstructions in defining intracranial aneurysms, particularly around the Circle of Willis. Two hundred consecutive patients with angiographic and/or surgical correlation were studied between 1993 and 1998, with CTA performed on a GE HiSpeed unit and Windows workstation. The following clinical situations were evaluated: conventional CT suspicion of an aneurysm; follow-up of treated aneurysm remnants or of untreated aneurysms; subarachnoid haemorrhage (SAH) and negative angiography; family or past aneurysm history; and for improved definition of aneurysm anatomy. Spiral CTA detected 140 of 144 aneurysms, and an overall sensitivity of 97%, including 30 of 32 aneurysms 3 mm or less in size. In 38 patients with SAH and negative angiography, CTA found six of the seven aneurysms finally diagnosed. There was no significant artefact in 17 of 23 patients (74%) with clips. The specificity of CTA was 86% with 8 false-positive cases. Spiral CTA is very useful in demonstrating intracranial aneurysms. (orig.)

  20. Acute stent thrombosis after bifurcation stenting with the crush technique visualized with 64-slice computed tomography

    Kristensen, T.S.; Engstrom, T.; Kofoed, Klaus Fuglsang

    2008-01-01

    Acute stent thrombosis remains a potential complication after stent implantation. With the introduction of electrocardiographic gated multidetector row computed tomography (MDCT), a new nonnvasive imaging modality has become available that may contribute to the detection of complications after co...... complex interventional procedures. We present a case where CT angiography was performed just prior to the clinical presentation of acute stent thrombosis in a 55-year-old male who was treated with the crush technique in a bifurcation lesion Udgivelsesdato: 2008/7...

  1. 320-detector row CT coronary angiography in patients with arrhythmia

    Objective: To evaluate the feasibility of CT coronary angiography (CTCA) in patients with arrhythmia using 320-detector row CT. Methods: Thirty-one patients with persistent atrial fibrillation and 8 patients with premature ventricular contraction were enrolled in this study. All patients underwent 320- detector row CTCA. CT image quality was evaluated with 4-point grading scale by two radiologists. Inter- observer agreement was evaluated by Kappa statistics. The radiation dose was calculated. Results: In total 510 coronary segments, 496 (97.2%) segments met diagnostic standard. The mean effective dose was (12.7±4.8) mSv in this study. There was a good agreement in image quality scoring between the two reviewers (Kappa = 0.72). Conclusion: 320-detector row CTCA is feasible in patients with atrial fibrillation and premature ventricular contraction. Arrhythmia may not be considered as a contraindication to CTCA. (authors)

  2. Combined CT Angiography and CT Venography in Thromboembolic disease: clinical impact

    Combined CT Venography and Pulmonary Angiography was described in 1998 as a tool for diagnostic Thromboembolic Disease. The purpose is to relate our own experience with this technique in a population with suspected pulmonary embolism. 46 consecutive patients with suspected pulmonary embolism underwent combined CT Venography after Pulmonary CT Angiography to depict Deep Venous Thrombosis (DVT). CT Venography where obtained with a 3 minutes delay from injection, without additional intravenous contrast, from upper abdomen to fibular head. A prospective study from emergency reports where used. The reports where aimed by nine different radiologist at diary emergency room (images where not retrospective review). We report if a pulmonary embolus or deep venous thrombus or another alternative diagnostic where done. An endo luminal thrombus in any pulmonary arteries was assessed as a positive study for PE. A Thrombus in the leg veins or in an abdominal vein without diminished size of vein was assessed as an acute DVT. In those patients with a CT negative to Thromboembolic Disease was the clinician who decide if more proves where needed. Those patients without evidence in CT of Thromboembolic Disease where asked for symptoms related to the episode in a 3 months period after initial CT. Patients free of symptoms for 3 months without anticoagulation therapy where considered true negative for CT. CT shows Thromboembolic Disease in 23 of 46 patients. 21PE, 14 DVT 2 of 14 patients with DVT don't show PE, CT excluded thromboembolic disease in 23 patients and in 15 of those patients an alternative diagnostic was shown. In 22 of those 23 patients CT excluded correctly Thromboembolic Disease. One patient result in a false negative CT, Pulmonary Angiography of that patient shows us a subsegmentary embolus. (Author) 9 refs

  3. Beam hardening artifacts by dental implants: Comparison of cone-beam and 64-slice computed tomography scanners

    Farzad Esmaeili

    2013-01-01

    Full Text Available Background: Cone beam computed tomography (CBCT is an alternative to a computed tomography (CT scan, which is appropriate for a wide range of craniomaxillofacial indications. The long-term use of metallic materials in dentistry means that artifacts caused by metallic restorations in the oral cavity should be taken into account when utilizing CBCT and CT scanners. The aim of this study was to quantitatively compare the beam hardening artifacts produced by dental implants between CBCT and a 64-Slice CT scanner. Materials and Methods: In this descriptive study , an implant drilling model similar to the human mandible was used in the present study. The implants (Dentis were placed in the canine, premolar and molar areas. Three series of scans were provided from the implant areas using Somatom Sensation 64-slice and NewTom VGi (CBCT CT scanners. Identical images were evaluated by three radiologists. The artifacts in each image were determined based on pre-determined criteria. Kruskal-Wallis test was used to compare mean values; Mann-Whitney U test was used for two-by-two comparisons when there was a statistical significance ( P < 0.05. Results: The images of the two scanners had similar resolutions in axial sections ( P = 0.299. In coronal sections, there were significant differences in the resolutions of the images produced by the two scanners ( P < 0.001, with a higher resolution in the images produced by NewTom VGi scanner. On the whole, there were significant differences between the resolutions of the images produced by the two CT scanners ( P < 0.001, with higher resolution in the images produced by NewTom VGi scanner in comparison to those of Somatom Sensation. Conclusion: Given the high quality of the images produced by NewTom VGi and the lower costs in comparison to CT, the use of the images of this scanner in dental procedures is recommended, especially in patients with extensive restorations, multiple prostheses and previous implants.

