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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

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

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    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.)

  3. Optimal image reconstruction intervals for non-invasive coronary angiography with 64-slice CT

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    Leschka, Sebastian; Husmann, Lars; Desbiolles, Lotus M.; Boehm, Thomas; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Gaemperli, Oliver; Schepis, Tiziano; Koepfli, Pascal [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Center for Integrative Human Physiology, Zurich (Switzerland)

    2006-09-15

    The reconstruction intervals providing best image quality for non-invasive coronary angiography with 64-slice computed tomography (CT) were evaluated. Contrast-enhanced, retrospectively electrocardiography (ECG)-gated 64-slice CT coronary angiography was performed in 80 patients (47 male, 33 female; mean age 62.1{+-}10.6 years). Thirteen data sets were reconstructed in 5% increments from 20 to 80% of the R-R interval. Depending on the average heart rate during scanning, patients were grouped as <65 bpm (n=49) and {>=}65 bpm (n=31). Two blinded and independent readers assessed the image quality of each coronary segment with a diameter {>=}1.5 mm using the following scores: 1, no motion artifacts; 2, minor artifacts; 3, moderate artifacts; 4, severe artifacts; and 5, not evaluative. The average heart rate was 63.3{+-}13.1 bpm (range 38-102). Acceptable image quality (scores 1-3) was achieved in 99.1% of all coronary segments (1,162/1,172; mean image quality score 1.55{+-}0.77) in the best reconstruction interval. Best image quality was found at 60% and 65% of the R-R interval for all patients and for each heart rate subgroup, whereas motion artifacts occurred significantly more often (P<0.01) at other reconstruction intervals. At heart rates <65 bpm, acceptable image quality was found in all coronary segments at 60%. At heart rates {>=}65 bpm, the whole coronary artery tree could be visualized with acceptable image quality in 87% (27/31) of the patients at 60%, while ten segments in four patients were rated as non-diagnostic (scores 4-5) at any reconstruction interval. In conclusion, 64-slice CT coronary angiography provides best overall image quality in mid-diastole. At heart rates <65 bpm, diagnostic image quality of all coronary segments can be obtained at a single reconstruction interval of 60%. (orig.)

  4. Comparative evaluation of 64-slice CT angiography and digital subtraction angiography in assessing the cervicocranial vasculature

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    Randolf Klingebiel

    2008-08-01

    Full Text Available Randolf Klingebiel1, Max Kentenich3, Hans-Christian Bauknecht3, Florian Masuhr2, Eberhard Siebert1, Markus Busch2, Georg Bohner11Department of Neuroradiology, 2Department of Neurology, 3Department of Radiology, Charité Universitary Medicine Berlin, GermanyBackground: Noninvasive 64-slice computed tomography angiography (64-MSCTA closely approximates conventional catheter angiography (DSA in terms of detail resolution. Objective: Retrospective evaluation of cervicocranial (cc 64-MSCTA in comparison with DSA in patients with presumptive cc vascular disorders.Material and methods: Twenty-four 64-MSCTA studies (32 mm detector width, slice thickness 0.5 mm, 120 kv, 150 mAs, pitch 0.75 of patients with presumptive cc vascular pathology (13 men, 11 women, mean age 38.3 ± 11.3 yrs, range 19–54 yrs were assessed in comparison with DSA studies without abnormal findings in age-matched patients (11 men, 13 women, mean age 39.7 ± 11.9 yrs, range 18–54 yrs. Study readings were performed in a blinded manner by two neuroradiologists with respect to image quality and assessibility of various cc vascular segments by using a five-point scale. Radiation exposure was calculated for 64-MSCTA.Results: Each reader assessed 384/528 different vessel segments (64-MSCTA/DSA. Superior image quality was attributed to DSA with respect to the C1 ICA–C6 ICA, A3 ACA, and P3 PCA segments as well the AICA and SCA. 64-MSCTA was scored superior for C7 ICA and V4 VA segments. A significantly increased number of nonassessable V2- and V3 VA segments in DSA studies was noted. The effective dose for 64-MSCTA amounted to 2.2 mSv.Conclusions: 64-MSCTA provides near-equivalent diagnostic information of the cc vasculature as compared with DSA. According to our results, DSA should be considered primarily when peripheral vessels (A3/P3 or ICA segments close to the skull base (C2-5 are of interest, such as in primary angiitis or stenoocclusive ICA disease, respectively.Keywords: CT-angiography

  5. Diagnostic value of 64-slice spiral CT angiography in the diagnosis of multiple intracranial aneurysms: a report of 25 cases

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    Hong-sheng WANG

    2013-02-01

    Full Text Available Objective  To evaluate the diagnostic value of 64-slice spiral CT angiography (CTA in multiple intracranial aneurysms (MIA. Methods  Twenty-five patients (9 males and 16 females, aged from 17 to 68 years with suspected MIA underwent 64-slice spiral CTA with slice thickness of 0.625mm. The data of all patients were reconstructed with multiplanar reconstruction (MPR, 3-dimensional shade surface display (3-SSD, volume rendering (VR and maximum intensity projection (MIP. The clinical diagnostic value was evaluated with the results of surgery or interventional embolization therapy. Results  A total of 61 aneurysms were detected by 64-slice spiral CTA in 25 patients, among them 17 patients were with 2 aneurysms, 6 patients with 3 aneurysms, 1 patient with 4 aneurysms and 1 patient with 5 aneurysms. The 64-slice spiral CTA could not only clearly demonstrate MIA, but also the size, neck, axis point and parent artery of each aneurysm, and the spatial relationship between aneurysm and the adjacent vessels and bone structures. Twenty-one patients underwent microsurgery and four underwent embolization, the location, size and shape of aneurysm and its spatial relationship with adjacent structures were in accordance with the findings of 64-slice spiral CTA. Conclusion  The 64-slice spiral CTA could be used as the first choice in the diagnosis of MIA for its high accuracy, and may be an important adjunct to digital subtraction angiography (DSA in MIA treatment.

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

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    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.)

  7. Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease

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    Gaemperli, Oliver; Valenta, Ines; Schepis, Tiziano [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); Husmann, Lars; Scheffel, Hans; Desbiolles, Lotus; Leschka, Sebastian; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland)

    2008-06-15

    The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 {+-} 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 {+-} 4 months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions ({>=}50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis. (orig.)

  8. Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography.

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    Ciolina, F; Sedati, P; Zaccagna, F; Galea, N; Noce, V; Miraldi, F; Cavarretta, E; Francone, M; Carbone, I

    2015-10-01

    In patients affected by aortic valve stenosis (AS) it is mandatory to rule out coronary artery disease (CAD). The role of retrospectively ECG-gated 64-slice CT angiography (64-SCTA) was assessed in patients with AS referred for surgical valve replacement. Forty-two patients with AS underwent ECG-gated 64-SCTA of thoracic aorta, including the heart and coronary arteries, before surgical valve replacement. Images were evaluated by two independent readers and compared with surgical findings in terms of aortic valve calcification grading, valvular morphology, aortic valve annulus and sino-tubular junction diameters, and valvular area planimetry. Quantitative evaluation of cusps opening was also performed. Finally, the presence of CAD, thoracic aortic aneurysm and left ventricle hypertrophy were assessed. Visualization of the aortic valve without motion artefacts was possible in 38 patients (90.5%). Valvular morphology was correctly assessed in all cases (100%). 64-SCTA correctly determined aortic valve calcification grading and the aortic valve annulus and sinotubular junction diameters in 100% of cases. The aortic valve planimetric area was assessed in 38 cases (90.5%). Ascending aortic aneurysms requiring surgical replacement were detected in 12 patients (28.6%). Significant left ventricle hypertrophy was found in 30 patients (71%). Preoperative evaluation of patients undergoing surgical replacement for AS with 64-SCTA is feasible. 64-SCTA can rule out CAD and evaluate the status of the aortic valve and thoracic aorta in the same examination, obtaining relevant information for surgical planning.

  9. CT angiography of pulmonary embolism using a 64 slice multi-detector scanner

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    QIN Nai-shan; JIANG Xue-xiang; QIU Jian-xing; ZHU Ying; WANG Ji-chen

    2009-01-01

    Background Multi-detector computed tomography (MDCT) has already been the first line investigation method for diagnosis of pulmonary embolism (PE). Reducing the amount of contrast medium used during CT scanning could decrease the incidental rate of adverse reactions. Our study amied to evaluate the image quality of pulmonary arteries using 64 slice multi-detector CT with small volumes of contrast media injection.Methods Forty nonconsecutive patients without PE or other lung diseases were randomly assigned to two groups.Group A underwent CT scanning with 16×1.25 mm collimation and a 70 ml contrast injection, while group B had CT with 64×0.625 mm collimation and 20 ml of contrast injection. Two readers independently depicted the segmental and subsegmental pulmonary arteries. Reasons we could not analyze the pulmonary artery or that led to misdiagnosis of pulmonary embolism were evaluated, including the degree of contrast enhancement of the main pulmonary artery, and factors that caused misdiagnosis of PE (flow-related artifacts, partial volume artifact, beam-hardening artifacts and enhancement of pulmonary vein). The independent samples t-test, Mann-Whitney U test and Pearson chi-square test were applied.Results There were no significant differences in image quality of segmental and subsegmental arteries between the two groups. No significant difference was found for factors that made pulmonary arteries non-analyzable or in the misdiagnosis of PE, except the degree of contrast enhancement.Conclusion 64×0.625 mm collimation with 20 ml contrast injection could depict the pulmonary arteries well.

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

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    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.)

  11. Myopericarditis diagnosed by a 64-slice coronary CT angiography "triple rule out" protocol

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    Ku, Bon S.; Halpern, Ethan J.

    2010-01-01

    We report a case of myopericarditis in a 30-year-old male complaining of shortness of breath. In an emergency department (ED) setting, the symptoms of myopericarditis may overlap with many disease entities and can be a challenging diagnosis to make. However, with the use of a 64-section coronary CT angiography in a “triple rule out” (TRO) protocol, we were able to detect a large pericardial effusion surrounding the heart and moderate global hypokinesis in the setting of normal-sized heart chambers and normal coronary arteries. We were further able to exclude pulmonary embolism and thoracic dissection. This is the first reported case of diagnosing myopericarditis using a TRO protocol. It demonstrates the usefulness of TRO in making an emergent diagnosis of myopericarditis while excluding other life-threatening diseases that can lead to earlier appropriate ED disposition and care. PMID:21373320

  12. Accuracy of 64-slice CT angiography for the detection of functionally relevant coronary stenoses as assessed with myocardial perfusion SPECT

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    Gaemperli, Oliver; Schepis, Tiziano; Koepfli, Pascal; Valenta, Ines; Soyka, Jan [University Hospital Zurich NUK C 40, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Leschka, Sebastian; Desbiolles, Lotus; Husmann, Lars; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich NUK C 40, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (CIHP), Zurich (Switzerland)

    2007-08-15

    CT angiography (CTA) offers a valuable alternative for the diagnosis of CAD but its value in the detection of functionally relevant coronary stenoses remains uncertain. We prospectively compared the accuracy of 64-slice CTA with that of myocardial perfusion imaging (MPI) using {sup 99m}Tc-tetrofosmin-SPECT as the gold standard for the detection of functionally relevant coronary artery disease (CAD). MPI and 64-slice CT were performed in 100 consecutive patients. CTA lesions were analysed quantitatively and area stenoses {>=}50% and {>=}75% were compared with the MPI findings. In 23 patients, MPI perfusion defects were found (12 reversible, 13 fixed). A total of 399 coronary arteries and 1,386 segments was analysed. Eighty-four segments (6.1%) in 23 coronary arteries (5.8%) of nine patients (9.0%) were excluded owing to insufficient image quality. In the remaining 1,302 segments, quantitative CTA revealed stenoses {>=}50% in 57 of 376 coronary arteries (15.2%) and stenoses {>=}75% in 32 (8.5%) coronary arteries. Using a cut-off at {>=}75% area stenosis, CTA yielded the following sensitivity, specificity, negative (NPV) and positive predictive value (PPV), and accuracy for the detection of any (fixed and reversible) MPI defect: by patient, 75%, 90%, 93%, 68% and 87%, respectively; by artery, 76%, 95%, 99%, 50% and 94%, respectively. Sixty-four-slice CTA is a reliable tool to rule out functionally relevant CAD in a non-selected population with an intermediate pretest likelihood of disease. However, an abnormal CTA is a poor predictor of ischaemia. (orig.)

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

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    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.

  14. Image Quality and Radiation Dose for Prospectively Triggered Coronary CT Angiography: 128-Slice Single-Source CT versus First-Generation 64-Slice Dual-Source CT

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    Gu, Jin; Shi, He-Shui; Han, Ping; Yu, Jie; Ma, Gui-Na; Wu, Sheng

    2016-10-01

    This study sought to compare the image quality and radiation dose of coronary computed tomography angiography (CCTA) from prospectively triggered 128-slice CT (128-MSCT) versus dual-source 64-slice CT (DSCT). The study was approved by the Medical Ethics Committee at Tongji Medical College of Huazhong University of Science and Technology. Eighty consecutive patients with stable heart rates lower than 70 bpm were enrolled. Forty patients were scanned with 128-MSCT, and the other 40 patients were scanned with DSCT. Two radiologists independently assessed the image quality in segments (diameter >1 mm) according to a three-point scale (1: excellent; 2: moderate; 3: insufficient). The CCTA radiation dose was calculated. Eighty patients with 526 segments in the 128-MSCT group and 544 segments in the DSCT group were evaluated. The image quality 1, 2 and 3 scores were 91.6%, 6.9% and 1.5%, respectively, for the 128-MSCT group and 97.6%, 1.7% and 0.7%, respectively, for the DSCT group, and there was a statistically significant inter-group difference (P ≤ 0.001). The effective doses were 3.0 mSv in the 128-MSCT group and 4.5 mSv in the DSCT group (P ≤ 0.001). Compared with DSCT, CCTA with prospectively triggered 128-MSCT had adequate image quality and a 33.3% lower radiation dose.

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

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    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.

  16. 64-Slice CT Angiography in Diagnosis of Congenital Heart Disease in Children%64排CTA在小儿先天性心脏病的应用

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    时胜利; 陈志平; 冯东曚

    2013-01-01

    Objective To investigate the value of 64-slice CT angiography(CTA) and post-processing(reconstruction) technique in the diagnosis of children with congenital heart disease.Methods The clinical and CT data of children with congenital heart disease undergoing CT angiography from April 2010 to March 2012 in our hospital were analyzed to summarize the diagnosis method of post-processing(reconstruction) technique.Results All 73 patients with congenital heart disease were confirmed by CT angiography,in which 40 cases were with complex congenital heart disease,17 cases with atrial septal defect,43 cases with ventricular septal defect,7 cases with patent ductus arteriosus,5 cases with pulmonary artery stenosis,1 case with congenital atresia of pulmonary artery,22 cases with right ventricular outflow tract obstruction,3 cases with anomalous pulmonary venous connection,2 cases with aortic stenosis,4 cases with persistent left superior vena cava,3 cases with right aortic arch.As compared with ultrasonography and surgical outcomes,there was no obvious difference among them.Conclusion 64-slice CT angiography and post-processing reconstruction technique has significant practical value in diagnosis of children congenital heart disease.%目的 探讨64排CTA对小儿先天性心脏病的诊断价值及后处理重建方法.方法 收集整理郑州市儿童医院2010年4月-2012年3月期间经64排心脏CTA检查患儿的临床及CT资料并进行分析,总结小儿先天性心脏病64排CTA后处理诊断方法.结果 73例经64排CTA检查的先天性心脏病患儿均能明确诊断,其中复杂先心病40例,有房间隔缺损者17例,有室间隔缺损者43例,有动脉导管未闭者7例,有肺动脉狭窄者5例,先天性肺动脉闭锁1例,有右室流出道狭窄者22例,有肺静脉异位引流者3例,有主动脉狭窄者2例,永存左上腔静脉4例,右位主动脉弓3例.与彩超及手术结果比较差异无统计学意义.结论 小儿先天性心脏病的64

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

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver; Schepis, Tiziano; Namdar, Mehdi; Valenta, Ines [University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kalff, Victor [Alfred Hospital, Department of Nuclear Medicine, Melbourne (Australia); Stefani, Laurent [GE Healthcare Bio-Sciences, Buc Cedex (France); Desbiolles, Lotus; Leschka, Sebastian; Husmann, Lars; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland)

    2007-07-15

    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 {sup 99m}Tc-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.)

  18. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  20. Body physique and heart rate variability determine the occurrence of stair-step artefacts in 64-slice CT coronary angiography with prospective ECG-triggering.

    Science.gov (United States)

    Husmann, Lars; Herzog, Bernhard A; Burkhard, Nina; Tatsugami, Fuminari; Valenta, Ines; Gaemperli, Oliver; Wyss, Christophe A; Landmesser, Ulf; Kaufmann, Philipp A

    2009-07-01

    The purpose of this study was to describe and characterize the frequency and extent of stair-step artefacts in computed tomography coronary angiography (CTCA) with prospective electrocardiogram (ECG)-triggering and to identify their determinants. One hundred and forty three consecutive patients (55 women, mean age 57 +/- 13 years) underwent 64-slice CTCA using prospective ECG-triggering. Occurrence of stair-step artefacts in CTCA of the thoracic wall and the coronary arteries was determined and maximum offset was measured. If stair-step artefacts occurred in both cases, a difference between thoracic wall and coronary artery offset of 0.6 mm or greater was attributed to additional motion of the heart. Mean effective radiation dose was 2.1 +/- 0.7 mSv (range 1.0-3.5 mSv). Eighty-nine patients (62%) had stair-step artefacts in CTCA of the coronary arteries (mean offset of 1.7 +/- 1.1 mm), while only 77 patients had thoracic wall stair-step artefacts (mean offset of 1.0 +/- 0.3 mm; significantly different, P < 0.001). Stair-step artefacts in CTCA of the thoracic wall were determined by BMI and weight (P < 0.01), while artefacts in CTCA of the coronary arteries were associated with heart rate variability (P < 0.05). Stair-step artefacts in CTCA with prospective ECG-triggering are determined by (a) motion of the entire patient during table travel, particularly in large patients and (b) by motion of the heart, particularly when heart rates are variable.

  1. 64层螺旋CT血管成像在自发性蛛网膜下腔出血中的应用价值%Application value of 64 slice spiral CT angiography in spontaneous subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    白光宇

    2016-01-01

    目的:总结、探讨64层螺旋CT血管成像在自发性蛛网膜下腔出血诊断中的应用价值。方法:收治自发性蛛网膜下腔出血患者110例,给予64层螺旋CT扫描及数字减影血管造影,再以容积再现、曲面重组、最大密度投影、多平面重组等方法处理。结果:110例 ASH 患者均经过 DSA、手术证实。动脉瘤及脑血管畸形105例,检出率95.45%,CTA 诊断符合率达100.00%。结论:64层螺旋 CT 血管成像在自发性蛛网膜下腔出血诊断中应用价值极高,可为临床疾病诊断、治疗提供有效依据。%Objective:To summarize and discuss the value of 64 slice spiral CT angiography in the diagnosis of spontaneous subarachnoid hemorrhage.Methods:110 patients with spontaneous subarachnoid hemorrhage were selected.64 slice spiral CT scanning and digital subtraction angiography were given,and then the volume rendering,surface reconstruction,maximum density projection,multi planar reconstruction and other methods were given.Results:110 cases of ASH were confirmed by DSA and operation.aneurysm and cerebral vascular malformation were 105 cases,the detection rate was 95.45% ,and the rate of CTA diagnosis was 100%.Conclusion:64 slice spiral CT angiography in the diagnosis of spontaneous subarachnoid hemorrhage is very high value.It can provide an effective basis for clinical diagnosis and treatment.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  3. The value of dual-source 64-slice CT coronary angiography in the assessment of patients presenting to an acute chest pain service.