  4. Sinus valsalva aneurysm on cardiac CT angiography: assessment and detection

    After the advent of ECG gated cardiac CT angiography (CCTA) there has been significant improvement in image quality of the ascending aorta. As a result the sinuses of valsalva are readily assessable. Sinuses of valsalva aneurysm can cause significant dysfunction of the aortic root and annulus and can be congenital or acquired. The aneurysm most commonly originates from the right coronary sinus. Complications related to sinuses of valsalva aneurysm can cause chest pain and can be life threatening. The cardiac imager should actively assess the sinuses of valsalva in every CCTA study.

  5. 3D Multislice CT Angiography in Post-Aortic Stent Grafting: A Pictorial Essay

    Helical CT angiography has been widely used in both pre- and post-aortic stent grafting and it has been confirmed to be the preferred modality when compared to conventional angiography. The recent development of multislice CT (MSCT) has further enhanced the applications of CT angiography for aortic stent grafting. One of the advantages of MSCT angiography over conventional angiography is that the 3D reconstructions, based on the volumetric CT data, provide additional information during follow-up of aortic stent grafting. While endovascular repair has been increasingly used in clinical practice, the use of 3D MSCT imaging in endovascular repair continues to play an important role. In this pictorial essay, we aimed to discuss the diagnostic performance of 3D MSCT angiography in post aortic stent grafting, including the most commonly used surface shaded display, curvilinear reformation, the maximum intensity projection, volume rendering and virtual endoscopy. The advantages and disadvantages of each 3D reconstruction are also explored

  6. Reverse Redistribution in Myocardial Perfusion Imaging: Revisited with 64-slice MDCT

    The authors report myocardial perfusion imaging of a patient showing reverse redistribution (RR) and a 64-slice multidetector-row computed tomography (MDCT) with corresponding findings. The patient had subendocardial myocardial infarction (MI) with positive electrocardiogram (EMG) findings and elevated levels of cardiac isoenzymes. Experiencing this case emphasizes the importance of complementary correlation of a new diagnostic modality that helps us to understand the nature of RR.

  7. Efficacy of 'fine' focal spot imaging in CT abdominal angiography

    To assess the efficacy of fine focal spot imaging in calcification beam-hardening artefact reduction and vessel clarity on CT abdominal angiography (CTAA). Adult patients of any age and gender who presented for CTAA were included. Thirty-nine patients were examined with a standard focal spot size (SFSS) of 1 x 1 mm in the first 3 months while 31 consecutive patients were examined with a fine focal spot size (FFSS) of 1 x 0.5 mm in the following 3 months. Vessel clarity and calcification beam-hardening artefacts of the abdominal aorta, celiac axis, superior mesenteric artery, inferior mesenteric artery, renal arteries, and iliac arteries were assessed using a 5-point grading scale by two blinded radiologists randomly. Cohen's Kappa test indicated that on average, there was substantial agreement among reviewers for vessel wall clarity and calcification artefact grading. Mann-Whitney test showed that there was a significant difference between the two groups, with FFSS performing significantly better for vessel clarity (U, 6481.50; p < 0.001; r, 0.73) and calcification artefact reduction (U, 1916; p < 0.001; r, 0.77). Fine focus CT angiography produces images with better vessel wall clarity and less vessel calcification beam-hardening artefact. (orig.)

  8. Quantitativa analysis by 64-slice computed tomography in diagnosis of intermediate coronary artery stenosis%64排CT冠状动脉造影定量分析在冠状动脉临界病变中的价值

    施鸿毓; 陈晖; 仇兴标; 曲新凯; 方唯一

    2012-01-01

    目的 评价64排CT冠状动脉造影对临界病变定量分析的可行性.方法 入选2009年5月-2010年8月于上海交通大学附属胸科医院行64排CT冠状动脉造影检查提示为临界病变的91例患者,共205处病变.在2周内进行经皮冠状动脉造影及定量冠状动脉造影(QCA)分析.采用Bland-Altman分析和Pearson相关分析对比64排CT冠状动脉造影定量分析与QCA的结果.结果 64排CT冠状动脉造影检查示,病变参考直径为(3.1±0.4) mm,病变长度为(14.2±11.3)mm;狭窄程度为(57.8±0.7)%,与QCA测定的(58.2±13.9)%的差异无统计学意义(P=0.64).205个经64排CT冠状动脉造影定量分析示冠状动脉狭窄程度为40%~70%的病变中,QCA检查示27个病变(13.2%)的狭窄程度低于40%,43个病变(21.0%)高于70%,135个病变(65.9%)属于冠状动脉狭窄程度为40%~70%的临界病变.64排CT冠状动脉造影定量分析与QCA结果呈中度相关(r=0.599,P<0.001),但一致性较差(平均偏差为0.4%,95%一致性可信区间为-22.1%~22.9%).结论 64排CT冠状动脉造影对临界病变的诊断价值有限,其定量分析与QCA的一致性欠佳,目前临床实用价值有限.%Objective To evaluate the feasibility of quantitative analysis by 64-slice computed tomography (CT) in intermediate coronary artery lesions. Methods Totally 91 patients with 205 lesions were diagnosed as intermediate coronary artery stenosis by 64-slice CT from May 2009 to August 2010. Conventional percutaneous coronary angiography was performed within 2 weeks after CT scan. The results of 64-slice CT quantitative analysis and quantitive coronary angiography (OCA) were compared by Bland-Altman analysis and Pearson correlations. Results The average reference values of lesions were (3.1 ±0.4) mm in diameter and (14.2±11.3) mm in length by CT scan. Diameter stenosis was (57.8 + 0.7)% by CT quantification and (58.2 + 13.91)% by OCAi there was no significant difference

  9. Radiation dose in cerebral angiography and flat detector CT applications in neuroradiology; Strahlendosis bei zerebraler Angiographie und Flachdetektor-CT-Applikationen in der Neuroradiologie