    Science.gov (United States)

    Hansen, Mark; Ginns, Jonathan; Seneviratne, Sujith; Slaughter, Richard; Premaranthe, Manuja; Samardhi, Himabindu; Harker, Jodi; Lai, Tony; Walters, Darren L; Bett, Nicholas

    2010-04-01

    The absence of radiological evidence of plaque on computed tomographic coronary angiography (CTCA) reliably excludes obstructive coronary artery disease. We studied patients who presented to our emergency department with chest pain and were admitted to our chest pain assessment service. If they were free of pain and without high-risk features of myocardial ischaemia including elevation of serum biomarkers they underwent CTCA and performed a standard treadmill exercise test. Eighty-nine patients aged 56.3+/-8.6 years were admitted. Eleven of them had selective angiography; CTCA identified all who had obstructive disease. More than half of the 85 patients who had normal values of cardiac troponin and of the 75 with a negative exercise test had radiological evidence of disease. During follow-up for 355+/-72 days none died, suffered myocardial infarction or required coronary artery surgery: two with obstructive disease underwent percutaneous coronary intervention 1 and 7 days after the index study. The CTCA findings were significantly correlated with those of selective angiography and with troponin status and increased the ascertainment of coronary artery disease in a cohort of patients at low risk for clinically significant ischaemic heart disease. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.

  4. Moyamoya Disease:Diagnostic Value of 64-slice Spiral CT Angiography%烟雾病64层螺旋CT血管成像的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李杨; 杨峰; 余河

    2012-01-01

    目的:探讨烟雾病64层螺旋CT血管成像(MSCTA)的表现,评价其临床诊断价值.方法:收集行64层螺旋CT平扫及血管成像检查并临床确诊的烟雾病患者27例,在ADW4.3工作站上对原始图像做二维及三维处理:容积再现(VR)、最大密度投影( MIP)、剪影后容积再现、多平面重组(MPR)及曲面重组(CPR),总结烟雾病的64层螺旋CT血管成像特点.结果:27例双侧颈内动脉远段、大脑前动脉及中动脉近端狭窄、闭塞20例,单侧大脑中动脉闭塞5例,双侧大脑前动脉并大脑中动脉狭窄、闭塞2例,5例双侧大脑后动脉代偿性增粗;3例合并基底动脉动脉瘤,2例合并大脑后动脉动脉瘤;27例均可见周围紊乱血管影,相应血管及其分支粗大、增多、迂曲延长.VR图像有利于显示狭窄闭塞段与周围骨性结构空间关系,但在显示评价脑底增生小血管和侧支血管方面不及MIP和MPR.结论:64层螺旋CT血管成像(MSCTA)可以清晰的显示烟雾病血管改变特点及周围侧支血管网,检查方法简单、快捷、无创伤,容积再现及剪影后容积再现可以直观显示病变周围空间结构关系,可作为诊断烟雾病的首选诊断方法.%Objective To explore the 64-slice spiral CT angiography (MSCTA) findings and clinical value for diagnosis of moyamoya disease. Methods Seventeen patients with moyamoya disease underwent routine CT scanning and MSCT angiography. All the patients were confirmed by DSA. The angiograms obtained were processed on the ADW4.3 workstation to perform volume rending(VR) , maximum intensity projection (MIP) and multiplanar Volume refomration (MPR) and curved planar reformatting( CPR). Results In all cases MSCTA showed the stenosis or obstruction of arteria carotis interna( ICA) or proximum of Wills circle, abnormal vessel network in brain basal part, including stenosis of bilateral ICA and anterior cerebral artery and middle cerebral artery(20 cases) ,one side middle

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Reconstruction of the portal vein with 64-slice spiral CT of bile duct obstruction

    OpenAIRE

    Xia, Yunbao; PAN, GONGMAO; Xue, Feng; Geng, Chengjun

    2013-01-01

    The aim of this study was to evaluate 64-slice spiral CT image reconstruction of the portal vein in biliary obstruction. A total of 34 clinical patients with biliary obstruction were confirmed by 64-slice spiral CT scanning with portal venous phase multi-planar reconstruction (MPR) of the biliary tract, curved planar reconstruction (CPR), thin-slab minimum-intensity projection (TS-MinIP) and maximum intensity projection (MIP). The reconstructed images were reviewed to further assess the posit...

  7. MSCT血管成像对肝移植受体术前血管结构的评价%The evalution of the vascular structure of preoperative liver transplantation recipients using 64-slice spiral CT angiography

    Institute of Scientific and Technical Information of China (English)

    李妙玲; 刘雯雁; 袁会军; 强永乾; 孙兴旺; 赵婷婷

    2011-01-01

    Objective To evaluate the clinical significance of 64-slice spiral CT angiography for vascular structures of preoperative liver transplantation recipients. Methods Tri-phase enhanced CT scan were performed in 32 cases, All cases were post-processing with maximum intensity projection(MIP) , volume rendering(VR) ,and all reformation images with axial images were analyzed. Results In all 32 cases, 1 case with absence of celiac artery, 3 cases with stenosis of celiac artery caused by plaque, 12 cases with dilated splenic artery, 2 cases with splenic artery aneurysm, 7 cases with variation of hepatic artery. 3 cases with extrahepatic portal vein thrombosis, 2 cases with intrahepatic portal vein thrombosis, 1 case with thrombosis in superior mesenteric vein, 1 case with muti-ple thrombosis in portal vein and superior mesenteric vein. In all 32 cases, 25 cases with good images of hepatic vein, 14 cases with standard hepatic vein, 11 cases with common drainage of the middle and the left hepatic vein into the inferior vena cava, and 1 case with inferior hepatic vein respectively,? Cases with poor images. In all 32 cases,30 cases with normal inferior vena cava, 1 case with embolism in inferior vena cava and 1 case with embolism near the right atrium. In all 32 cases, 24 cases received liver transplantation successfully, the other 8 cases had the contraindications of liver transplantation and gave up operation,of 8 cases, 3 cases with total diameter of cancer nodules were more than 8 cm,l case with mutiple thrombosis, 4 cases with extrohepatic metastasis(including 1 case with total diameter of cancer nodules were more than 8 cm) , 1 case with Michels MD had narrowing hepatic artery and the diameter was less than 3 mm separately. Conclusion 64-slice spiral CT tri-phase angiography could overall evaluate structural changes of the hepatic vessels and choose the cases suitable for surgery,it has an important value for surgery program.%目的 探讨64排螺旋CT血管成像对肝

  8. 64排螺旋CT对先天性主动脉缩窄诊断的临床应用价值%Clinical Application of 64-slice Spiral CT Angiography in Diagnosing the Congenital Coarctation of Aorta

    Institute of Scientific and Technical Information of China (English)

    王小红; 亓波

    2011-01-01

    Objective To evaluate the clinical diagnostic valie of 64-slice spiral CT angiography (CTA )in coarctation of aorta (CoA).M ethods 154 caseswith coarciation of the aorta(47 women and 107 men;mean age3 .3 years;age range 20 days-60 years) were diagnosed by by 64-slfce spiral CT angiDgraphy (CTA ) and translhoracic echocardiography (TTE ) ,and 77 of than were treated by operation .Results In the operative 77 cases ,17 m issed by TTE and no case missed by CTA .The definite diagnosis rate of TTE was 77 .9% ,and the definite diagnosis rate of CTA was 100% .Among 154 cases,44 cases (28 .6% ) were staple aortic coarctation , 95 cases(61.7% )were pediatric pcmpfex portic coarctation and 15 cases(9 .7% ) were atypicalpomplex portic coarctation .therewere significant differences bete een year of three types CoA ( P<0 .001) .The m ean stenotic ratio (the diam eterof the ooarctatbn to thatofthe proxinalnomalsegnentof the aortic ooarctation )R = 0 .29+0 .13 .Conclusion MDCT examhation is able to clearly display type,scope,extent and can plicated m alform ations ,can provide in portent infem ation for the diagnosis and teatn ent of aortic ooaictetian.%目的 评价64排螺旋CT(MDCT)在主动脉缩窄临床诊断中的价值.方法 154例主动脉缩窄患者,男性107例,女性47例,年龄20天-60岁,平均3.3岁,均采用64排螺旋CT血管成像扫描和经胸心脏超声检查.结果 77例经手术证实CoA病例中,超声心动图检查55例明确诊断,5例诊断可疑,17例漏诊,准确率为77.9%(60/77),MDCT均明确诊断,准确率为100%(77/77).154例主动脉缩窄患者中,单纯型44例(28.6%),复杂婴儿型95例(61.7%),复杂不典型型15例(9.7%);其中局限性缩窄91例(59.1%),管性缩窄63例(40.9%),3种类型的CoA在年龄分布上存在着显著性差异(K-W统计值为22.9,P<0.001).MDCT测量最窄处内径与主肺动脉水平升主动脉内径比值R为0.29±0.13.结论 CTA能够全面显示主动脉缩窄的类型、范围程度及伴随畸形,能

  9. Assessment of perigastric veins anatomy using 64-slice spiral CT angiography with image fusion%64层螺旋CT血管成像及融合技术评价胃周静脉

    Institute of Scientific and Technical Information of China (English)

    李雪华; 孙灿辉; 冯仕庭; 彭振鹏; 何裕隆; 韩方海; 李子平; 孟悛非

    2012-01-01

    To evaluate the efficacy and clinical value of 64-slice spiral CTA with image fusion on the anatomy of perigastric veins. Methods Totally 53 patients underwent abdominal 64-slice spiral CT examination. CTA of perigastric veins, arteries and stomach were reconstructed, and the images were fused with VR technique. The inflow and courses of perigastric veins were observed, as well as the spatial relationship among the perigastric veins, arteries and stomach on CTA. Moreover, the accuracy, sensitivity and specificity of preoperative CTA were detected with surgical findings as standard in 26 patients who underwent gastrectomy. Results In 53 patients, the display rate of the right gastroepiploic vein was 100% (53/53), 90. 57% (48/53) of the left gastric vein, 73. 58% (39/53) of the right gastric vein, 50. 94% (27/53) of the posterior gastric vein, 94. 34% (50/53) of the short gastric vein, 92. 45% (49/53) of the left gastroepiploic vein, and 71. 70% (38/53) of the gastrocolic trunk. The accuracy of preoperative CTA correctly identifying perigastric veins was 92. 31%—100%, the sensitivity was 90. 91%—100%, and the specificity was 100%. Conclusion 64-slice spiral CTA can clearly display perigastric veins and show the relationship among the stomach and perigastric arteries in the living body with the fused image.%目的 探讨64层螺旋CTA及融合技术对胃周静脉的显示能力和临床应用价值.方法 对53例患者行腹部64层螺旋CT扫描.采用VR技术分别重建胃周静脉、动脉和胃,并将其融合,观察胃周静脉的汇入点、走行及其与胃周动脉、胃的空间关系.将26例接受手术治疗患者的术前CTA资料与术中所见进行对比,评价64层螺旋CTA显示胃周静脉的准确率、敏感度及特异度.结果 胃网膜右静脉的显示率为100%(53/53),胃左静脉为90.57%(48/53),胃右静脉为73.58%(39/53)、胃后静脉为50.94%(27/53)、胃短静脉为94.34%(50/53)、胃网膜左静脉为92.45%(49

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. Investigation of acute lower gastrointestinal bleeding with 16- and 64-slice multidetector CT.

    Science.gov (United States)

    Lee, S; Welman, C J; Ramsay, D

    2009-02-01

    We evaluated the usefulness of 16- and 64-slice multidetector CT (MDCT) in the detection of a bleeding site in acute lower gastrointestinal tract (GIT) haemorrhage by conducting a retrospective study of cases of presumed acute lower GIT haemorrhage imaged with CT in two teaching hospitals in an 11-month period. The patients underwent contrast enhanced CT using either a 16 or 64 MDCT. No oral contrast was used. One hundred milliliters of non-ionic intravenous contrast agent was injected at 4.5 mL/s, followed by a 60 mL saline flush at 4 mL/s through a dual head injector. Images were acquired in arterial phase with or without non-contrast and portal phase imaging with 16 x 1.5 mm or 64 x 0.625 mm collimation. Active bleeding was diagnosed by the presence of iodinated contrast extravasation into the bowel lumen on arterial phase images with attenuation greater than and distinct from the normal mucosal enhancement or focal pooling of increased attenuation contrast material within a bowel segment on portal-venous images. Further management and final diagnosis was recorded. Fourteen patients and 15 studies were reviewed. CT detected and localized a presumed bleeding site or potential causative pathology in 12 (80%) of the patients. Seven of these were supported by other investigations or surgery, while five were not demonstrated by other modalities. Eight patients had mesenteric angiography, of which only four corroborated the site of bleeding. CT did not detect the bleeding site in three patients, of which two required further investigation and definitive treatment. We propose that MDCT serves a useful role as the initial rapid investigation to triage patients presenting with lower GIT bleeding for further investigation and management.

  12. 起搏器置入患者640层与64层CT冠状动脉造影图像质量和伪影的比较%Comparative Study of Image Quality and the Artifact of Coronary Angiography between 640-slice and 64-slice CT in the Patients with Pacemaker

    Institute of Scientific and Technical Information of China (English)

    王振; 丁忠祥; 王博业; 狄幸波; 袁建华; 徐健; 陈军法; 钟建国

    2012-01-01

    Objective To compare the image quality and artifact between 640 - slice and 64 - slice CT coronary angiography in the patients with pacemaker, and to evaluate the success rate and applicability of CT coronary angiography. Methods Twenty - four patients with pacemaker were divided into two groups. Group A ( 16 patient) underwent 640 - slice CT coronary angiography, and Group B ( 8 patient) underwent 64 - slice CT coronary angiography. Image quality and artifact of the fifteen coronary segments were assessed by two blinded observers. Radiation dosage and patient's common information were recorded. Data sets were analyzed using parametric and nonpara-metric statistical tests with the SPSS 13.0 software. Results There was no significant difference in body weight and body height between the two groups. Radiation exposure was significantly higher with 64 - slice CT than with 640 - slice CT ( 13. 8 ± 1. 53 mSv vs 9. 14 ± S.6S mSv; P<0.001) despite significantly higher heart rates in the 640 - slice CT group [61 ±4bpm ( beats per minute) vs 71 ±6bpm; P <0. 001 ] . The rate of available diagnostic images was greater for images obtained with 640 - slice CT than for images obtained with 64 -slice CT(99.06% vs93.27% ; P<0.05). Artifacts were the cause of coronary arteries that cannot be evaluated for coronary MSCT angiography. They were blurring artifact, stairstep artifact, streak artifact, missing data. There were significant differences in these artifacts between the two groups( continuity corrected^2 = 5.009,/* <0.05). Artifacts of group A were mild (94.3% ) , and artifacts of group B were severe artifacts (31.8% ). Conclusion 640 - slice and 64 - slice CT coronary angiography have excellent image quality in patients with pacemaker. 640 - slice CT provides significantly better diagnostic image quality and artifacts of little influence than those of 64 - slice CT, and it had more success rate and applicability of CT coronary angiography.%目的

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

    DEFF Research Database (Denmark)

    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......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 conducted on 10 studies examining stable, symptomatic and intermediate risk patients by 64-slice CTA. Patients were followed up for a mean of 21 month. Patient groups with CT-angiographic non-obstructive (stenosis /=50% of luminal narrowing) CAD were compared to those having normal angiography without CAD....... MACE (cardiac death, non-fatal myocardial infarction and revascularization) numbers were used to calculate odds ratios (OR) with 95% confidence interval (CI) in each group. Ten studies including 5,675 patients were eligible for meta-analysis. The cumulative MACE rate over 21 months were 0...

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

    Energy Technology Data Exchange (ETDEWEB)

    Feng Shiting [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou (China); Law, Martin Wai-Ming [Department of Clinical Oncology, Queen Mary Hospital (Hong Kong); Huang Bingsheng [Department of Diagnostic Radiology, University of Hong Kong (Hong Kong); Ng, Sherry [Department of Clinical Oncology, Queen Mary Hospital (Hong Kong); Li Ziping; Meng Quanfei [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou (China); Khong, Pek-Lan, E-mail: plkhong@hkucc.hku.hk [Department of Diagnostic Radiology, University of Hong Kong (Hong Kong)

    2010-11-15

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Thines, Laurent [Lille University Hospital, Department of Neurosurgery, Lille (France); Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Agid, Ronit; Da Costa, Leodante; Terbrugge, Karel G. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Dehdashti, Amir R.; Wallace, M.C.; Tymianski, Michael [Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada)

    2009-08-15

    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.)

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

    DEFF Research Database (Denmark)

    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...... arteries and 1,120 versus 514 patients in low versus high CACS subgroups from 19 eligible studies were compared. The per-patient prevalence of coronary artery disease was 48% versus 68%, respectively. Subgroups were stratified by different CACS thresholds ranging from 100 to 400. Meta-analyses of per......-patient data comparing overall low versus high CACS subgroups resulted in a sensitivity of 97.5 (95.5-99)% versus 97 (94.5-98.5)%, specificity of 85 (82-88)% versus 66.5 (58-74.5)%, diagnostic odds ratio of 153 (81-290) versus 40 (20-83), positive predictive value of 85 (82-87)% versus 86 (84-88)%, negative...

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

    LENUS (Irish Health Repository)

    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.

  18. The Correlation Analysis of 64-slice Coronary CT Angiography: Effect of Average Heart rate, Heart Rate Range and Heart Rate Variability on Image Quality%平均心率、心率波动和心率变异性对64层螺旋CT冠脉成像质量的相关性分析

    Institute of Scientific and Technical Information of China (English)

    朱玉春; 王建良; 吴志娟; 沈纪芳; 王伟伟; 刘丽华; 朱晟超; 张臻

    2012-01-01

    Objective The purpose of this study was to evaluate the effect of average heart rate,heart rate range and heart rate variability on the image quality with 64-slice spiral CT coronary angiography. Methods 200 patients underwent 64-slice coronary CT angiogra-phy ,which were suspected coronary artery diseases. Image quality was performed using five score method. The detailed analysis was performed to evaluate the relationship of average heart rate,heart rate range and heart rate variability on the image quality. Results 600 coronary angiography were analyzed in 200 patients. The average heart rate was 69.20 ± 8.80 beat per minute(heart rate rang , l~38bmp), with a variability of 8.50 ±6.75%. Image quality was sufficient for diagnosis for 94.3%(566/600)of arterial segment at the best reconstruction interval. A significan correlation (P<0.05) between overall image quality was found for average heart rate, heart rate range and heart rate variability. The lower average heart rate,the less heart rate range and variability, the better coronary image quality. Conclusion Coronary angiography with 64-slice spiral CT can provides best diagnostic image quality within a wide range of heart rates, and reducing average heart rate and heart rate variability in patients is beneficial in improving image quality.%目的 探讨平均心率、心率波动和心率变异性对64层螺旋CT冠脉造影成像质量的影响.方法 200例患者因怀疑存在冠心病进行64层螺旋CT冠状动脉造影检查,以5分法评定系统进行影像质量评价,着重分析平均心率、心率波动和心率变异性与冠状动脉图像质量的相关性.结果 200例患者,共纳入分析血管为600支,平均心率为69.20±8.80bmp,心率波动范围 1-38bmp,平均心率变异性8.50±6.75 %,共有94.3%(566/600)冠状动脉图像质量满足诊断需要.平均心率,心率波动和心率变异性与冠脉图像质量均有显著相关性.平均心率越慢,心率波动范围越小,心率

  19. Calculation of the Scattered Radiation Profile in 64 Slice CT Scanners Using Experimental Measurement

    Directory of Open Access Journals (Sweden)

    Afshin Akbarzadeh

    2009-06-01

    Full Text Available Introduction: One of the most important parameters in x-ray CT imaging is the noise induced by detected scattered radiation. The detected scattered radiation is completely dependent on the scanner geometry as well as size, shape and material of the scanned object. The magnitude and spatial distribution of the scattered radiation in x-ray CT should be quantified for development of robust scatter correction techniques. Empirical methods based on blocking the primary photons in a small region are not able to extract scatter in all elements of the detector array while the scatter profile is required for a scatter correction procedure. In this study, we measured scatter profiles in 64 slice CT scanners using a new experimental measurement. Material and Methods: To measure the scatter profile, a lead block array was inserted under the collimator and the phantom was exposed at the isocenter. The raw data file, which contained detector array readouts, was transferred to a PC and was read using a dedicated GUI running under MatLab 7.5. The scatter profile was extracted by interpolating the shadowed area. Results: The scatter and SPR profiles were measured. Increasing the tube voltage from 80 to 140 kVp resulted in an 80% fall off in SPR for a water phantom (d=210 mm and 86% for a polypropylene phantom (d = 350 mm. Increasing the air gap to 20.9 cm caused a 30% decrease in SPR. Conclusion: In this study, we presented a novel approach for measurement of scattered radiation distribution and SPR in a CT scanner with 64-slice capability using a lead block array. The method can also be used on other multi-slice CT scanners. The proposed technique can accurately estimate scatter profiles. It is relatively straightforward, easy to use, and can be used for any related measurement.

  20. 心率及其变异性对64层CT冠状动脉成像质量及辐射剂量的影响%Effects of heart rate and heart rate variability on image quality and radiation exposure of 64-slice coronary CT angiography

    Institute of Scientific and Technical Information of China (English)

    贺敬红; 李健丁; 乔英; 张瑞平

    2016-01-01

    目的:评价心率及心率变异性对64层螺旋CT冠状动脉影像质量及辐射剂量的影响。方法共90例患者进行了64层螺旋CT冠状动脉成像,以4分评判方法进行图像质量评价,分析心率及心率变异性对冠状动脉的影像质量及辐射剂量的影响。结果90例患者,共360支血管纳入分析,其中97.5%可满足影像评价。平均心率为(67±10)次/min,平均心率变异性为(7.2±9.3)%,辐射剂量平均为(20.2±2.3)mSv。平均心率和心率变异性与冠状动脉影像质量均呈负相关(r值分别为:-0.651、-0.662,P值均<0.01),与辐射剂量无相关性。结论不同心率、心率变异性患者,图像质量差异较大,降低心率,减少心率变异性有助于提高64层冠状动脉的成像质量,对辐射剂量无显著影响。%Objective To assess the effect of heart rate and heart rate variability on image quality and patient dose with 64-slice sprial CT coronary angiography. Methods Ninty patients underwent 64-slice coronary CT angiog-raphy.Image quality was performed usding four-score method.The analysis was performed to evaluate the relationship of heart rate and heart rate variability on the image quality and radiation dose. Results Three hundreds and sixty coronary arteries were analyzed in 90 patients, 97.5%of the coronary segments was sufficient for diagnosing. The aver-age heart rate was (67 ±10) beat per minute,with a variability of (7.2 ±9.3)%.The mean effective dose was (20.2 ±2.3) mSv.Significant negative correlations were observed both between heart rate and image quality and between heart rate variability and image quality. The results showed that heart rate and heart rate variability had no significant effect on radiation dose. Conclusion The image quality was significantly different in patients with different heart rate and heart rate variability.Reducing average heart rate and heart rate variability in

  1. Combined use of 64-slice computed tomography angiography and gated myocardial perfusion SPECT for the detection of functionally relevant coronary artery stenoses. First results in a clinical setting concerning patients with stable angina

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, M.; Hack, N.; Tiling, R. [Klinikum Grosshadern (Germany). Dept. of Nuclear Medicine; Jakobs, T.; Nikolaou, K.; Becker, C. [Klinikum Grosshadern (Germany). Dept. of Clinical Radiology; Ziegler, F. von; Knez, A. [Klinikum Grosshadern (Germany). Dept. of Cardiology; Koenig, A.; Klauss, V. [Medizinische Poliklinik-Innenstadt, Univ. of Munich (Germany). Dept. of Cardiology

    2007-07-01

    Aim: In patients with stable angina pectoris both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. High accuracy was shown for spiral computed tomography (MDCT) angiography acquired with a 64-slice CT scanner compared to invasive coronary angiography (ICA) in detecting ''obstructive'' coronary artery disease (CAD). Gated myocardial SPECT (MPI) is an established method for the noninvasive assessment of functional significance of coronary stenoses. Aim of the study was to evaluate the combination of 64-slice CT angiography plus MPI in comparison to ICA plus MPI in the detection of hemodynamically relevant coronary artery stenoses in a clinical setting. Patients, methods: 30 patients (63 {+-} 10.8 years, 23 men) with stable angina (21 with suspected, 9 with known CAD) were investigated. MPI, 64-slice CT angiography and ICA were performed, reversible and fixed perfusion defects were allocated to determining lesions separately for MDCT angiography and ICA. The combination of MDCT angiography plus MPI was compared to the results of ICA plus MPI. Results: Sensitivity, specificity, negative and positive predictive value for the combination of MDCT angiography plus MPI was 85%, 97%, 98% and 79%, respectively, on a vessel-based and 93%, 87%, 93% and 88%, respectively, on a patient-based level. 19 coronary arteries with stenoses =50% in both ICA and MDCT angiography showed no ischemia in MPI. Conclusion: The combination of 64-slice CT angiography and gated myocardial SPECT enabled a comprehensive non-invasive view of the anatomical and functional status of the coronary artery tree. (orig.)

  2. Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?

    Directory of Open Access Journals (Sweden)

    Dietrich Jehle

    2012-02-01

    Full Text Available CT angiography (CTA has improved significantly over the past few years such that the reconstructed images of the cerebral arteries may now be equivalent to conventional digital angiography. The new technology of 64 slice multi-detector CTA can reconstruct detailed images that can reliably identify small cerebral aneurysms, even those <3mm. In addition, it is estimated that CT followed by lumbar puncture (LP misses up to 4% of symptomatic aneurysms. We present a series of cases that illustrates how CT followed by CTA may be replacing CT-LP as the standard of care in working up patients for symptomatic cerebral aneurysms and the importance of performing three dimensional (3D reconstructions. A series of seven cases of symptomatic cerebral aneurysms were identified that illustrate the sensitivity of CT-CTA versus CT-LP and the importance of 3D reconstruction in identifying these aneurysms. Surgical treatment was recommended for 6 of the 7 patients with aneurysms and strict hypertension control was recommended for the seventh patient. Some of these patients demonstrated subarachnoid hemorrhage on presentation while others had negative LPs. A number of these patients with negative LPs were clearly symptomatic from their aneurysms. At least one of these cerebral aneurysms was not apparent on CTA without 3D reconstruction. 3D reconstruction of CTA is crucial to adequately identify cerebral aneurysms. This case series helps reinforce the importance of 3D reconstruction. There is some data to suggest that 64 slice CT-CTA may be equivalent or superior to CT-LP in the detection of symptomatic cerebral aneurysms.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Use of 64-slice Spiral CT Angiography of Renal Vein Imaging in Evaluating Renal Vein Abnor-malities%64层3DMSCT在肾静脉异常中的应用价值

    Institute of Scientific and Technical Information of China (English)

    侯伟伟; 王云华; 蒋中标; 郑凯

    2015-01-01

    【目的】探讨64层多排螺旋CT(MSCT)三维血管成像(3D MSCTA)在肾静脉中的诊断价值。【方法】收集拟行活体肾移植术供肾者96例,临床可疑胡桃夹综合征者5例,行64层3D M SC T A ,了解肾脏静脉血管起始、数目、分支走行及管径大小,进一步比较3D MSCTA各种图像后处理重建方法对肾静脉异常的显示效果。【结果】双肾静脉均为一支且其起源与走行正常者66例。肾静脉变异35例:包括2条右肾静脉者4例,3条右肾静脉者2例,主动脉后肾静脉者1例,肾静脉细小(考虑可疑胡桃夹综合征)者5例,性腺静脉和或腰静脉及左肾上腺静脉(左肾静脉常见属支)汇入左肾静脉主干者20例,2条左肾静脉者3例(2条肾静脉分别与腹主动脉前后分别汇入下腔静脉者1例;1条肾静脉汇入下腔静脉、一条肾静脉汇入半奇静脉者1例;1条肾静脉汇入下腔静脉、一条肾静脉汇入左髂总静脉者1例)。与手术所见完全一致者为99例,符合率为98%(99/101)。【结论】64层3D MSCTA结合适当的后处理重建方法可满意显示肾静脉正常解剖及变异情况,是评价各种肾静脉异常的准确、安全方法。%[Objective] To explore the use of 3‐dimensional 64‐slice Spiral computed tomography angiogra‐phy (3D MSCTA) in the diagnosis of renal veins .[Methods] A total of 96 cases of potential live renal donor and 5 cases of clinically diagnosed nut‐cracker sign (NCS) were examined by 64‐slice spiral computed tomo‐graphy angiography (CTA) .The origin ,number ,branch ,course and size of renal veins were observed .Fur‐ther comparisons were made for the capacities of deciphering renal vein abnormalities on all kinds of postpro‐cessing reconstruction images of 3D MSCT .[Results]Double renal vein with normal origins and courses were found in 66 cases .Among 35 cases of renal vein variation ,there were double right renal

  5. Relationship between the Self-Rating Anxiety Scale score and the success rate of 64-slice computed tomography coronary angiography.

    Science.gov (United States)

    Li, Hui; Jin, Dan; Qiao, Fang; Chen, Jianchang; Gong, Jianping

    Computed tomography coronary angiography, a key method for obtaining coronary artery images, is widely used to screen for coronary artery diseases due to its noninvasive nature. In China, 64-slice computed tomography systems are now the most common models. As factors that directly affect computed tomography performance, heart rate and rhythm control are regulated by the autonomic nervous system and are highly related to the emotional state of the patient. The aim of this prospective study is to use a pre-computed tomography scan Self-Rating Anxiety Scale assessment to analyze the effects of tension and anxiety on computed tomography coronary angiography success. Subjects aged 18-85 years who were planned to undergo computed tomography coronary angiography were enrolled; 1 to 2 h before the computed tomography scan, basic patient data (gender, age, heart rate at rest, and family history) and Self-Rating Anxiety Scale score were obtained. The same group of imaging department doctors, technicians, and nurses performed computed tomography coronary angiography for all the enrolled subjects and observed whether those subjects could finish the computed tomography coronary angiography scan and provide clear, diagnostically valuable images. Participants were divided into successful (obtained diagnostically useful coronary images) and unsuccessful groups. Basic data and Self-Rating Anxiety Scale scores were compared between the groups. The Self-Rating Anxiety Scale standard score of the successful group was lower than that of the unsuccessful group (P = 0.001). As the Self-Rating Anxiety Scale standard score rose, the success rate of computed tomography coronary angiography decreased. The Self-Rating Anxiety Scale score has a negative relationship with computed tomography coronary angiography success. Anxiety can be a disadvantage in computed tomography coronary angiography examination. The pre-computed tomography coronary angiography scan Self-Rating Anxiety Scale

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Evaluation of temporal windows for coronary artery bypass graft imaging with 64-slice CT

    Energy Technology Data Exchange (ETDEWEB)

    Desbiolles, Lotus; Leschka, Sebastian; Scheffel, Hans; Husmann, Lars; Garzoli, Elisabeth; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Plass, Andre [University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland); Gaemperli, Oliver [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Center for Integrative Human Physiology, Zurich (Switzerland)

    2007-11-15

    Temporal windows providing the best image quality of different segments and types of coronary artery bypass grafts (CABGs) with 64-slice computed tomography (CT) were evaluated in an experimental set-up. Sixty-four-slice CT with a rotation time of 330 ms was performed in 25 patients (four female; mean age 59.9 years). A total of 84 CABGs (62 individual and 22 sequential grafts) were evaluated, including 28 internal mammary artery (33.3%), one radial artery with sequential grafting (2.4%), and 54 saphenous vein grafts (64.3%). Ten data sets were reconstructed in 10% increments of the RR-interval. Each graft was separated into segments (proximal and distal anastomosis, and body), and CABG types were grouped according to target arteries. Two readers independently assessed image quality of each CABG segment in each temporal window. Diagnostic image quality was found with good inter-observer agreement (kappa=0.62) in 98.5% (202/205) of all graft segments. Image quality was significantly better for saphenous vein grafts versus arterial grafts (P<0.001) and for distal anastomosis to the right coronary compared with other target coronary arteries (P<0.05). Overall, best image quality was found at 60%. Image quality of proximal segments did not significantly vary with the temporal window, whereas for all other segments image quality was significantly better at 60% compared with other temporal windows (P<0.05). Sixty-four-slice CT provides best image quality of various segments and types of CABG at 60% of the RR-interval. (orig.)

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

    LENUS (Irish Health Repository)

    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.

  9. 扫描方式对64层螺旋CT头颅 CTA图像质量和辐射剂量影响的研究%Comparison study of image quality and radiation dose between helical and axial CT angiography of the head with 64-slice helical CT

    Institute of Scientific and Technical Information of China (English)

    戴贵东; 肖正远; 兰永树; 粱卡丽

    2012-01-01

    目的:探讨64层螺旋CT扫描方式对头颅CTA图像质量和辐射剂量的影响.方法:采用GE Lightspeed VCT 对100例需要行头颅CTA检查的患者进行对比研究,50例行螺旋扫描,另50例行轴层扫描.两组数据经过VR、MIP、去骨VR和多平面重组等方法后处理,然后由3组医师通过5分评价法对CTA图像质量进行主观评价,取其均值纳入统计学分析;记录每组扫描的容积剂量指数(CTDIvol)和剂量长度乘积(DLP).对两组数据进行两独立样本t检验.结果:轴向扫描图像质量评分是(4.66±0.42)分、螺旋扫描CTA的成像质量评分(4.67±0.38)分;两组数据差异无统计学意义(P>0.05).轴向扫描、螺旋扫描的CTDIvol分别是45.71和54.18mGy; DLP分别是731.43和954.68mGy·cm.两组间差异有统计学意义(P<0.05),轴层扫描方式辐射剂量更低.结论:64层CT头颅CTA轴扫可以显著降低辐射剂量而不降低图像质量,在临床运用中值得关注.%Objective: To compare the difference in image quality and radiation dose between helical and axial CT angiography of the head with 64 slices helical CT. Methods:100 patients with suspected or confirmed cerebrovascular disease in our hospital,were divided into two groups to accept CTA examination :helical scanning group (50 cases) and axial scan ning group (50 cases). Except the parameter of scanning method,each group was examined with the same scan parameters and equipment. 80ml contrast medium was injected (via a cubital vein) by 4. 3ml/s and followed by 35ml normal sodium at the same speed. The cerebral vessels were imaged by these postprocessing methods: maximum intensity projection (MIP) volume rendering (VR) ,and "Auto Select" technique. Three group of doctors evaluated the image quality by means of 5 point scoring subjective evaluation. The radiation dose report was auto generated, trie average value ol volume CT dose index (CTDIvol) and dose length product (DLP) were taken into the sheet. All the data

  10. Advanced NSCLC First Pass Perfusion at 64-slice CT: Reproducibility of Volume-based Quantitative Measurement

    Directory of Open Access Journals (Sweden)

    Jie HU

    2010-05-01

    Full Text Available Background and objective The aim of this study is to explore the reproducibility of volume-based quantitative measurement of non-small cell lung cancer (NSCLC perfusion at 64-slice CT. Methods Fourteen patients with proved advanced NSCLC were enrolled in this dynamic first pass volume-based CT perfusion (CTP study (8×5 mm collimation, and they underwent the second scan within 24 h. According to the longest diameters, those patients were classified to ≤3 cm and >3 cm groups, and each group had 7 patients. Intraclass correlation coefficient (ICC and Bland-Altman statistics were used to evaluate the reproducibility of CTP imaging. Results In both groups of advanced NSCLC, the reproducibility with BF, BV, and PS values were good (ICC >0.75 for all, but mean transit time (MTT values. For advanced NSCLC (≤3 cm, repeatability coefficient (RC values with blood flow (BF, blood volume (BV, MTT and permeability surface area product (PS values were 56%, 45%, 114%, and 78%, respectively, and the 95% change intervals of RC were -39%-53%, -29%-62%, -83%-145%, and -57%-98%, respectively. For advanced NSCLC (>3 cm, those values were 46%, 30%, 59%, and 33%, respectively, and the 95% change intervals of RC were -48%-45%, -33%-26%, -54%-64%, and -18%-48%. Conclusion There is greater reproducibility of tumor size >3 cm than that of ≤3 cm. BF and BV could be addressed for reliable clinical application in antiangiogenesis therapeutic monitoring with advanced NSCLC patients.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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

  12. The influence of heart rate,heart rate variability and electrocardiogram editing on image quality of 64-slice CT coronary angiography in patients with atrial fibrillation%心室率、心室率波动及心电编辑对心房颤动患者64层螺旋CT冠状动脉成像质量的影响

    Institute of Scientific and Technical Information of China (English)

    杨琳; 张兆琪; 范占明; 徐超; 赵蕾; 晏子旭; 姜红

    2010-01-01

    Objective To prospectively evaluate the influence of average heart rate,heart rate variability and ECG editing on image quality of 64-slice CT coronary angiography(CTCA)in patients with atrial fibrillation(AF).Methods Fifty patients who were diagnosed with AF underwent respective ECG-gating 64-slice CTCA Image quality(good,moderate,poor)were evaluated on vessel segment level pre-and post ECG editing.Chi-square test was performed to compare the image quality in patients with various average heart rate,heart rate variability,and pre-and post ECC editing.Pearson correlation analysis was performed to test the relationship between the image quality and average heart rate and heart rate variability.Sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)were calculated by using the conventional angiography as the standard reference.Results The average heart rate of the fifty AF patients was(89±23)beat/min,with variability of(18.2±6.1)beat/min.Finally,24(3.4%)segments were considered to have poor image quality in 6(12.0%)patients.Image quality decreased significantly(P<0.05)at the average heart rate of over 100 beats per minute(11 segments)or the standard deviation of heart rate of over 24 beats per minute(11 segments).There was significant correlation between the mean heart rate and the image quality for all segments,the RCA,and distal section of coronary artery(r=0.50,0.55,0.53,0.49,0.42,0.44;P<0.05).Heart rate variability was also significant correlated with the image quality.There was significant difference on image quality pre-and post ECG editing(P=0.013).The respective overall sensitivity,specificity,NPV,PPV values were 100%(6/6),93.2%(41/44),100%(41/41),and 66.7%(6/9).Conclusion ECG editing can improve the success rate and the image quality of 64-slice CTCA effectively in patients with AF within a certain range of average heart rates and heart rate variability.%目的 探讨不同心室率、心室

  13. Effect of obesity on coronary artery plaque using 64 slice multidetector cardiac computed tomography angiography.

    Science.gov (United States)

    Isma'eel, Hussain; Tellalian, David; Hamirani, Yasmin S; Kadakia, Jigar; Nasir, Khurram; Budoff, Matthew J

    2010-04-30

    Patients with a coronary artery calcification score (CACS) of zero and an intermediate risk of coronary artery disease have been shown to have a low prevalence of non-calcified coronary artery plaque (NCP). 181 consecutive patients with CAC 'zero', undergoing cardiac computed tomography angiography (CCTA) angiography at our center were evaluated. Presence of detectable NCP on CCTA in these patients was 13.8%. Mild non-obstructive disease (50%). Traditional risk factors were not found to be associated with the presence of NCP. However higher body mass index (BMI) was strongly found to be associated with NCP (31.6 in patients with NCP vs. 27.6 kg/m(2) in patients without NCP, pNCP as compared to normal BMI (p<0.05).