    Struffert, T.; Lang, S.; Doerfler, A. [Universitaetsklinikum Erlangen, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Abteilung fuer Neuroradiologie, Erlangen (Germany); Scholz, R. [Siemens Healthcare GmbH, Forchheim (Germany); Hauer, M. [Klinikum Nuernberg Sued, Institut fuer Radiologie und Neuroradiologie, Nuernberg (Germany)

    2015-08-15

    Flat detectors (FD) have completely replaced image intensifiers in angiography. Due to this development not only the image quality of 2D digital subtraction angiography series (2-D-DSA) could be improved but also the acquisition of computed tomography (CT)-like cross-sectional images (FD-CT) within the angio suite became feasible. These techniques are now being used in daily clinical routine. Only little information about effective doses of these applications to patients has been published in the literature. We describe the effective patient dose of current applications in the field of angiography and demonstrate strategies to minimize the dose to the patient. In addition, we compare FD-CT applications to standard multislice CT applications. (orig.) [German] Flachdetektoren haben Bildverstaerker in der Angiographie vollstaendig abgeloest. Mit dieser Entwicklung verbesserte sich nicht nur die Bildqualitaet subtrahierter 2-D-Angiographieserien (2-D-DSA), sondern auch die Akquisition CT-aehnlicher Schnittbilder (FD-CT) mit unterschiedlichen Indikationen wurde moeglich. Diese Techniken werden nun in der taeglichen klinischen Routine eingesetzt. Angaben zur effektiven Patientendosis dieser Applikationen sind bis jetzt in der Literatur nur wenige publiziert worden. Wir beschreiben die effektive Patientendosis aktueller Anwendungen im Bereich der Angiographie und zeigen Strategien zur Minimierung der Dosis fuer den Patienten auf. Zudem vergleichen wir FD-CT-Applikationen mit Standard-Multislice-CT-Anwendungen. (orig.)

  10. Diagnostic Accuracy of Sixty Four Multi-Slice CT Angiography in Assessment of Arterial Cut-Off and Run-Off in Comparison with Surgical Findings

    M. Noaparast

    2011-06-01

    Full Text Available Background/Objective: The accurate anatomic mapping and determination of the severity of arterial disease, an important health problem of the elderly, is of great significance. We aimed todetermine the diagnostic value of 64-multislice CT angiography (MSCTA in run-off and cut-off sites of arterial disease.Patients and Methods: Throughout the study, MSCTA followed by an operative intervention was carried out on a total of 38 patients with clinical signs and symptoms suggestive of arterialdisease (AD all of whom had the indication for vascular surgery. The mean age of patients was 34±15.86 (range, 23 to 93 years. MSCTA was executed using a 64-slice CT scanner, during the arterial phase of injecting the nonionic, contrast medium with a power injector at the rate of 5 ml/sec into the antecubital vein and exploration and revascularization of peripheral arterial disease was performed intraoperatively.Results: Atherosclerosis and arterial disease, the most common causes of vascular occlusion,were more common in the lower extremities. According to MSCTA findings, the most frequentsite of stenosis was the superficial femoral artery. Spearman’s correlation coefficient showed a high degree of agreement amongst the raters. The sensitivity, specificity, positive predictivevalue (PPV, negative predictive value (NPV and the accuracy of MSCTA compared to surgery were 83.8%, 96%, 96.8%, 81.3% and 89%, respectively. MSCTA findings were compared with surgeryas a standard of reference, which showed concordance in the majority of cases (81.6%. Cut-off sites were correctly identified by MSCTA in 97.3% of the patients and the most common sites of discordance were the run-off sites (18.2%.Conclusion: MSCTA angiography as a novel diagnostic modality may be a suitable alternative and a viable choice for routine clinical diagnosis.

  11. Investigation of temporal resolution required for CT coronary angiography

    Ohashi, Kazuya; Ichikawa, Katsuhiro; Kawai, Tatsuya; Shibamoto, Yuta

    2012-03-01

    Sub-second multi-detector computed tomography systems (MDCTs) offer great potentials for improving cardiac imaging. However, since the temporal resolution of such CT systems is not sufficient, blurring and artifacts produced by fast cardiac motion are still problematic. The purposes of this study were to investigate the accurate method for measurement of temporal resolution (TR) of the cardiac CT and required TR for obtaining better CT coronary angiography (CTCA). We employed a dual source CT system (Somatom Definition, Siemens), which has various temporal resolution modes (83, 125, and 165 msec) for electro-cardiogram (ECG)-gated scanning. The temporal sensitivity profiles (TSPs) were measured by a new method using temporal impulse generated by metal ball (impulse method). The CTCA images of 200 patients with heart rates (HRs) ranging from 36 to 117 beat per minute (bpm) were visually evaluated using a 4-point scale. The 165-msec TR mode, which is mostly available on recent MDCTs, showed a sufficient image quality only at low HR (80 bpm).

  12. Diagnosis of carotid artery disease by CT scan. Intravenous CT carotid-angiography

    Kuriyama, Y.; Sawada, T.; Naito, H.; Karasawa, J. (National Cardiovascular Center, Osaka (Japan))

    1981-09-01

    Non-invasive methods, such as radioisotope angiography, oculoplethsmography, and ultrasonic Doppler flowmetry, are used for the detection of caroid artery lesion. However, these methods are qualitative, and diagnostic accuracies are inferior to arteriography. On the other hand arterography needs catheterization. So we tried to use CT scan and intravenous contrast enhancement for the diagnosis of carotid artery disease. A CT/T scanner (X-2) was used, which enabled to produce computer reconstruction image of the carotid artery by use of the arrange program. 12 sequential axial images of the neck (between heights of C2 and C5) were obtained before and during infusion of contrast material. Analysis of sequential axial images and reformatted images were obtained in patients with cerebrovascular disease. Carotid arteriography were made in 53 arteries, lesions with stenosis and/or occlusion were demonstrated in 26/53 arteries. Intravenous CT carotid-angiography revealed lesions with stenosis and/or occlusion in 25/53 arteries. Results of statistical analysis were as follows; overall diagnostic accuracy 52/53 (98%), diagnostic sensitivity 25/26 (96%) and diagnostic specificity 27/27 (100%), respectively. Moreover, intravenous CT carotid-angiography provided following benefits beyond arteriography. 1) Minimal calcification of the carotid wall and precise localisation of atheromatous plaque could be detected. 2) Patent arterial lumen above the occluded lesion could be found out. 3) CT carotid-angiography would be suitable for the follow-up study after carotid endoarterectomy because of the unneccessity of catheterization. 4) Thrombus formation in the internal jugular vein could be grasped.