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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. 后置滤过器对64排螺旋CT冠状动脉成像质量影响的CATPHAN模型研究%Effect of various post-processing filters on image quality of 64-slice CT coronary angiography by using a Catphan phantom

    Institute of Scientific and Technical Information of China (English)

    Syed Shareef Fahad; 宦坚; 张伟; 龚建平; 乔方; 朱建兵; 陈光强

    2012-01-01

    Objective To evaluate the effect of various post-processing filters on image quality of 64-Slice CT coronary angiography. Methods Catphan 600 underwent cardiac scans by using GE LightSpeed VCT. The scan techniques undergone at 120 kV, 600 mA, speed of 0. 35 s per 360° rotation, pitch of 0. 20, slice thickness of 625 mm. Cardiac images were reconstructed by using filters of Cl ( UC1) , C2 (UC2), C3 (UC3 ) and were constracted without filter ( NUC) to create four image sets from the same scanning. Image noises were measured, and CNR, SNR, MTF were calculated for the four sets. Difference was examined by using one-way analysis of variance. Results Significant difference was found in terms of SD,CNR,SNR, MTF 50% (P 0.05). MTF 10% was significantly lower for UC3 than fhat for the other three sets (P<0.05). Conclusion Different post-processing filters should be selected according to the clinical requirements, because of their different effect on SD,CNR,SNR and MTF.%目的 探讨不同后置滤过器对64排螺旋CT冠状动脉成像(CTCA)质量的影响.方法 使用GE LightSpeed VCT机,采用120 kV,600 mA,0.35s/360°,层厚0.625 mm,pitch 0.2对Catphan 600模型进行扫描.采像后对原始图像分别进行不使用后置滤过器和使用后置滤过器C1、C2、C3重建,得到4组图像(NUC组、UC1组、UC2组和UC3组).测量图像噪声(SD),计算对比噪声比(CNR)、信噪比(SNR)、调制传输函数(MTF).统计分析采用单因素方差分析.结果 NUC组、UC1组、UC2组和UC3组的SD、CNR、SNR及MTF 50%差异均有高度统计学意义(均P<0.001),NUC组、UC1组和UC2组的MTF 10%差异无统计学意义(均P>0.05);UC3组与其余3组的MTF 10%差异有高度统计学意义(均P<0.01).结论 不同后置滤过器对CTCA图像SD、CNR、SNR和MTF的影响不同,可根据不同临床需要适当选择.

  17. Optimization of the imaging quality of 64-slice CT acquisition protocol using Taguchi analysis: A phantom study.

    Science.gov (United States)

    Pan, Lung Fa; Erdene, Erdenetsetseg; Chen, Chun Chi; Pan, Lung Kwang

    2015-01-01

    In this study, the phantom imaging quality of 64-slice CT acquisition protocol was quantitatively evaluated using Taguchi. The phantom acrylic line group was designed and assembled with multiple layers of solid water plate in order to imitate the adult abdomen, and scanned with Philips brilliance CT in order to simulate a clinical examination. According to the Taguchi L8(2(7)) orthogonal array, four major factors of the acquisition protocol were optimized, including (A) CT slice thickness, (B) the image reconstruction filter type, (C) the spiral CT pitch, and (D) the matrix size. The reconstructed line group phantom image was counted by four radiologists for three discrete rounds in order to obtain the averages and standard deviations of the line counts and the corresponding signal to noise ratios (S/N). The quantified S/N values were analyzed and the optimal combination of the four factor settings was determined to be comprised of (A) a 1-mm thickness, (B) a sharp filter type, (C) a 1.172 spiral CT pitch, and (D) a 1024×1024 matrix size. The dominant factors included the (A) filter type and the cross interaction between the filter type and CT slice thickness (A×B). The minor factors were determined to be (C) the spiral CT pitch and (D) the matrix size since neither was capable of yielding a 95% confidence level in the ANOVA test.

  18. Evaluation of MRI-based Polymer Gel Dosimetry for Measurement of CT Dose Index (CTDI on 64 slices CT Scanners

    Directory of Open Access Journals (Sweden)

    Leaila Karimi-Afshar

    2009-06-01

    Full Text Available Introduction: Computed tomography (CT has numerous applications in clinical procedures but its main problem is its high radiation dose to the patients compared to other imaging modalities using x-ray. CT delivers approximately high doses to the nearby tissues due to the scattering effect, fan beam (beam divergence and limited collimator efficiency. The radiation dose from multi-slice scanners is greater than the single-slice scanners and since multi-slice scanners increasingly employ a wide beam, 100 mm ion chambers currently used in measuring the CTDI100, are not capable of accurately measuring the total dose profile of the slice width. Therefore, the CT dose is underestimated by using them. The purpose of this study is to measure the Computed Tomography Dose Index (CTDI of a GE multi-slice CT scanner (64-slice using polymer gel dosimetry based on MRI imaging (MRPD. CTDI is the sum of point doses along the central axis and estimates the average patient dose during CT scanning. Materials and Methods: For measuring CTDI, after designing and fabricating the phantom and preparing the MAGIC gel, MRI imaging using a 1.5 T Siemens MRI scanner was performed with the imaging parameters of ST = 2 mm, NEX = 1, TE = 20-640 ms and TR = 2000 ms. CTDI was measured with a 100 mm ion chamber (CTDI100 and also the MAGIC gel with MRPD method for 10 mm and 40 mm CT scan nominal widths. Results: Following the measurement of the CTDI100 for 10 mm and 40 mm nominal slice widths of the multi-slice scanner using both ion chamber and MAGIC gel, the results showed that the ion chamber underestimates CTDI100 by 28.71% and 14.03% compared to gel for 10 mm and 40 mm respectively. Discussion and Conclusion: It was concluded from this study that gel dosimeters have the capability to measure CTDI in wide beams of multi-slice CT scanners whereas 100 mm standard ion chamber due to its limited length is not reliable even for a 10 mm beam width. In addition, due to the 3

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

    Science.gov (United States)

    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 (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.

  1. 下肢动脉闭塞性疾病64层CT血管成像中腘动脉小剂量对比剂试验的意义%64-slice CT angiography in lower extremity peripheral arterial occlusive disease: clinical value of test injection at popliteal arteries

    Institute of Scientific and Technical Information of China (English)

    舒政; 邓小飞; 葛琛瑾; 孙凤; 邹银鸽; 孟文斌

    2011-01-01

    Objective To investigate the clinical value of the test injection at popliteal arteries on 64-slice CTA in lower extremity peripheral arterial occlusive disease (PAOD). Methods Twenty-eight patients with PAOD referred for 64-slice CTA were enrolled consecutively in the study. Test injection was performed at bilateral popliteal arteries (the level of knee joints) and the clinic value of the peak value and the time to peak was analyzed. The relationship between the time to peak and the peak value was evaluated with Pearson test. The time to peak was used for programming of the CT angiographic acquisitions with fast scanning mode. The quality of visualization of each arterial segment was determined independently by two radiologists. Results Fifty-four (96%, 54/56) time-attenuation curves were obtained in 28 patients. The wide interindividual variation in the peak value and the time to peak was observed in 52 curves of 26 patients with range of 60-178 HU,21-46 s and an average of (135±28) HU,(31±6) s, respectively. The difference in the peak value and the time to peak between bilateral popliteal arteries was also observed with range of 10-80 HU and an average of (32±18) HU in 19 patients,with range of 1-12 s and an average of (5±3) s in 21 patients. There was negative relationship between the peak value and the time to peak (r=-0.526, P<0.01). The CTA images were of good (598 segments) or medium quality (12 segments) in 99% segments (610/616). Conclusions The test injection at popliteal arteries was useful for 64-slice CTA in the patients with PAOD, as it could accurately specify the delay time of CT angiographic acquisitions.%目的 探讨下肢动脉闭塞性疾病采用64层CT血管成像时,在腘动脉行小剂量对比剂试验的意义.方法 连续选取28例临床怀疑下肢动脉闭塞性疾病患者,应用64层CT在两侧腘动脉(膝关节层面)各设置一ROI进行小剂量对比剂试验,明确显示峰值及达峰时间者认为曲线获取成功.

  2. A head phantom study for intraocular dose evaluation of 64-slice multidetector CT examination in patients with suspected cranial trauma

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, Kosuke, E-mail: matsuk@mhs.mp.kanazawa-u.ac.jp [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Koshida, Kichiro [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Noto, Kimiya; Takata, Tadanori [Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Suzuki, Masayuki [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Shimono, Tetsunori [Department of Radiology, Hoshigaoka Koseinenkin Hospital, Hirakata, Osaka (Japan); Yamamoto, Tomoyuki [Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Matsui, Osamu [Department of Radiology, Faculty of Medicine, Kanazawa University, Kanazawa, Ishikawa (Japan)

    2011-08-15

    Purpose: In cases of suspected cranial trauma, cranial CT examinations should be performed to rule out pathology. There are some methods available for reducing intraocular doses; however, it is difficult for the operators to conduct the necessary measurements because of restrictions in time and patient mobility, especially in high-energy trauma cases. Therefore, we performed a head phantom study for intraocular dose evaluation of 64-slice multidetector CT examination in patients with suspected cranial trauma. Materials and methods: Assuming that the orbitomeatal (OM) line and bed were vertical, a head phantom was tilted from 10 degrees caudally to 25 degrees cranially at 5-degree intervals. At each tilted position, the phantom was examined using a 64-section multidetector CT device using three acquisition protocols. Intraocular doses during each examination were measured using small dosimeters. Results: Assuming that the OM line and bed were vertical, intraocular doses varied between 52 and 140%, 17-138%, and 90-142% during helical, non-helical, and helical CT angiographic examinations, respectively. Intraocular doses increased when the phantom was tilted cranially. Conclusion: If possible, the best way to reduce the intraocular dose is by angling the gantry cranially, tilting the head of each patient caudally and adopting a non-helical acquisition method. During procedure, the acquisition angle should be angled cranially more than 0 degrees based on the OM line. The estimation of intraocular dose using the acquisition angle and displayed volumetric CT dose index might be useful to evaluate the deterministic effect risks and to inform patients about the associated risks.

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

    Institute of Scientific and Technical Information of China (English)

    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

  4. 东软64层CT整机研制及关键技术研发%Neusoft 64-slice CT Scanner Development with Key Technology

    Institute of Scientific and Technical Information of China (English)

    马建华; 张华; 边兆英; 李双学; 赵大哲; 陈武凡

    2015-01-01

    目的:64层C T整机研制与关键技术研发。方法:按照产、学、研、医联合方式,通过原始与系统创新,攻克系统平台技术、数据采集技术、低剂量成像伪影校正及噪声抑制技术、图像重建及优化技术等多项64层C T关键技术。结果:成功研制出中国首台具有完全自主知识产权的64层CT整机,其性能指标达到国际同类产品先进水平,产品通过CCC、SFDA,CE、FDA、CB、CSA等认证。结论:东软集团的64层CT已正式进入医用CT高端市场。%Objective:developing 64-slice CT scanner with key technology research.Methods: under industry-university-research-medicine cooperation pattern, through the original and system innovation, we conquer many 64-slice CT key technologies, including system platform technology, data acquisition technology, low-dose imaging artifacts correction and noise suppression technology, image reconstruction and optimization technology and so on.Results: The developed ifrst 64-slice CT scanner of China contains ful independent intelectual property rights with international advanced levels and geting the CCC, SFDA, CE, FDA, CB, CSA certiifcations, etc.Conclusion: Neusoft 64-slice CT scanner has formaly entered the medical CT high-end market.

  5. Application of ECG editing soltware in coronary angiography using 64-slice CT in arrythmia patients%心电编辑软件在64层螺旋CT心律失常患者冠状动脉成像中的初步应用

    Institute of Scientific and Technical Information of China (English)

    姚红霞; 张国富; 张鹏; 崔二峰; 杨鹏午

    2011-01-01

    目的:探讨64层螺旋CT冠状动脉成像心电编辑功能对于改善心律失常或心电图信号不明原因故障中冠脉成像质量的作用.方法:搜集30例在检查前已知心律失常或仅在检查过程中出现心律失常或检查过程中出现同步记录的心电图信号部分缺失的64层螺旋CT冠状动脉成像资料,使用心电图编辑功能,比较编辑前后重建的冠状动脉图像质量.结果:对于低心率(<70次/分)的房性早搏(扫描过程中出现一次),心电编辑软件可以有效改善其冠脉图像质量,编辑前后可评估率差异有统计学意义(P<0.05);对于房室传导阻滞、心电信号缺失冠脉图像质量可以有限度地改善,对房颤改善不明显.对于高心率(≥70次/分)的房性早搏(扫描过程中出现一次)、房室传导阻滞,心电编辑软件均可有限度地改善,对房颤改善不明显,编辑前后可评估率差异无统计学意义(P>0.05).对心率不同的两组心律失常,低心率组图像质量可评估率(74.74%)高于高心率组(66.07%),心电编辑软件均可改善两组图像质量,但两组间比较差异无统计学意义.对于窦性心律不齐,心率波动幅度越大,冠脉图像不可评估率越大,两组心电编辑后图像质量均得到明显改善,差异有统计学意义(P<0.05).结论:在检查前或检查过程中出现的心律失常或者不明原因出现心电信号的异常,使用心电编辑功能,能提高冠脉成像质量.%Objective : To investigate the value of ECG editing software in improving the image quality of coronary an giography with 64-slice spiral CT (MSCTCA) in patients having arrhythmia or unidentified synchronous ECG error. Methods : MSCTCA materials of 30 patients with previously known arrhythmia/arrhythmia merely occurred during MSCT CA/unidentified ECG mechanic error happened during examination were included in this study. Using ECG editing soft ware,the image quality of MSCTCA before and after

  6. New Progress of Post 64 Slice CT for Coronary Artery%后64排螺旋CT冠脉检查新进展

    Institute of Scientific and Technical Information of China (English)

    赵义芹; 祖德贵; 曾庆玉

    2012-01-01

    64排CT冠状动脉成像已成为冠脉病变诊断及筛查的重要无创性检查,但心律不齐、心动过速、钙化支架伪影仍影响其冠脉成像质量以及辐射剂量过高。本文总结了后64排CT如双源CT、Brilliance ICT、宝石CT、320排CT在上述检查中取得的进展和仍然存在的不足,表明后64排CT的辐射剂量均有所减低,双源CT、Brilliance ICT随着时间分辨率的提高基本上解决了心动过速的问题,320排CT根本上解决了心律不齐的问题,并对后64排螺旋CT冠脉检查的发展前景进行讨论。%64-slice CT coronary artery imaging has gradually become the important noninvasive test of diagnosis and screening for coronary artery disorder,whose quality is still limited by cardiac arrhythmia,tachycardia,calcification and stents,and it has excessive radiation dose.The paper sums up the progress and disadvantage of post 64 Slice CT such as dual CT,Brilliance ICT,Gemstone CT,and 320 slice CT,shows the radiation dose has been cut down,indicates that tachycardia is settled essentially in Dual CT and Brilliance ICT with the improvement of temporal resolution and cardiac arrhythmia is resolved radically in 320 slice CT,at last,discusses the investigative foreground of post 64 Slice CT for coronary artery.

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

    Energy Technology Data Exchange (ETDEWEB)

    Marini, Davide; Agnoletti, Gabriella; Bonnet, Damien [University Rene Descartes-Paris V, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, AP-HP, Paris (France); Brunelle, Francis; Ou, Phalla [University Rene Descartes-Paris V, Department of Paediatric Radiology, Hopital Necker-Enfants Malades, AP-HP, Paris (France)

    2008-03-15

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  9. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  10. 64-Slice CT angiography of the abdominal aorta and abdominal arteries: comparison of the diagnostic efficacy of iobitridol 350 mgI/ml versus iomeprol 400 mgI/ml in a prospective, randomised, double-blind multi-centre trial

    Energy Technology Data Exchange (ETDEWEB)

    Loewe, Christian; Schernthaner, Melanie; Lammer, Johannes [Medical University Vienna, Section of Cardiovascular and Interventional Radiology, Department of Radiology, Vienna (Austria); Becker, Christoph R.; Hittinger, Markus [University Hospital Grosshadern, Department of Clinical Radiology, Munich (Germany); Berletti, Riccardo; Favat, Massimo [Belluno Civil Hospital, Department of Radiology, Belluno (Italy); Cametti, Carlo Alberto; Marangoni, Roberto [ASL TO2 Ospedale San G. Bosco, Department of Radiology, Torino (Italy); Caudron, Jerome; Lestrat, Jean-Pierre [University Hospital of Rouen, Department of Radiology, Rouen (France); Coudyzer, Walter; Heye, Sam [UZ Leuven, Department of Radiology, Leuven (Belgium); Mey, Johan de; Nieboer, Koenraad [UZ Brussel, Department of Radiology, Brussels (Belgium); Heautot, Jean-Francois; Larralde, Antoine [Pontchaillou Hospital, Department of Radiology, Rennes (France); Reimer, Peter; Schwarz, Martin [Staedt. Klinikum Karlsruhe, Department of Radiology, Karlsruhe (Germany)

    2010-03-15

    The purpose of this study was to assess the influence of iodine concentration on diagnostic efficacy in multi-detector-row computed tomography (MDCT) angiography of the abdominal aorta and abdominal arteries. IRB approval and informed consent were obtained. In this double-blind trial, patients were randomised to undergo MDCT angiography of the abdominal arteries during administration of iobitridol (350 mgI/ml) or iomeprol (400 mgI/ml). Each centre applied its own technique for delivery of contrast medium, regardless of iodine concentration. Diagnostic efficacy, image quality, visualisation of the arterial wall and arterial enhancement were evaluated. A total of 153 patients received iobitridol and 154 received iomeprol. The ability to reach a diagnosis was ''satisfactory'' to ''totally satisfactory'' in 152 (99.3%) and 153 (99.4%) patients respectively. Image quality was rated as being ''good'' to ''excellent'' in 94.7 and 94.8% segments respectively. Similar results were observed for image quality of arterial walls (84.3 vs. 83.2%). The mean relative changes in arterial enhancement between baseline and arterial phase images showed no statistically significant differences. This study demonstrated the non-inferiority of the 350 versus 400 mgI/ml iodine concentration, in terms of diagnostic efficacy, in abdominal MDCT angiography. It also confirmed the high robustness and reliability of this technique across multi-national practices. (orig.)

  11. 64-Slice CT angiography of the abdominal aorta and abdominal arteries: comparison of the diagnostic efficacy of iobitridol 350 mgI/ml versus iomeprol 400 mgI/ml in a prospective, randomised, double-blind multi-centre trial.

    Science.gov (United States)

    Loewe, Christian; Becker, Christoph R; Berletti, Riccardo; Cametti, Carlo Alberto; Caudron, Jerome; Coudyzer, Walter; De Mey, Johan; Favat, Massimo; Heautot, Jean-François; Heye, Sam; Hittinger, Markus; Larralde, Antoine; Lestrat, Jean-Pierre; Marangoni, Roberto; Nieboer, Koenraad; Reimer, Peter; Schwarz, Martin; Schernthaner, Melanie; Lammer, Johannes

    2010-03-01

    The purpose of this study was to assess the influence of iodine concentration on diagnostic efficacy in multi-detector-row computed tomography (MDCT) angiography of the abdominal aorta and abdominal arteries. IRB approval and informed consent were obtained. In this double-blind trial, patients were randomised to undergo MDCT angiography of the abdominal arteries during administration of iobitridol (350 mgI/ml) or iomeprol (400 mgI/ml). Each centre applied its own technique for delivery of contrast medium, regardless of iodine concentration. Diagnostic efficacy, image quality, visualisation of the arterial wall and arterial enhancement were evaluated. A total of 153 patients received iobitridol and 154 received iomeprol. The ability to reach a diagnosis was "satisfactory" to "totally satisfactory" in 152 (99.3%) and 153 (99.4%) patients respectively. Image quality was rated as being "good" to "excellent" in 94.7 and 94.8% segments respectively. Similar results were observed for image quality of arterial walls (84.3 vs. 83.2%). The mean relative changes in arterial enhancement between baseline and arterial phase images showed no statistically significant differences. This study demonstrated the non-inferiority of the 350 versus 400 mgI/ml iodine concentration, in terms of diagnostic efficacy, in abdominal MDCT angiography. It also confirmed the high robustness and reliability of this technique across multi-national practices.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Acute chest pain in emergency room. Preliminary findings with 40-64-slice CT ECG-gated of the whole chest.

    Science.gov (United States)

    Coche, E

    2007-01-01

    ECG-gated MDCT of the entire chest represents the latest technical advance in the diagnostic work-up of atypical chest pain. The authors report their preliminary experience with the use of 40 and 64-slice CT in the emergency room and recommend to study only patients with moderate likelihood of coronary artery disease. ECG-gated MDCT of the entire chest will be preferentially performed on 64-slice MDCT rather than 40-slice MDCT because it enable to reduce the scan time (18 seconds versus 28 seconds acquisition time), the volume of contrast medium (82 mL + 15 mL versus 97 mL + 15 mL of highly concentrated contrast agent for a patient of 70 kgs) and radiation exposure (17 mSv versus 19 mSv). Approximately 1500 to 2000 of images are produced and need to be analysed on a dedicated workstation by a radiologist expert in cardiac and thoracic disorders. At the present time, only a few studies exist in the literature showing some promising results but further large clinical studies are needed before to implement such sophisticated protocol in emergency room.

  14. 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

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, Jun; Kiguchi, Masao; Fujioka, Chikako [Hiroshima University Hospital, Hiroshima (Japan); Matsuura, Noriaki; Yamamoto, Hideya; Kitagawa, Toshiro; Ito, Katsuhide [Hiroshima University, Hiroshima (Japan)

    2009-08-15

    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/m{sup 2} (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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

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

    Science.gov (United States)

    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 ...

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

    Science.gov (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Christiaens, Luc [Departement d' imagerie Cardiovasculaire, Assistance Publique- Hopitaux de Paris, Hopital Lariboisiere, Paris (France); CHU de Poitiers, Departement de Cardiologie, Poitiers (France); Duchat, Florent; Boudiaf, Mourad; Fargeaudou, Yann; Ledref, Olivier; Soyer, Philippe [Departement d' imagerie Cardiovasculaire, Assistance Publique- Hopitaux de Paris, Hopital Lariboisiere, Paris (France); Tasu, Jean-Pierre [CHU de Poitiers, Departement de Radiologie, Poitiers (France); Sirol, Marc [Departement d' imagerie Cardiovasculaire, Assistance Publique- Hopitaux de Paris, Hopital Lariboisiere, Paris (France); INSERM UFR U942, Insuffisance Cardiaque et Biomarqueurs, Universite Paris 7 - Denis Diderot, Hopital Lariboisiere, Paris (France); Universite Paris VII - Denis Diderot, Assistance Publique - Hopitaux de Paris, Service de Radiologie Vasculaire, Hopital Lariboisiere, Paris (France)

    2012-05-15

    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.)

  20. Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sun Zhonghua [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, WA (Australia)], E-mail: z.sun@curtin.edu.au; Almutairi, Abdulrahman Marzouq D. [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, WA (Australia)

    2010-02-15

    Purpose: The aim of this study was to perform a meta-analysis of the diagnostic accuracy of 64-slice CT angiography for the detection of coronary in-stent restenosis in patients treated with coronary stents when compared to conventional coronary angiography. Materials and methods: A search of PUBMED/MEDLINE, ProQuest and Cochrane library databases for English literature was performed. Only studies comparing 64-slice CT angiography with conventional coronary angiography for the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. Results: Fourteen studies met selection criteria for inclusion in the analysis. The mean value of assessable stents was 89%. Prevalence of in-stent restenosis following coronary stenting was 20% among these studies. Pooled estimates of the sensitivity and specificity of overall 64-slice CT angiography for the detection of coronary in-stent restenosis was 90% (95% CI: 86%, 94%) and 91% (95% CI: 90%, 93%), respectively, based on the evaluation of assessable stents. Diagnostic value of 64-slice CT angiography was found to decrease significantly when the analysis was performed with inclusion of nonassessable segments in five studies, with pooled sensitivity and specificity being 79% (95% CI: 68%, 88%) and 81% (95% CI: 77%, 84%). Stent diameter is the main factor affecting the diagnostic value of 64-slice CT angiography. Conclusion: Our results showed that 64-slice CT angiography has high diagnostic value (both sensitivity and specificity) for detection of coronary in-stent restenosis based on assessable segments when compared to conventional coronary angiography.

  1. 64层螺旋CT血管成像在脊髓血管介入术前评估中的价值%Value of 64-slice spiral computed tomography angiography in preoperative evaluation of spinal vascular intervention

    Institute of Scientific and Technical Information of China (English)

    肖云华; 吕富荣; 吕发金; 孙向前; 彭冈力

    2011-01-01

    目的 探讨64层螺旋CT在脊髓血管介入术前评估中的价值.方法 选择17例胸腰段脊髓损伤患者行脊柱64层螺旋CT增强扫描,重建薄层图像,层厚0.625 mm,间隔0.625 mm,以DICOM格式传输到ADW4.2工作站,采用容积显示(volume rendering,VR)、最大密度投影(maximum intensity projection,MIP)及多平面重建(multi-planar reformat,MPR)等后处理技术进行三维重建,分析脊髓供血动脉的走行特征.结果 17例患者中有16例患者(94%)胸腰段均可见根髓动脉供血脊髓,其中1支(6%)自T4/5左侧椎间孔进入椎管,2支(12%)自T10/11左侧椎间孔进入椎管,1支(6%)自T11/12左侧椎间孔进入椎管,4支(24%)根髓动脉自L1/2左侧椎间孔进入椎管,2支(12%)自L2/3左侧椎间孔进入椎管,2支(12%)自T11/12右侧椎间孔进入椎管,2支(12%)自T12/L1右侧椎间孔进入椎管,2支(12%)自L2/3右侧椎间孔进入椎管,10例(59%)患者根髓动脉自左侧椎间孔进入椎管.另有1例(6%)患者行CT和DSA检查均未发现根髓动脉.结论 64层螺旋CT能准确直观反映脊髓供血动脉的开口位置、走行方向、管径大小及其与周围血管的空间关系,为脊髓血管介入术前提供丰富的评估信息.%Objective To investigate the value of 64-slice spiral computed tomography(CT)angiography in preoperative evaluation of spinal vascular intervention.Methods Seventeen patients with segmental injury of the spinal cord underwent the enhanced 64-slice CT scan of the spine.Thin-slice reconstruction was done,with the slice thickness of 0.625 mm and interval of 0.625 mm.The data were transferred to the work station ADW4.2 in DICM format.Image postprocessing technologies such as volume rendering(VR),maximum intensity projection(MIP)and multi-planar reformat(MPR)were used to conduct three-dimensional reconstruction and analyze the anatomical characteristics of radiculomedullary artery.Results Radiculomedullary artery could be found in the thoracolumbar segment of

  2. Clinical application value of 64 slice spiral CT in the diagnosis of upper gastrointestinal bleeding%64层螺旋CT在上消化道出血诊断中的临床应用价值分析

    Institute of Scientific and Technical Information of China (English)

    王振栋; 马淑华; 黎叶芳; 袁珠

    2016-01-01

    Objective:To explore the clinical application value of 64 slice spiral CT in the diagnosis of upper gastrointestinal bleeding.Methods:70 patients with upper gastrointestinal bleeding were selected.They were given x-ray barium meal examination and 64 slice spiral CT examination.We compared the test results of two kinds.Results:The detection rate of 64 slice spiral CT was 100%,and the detection rate of X-ray was 95.71%(P<0.05).The consistent rate of CT diagnosis of bleeding was 100%,which was significantly better than 85.71% of X-ray(P<0.05).Conclusion:The clinical application value of 64 slice spiral CT in the diagnosis of upper gastrointestinal bleeding was significant.%目的:探讨64层螺旋CT在上消化道出血诊断中的临床应用价值。方法:收治上消化道出血患者70例,均接受 X 线钡餐检查和64层螺旋 CT检查,比较两种检查结果。结果:64层螺旋 CT检出率100%,X 线检出率95.71%(P<0.05)。CT诊断出血原因相符率100%,显著优于X线的85.71%(P<0.05)。结论:64层螺旋CT在上消化道出血诊断中的临床应用价值显著。

  3. 肺癌特异血管征象的64层CT首过期灌注增强表达%Expressing the specific vessels signs in lung cancer by 64-slice spiral CT in first phase perfusion imaging *

    Institute of Scientific and Technical Information of China (English)

    苏冠琴; 薄晓庆; 杨署; 孙国鹏; 柴军; 周苛; 高阿枚; 段呼兵; 董秀萍

    2013-01-01

    Objective To investigate the specific vessels signs in lung cancer by 64-slice spiral CT in first phase perfusion ima-ging so as to get more reasonable time about CT angiography .Methods Among the 47 cases ,there were 38 cases of central and 9 cases of peripheral primary lung cancer underwent 64-slice spiral CT in first phase perfusion imaging :one scan was obtained every 1 seconds during 8-38 seconds with 8 section × I without scanning interval after injection .Precontrast and postcontrast attenuation on every leisions was recorded ,to calculate the peak height(PH) and peak height time by time density curves TDC of pulmonary le-sions to aorta ,those reflect the the tumor feeding artery Imaging about lesions of lung cancer and inflammation .observed and calcu-lated the display rate and display time of lesions of lung cancer and inflammation .means of t test was used for statistics .Results a-bout the peak heights of in pulmonary artery and aorta phese ,statistically significant differences were found between inflammation and lung cancer(P0 .05) . about the peak heights time in aorta phase ,no statistically significant differences were found among three groups (P>0 .05) .The tumor vascularity were discoved in lesions in patients with lung cancer (44/47 cases ,93 .62% );The erosion narrow pulmonary ar-tery were discoved in central lung cancer (37/38 cases ,97 .37% ) ,in peripheral lung cancer(6/9 cases 66 .67% );no abnormal pulmo-nary artery were discoved only in 4 patients with lung cancer .Both tumor vascularity and abnormal pulmonary artery were most dis-plaied in 18-31s in CT angiography .Conclusion 64-slice spiral CT in first phase dynamic perfusion imaging can order completely show the specific vessels signs in lung cancer and reflect the tumor feeding artery Imaging of lung cancer .Analysising those benefi-ted to select reasonably the time of CT angiography and Improve the rate of lung cancer diagnosis .%目的分析64层C T首过期灌注增强对肺癌特

  4. The One-step Imaging Study of Acute Chest Pain Trilogy by 64 Slice Spiral CT%急性胸痛三联症64层螺旋CT“一站式成像”的研究

    Institute of Scientific and Technical Information of China (English)

    李欣; 孙吉林; 戴国华; 付英杰; 李志远; 柳溪

    2011-01-01

    [Abstract] Objective To investigate the image quality and ability of one-time unified examination of the 64-slice spiral CT(MSCT)in showing coronary artery, pulmonary artery and aorta. Materials and Methods 60 patients with acute chest pain received unified examination of coronary artery .pulmonary artery, aorta with 64-slice MSCT using ECG-gated function respectively. The coronary artery,pulmonary artery and aorta were imaged by using a variety of reconstruction techniques compare to 50 cases with pure 64-slice MSCT coronary angiography ,30 cases with pulmonary artery imaging and 20 cases with aortic imaging. The results from the above examinations were analyzed to evaluate whether or not the quality of the images could meet the need of the clinical diagnosis. Results The average scan time of one step examination was(8.0 ± 1.5)S,and the dose of contrast medium injected was 100 ml,and the injection flow rate of 4.0 -4.5 ml/s. There was significant difference between the chest pain group and the control group in the images of the coronary artery (P 0.05;P=0.44, >0.05;P =0.068, >0.05).The image quality of the chest pain group was as good as the one of the control group. There was significant difference between two groups and intragroup in the images of the central, peripheral and whole pulmonary artery in chest pain group and the control group (P<0.01 ;P<0.01 ;P<0.01).The image quality of the chest pain group was better than the one of the control group. Conclusion The one-step examination of coronary artery .pulmonary artery,aorta by 64-slice MSCT can be finished within 10 seconds. The image quality of aorta, pulmonary artery is excellent. There is no significant difference between the image quality of the single aorta imaging and the unified examination of the MSCT,of which image quality is better than that of single pulmonary artery MSCT. The image of the coronary artery in one time unified examination is good,can meet the needs of the clinical diagnosis,but is

  5. Diagnostic performance of exercise bicycle testing and single-photon emission computed tomography: Comparison with 64-slice computed tomography coronary angiography

    NARCIS (Netherlands)

    A.C. Weustink (Annick); L.A.E. Neefjes (Lisan); A. Rossi (Alexia); W.B. Meijboom (Willem Bob); K. Nieman (Koen); E. Capuano (Ermanno); H. Boersma (Eric); N.R.A. Mollet (Nico); G.P. Krestin (Gabriel); P.J. de Feyter (Pim)

    2012-01-01

    textabstractTo conduct a comparison of the diagnostic performance of exercise bicycle testing and singlephoton emission computed tomography (SPECT) with computed tomography coronary angiography (CTCA) for the detection of obstructive coronary artery disease (CAD) in patients with stable angina. 376

  6. 64排螺旋 CT 支气管动脉成像对咯血的诊断意义%Diagnostic significance of bronchial artery imaging by 64-slice spiral CT for hemoptysis

    Institute of Scientific and Technical Information of China (English)

    舒圣捷; 赵雁鸣; 刘白鹭; 赵德利; 贾广生; 张黎黎; 王非; 王海波; 张海涛

    2014-01-01

    Objective To discuss the diagnostic value of bronchial and non-bronchial artery system by 64-slice CT bronchial artety imaging in patients with hemoptysis as the main symptom of lung disease .Methods 64-slice CT bronchial artery imaging was performed in 28 patients with hemoptysis .The resulting CT images were analysed to identify position of the bronchial and non-bronchial systemic artery .Results Bronchial arteries were shown in the CT images as follows, 43 bronchial arteries were identified on the right side and 46 on the left side; normal origin of bronchial artery accounted for 46%of the total .Twenty-three arteries of all the arter-ies originated in the non-bronchial arterial system were located on the right , and 41 on the left side .Conclusion 64-slice CT bronchial artety imaging can not only determine the location of the bronchial and non-bronchial systemic artery , but also confirm the reason of the disease with hemoptysis as the main symptom .Then, it may lay the foundation for further clinical treatment .%目的:探讨支气管和非支气管动脉系统的64排CT支气管动脉成像对以咯血为主要症状的肺部疾病的诊断价值。方法对28例咯血患者进行64排CT支气管动脉成像。分析所得的CT图像以确定支气管和非支气管系统的动脉的位置。结果 CT可见支气管动脉情况为右侧43支,左侧46支;正常起源的支气管动脉占总数的46%;起源于非支气管动脉系统的动脉中有23支位于右侧,41支位于左侧。结论64排CT支气管动脉成像不仅可以确定支气管动脉及非支气管动脉系统的血管位置,还可以明确以咯血为主要症状的疾病的病因,为临床进一步治疗奠定基础。

  7. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  8. Assessment of Coronary Stents by 64-slice Computed Tomography:In-stent Lumen Visibility and Patency

    Institute of Scientific and Technical Information of China (English)

    Ling-yan Kong; Zheng-yu Jin; Shu-yang Zhang; Zhu-hua Zhang; Yi-ning Wang; Lan Song; Xiao-na Zhang; Yun-qing Zhang

    2009-01-01

    Objective To assess lumen visibility of coronary stents by 64-slice computed tomography(CT)coronary angiography,and determine the value of 64-slice CT in non-invasive detecting of in-stent restenosis after coronary artery stent implantation.Methods Totally,60 patients(54 males,aged 57.0±12.7 years)and 105 stents were investigated by 64-slice CT at a mean interval of 20.0±16.6 months after coronary stents implantation.Axial multi-planar reconstruction images of the stents and curved-planar reconstruction images through the median of the stents were reconstructed for evaluating stent image quality on a 5-point scale(1=excellent,5=nonassessable),and stent lumen diameter was detected.Conventional coronary angiography was performed in 18 patients,and 32 stents were evaluated.Results Image quality was good to excellent on average(score 1.71±0.76).Stent image quality score was correlated to heart rate(r=0.281,P<0.01)and stent diameter(r=0.480,P<0.001).All the stents were assessable in lumen visibility with an average visible lumen diameter percentage of 60.7% ±13.6% .Visible lumen diameter percentage was correlated to heart rate(r=-0.193,P<0.05),stent diameter (r=0.403,P<0.001),and stent image quality score(r=-0.500,P<0.001).Visible lumen diameter percentage also varied depending on the stent type.In comparison with the conventional coronary angiography,4 of 6 in-stent stenoses were correctly detected.The sensitivity and specificity for the detection of in-stent stenosis were 66.7% and 84.6% ,respectively.Conclusions Using a 64-slice CT,the stent lumen is partly visible in most of the stents.And 64-slice CT may be useful in the assessment of stent patency.

  9. Application of 64-slice spiral CT and post-processing technique in evaluation of Crohn's disease%64层螺旋CT检查及后处理技术在Crohn病中的应用

    Institute of Scientific and Technical Information of China (English)

    沈永菊; 冷永新; 唐翠松; 汤光宇

    2012-01-01

    目的 探讨64层螺旋CT及各种后处理技术在Crohn病中的应用.方法 对32例Crohn病患者CT扫描图像进行回顾性分析,由两位资深放射科医师对原始图像进行VR、MIP、MPR后处理.结果 Crohn病的影像学表现为:(1)肠壁增厚;(2)肠壁强化;(3)肠系膜的异常改变;(4)并发症.结论 MSCT检查可清楚显示肠壁及肠腔外病变,可得到更多的解剖和血流灌注的信息,对Crohn病的诊断、判断疾病活动度及并发症有优越性.%Objective To assess the application of multiple post-processing technique of 64-slice spiral CT in diagnosis of Crohn's disease. Methods Thirty two patients with Crohn's disease confirmed by endoscopic and pathological examination underwent 64-slice spiral CT scan. The images were reconstructed with volume rendering, maximum intensity projection, multiplanar reconstruction by two senior radiologists. Results The CT features of Crohn's disease included intestinal wall thickening, enhancement of the intestinal wall, abnormal changes of the mesentery and the complicating disease. Conclusion The 64-Slice spiral CT scan provides more information of the anatomy and blood perfusion of the lesions, which has unique superiority in diagnosis of Crohn's disease and complications.