  13. Evaluation of middle cerebral artery stents using multidetector row CT angiography in vivo study: comparison of the three different kernels

    Background: There are very few reports assessing middle cerebral artery (MCA) stents using multidetector computed tomography (MDCT). Purpose: To assess MCA stents using multidetector CT angiography (CTA) in vivo evaluation: the differences in the CTA results according to the three different kernels. Material and Methods: We retrospectively evaluated 27 MCA stents from 26 patients who underwent CTA with 16- and 64-slice MDCT after percutaneous transluminal angioplasty and stenting (PTAS). By CTA, using medium-smooth kernel (B30), medium-sharp kernel (B50), and sharp kernel (B60), the lumen diameter, artificial luminal narrowing (ALN), and subjective visibility score of the stented vessels were evaluated. The subjective visibility score ranged from 1 (poor quality) to 5 (excellent) using a five-point scale. Results: There were excellent inter-observer agreements for the lumen diameter measurements (P < 0.001). The mean diameter of the stented vessels was 2.10 ± 0.31 mm on digital subtraction angiography (DSA), 0.93 ± 0.20 mm on CTA using B30, 1.18 ± 0.27 mm on CTA using B50, and 1.29 ± 0.29 mm on CTA using B60. The mean ALN was 55.7 ± 6.0% on CTA using B30, 43.8 ± 7.5% on CTA using B50, and 38.7 ± 8.3% on CTA using B60. CTA with higher kernels had a smaller ALN than images with smaller kernels. The median subjective visibility score on the CTA using B50 was 3, which was higher than for the other kernels. The differences in the lumen diameter, ALN, and the subjective visibility score of the stented vessels on CTA using the three different kernels was statistically significant (P < 0.001). Conclusion: The sharp kernel was better to assess the lumen diameter and ALN, but was inferior to the medium-sharp kernel for in-stent evaluation due to high image-to-noise. CTA with medium-sharp kernel showed good lumen visibility and acceptable ALN for MCA stents. This could therefore be a non-invasive, readily applicable clinical method for assessing MCA stent patency after

  14. Evaluation of middle cerebral artery stents using multidetector row CT angiography in vivo study: comparison of the three different kernels

    Jang, Jin Hee; Lim, Yeon Soo; Lee, Youn Joo; Yoo, Won Jong; Sung, Mi Sook (Dept. of Radiology, Bucheon St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Bucheon (Korea, Republic of)), email: wjyu@catholic.ac.kr; Kim, Bum Soo (Dept. of Radiology, Seoul St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of))

    2012-05-15

    Background: There are very few reports assessing middle cerebral artery (MCA) stents using multidetector computed tomography (MDCT). Purpose: To assess MCA stents using multidetector CT angiography (CTA) in vivo evaluation: the differences in the CTA results according to the three different kernels. Material and Methods: We retrospectively evaluated 27 MCA stents from 26 patients who underwent CTA with 16- and 64-slice MDCT after percutaneous transluminal angioplasty and stenting (PTAS). By CTA, using medium-smooth kernel (B30), medium-sharp kernel (B50), and sharp kernel (B60), the lumen diameter, artificial luminal narrowing (ALN), and subjective visibility score of the stented vessels were evaluated. The subjective visibility score ranged from 1 (poor quality) to 5 (excellent) using a five-point scale. Results: There were excellent inter-observer agreements for the lumen diameter measurements (P < 0.001). The mean diameter of the stented vessels was 2.10 +- 0.31 mm on digital subtraction angiography (DSA), 0.93 +- 0.20 mm on CTA using B30, 1.18 +- 0.27 mm on CTA using B50, and 1.29 +- 0.29 mm on CTA using B60. The mean ALN was 55.7 +- 6.0% on CTA using B30, 43.8 +- 7.5% on CTA using B50, and 38.7 +- 8.3% on CTA using B60. CTA with higher kernels had a smaller ALN than images with smaller kernels. The median subjective visibility score on the CTA using B50 was 3, which was higher than for the other kernels. The differences in the lumen diameter, ALN, and the subjective visibility score of the stented vessels on CTA using the three different kernels was statistically significant (P < 0.001). Conclusion: The sharp kernel was better to assess the lumen diameter and ALN, but was inferior to the medium-sharp kernel for in-stent evaluation due to high image-to-noise. CTA with medium-sharp kernel showed good lumen visibility and acceptable ALN for MCA stents. This could therefore be a non-invasive, readily applicable clinical method for assessing MCA stent patency after