  10. Diagnostic value of 64-slice CT examination and multi-planar reconstruction of carpal fractures%64层螺旋CT及多平面重建对腕骨骨折的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王聚宝; 奚甘平; 张建福

    2014-01-01

    To investigate the value of 64-slice CT examination and multi -planar reconstruction technique in the diagno-sis of carpal fractures .Methods:A retrospective analysis of 31 patients imaging data with carpal fracture diagnosed by 64-slice CT exam-ination and multi-planar reconstruction , by comparing with conventional X -ray radiography examination .Results:31 patients in routine X-ray examination revealed 19 carpal fractures , CT and multi-planar reconstruction examination revealed 39 .There was significant difference ( P <0.05) for carpal fracture detection between the two examination .Conclusion:Compared to the conventional X -ray ex-amination, the 64-slice CT examination and multi -planar reconstruction might have important clinical significance in the diagnosis of carpal fractures .%目的:探讨64层螺旋CT及多平面重建技术在腕骨骨折诊断中的价值。方法:回顾分析31例经64层螺旋CT及多平面重建检查确诊腕骨骨折患者的影像学资料,并与常规X线摄影检查结果相对比。结果:31例患者中常规X线检查发现腕骨骨折19处,CT及多平面重建检查发现39处。两者对腕骨骨折的检出有明显差别(P<0.05)。结论:与常规X线检查相比较,64层螺旋CT及多平面重建对确诊腕骨骨折及骨折部位、类型的显示有重要的临床价值。

  11. Diagnostic value of 64-slice spiral computed tomography chest angiography triple examination in acute chest pain%64排螺旋CT血管成像胸部三联检查对急性胸痛的诊断价值

    Institute of Scientific and Technical Information of China (English)

    齐晨晖; 范红燕; 史琼玉

    2012-01-01

    Objective To explore the clinical value of triple examination with 64-slice spiral CT chest angiography(CTA) in diagnosis of acute chest pain. Methods 80 patients with acute chest pain as study group underwent CTA. The examinations of coronary artery,pulmonary artery and aorta were done one time under ECG-gated. 50 patients received only 64-slice computed tomography coronary angiography, pulmonary angiography and aortic angiography as control group. The image quality of CTA in two groups was evaluated. Results The image quality of control group was better than that of study group, but there was of significant statistical difference between study group and the control group (χ =324. 4,P = 0. 00). There were no statistical difference between two groups and intragroup about the image quality of aorta, pulmonary artery including ascending aorta,aortic arch,descending aorta and the central pulmonary artery, peripheral pulmonary artery (P>0. 05) , the image quality of two groups was as the same as batter. Conclusion 64-slice spiral CT chest angiography triple examination can display aorta, pulmonary artery and coronary artery with good image quality, it has a important clinical value in differential diagnosis of the cause of acute chest pain.%目的 探讨64排螺旋CT血管成像(computed tomography angiography,CTA)胸部三联检查在急性胸痛诊断中的临床应用价值.方法 收集本院以急性胸痛为首发症状者80例为研究组,行64排螺旋CT胸部动脉成像,在心电门控下一次性完成主动脉、肺动脉及冠状动脉扫描;选择单纯行冠状动脉、肺动脉及主动脉CTA扫描者各50例为对照组,评价胸部CTA三联检查成像质量.结果 冠状动脉成像质量研究组与对照组比较有显著统计学差异(χ2=324.4,P=0.00),对照组优于研究组.主动脉和肺动脉成像质量在升主动脉、主动脉弓、降主动脉及中央肺动、外周肺动脉2组整体和组间比均无统计学差异(P>0.05),2

  12. Evaluation of Coronary Artery Bypass Grafts in the Early Postoperative Period Using 64-Slice MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yu Mi; Kim, Jeong Ho; Park, Chul Hyun; Park, Kook Yang; Byun, Sung Su; Hwang, Hee Young; Park, Chul Hi; Kim, Hyung Sik [Gachon University Hospital, Incheon (Korea, Republic of)

    2009-05-15

    The aim of this study was to evaluate the accuracy of 64-slice multidetector row CT (MDCT), as compared with conventional coronary angiography (CCA), for assessing coronary artery bypass grafts (CABG) in the early (< 1 month) postoperative period. Twenty-four patients underwent both 64-slice MDCT (0.6 mm collimation, 0.37s gantry rotation) and CCA within 15 days after CABG. Sixty-five bypass grafts (20 venous grafts and 45 arterial grafts) and 67 distal runoff arteries in 24 patients were included in the analysis. The bypass grafts and distal runoffs were evaluated for the presence of significant stenosis, including obstruction. The CT findings were compared with the CCA findings. CCA confirmed that 62 of the 65 grafts were patent and that 3 had significant stenosis or obstruction. Sixty of the 62 patent grafts were correctly identified by MDCT. One of the three grafts that had significant stenosis was misinterpreted on the MDCT images. The sensitivity, specificity and positive and negative predictive values for detecting stenosis were 67%, 97%, 50% and 98%, respectively, with an overall diagnostic accuracy of 95%. MDCT also correctly detected all the stenotic distal runoff arteries (4 of 67). 64-slice MDCT is a promising alternative diagnostic modality for evaluating a CABG in the early postoperative period.

  13. 64排螺旋CT重建技术在急性阑尾炎诊断中的应用价值%application of 64-Slice Spiral CT Reconstruction Technique in diagnosis of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    任春慧; 冯华; 梁爽; 曲世巍

    2013-01-01

    Objective To investigate the effectiveness of 64-slice spiral CT reconstruction technique in diagnosis of acute appendicitis. Methods Retrospective analysis of 64-slice spiral CT scan images was performed on 60 patients who underwent abdominal 64-slice spiral CT scans and were confirmed through clinical pathology as acute appendicitis sufferers. After multi-planar and curve reconstruction of all the images in the workstation, observation and analysis of appendicitis were made on the size, morphology and surrounding changes. Results Among 60 patients with acute appendicitis, 21 cases were found acute simple appendicitis, 32 superlative appendicitis, 5 appendiceal abscess, 2 appendiceal perforation. Two kinds of features - direct and indirect features could be gained from 64-slice spiral CT findings. Direct features include thickened and enlarged appendicitis(diameter> 6 mm), thickened wall of the appendicitis, appendicitis calculus. Indirect features included inflammation, abscess or inflammatory mass around the appendicitis, free intraperitoneal gas and swelling local lymph nodes. Conclusion Acute appendicitis had typical features in its CT iamges. Application of 64-slice spiral CT reconstruction techniques could have a better reveal of appendicitis and its surrounding circumstances, which significantly improved the diagnosis of appendicitis and was of great application value.%  目的探讨64排螺旋CT重建技术在急性阑尾炎诊断中的应用价值。方法对60例经临床病理证实的急性阑尾炎患者的64排螺旋CT扫描资料进行回顾性分析,所有患者行全腹部64排螺旋平扫,所得图像在工作站进行多平面及曲面重建,对阑尾的大小、形态及周围改变进行观察分析。结果60例资料中,急性单纯性阑尾炎21例、化脓性阑尾炎32例、阑尾脓肿5例、阑尾穿孔2例。64排螺旋CT直接征象为阑尾增粗、增大(直径>6 mm),阑尾壁增厚,阑尾结石;间接征象

  14. In the workup of patients with obscure gastrointestinal bleed, does 64-slice MDCT have a role?

    Directory of Open Access Journals (Sweden)

    Chinmay Kulkarni

    2012-01-01

    Full Text Available Purpose: The purpose was to prospectively determine the sensitivity of 64-slice MDCT in detecting and diagnosing the cause of obscure gastrointestinal bleed (OGIB. Materials and Methods: Our study included 50 patients (male 30, female 20 in the age range of 3-82 years (average age: 58.52 years who were referred to our radiology department as part of their workup for clinically evident gastrointestinal (GI bleed or as part of workup for anemia (with and without positive fecal occult blood test. All patients underwent conventional upper endoscopy and colonoscopy before undergoing CT scan. Following a noncontrast scan, all patients underwent triple-phase contrast CT scan using a 64-slice CT scan system. The diagnostic performance of 64-slice MDCT was compared to the results of capsule endoscopy, 99m-technetium-labeled red blood cell scintigraphy (99mTc-RBC scintigraphy, digital subtraction angiography, and surgery whenever available. Results: CT scan showed positive findings in 32 of 50 patients. The sensitivity, specificity, positive predictive value, and negative predictive values of MDCT for detection of bleed were 72.2%, 42.8%, 81.2%, and 44.4%, respectively. Capsule endoscopy was done in 15 patients and was positive in 10 patients; it had a sensitivity of 71.4%. Eleven patients had undergone 99mTc-RBC scintigraphy prior to CT scan, and the result was positive in seven patients (sensitivity 70%. Digital subtraction angiography was performed in only eight patients and among them all except one patient showed findings consistent with the lesions detected on MDCT. Conclusion: MDCT is a sensitive and noninvasive tool that allows rapid detection and localization of OGIB. It can be used as the first-line investigation in patients with negative endoscopy and colonoscopy studies. MDCT and capsule endoscopy have complementary roles in the evaluation of OGIB.

  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

    Institute of Scientific and Technical Information of China (English)

    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. 64排螺旋CT诊断成人门静脉海绵样变性的影像学表现及价值%Imaging Findings and Value of 64-slice Spiral CT in Diagnosis of Cavernous Transformation of Portal Vein

    Institute of Scientific and Technical Information of China (English)

    施健; 施小平; 王强; 王勤英

    2012-01-01

    目的 探讨利用64排螺旋CT动态增强扫描技术及多种血管重建方法诊断门静脉海绵样变性(Cavernous transformation of portal vein,CTPV)的价值和意义.方法 10例经手术、数字血管造影、超声诊断证实的门静脉海绵样变性病例,均行腹部平扫和动态增强扫描及血管后处理成像.结果 门静脉海绵样变性主要表现为门脉主干和(或)分支的阻塞,门脉走行区正常结构消失,出现大量向肝性及离肝性侧枝静脉.通过VR、MIP、MPR等血管成像技术能很好的显示门静脉栓塞、侧枝血管的重建与开放情况.结论 64排螺旋CT动态增强扫描及血管成像技术对诊断门静脉海绵样变性及侧枝血管的显示有较大优势和意义.%Objective To evaluate 64-slice spiral CT dynamic contrast-enhanced scanning combined with angiography reconstruction techniques in diagnosis of cavernous transformation of portal vein (CTPV). Methods 10 patients with CTPV conformed by surgery, digital angiography and ultrasound underwent plain and dynamic contrast enhanced CT. Multiple angiography reconstruction techniques were used to obtain vascular post-processing images. Results CTPV was primarily characteristic of the portal vein and (or) branch obstruction, loss of normal structure of portal vein region, presence of abundant venous collaterals through and out of liver. Volume rendering view (VR), maximum intensity projection (MIP) and multiplanar reconstruction (MPR) could distinctly display the portal vein embolization as well as reconstruction and opening situation of collateral vessels. Conclusion 64-slice spiral CT dynamic contrast-enhanced scanning combined with angiography reconstruction techniques is capable of making an accurate diagnosis of CTPV and providing more information for clinical therapy decisions.

  17. Clinical Application of Multi-Planar Reconstruction with 64-slice Spiral CT on Protrusion of Spondylolisthesis%64层螺旋CTMPR重组对腰椎滑脱的临床应用

    Institute of Scientific and Technical Information of China (English)

    刘兆芹; 钱学江

    2011-01-01

    Objective To investigate the value of multi-planar reconstruction(MPR) with 64-slice spiral CT for disease of spondylolisthesis.Methods MPRimages of 100 cases with spondylolisthesis were compared at random.Results MPR images could show not the graduation of spondylolisthesis,and could demonstrate isthmicspondy lolisthesis(ISS) or degenerative lumbar spondylolisthesis,but also could show the changes of peripheral soft tissue,the facet degeneration,and soft tissue structure.Conclusion 64-slices CT MPR images has more advantages in demonstrating the reason of spondylolisthesis,and can supply the reliable information for clinical doctors,is helpful for clinical doctors to choose the appropriate therapeutic schedule.[Chinese Medical Equipment Journal,2011 ,32(4 ) : 75-76]%目的:探讨64层螺旋CT多平面重组(MPR)对腰椎滑脱的临床应用价值.方法:随机抽取100例腰椎滑脱患者的CT MPR重建图像资料.结果:MPR不仅能够显示腰椎滑脱的分度,辨别是峡部型(真性)或是退变型滑脱(假性),并且能够显示合并的腰椎间盘膨出、小关节退变及周围软组织结构改变.结论:64层螺旋CT MPR图像,有利于全面、直观地显示腰椎滑脱的原因,并且能够为临床医生提供可靠信息,有助于临床医生选择合适的治疗方案.

  18. 64层螺旋CT在消化道穿孔的诊断价值%The Value of 64 Slice Spiral CT in the Diagnosis of Digestive Tract Perforation

    Institute of Scientific and Technical Information of China (English)

    孙晓霞; 郭强强; 兰国宾; 路凯; 李宝栋; 郭福庆

    2015-01-01

    Objective:To investigate the value of 64-slice spiral CT in the diagnosis of digestive tract perforation.Method:A retrospective analysis was conducted in imaging information of 76 cases confirmed by surgery in patients with digestive tract perforation.Result:In the 76 patients,the main CT signs were peritoneal effusion,free gas,surrounding cellulites or peritonitis change around the perforation and gastrointestinal wall thickening. Preoperative diagnostic accuracy was 92.0%. The correct localization rate was 81.2%.Conclusion:64 slice spiral CT in gastrointestinal perforation can timely,accurate diagnosis. It also has high value in judging the digestive tract perforation location.%目的:探讨64层螺旋CT在消化道穿孔诊断中的价值。方法:回顾性分析76例经手术证实的消化道穿孔患者的影像资料。结果:76例患者中,CT主要征象为腹腔积液、游离气体、穿孔处周围蜂窝组织炎或腹膜炎改变、胃肠壁增厚,术前正确诊断穿孔92.0%,定位正确诊断81.2%。结论:64层螺旋CT用于消化道穿孔中能够及时、准确地作出诊断,在判断消化道穿孔位置具有较高的价值。

  19. 64排容积CT扫描在严重多发伤快速评估中的应用%Clinical application of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma

    Institute of Scientific and Technical Information of China (English)

    熊坤林; 龚水根; 李然; 曹红元; 张伟国

    2008-01-01

    Objective To discuss clinical value of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma.Methods A retrospective study was carried out on data of 72 multiple trauma patients diagnosed with systemic 64-slice spiral CT scanning in our hospital from January 2006 to June 2008.Of all,28 patients with traffic injuries,24 with falling injuries,10 with blunt injuries,6 with stab injuries and 4 with explosive injuries.Results There were 72 multiple trauma patients with mean scanning time of 10.2 seconds.The CT scanning showed both craniocerebral and thoracic injuries in 30 patients,brain injuries in 16,thoracoabdominal injuries plus pelvic injuries in 10,extremity and brain injuries in 14 and systemic soft tissue injuries in 2.Isotropic characteristics and postprocessing function of 64-slice spiral CT scanning could accurately diagnose and evaluate injury severity of multiple trauma.Conclusions 64-slice spiral CT scanning is a fast and effective method for fast evaluating injury severity of multiple trauma,for it can not only shorten checking time,reduce movements of the patients and relieve the pain of the patients,but also can avoid defects induced by respiratory movement and provide fairly integrated imaging materials by its isotropic characteristics and pestprecessing function.%目的 探讨64排容积CT扫描在严重多发伤快速评估中的临床价值.方法 回顾性分析我院2006年1月-2008年6月收治的72例严重多发伤患者.致伤原因:交通伤28例,坠落伤24例,钝器伤10例,刀刺伤6例,爆炸伤4例.根据患者当时受伤情况及可疑损伤部位均及时行全身64排容积CT扫描.结果 本组72例严重多发伤患者中,头、胸部均有损伤30例,头部损伤16例,胸腹盆部均有损伤10例,四肢及头部损伤14例,全身软组织损伤2例.平均扫描耗时约10.2 s.64排容积CT各向同性特点和强大的后处理功能使其能准确地对组织器官的损伤情况及损伤程度进行

  20. 不同临床分期肾细胞癌的多层螺旋 CT 灌注研究%Study on value of 64 slice spiral CT perfusion in different clinical stages of renal cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    张颖颖; 董莹; 王义云

    2015-01-01

    Objective To evaluate the clinical value 64 slice spiral CT perfusion imaging in diagnosis for differ‐ent stages of renal cell carcinoma .Methods The clinical data of 41 patients with renal cell carcinoma from January 2011 to October 2013 were analyzed retrospectively .Using the pathological examination results as gold standard , blood flow perfusion after treatment ,blood volume(BV) ,peak enhancement (PEI) ,time to peak (TTP) ,mean transit time (MTT) and permeability surface (PS) were compared in differen stages ,evaluation index of CT in diagnosis for renal cell carcinoma staging were calculated .Results There were significant difference on perfusion ,BV ,PEI ,MTT , PS parameters between early and advanced renal cell carcinoma (P0 .05) .The sensitivity ,specificity ,misdiagnosis rate ,missed diagnosis rate and Youden index of renal CT perfusion imaging were 86 .36% ,89 .47% ,10 .53% ,13 .64% ,1 .758 and 0 .758 respetively .Conclusion There is high accuracy of 64 slice spiral CT perfusion imaging in diagnosis for different stages of renal cell carcinoma , which is worthy of application and promotion .%目的:探讨利用64排螺旋C T灌注成像技术对不同分期肾细胞癌进行诊断的临床价值及方法。方法回顾性分析莱芜市人民医院2011年1月至2013年10月收治的41例肾细胞癌患者的临床资料,以病理学检查结果作为临床分期的金标准,比较不同分期肾细胞癌的CT灌注成像经灌注软件包处理后的血流量(Perfusion),血容量(BV),峰值强化(PEI),达峰时间(TTP),平均通过时间(MTT),表面通透性(PS)指标的差异,同时计算CT诊断肾细胞癌分期的诊断学评价指标。结果早期肾细胞癌和晚期肾细胞癌的Perfusion、BV、PEI、M T T、PS参数比较,差异有统计学意义(P<0.05),而TTP参数比较差异无统计学意义(P>0.05)。采用CT 灌注成像技术诊断肾细胞癌分期的灵敏度为86.36

  1. 精益六西格玛法对64排CT检查流程的优化研究%Optimizing Study of 64 Slices CT Examination Workflow with Lean Six Sigma

    Institute of Scientific and Technical Information of China (English)

    郝光远; 陈军; 魏从全; 许诗丽; 王丽; 刘文婷; 孔雀

    2012-01-01

    Objective: To study the process of 64-slices detectors CT examination in patients by the implement of Lean Six Sigma methods: In order to reduce the patients' invalid waiting time so as to raise the patient's flux. Methods Five-step method in Lean Six Sigma management system was performed and implemented. According to such segments as the time of registration, waiting for CT examination, CT examination, films printing, films collecting, CT image interpretation, taking diagnostic report, 160 patients were randomly selected to analyze the times of each segment to find the key factor of resulting in extending the whole CT examination time. Refining methods to aim directly at the factors of resulting in the whole CT examination time were prolonged were proposed to improve the conventional CT examination process. And these methods were retained to be modified and optimized to increase the performed CT scan's patients in each segment. Then, another 160 patients were randomly selected to be compared with the fore 160 patients for the total time of CT examination after the refining methods were performed. Results: The average invalid waiting time of the patients were dropped from 88.50 min to 52.30 rain with statistically difference (P〈 0.01). The Six Sigma value (Z value) was increased from -0.54 to 5.12. Conclusion: The implementing of Lean Six Sigma in the 64-slices CT examination process can shorten the patient's invalid waiting time significantly and improve the patient's flux of single 64-slices CT scanner in each work-day.%目的:运用精益六西格玛方法研究64排CT检查流程,减少患者无效等待时间,提高单台64排CT检查患者的流通量。方法:运用和实施精益六西格玛管理体系5步法,按登记时间、检查前时间、检查时间、打印时间、收片时间、报告时间、取片时间,随机抽取160名患者分析其各阶段时间,找出致患者侯检时间延长的关键因素;对传统检查流程中导致等

  2. Cirrhosis:CT grading with 64-slice spiral CT perfusion imaging%肝硬化CT分级的64层螺旋CT灌注成像分析

    Institute of Scientific and Technical Information of China (English)

    陈勇; 郝凯; 尚英杰; 石俊英; 杨文魁

    2012-01-01

    目的 探讨肝硬化CT分级的临床价值.方法 对17例健康正常志愿者、54例肝硬化患者行CT灌注扫描,测量其血流量(BF)、血容量(BV)、肝动脉分数(HAF)、对比剂平均通过时间(MTT)、血管表面通透性(PS),对获得的相应灌注图进行肝硬化分级分析.结果 CT分级肝硬化程度越重,BF、BV越小,MTT、HAF、PS、肝动脉灌注量(HAP)越大.HAF、HAP在正常肝与轻、中、重度肝硬化之间有明显差异,HAF在中、重度肝硬化组明显增高.HAP在重度肝硬化组明显增高,PS、MTT在各组之间没有统计学意义.结论 通过肝脏的CT灌注研究,进一步证明了肝硬化CT分级确实与肝脏的灌注有一定关系,对临床肝硬化评估有一定价值.%Objective To evaluate the clinical value in grading of liver cirrhosis with 64-slice spiral CT perfusion imaging. Methods 17 healthy volunteers and 54 patients with liver cirrhosis underwent liver CT perfusion scanning. The blood flow(BF) , blood vol-ume(BV) , hepatic arterial fraction( HAF) , contrast agent mean transit time(MTT) and vascular permeability surface) PS) were measured on CT perfusion maps. Results CT perfusion imaging showed that the serious of cirrhosis,the lower of perfusion values of BF and BV,the higher of MTT,HAF,PS and hepatic arterial perfusionf HAP). There were significant differences between the normal liver and mild,moderate and severe cirrhosis in HAF and HAP,and HAF in moderate and severe cirrhosis of the liver was significantly increased. HAP in severe liver cirrhosis was significantly higher, PS, MTT between groups was not statistically significant. Conclusion By liver CT perfusion imaging study shows that the CT grading of cirrhosis is of certain relativity with liver perfusion, which is of significant value in evaluating cirrhosis clinically.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    NARCIS (Netherlands)

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

    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

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

  7. Influence of cardiac hemodynamic parameters on coronary artery opacification with 64-slice computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Husmann, Lars; Alkadhi, Hatem; Boehm, Thomas; Leschka, Sebastian; Desbiolles, Lotus; Marincek, Borut [University Hospital of Zurich, Department of Medical Radiology, Institute of Diagnostic Radiology, Zurich (Switzerland); Schepis, Tiziano; Koepfli, Pascal; Wildermuth, Simon [University Hospital of Zurich, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital of Zurich, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Center for Integrative Human Physiology, Zurich (Switzerland)

    2006-05-15

    The purpose of this study was to evaluate the influence of ejection fraction (EF), stroke volume (SV), heart rate, and cardiac output (CO) on coronary artery opacification with 64-slice computed tomography (CT). Sixty patients underwent, retrospectively, electrocardiography-gated 64-slice CT coronary angiography. Left ventricular EF, SV, and CO were calculated with semi-automated software. Attenuation values were measured and contrast-to-noise ratios (CNRs) were calculated in the proximal right coronary artery (RCA) and left main artery (LMA). Mean EF during scanning was 61.5{+-}12.4%, SV was 63.2{+-}15.6 ml, heart rate was 62.5{+-}11.8 beats per minute (bpm), and CO was 3.88{+-}1.06 l/min. There was no significant correlation between the EF and heart rate and the attenuation and CNR in either coronary artery. A significant negative correlation was found in both arteries between SV and attenuation (RCA r=-0.26, P<0.05; LMA r=-0.34, P<0.01) and between SV and CNR (RCA r=-0.26, P<0.05; LMA r=-0.26, P<0.05). Similarly, a significant negative correlation was found between the CO and attenuation (RCA r=-0.42, P<0.05; LMA r=-0.56, P<0.001) and between the CO and CNR (RCA r=-0.39, P<0.05; LMA r=-0.44, P<0.001). The actual hemodynamic status of the patient influences the coronary artery opacification with 64-slice CT, in that vessel opacification decreases as SV and CO increase. (orig.)

  8. Study of Relationship Between 64-slice CT Features and Chronic Rhino Sinusitis in Children with Adenoid Hypertrophy%儿童腺样体肥大的CT表现与慢性鼻-鼻窦炎的关系

    Institute of Scientific and Technical Information of China (English)

    王乐秋; 张瑞迪; 隋萍萍; 马秀凤; 李丽娟

    2013-01-01

    Objective To study the relationship between 64-slice CT features and chronic rhino sinusitis in children with adenoid hypertrophy. Methods The noses of 125 children with adenoid hypertrophy were scanned by 64-slice CT. The relationship between incidence of chronic rhino sinusitis and the volume of adenoid measured by CT was analyzed statistically. Results Mild adenoid hypertrophy (A/N 0.05). While the moderate or severe hypertrophy is (A/N ≥ 0.61) more likely to cause chronic rhino sinusitis. There is positive correlation between the hypertrophy degree and the incidence of chronic rhino sinusitis(P<0.05). Conclusion The CT features of adenoid hypertrophy is closely related to chronic rhino sinusitis. It is of great significance to treat adenoid hypertrophy timely for the prevention of chronic rhino sinusitis.%目的 探讨腺样体肥大儿童中慢性鼻-鼻窦炎发病情况与其CT表现的关系.方法 对125例腺样体肥大的儿童行常规鼻部64排CT检查,统计分析慢性鼻-鼻窦炎的发生率与CT测量腺样体体积的关系.结果 腺样体轻度肥大(A/N<0.6)与慢性鼻-鼻窦炎发病与否无关(P >0.05).腺样体中重度肥大(A/N≥0.61)的患儿更易合并慢性鼻-鼻窦炎,且呈正相关关系(P <0.05).即随着腺样体肥大程度的增加,慢性鼻-鼻窦炎发病率亦增加.结论 儿童腺样体肥大CT表现与慢性鼻-鼻窦炎密切相关,及时治疗腺样体肥大对预防及治疗慢性鼻-鼻窦炎具有十分重要的意义.

  9. 门静脉系统血栓的64层螺旋CT诊断价值%The Diagnostic Value of Thrombus in Portal Vein on 64-slice Spiral CT

    Institute of Scientific and Technical Information of China (English)

    韩新巍; 周朋利; 郑颖; 丁鹏绪; 路慧彬; 司江涛

    2009-01-01

    Objective To study the 64-slice spiral CT feature of the thrombus in portal vein. Materials and Methoils Noocontrast-enhanced CT and contrast enhanced CT were performed in all 15 patients. MIP,VR and MPR were used for three dimensional reconstruction. The features of the throw.bus in portal vein were analyzed. Results In 15 cases, 13 cases(83%) occurred in trunk vein,6 cases in right branch,7 cases in left branch,3 cases in splenic vein,9 cases in superior mesenterie vein. Yerdel Grade:Grade Ⅰ1 case,Grade Ⅱ10 cases, Grade Ⅲ 3 cases,GradelV 1 case. 10 cases showed high-dense in thrombus ,3 cases appeared low-dense. 12 cases presented partial filling defect, which is described as stripe and bundles in contrasted vein. All the involved vein had smooth and successive wall and had no appeared nodes protrude out at portal vein period. All the cases with thrombus showed typical track sign or line augmentation sign in involved vein wall. 12 cases displayed collateral circulation in esophag-ogastricand splenic vein, and 4 cases displayed pericholecystic and pericholedochal collateral branches. No case visualized A-P shunt. Conclusion 64-slice spiral CT can display the location, feature and cumulative branch of the thrombus in portal vein distinctly and stereoscopically. 64-slice spiral CT is very important modality for the thrombus in portal vein.%目的 探讨门静脉系统血栓(portal vein thrombosis,PVT)的64层螺旋CT表现特征.资料与方法 15例PVT行64层螺旋CT平扫和双期增强扫描,采用最大密度投影(MIP)、容积再现(VR)及多平面重组(MPR)观察其影像学特征.结果 15例中,血栓发生于门静脉(PV)主干13例,右支6例,左支7例,脾静脉(SV)3例,肠系膜上静脉(SMV)9例,其中血栓同时累及PV主干和SMV 8例,同时累及PV左右支、主干和SMV 4例,累及PV主干和右支6例,累及PV主干和左支6例,累及SV和SMV 2例,PV主干、SV、SMV三岔口处血栓1例.Yerdel分级:Ⅰ级1例,Ⅱ级10例,Ⅲ级3

  10. Coronary artery stent geometry and in-stent contrast attenuation with 64-slice computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Schepis, Tiziano; Koepfli, Pascal; Gaemperli, Oliver; Eberli, Franz R.; Luescher, Thomas F. [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Leschka, Sebastian; Desbiolles, Lotus; Husmann, Lars; Wildermuth, Simon; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Zurich Center for Integrative Human Physiology, Zurich (Switzerland)

    2007-06-15

    We aimed at assessing stent geometry and in-stent contrast attenuation with 64-slice CT in patients with various coronary stents. Twenty-nine patients (mean age 60 {+-} 11 years; 24 men) with 50 stents underwent CT within 2 weeks after stent placement. Mean in-stent luminal diameter and reference vessel diameter proximal and distal to the stent were assessed with CT, and compared to quantitative coronary angiography (QCA). Stent length was also compared to the manufacturer's values. Images were reconstructed using a medium-smooth (B30f) and sharp (B46f) kernel. All 50 stents could be visualized with CT. Mean in-stent luminal diameter was systematically underestimated with CT compared to QCA (1.60 {+-} 0.39 mm versus 2.49 {+-} 0.45 mm; P < 0.0001), resulting in a modest correlation of QCA versus CT (r = 0.49; P < 0.0001). Stent length as given by the manufacturer was 18.2 {+-} 6.2 mm, correlating well with CT (18.5 {+-} 5.7 mm; r = 0.95; P < 0.0001) and QCA (17.4 {+-} 5.6 mm; r = 0.87; P < 0.0001). Proximal and distal reference vessel diameters were similar with CT and QCA (P = 0.06 and P = 0.03). B46f kernel images showed higher image noise (P < 0.05) and lower in-stent CT attenuation values (P < 0.001) than images reconstructed with the B30f kernel. 64-slice CT allows measurement of coronary artery in-stent density, and significantly underestimates the true in-stent diameter compared to QCA. (orig.)

  11. Comprehensive Application of 64-slice Spiral CT Scan Techniques on Diagnosis Value of Nodular Goiter%64排CT的综合运用对诊断结节性甲状腺肿价值探讨

    Institute of Scientific and Technical Information of China (English)

    肖继伟; 王晓燕; 胡道予

    2014-01-01

    目的:探讨64排螺旋CT扫描技术的综合运用对结节性甲状腺肿的诊断及鉴别诊断方面的价值。方法:选择41例经过病理证实的结节性甲状腺肿,甲状腺肿瘤及其他结节性甲状腺疾病若干,全部行64排螺旋CT平扫及动态增强扫描加后续重建,观察病灶的大小、形态、密度、边缘、强化特点及有无侵犯和转移等,总结和归纳病灶的影像学表象及特征。结果:结节性甲状腺肿、甲状腺肿瘤及其他结节性甲状腺疾病在CT影像上的表现可能少部分有所重叠,但大多数趋于不同,且有一定规律可循。结论:基于64排CT扫描技术的综合运用可在很大程度上掌握结节性甲状腺肿及相似疾病的表象及特征,对结节性甲状腺肿诊断及鉴别诊断具有重要意义。%Objective:To discuss the comprehensive application of 64-slice spiral CT scan techniques on the diagnosis value of nodular goiter and its differential diagnostic value. Methods:41 cases of nodular goiter,thyroid tumors and other nodular thyroid diseases,which had been verified by pathology,were selected to conduct 64-slice spiral CT scan and dynamic contrast-enhanced scan plus follow-up reconstruction. With observing the size,shape,density,edge,enhancing char-acteristics of the lesion as well as its infringement and metastasis,imaging characteristics of the le-sion were concluded. Results:The imaging manifestations of nodular goiter,thyroid tumors and oth-er nodular thyroid diseases overlap only in small portion on CT,but mostly they are different. Con-clusion:The comprehensive application of 64-slice spiral CT scan techniques can considerably di-agnose the representations and characteristics of nodular goiter and similar diseases,which is signifi-cant to the diagnosis and differential diagnosis of nodular goiter.

  12. The analysis of diagnostic value of 64-slice spiral CT in acute mesenteric vascular embolism%64层螺旋CT对急性肠系膜血管栓塞的诊断价值分析

    Institute of Scientific and Technical Information of China (English)

    张浩亮; 杜海; 武轶非; 张凤翔

    2012-01-01

    目的 探讨64层螺旋CT血管造影对急性肠系膜血管栓塞(AMI)的诊断价值.方法 回顾性分析经64层螺旋CT全腹平扫加多期动态增强扫描诊断的15例AMI.其中,肠系膜上动脉栓塞3例(完全栓塞1例,不完全栓塞2例),肠系膜上静脉栓塞12例.结果 15例AMI直接征象:动脉期显示肠系膜上动脉完全或部分充盈缺损,可诊断为肠系膜上动脉完全或部分栓塞(3例).静脉期显示肠系膜上静脉完全或部分充盈缺损,可诊断为肠系膜上静脉完全或部分栓塞(12例);间接征象“缆绳征”12例,肠系膜水肿10例,肠管壁增厚12例,肠管扩张、积液8例,肠壁强化减弱7例,其中2例可见节段性未强化区,腹水6例,肾前筋膜增厚4例,肠壁积气2例.平扫肠系膜上动脉或上静脉高密度征7例(静脉栓塞6例,动脉栓塞1例),肠系膜上静脉栓塞累及门静脉、脾静脉6例,其中4例在增强扫描时,可见肝脏异常低灌注区.结论 64层螺旋CT平扫加多期动态增强扫描对急性肠系膜血管栓塞的诊断及时准确,应作为临床怀疑肠系膜血管疾病首选检查方法,值得推广应用.%Objective To explore the diagnostic value of 64-slice spiral CT in acute mesenteric vascular embolism. Methods We retrospectively analyzed the images of 15 AMI by multiphase dynamic contrast-enhanced 64-slice spiral CT, 3 superior mesenteric artery embolization (1 completely embolization, 2 incompletely embolization), and 12 superior mesenteric vein embolization. Results The direct signs: superior mesenteric artery was full or partial filling defect in arterial phase, and superior mesenteric vein was full or partial filling defect in vein phase. Indirect sign: there were 12 cases of "stranding sign", 10 cases of mesenteric edema, 8 cases of bowel expansion and effusion, and 6 cases with ascites, 7 cases of high density for the blood vessel by CT plain scan (6 in superior mesenteric vein embolization, 1 in superior mesenteric

  13. Diagnostic Value of 64-slice CT Perfusion Imaging in Prostate Cancer and Benign Prostatic Hyperplasia%64排CT灌注成像对前列腺癌与良性前列腺增生的诊断价值

    Institute of Scientific and Technical Information of China (English)

    常泰; 戴娜

    2011-01-01

    [目的]探讨前列腺64排CT灌注成像的可行性及对前列腺癌与良性前列腺增生(BPH)的诊断价值.[方法]选择经手术或穿刺病理证实的前列腺癌患者28例(A组)和BPH患者35例(B组),所有患者均行前列腺64排CT灌注扫描,比较两组灌注参数:血流量 (BF)、血容量(BV)、峰值(PE)、达峰时间(TTP)、表面通透性(PS).[结果]A组BF、BV、PE分别为(0.492±0.115) mL/(100 g·min),(0.146±0.019) mL/100 g,(33.4±5.1) HU均显著小于BPH组(1.712±0.095) mL/(100 g·min),(0.276±0.031) mL/100 g,(56.7±6.7) HU(P<0.05),TTP、PS分别为(54.2±5.6)S和(54.8±6.9)mL/(100 g·min)均显著大于BPH组(26.4±4.6)S和(20.1±4.8)mL/(100 g·min) (P<0.05).[结论]前列腺64排CT灌注成像方法可行,灌注数据获得简单快捷,能够在一定程度上反映出前列腺血流灌注变化;前列腺64排CT灌注成像能定量地提供前列腺血流信息,可无创性地辅助诊断前列腺癌和BPH.%[Objective] To explore the feasibility and diagnostic value of 64-clice CT perfusion imaging in prostate cancer(PC) and benign prostatic hyperplasia(BPH). [Methods] Twenty-eight PC patients (group A) and thirty-five BPH patients (group B) confirmed by surgery or pathology were selected. All patients were performed by 64-slice CT perfusion of prostate. The perfusion parameters such as blood flow(BF) , blood volume (BV) , peak enhancement (PE) , time to peak (TTP) and permeability surface(PS) were compared between two groups. [Results] BF, BV and PE in group A were 0. 492 ± 0. 115 mL/(100g · min),(0. 146 ± 0. 019) mL/100g and (33. 4 ± 5. 1)HU respectively, which were significantly lower than those in group B[(1. 712 ± 0.095) mL/(100 g · min),(0. 276 ± 0. 031) mL/100 g and (56. 7 ± 6. 7) HU] ( P <0. 05). TTP and PS in group A were 54. 2 ± 5. 6S and 54. 8 ± 6. 9ml/(100g · min) respectively, which were significantly higher than those in group B[(26. 4 ± 4. 6)s and (20. 1 ± 4. 8) mL/(100g · min)]( P <0. 05

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

    Institute of Scientific and Technical Information of China (English)

    武军; 李彦杰

    2015-01-01

    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。%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.