  15. CT angiography versus 3D rotational angiography in patients with subarachnoid hemorrhage

    CT angiography (CTA) is increasingly used as primary diagnostic tool to replace digital subtraction angiography (DSA) in patients with subarachnoid hemorrhage (SAH). However, 3D rotational angiography (3DRA) has substituted DSA as a reference standard. In this prospective observational study, we compare CTA with 3DRA of all cerebral vessels in a large cohort of patients with SAH. Of 179 consecutive patients with SAH admitted between March 2013 and July 2014, 139 underwent 64- to 256-detector row CTA followed by complete cerebral 3DRA within 24 h. In 86 patients (62 %), 3DRA was performed under general anesthesia. Two observers from outside hospitals reviewed CTA data. In 118 of 139 patients (85 %), 3DRA diagnosed the cause of hemorrhage: 113 ruptured aneurysms, three arterial dissections, one micro-arteriovenous malformation (AVM), and one reversible vasoconstriction syndrome. On CTA, both observers missed all five non-aneurysmal causes of SAH. Sensitivity of CTA in depicting ruptured aneurysms was 0.88-0.91, and accuracy was 0.88-0.92. Of 113 ruptured aneurysms, 28 were ≤3 mm (25 %) and of 95 additional aneurysms, 71 were ≤3 mm (75 %). Sensitivity of depicting aneurysms ≤3 mm was 0.28-0.43. Of 95 additional aneurysms, the two raters missed 65 (68 %) and 58 (61 %). Sensitivity in detection was lower in aneurysms of the internal carotid artery than in other locations. CTA had some limitations as primary diagnostic tool in patients with SAH. All non-aneurysmal causes for SAH and one in ten ruptured aneurysms were missed. Performance of CTA was poor in aneurysms ≤3 mm. The majority of additional aneurysms were not depicted on CTA. (orig.)

  16. CT angiography versus 3D rotational angiography in patients with subarachnoid hemorrhage

    Bechan, R.S.; Peluso, J.P.; Sluzewski, M.; Rooij, W.J. van [Sint Elisabeth Ziekenhuis Tilburg, Department of Radiology, Tilburg (Netherlands); Rooij, S.B. van [Medisch Centrum Alkmaar, Department of Radiology, Alkmaar (Netherlands); Sprengers, M.E.; Majoie, C.B. [Academisch Medisch Centrum, Department of Radiology, Amsterdam (Netherlands)

    2015-12-15

    CT angiography (CTA) is increasingly used as primary diagnostic tool to replace digital subtraction angiography (DSA) in patients with subarachnoid hemorrhage (SAH). However, 3D rotational angiography (3DRA) has substituted DSA as a reference standard. In this prospective observational study, we compare CTA with 3DRA of all cerebral vessels in a large cohort of patients with SAH. Of 179 consecutive patients with SAH admitted between March 2013 and July 2014, 139 underwent 64- to 256-detector row CTA followed by complete cerebral 3DRA within 24 h. In 86 patients (62 %), 3DRA was performed under general anesthesia. Two observers from outside hospitals reviewed CTA data. In 118 of 139 patients (85 %), 3DRA diagnosed the cause of hemorrhage: 113 ruptured aneurysms, three arterial dissections, one micro-arteriovenous malformation (AVM), and one reversible vasoconstriction syndrome. On CTA, both observers missed all five non-aneurysmal causes of SAH. Sensitivity of CTA in depicting ruptured aneurysms was 0.88-0.91, and accuracy was 0.88-0.92. Of 113 ruptured aneurysms, 28 were ≤3 mm (25 %) and of 95 additional aneurysms, 71 were ≤3 mm (75 %). Sensitivity of depicting aneurysms ≤3 mm was 0.28-0.43. Of 95 additional aneurysms, the two raters missed 65 (68 %) and 58 (61 %). Sensitivity in detection was lower in aneurysms of the internal carotid artery than in other locations. CTA had some limitations as primary diagnostic tool in patients with SAH. All non-aneurysmal causes for SAH and one in ten ruptured aneurysms were missed. Performance of CTA was poor in aneurysms ≤3 mm. The majority of additional aneurysms were not depicted on CTA. (orig.)

  17. Hilar cholangiocarcinoma. An evaluation of subtypes with CT and angiography.

    Yamashita, Y; Takahashi, M; Kanazawa, S; Charnsangavej, C; Wallace, S

    1992-07-01

    Sixty-seven patients had hilar cholangiocarcinomas which were divided into 3 types based on tumor morphology as observed on cholangiography and CT. The pathology, vascularity, and pattern of tumor spread of these types were compared. Most of the infiltrative tumors (n = 44) were scirrhous adenocarcinomas, which on CT showed poor or no contrast enhancement with frequent lymph node metastases and liver atrophy. At angiography, there was vascular encasement in 52%, in rare cases neovascularity, and tumor stain. The exophytic type (n = 19) was divided into 2 subgroups depending on the main location of the tumor. The nodular subtype (n = 16) was mainly inside the liver and somewhat hypervascular similar to peripheral cholangiocarcinoma, often with intrahepatic metastases. The periductal subtype (n = 3) was hypovascular, similar to the infiltrative cholangiocarcinoma, and had a tendency to spread along the portal vein. The intraductal type (n = 4) was observed as a filling defect on cholangiography. CT revealed an intraluminal low density mass. Histologically, they were papillary adenocarcinomas. The radiologic types of hilar cholangiocarcinoma showed different characteristics with regard to pathologic findings, vascularity, and pattern of spread. PMID:1321653

  18. Hilar cholangiocarcinoma; An evaluation of subtypes with CT and angiography

    Yamashita, Y.; Takahashi, M.; Kanazawa, S.; Charnsangavej, C.; Wallace, S. (Dept. of Radiology, Kumamoto University School of Medicine (Japan) Dept. of Radiology, Univ. of Texas, M.D. Anderson Hospital and Tumor Inst., Houston, TX (United States))

    1992-07-01

    Sixty-seven patients had hilar cholangiocarcinomas which were divided into 3 types based on tumor morphology as observed on cholangiography and CT. The pathology, vascularity, and pattern of tumor spread of these types were compared. Most of the infiltrative tumors were scirrhous adenocarcinomas, which on CT showed poor or no contrast enhancement with frequent lymph node metastases and liver atrophy. At angiography, there was vascular encasement in 52%, in rare cases neovascularity, and tumor stain. The exophytic type was divided into 2 subgroups depending on the main location of the tumor. The nodular subtype was mainly inside the liver and somewhat hypervascular similar to peripheral cholangiocarcinoma, often with intrahepatic metastases. The periductal subtype was hypovascular, similar to the infiltrative cholangiocarcinoma, and had a tendency to spread along the portal vein. The intraductal type was observed as a filling defect on cholangiography. CT revealed an intraluminal low density mass. Histologically, they were papillary adenocarcinomas. The radiologic types of hilar cholangiocarcinoma showed different characteristics with regard to pathologic findings, vascularity, and pattern of spread. (orig.).

  19. Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis.

    Choi, Jin-Ho; Min, James K; Labounty, Troy M; Lin, Fay Y; Mendoza, Dorinna D; Shin, Dae Hee; Ariaratnam, Nikki S; Koduru, Sunaina; Granada, Juan F; Gerber, Thomas C; Oh, Jae K; Gwon, Hyeon-Cheol; Choe, Yeon Hyeon

    2011-11-01

    Coronary computed tomography angiography (CTA) assessment of calcified or complex coronary lesions is frequently challenging. Transluminal attenuation gradient (TAG), defined as the linear regression coefficient between luminal attenuation and axial distance, has a potential to evaluate the degree of coronary stenosis. We examined the value of TAG in determining the stenosis severity on 64-slice coronary CTA. The value of TAG of 370 major coronary arteries was measured from 7,263 intervals of 5-mm length. Compared with coronary CTA and invasive coronary angiography, TAG decreased consistently and significantly with maximum stenosis severity on a per-vessel basis, from -1.91 ± 4.25 Hounsfield units/10 mm for diameter stenosis of 0% to 49% to -13.37 ± 9.81 Hounsfield units/10 mm for diameter stenosis of 100% (p TAG to the interpretation of coronary CTA improved diagnostic accuracy (p = 0.001), especially in vessels with calcified lesions (N = 127; net reclassification improvement 0.095; p = 0.046). TAG appears to be able to contribute to improved classification of coronary artery stenosis severity in coronary CTA, especially in severely calcified lesions. PMID:22093264

  20. Usefulness of Y-shaped sheaths in CT angiography for examination of liver tumors

    Toru; Ishikawa; Kazuo; Higuchi; Tomoyuki; Kubota; Kei-ichi; Seki; Terasu; Honma; Toshiaki; Yoshida; Takeo; Nemoto; Keiko; Takeda; Tomoteru; Kamimura

    2010-01-01

    AIM: To conduct a single-stage, combined computed tomography (CT) arterial portography (CTAP) and CT arteriography (CTA) imaging operation, we used Y-shaped sheaths with 2 valves, which allowed the insertion of 2 catheters simultaneously. METHODS: Of 1254 patients who underwent abdominal angiography for transarterial embolization and/or intraarterial chemotherapy in our department from May 2002 to November 2009, 664 patients in whom Y-shaped sheaths with 2 valves were used underwent CT angiography using a c...

  1. The structures mimicking aneurysm on 3-dimensional volume rendering CT angiography using a 16-row detector CT

    This study was conducted to identify the structures that can mimic aneurysm on CT angiography with using the 3-D volume rendering technique and a 16-row detector CT. This study examined 206 patients who underwent CT angiography with a 16-row detector CT from May 2003 to July 2004. For the CT angiography, the contrast media was injected at a rate of 4 cc per second. The scanning was then done when 5 seconds delay time had elapsed after the CT number of the common carotid artery had reached 150. The baseline images were obtained by reconstructing the row data with a kernel value of H31f, a slice thickness of 1 mm and an increment of 0.5 mm. Finally, the 3-D images were constructed by using a volume rendering technique. The structures that were confused with aneurysm on CT angiography were further evaluated by MPR or MIP to ascertain whether they were aneurysms. For comparison, digital subtraction angiography was done in 86 patients and surgery was done in 5 patients. On CT angiography, 51 patients did not show any abnormalities, and 80 patients showed definitive aneurysms, as was ascertained by their sizes, shapes and locations, or by the aneurysm clips only. The remaining 75 patients showed 90 aneurysm mimicking structures that were 35 infundibular dilatations or preaneurysmal blebs, 24 focal dilatations of the branches of the deep middle cerebral veins, 6 focal dilatations of the sphenoparietal sinuses adjacent to the middle cerebral artery, 18 focal dilatations of the inferior sagittal sinuses adjacent to the pericallosal artery and 7 low density calcifications of the vessel walls that were adjacent to the aneurysm-prevalent arteries. CT angiography based on volume rendering technique was able to identify the structures that were confused with aneurysm. Accordingly, careful observation is required for interpreting the reconstructing 3-D images since a wide variety of structures can be confused with aneurysm on CT angiography

  2. CT coronary angiography versus conventional invasive coronary angiography. The view of the referring physician

    Maurer, Martin H. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Universitaetsspital Bern (Switzerland). Dept. fuer Diagnostische, Interventionelle und Paediatrische Radiologie; Zimmermann, E.; Hamm, B. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Dewey, M.

    2014-12-15

    Assessment of experience gained by local referring physicians with the procedure of coronary computed tomographic angiography (CCTA) in the everyday clinical routine. A 25-item questionnaire was sent to 179 physicians, who together had referred a total of 1986 patients for CCTA. They were asked about their experience to date with CCTA, the indications for coronary imaging, and their practice in referring patients for noninvasive CCTA or invasive catheter angiography. 53 questionnaires (30%) were assessable, corresponding to more than 72% of the patients referred. Of the referring physicians who responded, 94% saw a concrete advantage of CCTA in the treatment of patients, whereby 87% were 'satisfied' or 'very satisfied' with the reporting. For excluding coronary heart disease (CHD) where there was a low pre-test probability of disease, the physicians considered CCTA to be superior to conventional coronary diagnosis (4.2 on a scale of 1-5) and vice versa for acute coronary syndrome (1.6 of 5). The main reasons for unsuitability of CCTA for CT diagnosis were claustrophobia and the absence of a sinus rhythm. The level of exposure to radiation in CCTA was estimated correctly by only 42% of the referring physicians. 90% of the physicians reported that their patients evaluated their coronary CT overall as 'positive' or 'neutral', while 87% of the physicians whose patients had undergone both procedures reported that the patients had experienced CCTA as the less disagreeable of the two. CCTA is accepted by the referring physicians as an alternative imaging procedure for the exclusion of CHD and received a predominantly positive assessment from both the referring physicians and the patients.

  3. CT coronary angiography versus conventional invasive coronary angiography. The view of the referring physician

    Assessment of experience gained by local referring physicians with the procedure of coronary computed tomographic angiography (CCTA) in the everyday clinical routine. A 25-item questionnaire was sent to 179 physicians, who together had referred a total of 1986 patients for CCTA. They were asked about their experience to date with CCTA, the indications for coronary imaging, and their practice in referring patients for noninvasive CCTA or invasive catheter angiography. 53 questionnaires (30%) were assessable, corresponding to more than 72% of the patients referred. Of the referring physicians who responded, 94% saw a concrete advantage of CCTA in the treatment of patients, whereby 87% were 'satisfied' or 'very satisfied' with the reporting. For excluding coronary heart disease (CHD) where there was a low pre-test probability of disease, the physicians considered CCTA to be superior to conventional coronary diagnosis (4.2 on a scale of 1-5) and vice versa for acute coronary syndrome (1.6 of 5). The main reasons for unsuitability of CCTA for CT diagnosis were claustrophobia and the absence of a sinus rhythm. The level of exposure to radiation in CCTA was estimated correctly by only 42% of the referring physicians. 90% of the physicians reported that their patients evaluated their coronary CT overall as 'positive' or 'neutral', while 87% of the physicians whose patients had undergone both procedures reported that the patients had experienced CCTA as the less disagreeable of the two. CCTA is accepted by the referring physicians as an alternative imaging procedure for the exclusion of CHD and received a predominantly positive assessment from both the referring physicians and the patients.

  4. Hepatic arterial supply in 1297 CT-angiographies; Die arterielle Leberversorgung in 1297 CT-Angiografien

    Loeschner, C.; Kausche, S.; Teichgraeber, U. [Jena University Hospital, Jena (Germany). Dept. of Radiology; Nagel, S.N. [Charite Universitaetsmedizin Berlin (Germany). Dept. of Radiology

    2015-04-15

    Analysis, evaluation and classification of hepatic arterial supply variants and determination of their frequency distribution in CT-angiographies. CT-angiographies of 1,568 patients were evaluated retrospectively for the period between January 1, 2010 and August 30, 2012. The hepatic arterial anatomy was assessed and categorized according to Michels's classification. So far unclassified variants were considered separately. Results: CT-angiographies of 1297 patients were included in the study. Type I according to Michels was seen in 937 cases (72.2%), followed by type V in 114 patients (8.8%) and type III in 83 patients (6.4%). Type X could not be found in any of the patients. Not yet classified variants were discovered in 26 patients. The most frequent variant in this connection was a right hepatic artery originating from the superior mesenteric artery with the left hepatic artery originating from the left gastric artery (n=10). Michels's classification could be largely confirmed on the basis of a radiologically examined patient population. Not yet classified variants were categorized into subgroups of the existing classification.

  5. Minimizing the acquisition phase in coronary CT angiography using the second generation 320-row CT

    We aimed to compare the radiation dose and image quality of a minimal phase window centered at 77% compared with a wide phase window in coronary CT angiography using the second-generation 320-row CT. Eighty patients with heart rate ≤75 bpm were retrospectively included. The first 40 patients underwent scanning with a wide phase window (65-85%), while the last 40 patients underwent scanning with a minimal phase window centered at 77%. Subjective image quality was graded using a 4-point scale (4=excellent). Image noise and contrast-to-noise ratio at the proximal segments were also analyzed. The mean effective dose was derived from the dose length product multiplied by a chest conversion coefficient (κ=0.014 mSv mGy-1 cm-1). Minimal phase window scanning centered at 77% reduced the radiation dose by 30% compared with wide phase window scanning (1.7 vs 2.4 mSv, p=0.0009). The subjective image quality showed no significant difference (3.75 vs 3.76, p=0.77). No significant difference was observed in the image noise, CT number, and contrast-to-noise ratio. Radiation dose could be reduced while maintaining image quality by use of a minimal phase window centered at 77% compared with a wide phase window in coronary CT angiography using the second generation 320-row CT. (author)

  6. Can CT angiography rule out aneurysmal subarachnoid haemorrhage in CT scan-negative subarachnoid haemorrhage patients?

    Lim, Lee Kai; Dowling, Richard J; Yan, Bernard; Mitchell, Peter J

    2014-01-01

    Current management guidelines for CT scan-negative subarachnoid haemorrhage (SAH) patients recommend cerebral digital subtraction angiography (DSA). We aimed to investigate the utility of CT angiography (CTA) as a substitute for DSA in these patients. We included patients who presented with SAH confirmed by spectrophotometric xanthochromia analysis of cerebrospinal fluid (CSF) whereby the CT scan was negative. Electronic records were reviewed to collect data on non-contrast CT scan, CTA and DSA results. Patients without DSA or with other explanations for CSF xanthochromia were excluded. Sixty-three patients with CT scan-negative SAH were included. The diagnosis of SAH was confirmed by CSF analysis. All 63 patients underwent both DSA and CTA. Using DSA as the benchmark, CTA demonstrated a negative predictive value, positive predictive value, sensitivity and specificity of 98%, 82%, 90% and 96%, respectively, for the detection of intracranial aneurysms. CTA correctly identified patients in whom there were no underlying aneurysms responsible for SAH, with one patient with suspected dissection referred for further evaluation using MRI and DSA. PMID:23954458

  7. Detection of hypervascular hepatocellular carcinoma: Comparison of multi-detector CT with digital subtraction angiography and Lipiodol CT

    Zheng, Xiao-Hua; Guan, Yong-Song; Zhou, Xiang-Ping; Huang, Juan; Sun, Long; Li, Xiao; Liu, Yuan

    2005-01-01

    AIM: The purpose of this study was to compare the diagnostic accuracy of biphasic multi-detector row helical computed tomography (MDCT), digital subtraction angiography (DSA) and Lipiodol computed tomography (CT) in detection of hypervascular hepatocellular carcinoma (HCC).

  8. First results of spiral CT angiography in the evaluation of carotid artery stenosis; Erste Ergebnisse der Spiral-CT-Angiographie beim Nachweis von Stenosen der A. carotis

    Link, J. [Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany); Mueller-Huelsbeck, S. [Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany); Brossmann, J. [Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany); Grabener, M. [Klinik fuer Herz- und Gefaesschirgurgie, Kiel Univ. (Germany); Voss, C. [Klinik fuer Herz- und Gefaesschirgurgie, Kiel Univ. (Germany); Heller, M. [Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany)

    1995-03-01

    To determine the value of spiral CT angiography in Maximum Intensity Projection (MIP)-technique for evaluation of carotid artery stenosis. A comparison of the MIP technique with intraarterial DSA was done in 24 patients with 40 stenoses. Quantification of stenosis was determined according to the NASCET study: mild (0-29%), moderate (30-69%), severe (70-99%) and occlusion (100%). Totally the correlation of spiral CT angiography with DSA was 80% (r=0.93; p=0.0001). In the moderate stenosis group (r=1; p=0.1573), severe stenosis group (r=0.89; p=0.002) and the occlusion group (r=1; p=0.0009) there was a good correlation with DSA. In the mild stenosis group (r=0.55; p=0.0704) correlation of spiral CT angiography with DSA was poor. Spiral CT angiography allows an excellent delineation of calcifications. Tandem lesions and collateral flow cannot be shown with spiral CT angiography. (orig./MG) [Deutsch] Ziel der Studie war es, die Wertigkeit der Spiral-CT-Angiographie in der Maximum-Intensitaets-Projektion (MIP)-Technik bei der Beurteilung von Stenosen der A. carotis interna zu ueberpruefen. Ein Vergleich der MIP-Technik mit der selektiven DSA wurde bei 24 Patienten mit 40 Stenosen der A. carotis interna durchgefuehrt. Die Stenosequantifizierung erfolgte nach den Kriterien der NASCET-Studie: Geringgradig (0-29%); mittelgradig (30-69%); hochgradig (70-99%); Verschluss (100%). Die Spinal-CT-Angiographie korrelierte mit der DSA in 80% (R=0,93; p=0,0001). Bei den mittelgradigen (R=1; p=0,1573) und hochgradigen Stenosen (R=0,89; p=0,002) sowie bei den Verschluessen (R=1; p=0,0009) bestand eine gute Korrelation zur DSA. Bei den geringgradigen Stenosen (R=0,55; p=0,0704) war die Korrelation mit der DSA weniger gut. Kalkplaques lassen sich mit der Spiral-CT-Angiographie hervorragend darstellen. Tandemstenosen und der intrazerebrale Kollateralkreislauf sind mit der Spiral-CT-Angiographie bisher nicht evaluierbar. (orig./MG)

  9. CT angiography and Color Doppler ultrasonography features and sensitivity in detection of carotid arteries diseases

    Samir Kamenjaković

    2013-04-01

    Full Text Available Introduction: The aim of this research was to compare specifi city and sensitivity of Color Doppler ultrasonographywith CT angiography.Methods: A total of one hundred patients suffering from carotid artery disease (n=200 were tested in this research in the period from June till October, 2011. Average age of the patients was 61.5 years, and most of the patients were in the age group ranging from 55 to 65 years. The level of carotid artery stenosis is measured according to Standards of the North America Symptomatic Carotid Endarterectomy Trail study,by method of Color Doppler ultrasonography and CT angiography.Results: Stenosis <50% registered by Doppler ultrasonography was found in 62% and by CT angiography in 64% patients. Stenosis from 70 to 79% registered by Doppler ultrasonography was found in 88% and by CT angiography in 82% patients. In patients with level of stenosis 70-79% there was a tendencyof registering the stenosis to be higher by Color Doppler ultrasonography, than by CT angiography. In the case of the occlusion, there was also the similar observation, with variation of 8% carotid arteries.Conclusion: Extracranial Doppler and color duplex ultrasound enable reliable detection of both stenosis and occlusion of carotid arteries and accordingly they occupy an important place in radiological algorithm. When it comes to CT angiography it can be concluded that it can provide accurate and exact information regarding the condition of blood vessels as good as Digital Subtractive Angiography can.

  10. Developmental venous anomalies: appearance on whole-brain CT digital subtraction angiography and CT perfusion

    Developmental venous anomalies (DVA) consist of dilated intramedullary veins that converge into a large collecting vein. The appearance of these anomalies was evaluated on whole-brain computed tomography (CT) digital subtraction angiography (DSA) and CT perfusion (CTP) studies. CT data sets of ten anonymized patients were retrospectively analyzed. Five patients had evidence of DVA and five age- and sex-matched controls were without known neurovascular abnormalities. CT angiograms, CT arterial-venous views, 4-D CT DSA and CTP maps were acquired on a dynamic volume imaging protocol on a 320-detector row CT scanner. Whole-brain CTP parameters were evaluated for cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT), and delay. DSA was utilized to visualize DVA anatomy. Radiation dose was recorded from the scanner console. Increased CTP values were present in the DVA relative to the unaffected contralateral hemisphere of 48%, 32%, and 26%; and for the control group with matched hemispheric comparisons of 2%, -10%, and 9% for CBF, CBV, and MTT, respectively. Average effective radiation dose was 4.4 mSv. Whole-brain DSA and CTP imaging can demonstrate a characteristic appearance of altered DVA hemodynamic parameters and capture the anomalies in superior cortices of the cerebrum and the cerebellum. Future research may identify the rare subsets of patients at increased risk of adverse outcomes secondary to the altered hemodynamics to facilitate tailored imaging surveillance and application of appropriate preventive therapeutic measures. (orig.)