  15. 64层螺旋CT对寰椎椎动脉沟环综合征的诊断价值%The diagnostic value of 64-slice spiral CT on atlas vertebral artery sulcus ring syndrome

    Institute of Scientific and Technical Information of China (English)

    路明; 陈穹; 汪茂文; 王钢; 陈小昕; 虞鲲

    2012-01-01

    目的 探讨64层螺旋CT对寰椎椎动脉沟环综合征的诊断价值.方法 收集因常规颈椎正侧位X线检查发现的寰椎椎动脉沟环患者48例,进行64层螺旋CT容积扫描后,进行容积重建和多平面重建,多方位显示寰椎结构形态及寰枢关节间隙,并探讨其与临床症状之间的关系.结果 48例寰椎椎动脉沟环患者中,右侧完整环型24例,孔径(6.59±0.50)mm,左侧完整环型36例,孔径(6.19±0.49)mm,右侧不完整环型24例,左侧不完整环型12例.30例诊断为寰椎椎动脉沟环综合征,均有寰枢关节不稳及不同程度头颈转动性眩晕症状.结论 64层螺旋CT能清晰显示寰椎后弓桥的解剖结构和测量寰椎椎动脉沟环的孔径,结合对枕颈失稳的判断,对寰椎椎动脉沟环综合征具有重要的诊断价值.%Objective To explore the diagnostic value of 64-slice spiral CT on atlas vertebral artery sulcus ring syndrome.Methods The 48 atlas vertebral artery sulcus ring patients who were found by conventional anterior posterior and lateral X-ray film were collected.The 64-slice spiral CT volume scan and following volume restitution(V R)and multiplanar reconstruction(MPR)were underwent,and multi-directional structural morphology was displayed.Their relationship with clinical features were analyzed.Results Among 48 cases of atlas vertebral artery sulcus ring,24 cases were shown with right complete bridge[pore size(6.59±0.50)mm],36 cases with left complete bridge[pore size(6.19±0.49)mm],24 cases with right incomplete bridge and 12 cases with left incomplete bridge.Thirty cases were diagnosed as atlas vertebral artery sulcus ring syndrome,and all had the atlantoaxial joint asymmetry and vertigo of different degree when head and neck rotated.Conclusions The 64-slice spiral CT can clearly display the anatomical features of posterior bridge of atlas and measure the pore size of atlas vertebral artery sulcus ring,and it has important diagnostic value for atlas

  16. 64层螺旋CT尿路成像技术在泌尿系疾病中的临床应用%Clinical application of 64-slice spiral CT urography in patients with urologic diseases

    Institute of Scientific and Technical Information of China (English)

    王富山

    2014-01-01

    目的 探讨64层螺旋CT尿路成像技术(CTU)对泌尿系统疾病的诊断价值.比较CT尿路成像技术和静脉肾盂造影(IVP)检查诊断泌尿系统疾病的准确率.方法 总结2年来泌尿系疾病患者217例完整的临床资料,其中输尿管和肾结石87例,输尿管和肾盂肿瘤66例,膀胱肿瘤35例,肾盂源性囊肿和肾盂旁囊肿13例,肾盂输尿管连接处畸形9例,双侧巨输尿管症7例.全部进行64层螺旋CT尿路成像检查,对影像学资料进行回顾性分析.结果 217例患者中CTU和IVP检查诊断准确率分别为98.2%(213/217)、65.4%(142/217).CTU、IVP检查所用时间分别为(19.1±2.9)、(65.3±24.8)min,两者比较差异有统计学意义(P<0.05).结论 CTU可多角度观察病变局部情况,且扫描时间更短,图像分辨率更高.此检查在诊断泌尿系统疾病准确率、了解病变周围组织情况以及对梗阻远端尿路显示率方面明显优于IVP,可应用于绝大多数的泌尿系统疾病患者中.%Objective To investigate the diagnostic value of 64-slice spiral CT urography(CTU) on patients with diseases of urinary system,and compare the diagnostic accuracy of computed tomography urography(CTU) and conventional intravenous pyelography (IVP)in diagnosis of urologic disease.Methods Two hundred and seventeen patients with urinary tract diseases who presented complete clinical data over the past 2 years were reviewed.There were 87 cases of ureterolithiasis and nephrolithiasis,66 cases of cancer in ureter and pelvis,35 cases of cancer in bladder,13 cases of parapelvic cyst and pyelogenic cyst,9 cases of ureteropelvic junction obstruction(UPJO),7 cases of megaloureter.All of the cases underwent 64-slice CT urography,and the images were analyzed retrospectively.Results The accuracy of diagnosis was 98.2% (213/217) in CTU group and 65.4% (142/217) in IVP group.The examination time was (19.1 ± 2.9) rmin in CTU group and (65.3 ± 24.8) min in IVU group.There were

  17. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  18. 64排螺旋CT仿真结肠镜在结肠癌诊断中的应用%Clinical application of 64-slice spiral CT virtual colonoscopy in diagnosis of colonic carcinoma

    Institute of Scientific and Technical Information of China (English)

    张明

    2012-01-01

    目的 探讨64排螺旋CT仿真结肠镜(CT virtual colonoscopy,CTVC)及其二维三维重建在结肠占位的CT表现及临床应用.方法 回顾分析52例行64排螺旋CT双体位结肠扫描的结肠癌病例,所有患者均进行结肠充气仰卧位及俯卧位增强扫描,其中20例增加了左或右侧位三期扫描,将MSCT扫描原始数据传送至ADW4.4工作站采用CT仿真结肠镜(CTVC)、多平面重建(MPR)、表面遮盖显示(SSD)、透明重建显示(Raysum)4种方法进行结肠重建处理,对病灶的形态、大小、密度、结肠壁受损的程度、范围以及结肠外情况、淋巴结转移情况进行综合分析,做出准确判断.结果 结肠、直肠癌52例,全部病例均经过手术及纤维结肠镜检查活检病理证实.结论 MSCT仿真结肠镜可显示结肠占位病变的形态、大小及肠壁、肠周侵犯情况,多体位扫描能使病变肠管扩张充分,更好地显示病灶的细节,提高病变检出的敏感性,为临床选择合理的治疗提供有价值的依据,是诊断结肠占位的一种有效检查方法.%Objective To investigate the CT manifestations and diagnostic value of 64 - slice spiral CT virtual colonoscopy (CTVC) and its 2D/3D - reslruction in colonic neoplasms. Methods 64 - slice spiral CT scan of colon was performed in 52 patients, Spiral CT enhancing scan was performed in both the supine and prone positions after appropriately distended by introduction of air and water, and triple - phase spiral CT enhanced scan were additionally performed in 20 of 52 cases, and the data of MSCT were transferred to ADW4.4 workstation for colon reconstruction image post processing including CT virtual colonoscopy (CTVC) , multiple planar reconstruction (MPR) , shaded surface display (SSD) and Raysum display. The MSCT findings of the shape, size and density of lesions, the injury extent and range of colonic wall and extracolon, and lymph node metastasis were analyzed and estimated. Results Totally 52

  19. 64排CT用于创伤性颅脑损伤诊断中的价值%Value of Applying 64-slice CT to Diagnosis of Traumatic Brain Injury

    Institute of Scientific and Technical Information of China (English)

    刘光祖

    2016-01-01

    Objective To research and analyze the value of applying 64-slice CT to diagnosis of traumatic brain injury. Methods 100 patients with traumatic brain injury were selected as main survey samples randomly. All patients received CT examination when they were admitted to the hospital. The patients with negative examination result received CT reexamination in 1 day. If the examination results were negative, the patients needed to receive CT examination for the third day. CT image features of 100 patients were analyzed carefully, and were divided into three types according to the actual characteristics of CT image. The condition of different injury classiifcations was analyzed. Results The sensitivity of the patients for the admission to hospital (30~180 minute), in one day and in 2~3 day was 69.00%, 73.00%and 100.00%. The light, medium and severe brain injury had different prognostic effect. The severer the injury, the higher disability rate and fatality rate, which had evident statistical signiifcance, P<0.05. Conclusion 64-slice CT achieves evident effect for diagnosing brain injury.%目的:研究分析64排CT用于创伤性颅脑损伤诊断中的价值。方法随机选取创伤性颅脑损伤患者100例作为主要的调查样本,在患者入院时均接受CT检查,对于检查结果为阴性的患者,在1天之内完成CT复查;若其检查结果还是阴性的患者,则需要在第2-3天之内第三天接受CT检查。对100例患者的CT影像特点进行缜密分析,严格按照CT影像的实际特点完成轻、中、重三型划分,对不同损伤分型影响预后的情况进行针对分析。结果刚刚入院时候(30~180分钟)、1天之内、2~3天内患者的灵敏度分别为69.00%、73.00%、100.00%。轻型、中型以及重型颅脑损伤存在不同的预后效果,即损伤越严重就会有越高的致残率以及致死率,具有明显的统计学意义,P<0.05。结论64排CT在诊断颅脑损伤优势的过程中可以取得非常明显的效果。

  20. CT angiography and CT perfusion in acute ischemic stroke

    NARCIS (Netherlands)

    Seeters, T. van

    2016-01-01

    CT angiography and CT perfusion are used in patients with acute ischemic stroke for diagnostic purposes and to select patients for treatment. In this thesis, the reproducibility of CT angiography and CT perfusion is examined, the additional value of CT angiography and CT perfusion for stroke outcome

  1. 64-slice spiral CT diagnosis of juxtapapillary diverticulum of duodenum%64层螺旋CT在十二指肠乳头旁憩室中的诊断

    Institute of Scientific and Technical Information of China (English)

    陈穹; 王钢; 汪茂文; 钱春锋; 姚强; 路明; 汤友英

    2011-01-01

    目的 探讨64层螺旋CT在十二指肠乳头旁憩室(JDD)中的诊断价值.方法 回顾分析经64层螺旋CT扫描发现并经消化道造影或内窥镜逆行性胆胰管造影(ERCP)证实的JDD 34例,通过后处理软件进行多平面重建(MPR)、容积再现(VR),显示其与胆总管下端的关系,并结合临床进行分析.结果 34例JDD,共发现乳头上型19例,乳头缘型10例,乳头水平外侧缘型1例,乳头下型4例.34例JDD合并胆总管结石7例,胆总管下端炎性狭窄11例,胆囊结石7例,急性胆囊炎4例,慢性胆囊炎17例,合并急性胰腺炎1例,慢性胰腺炎2例,合并肝内胆管小结石3例.结论 64层螺旋CT强大的后处理功能,不仅使JDD的检出率明显提高,更可显示其与十二指肠乳头的关系,可对临床胆系疾病的发病原因提供有益的帮助.%Objective To explore the value of 64-slice spiral CT in the diagnosis of juxtapapillary diverticulum of duodenum (JDD). Methods CT data in 34 cases of JDD confirmed by gastrointestinal radiography or endoscopic retrograde cholangiopancre-atography(ERCP) were retrospectively analysed. The relationship between the diverticulum and distal common bile duct was showed with multiplanar reconstruction!MPR) and volume rendering ( VR) by post-processing software. Results Among 34 cases, there were 19 cases of papillary-superior, 10 cases of nipple-margin, 1 case of the lateral opposite of the papillary-margin and 4 cases of papillary-inferior. In 34 cases ,there were 7 cases in combination with common bile duct stones, 11 cases of distal common bile duct inflammatory stricture,7 cases of cholelithiasis, 4 cases of acute cholecystitis, 17 cases of chronic cholecystitis, 1 case of acute pancreatitis, 2 cases of chronic pancreatitis and 3 cases of intrahepatic bile duct calculus correspondingly. Conclusion 64-slice spiral CT post-processing technology can not only improve the detecting rate of JDD significantly, but also can display the relationship

  2. 64排螺旋CT多种后处理技术在肋骨骨折诊断中的应用%Application of Various Post Processing Techniques of 64 Slice Spiral CT in the Diagnosis of Rib Fractures

    Institute of Scientific and Technical Information of China (English)

    潘兴朋

    2016-01-01

    目的:探讨64排螺旋CT多种后处理技术对肋骨骨折的诊断价值。方法以本院2014年2月-2016年2月就诊的疑似肋骨骨折75例胸部外伤患者为研究对象,均行X线平片、多层螺旋CT轴位、容积再现(VR)、多平面重建(MPR)等后处理技术检查,比较不同影像学方法对肋骨骨折、骨折数量检出情况。结果临床、影像学检查及复查确诊肋骨骨折165处,CT轴位、CT后处理技术对肋骨骨折例数检出率分别为96.00%、98.67%,较X线平片的80.00%差异有统计学意义(P<0.05)。CT后处理技术对肋骨骨折数量检出率为99.39%,较X线平片、CT轴位的71.52%、78.79%差异有统计学意义(P<0.05)。漏诊情况:X线平片漏诊41处,其中以肋软骨附近漏诊最多,占58.54%;CT轴位漏诊24处,其中肋软骨附近、腋段肋骨漏诊各5处;CT后处理技术未漏诊,可疑骨折数1处。结论64排螺旋CT后处理技术对肋骨骨折、骨折数量检出率高,漏诊率低,能有效弥补X线平片、CT轴位不足。%Objective To investigate the value of various post processing techniques of 64 slice spiral CT in the diagnosis of rib fractures. Methods 75 cases of patients with thoracic trauma and suspected rib fractures who were treated in our hospital between February 2014 and February 2016 were selected as study subjects. All of them were examined by X-ray plain film, multi-slice spiral axial CT, volume rendering (VR), multi planar reconstruction (MPR) and other post-processing techniques. The situation of different imaging methods in the detection of rib fractures and number of fractures was compared. Results 165 rib fractures were diagnosed by clinical, imaging examination and reexamination. The detection rates of axial CT and CT post processing techniques in number of cases with rib fractures were 96.00%and 98.67%, respectively. Compared with X-ray plain film (80.00%), the difference was significant (P<0.05). The

  3. 64层CT脑灌注联合CTA在早期缺血性脑血管病中的应用%Application of perfusion and CTA by 64 slice CT in early ischemia cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    李培秀; 都日娜; 丁俊丽; 张强

    2011-01-01

    目的 探讨64层螺旋CT脑灌注加CT血管成像技术在早期脑梗死的应用价值.方法 分析总结108例发病在6h内临床可疑脑梗死,其中105例进行CT平扫、CT脑灌注和CTA,部分复查CTP的住院患者资料,并对影像资料做统计学分析.结果 CT平扫7例脑实质密度轻微减低、脑沟变浅(6.6%),CT脑灌注83例显示与临床症状对应区域血流灌注异常(79.1%),与对侧比较CBF下降、CBV下降或正常、TTP延长.22例CT灌注未见异常(20.9%).CT血管成像显示53支动脉(39例)有不同密度斑块及管腔狭窄,3例检查未成功.结论 CT脑灌注加CTA成像技术可以快速、准确确定缺血半暗带及病变血管,对早期缺血性脑血管脑的诊断和指导治疗有重要的临床应用价值.%Objective To discuss the application of cerebral perfusion and CT blood vessel imaging technique by 64-slice CT in diagnosis of cerebral infarction in its early phase. Methods To analyze and summarize the data of 108 patients who were suspected of the ischemic infarction in 6 hours. 105 among the patients were examined by CT scanning, CT perfusion and CTA. Some of those patients needed the examination by CTP again. All data were analyzed statistically. Results CT scanning showed a slight reduction in the density of brain parenchyma in 7 cases, with brain shallow groove(6. 6%) and CT perfusion showed blood perfusion abnormal corresponding to clinical symptom region in 83 cases (79. 1%). Compared with the contra-lateral, CBF were decreased and CBV were decreased or normal while TTP was extend. 22 cases of CT perfusion showed regular!20. 9%). CT blood vessel imaging showed that 53 arteries of 39 patients had spots and the pipes were narrow. 3 cases were not successful. Conclusion Cerebral perfusion and CTA imaging technique by CT can quickly and exactly definite ischemia and pathology blood vessel, which is of great clinical importance for diagnosing and curing brain ischemia in its early phase.

  4. CT Angiography (CTA)

    Science.gov (United States)

    ... during the procedure. Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and ... of the procedure, you may be asked to complete a questionnaire to ensure your safety during this ...

  5. Clinical application analysis of 64-slice CT coronary CTA dynamic volume rendering diagnosis of myocardial bridge & nbsp;of the anterior descending branch%64层螺旋CT冠状动脉CTA动态容积再现辅助诊断前降支心肌桥的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    郝晓光

    2013-01-01

      Objective To explore the clinical value of 64-slice CT coronary CTA dynamic volume rendering images auxiliary diagnosis of myocardial bridge. Methods 96 patients underwent coronary CTA from January 2009 to the end of December 2012, with confirm of coronary angiography, were chosen. CT images are routinely reconstructed in the best phase period and in 0-90% phase period, an interval of 10%. Reconstruction data was sent to the workstation to get the MPR, the CPR, as well as dynamic volume rendering images. Images were analyzed by the two groups of doctors of medical imaging department to determine whether the presence of myocardial bridge of the left anterior descending artery based on static images, both static and dynamic volume images, respectively. Results 96 cases with myocardial bridge of the left anterior descending artery confirmed by coronary angiography, 83 cases were diagnosed by the static CTA image, 93 cases were diagnosed by both static and dynamic volume images. The sensitivity of two groups was 93.75% and 82.29%, specificity 99.68% and 99.57%, respectively. Conclusion The comprehensive analysis of the 64-slice spiral CT coronary CTA static and dynamic volume rendering images can improve the accuracy of the diagnosis of left anterior descending artery myocardial bridge.%  目的探索64层螺旋CT冠状动脉CTA动态容积再现图像辅助诊断心肌桥的临床应用价值。方法选择我院2009年1月-2012年12月行冠状动脉CTA检查并经冠脉造影证实的心肌桥96例,所有CT图像均进行常规best phase期相重建及0-90%、间隔10%的多期相重建,重建后的数据传送至工作站进行MPR、CPR重建以及动态容积再现处理。图像由两组医师分别根据静态图像、静态加动态容积再现图像判断是否存在前降支心肌桥,诊断结果分别统计,并进行统计学分析。结果经冠脉造影证实的前降支心肌桥患者96例中,静态CTA图像诊断肌桥83例,静

  6. 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

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Bo Ram; Yong, Hwan Seok; Kang, Eun-Young; Woo, Ok Hee; Choi, Eun Jung [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)], E-mail: yhwanseok@naver.com

    2012-12-15

    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

  7. 64排螺旋CT检测冠状动脉病变与同型半胱氨酸水平的相关性研究%Correlation between 64-slice spiral computed tomography coronary angiography and homocystein in coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    刘丽; 贺延; 王松涛; 吕俊刚

    2012-01-01

    目的 探讨64排螺旋CT(MSCT)检测冠状动脉病变与同型半胱氨酸水平的相关性.方法 入选研究对象87例,均未接受叶酸和(或)维生素B12等治疗,分为急性冠状动脉综合征(ACS)组33例、稳定型心绞痛(SAP)组29例和正常对照组25例,均行冠状动脉MSCT成像检查,根据CT值进一步将ACS和SAP患者分为易损斑块组26例,混合斑块组19例,钙化斑块组17例;对所有研究对象检测血清同型半胱氨酸(Hcy)浓度.结果 3组间血清Hcy浓度按ACS组(16.44±5.48) μmol/L、SAP组(13.06±5.80) μmol/L、正常对照组(9.94±4.23) μmol/L顺序递减(均P<0.01);易损斑块组和混合斑块组血清Hcy浓度均高于钙化斑块组,为(16.50±5.24) μmol/L、(15.51±6.24) μmol/L vs(11.63±5.21) μmol/L(均P<0.01);ACS组与SAP组斑块构成比不同(x2=7.628,P<0.05);ACS组易损斑块检出率(42.4%)高于SAP组(17.2%),ACS组钙化斑块检出率(18.2%)低于SAP组(48.3%)(均P<0.05);斑块的不同性质与血清Hcy浓度间存在相关关系(rs=0.467,P<0.01).结论 冠状动脉MSCT联合血清Hcy化验检查可作为诊断冠心病并预测其严重程度的无创方法在临床上得以应用.%Objective To explore the correlation between 64-slice spiral computed tomography ( MSCT) coronary angiography and homocystein( Hey) in coronary artery disease. Methods Eighty-seven patients were divided into three groups:coronary artery syndrome (ACS) group 33 cases, stable angina pectoris(SAP) group 29 cases and healthy control group 25 cases. No one had received drug therapy with folic acid and/or vitamin B12. All patients underwent 64-slice spiral computed tomography angiography to distinguish the different quality of coronary plaques. According to the CT scale, all coronary artery disease patients were divided into vulnerable plaque group, mix plaque group and hard plaque group. Blood samples were taken to measure Hey level in all patients. Results Mean Hey level of ACS

  8. 64层螺旋CT灌注成像在乳腺疾病诊断中的应用研究%APPLICATION OF 64-SLICE SPIRAL CT PERFUSION IMAGING IN THE DIAGNOSIS OF BREAST DISEASES

    Institute of Scientific and Technical Information of China (English)

    曾勇; 吴垦; 黎学刚

    2011-01-01

    [目的]进行64层螺旋CT灌注成像研究,探讨该技术在乳腺疾病诊断中的应用前景.[方法]选择于2008年5月~2009年5月期间临床检查或钼靶检查怀疑有乳腺疾病的61例女性患者行CT灌注扫描.按照病理将其分为3组:增生病组(n= 14)、纤维腺瘤组(n=19)和乳腺癌组(n=20),并将所有患者对侧乳腺定为正常组(n=61).进行灌注序列body perfusion扫描及Perfusion 3体部灌注软件处理,计算感兴趣区的血流动力学参数血流量(BF)、平均通过时间、血容量(BV)(MTT)和表面通透性(PS),统计分析不同组间的测量值.[结果]与乳腺癌组比较,正常组BF、BV及PS的差异均有统计学意义(P<0.05),MTT的差异无统计学意义(P>0.05);正常乳腺组与纤维腺瘤组、增生病组比较,BF及BV的差异均有统计学意义(P<0.05),MTT及PS的差异均无统计学意义(P>0.05);乳腺癌组与纤维腺瘤组比较,其BF、PS的差异有统计学意义(P<0.05),BV及MTT的差异无统计学意义(P>0.05);乳腺癌组与增生病组比较,其BF、BV及PS的差异均有统计学意义(P<0.05),MTT的差异无统计学意义(P>0.05);增生病组与纤维腺瘤组比较,其BF、BV、MTT及PS的差异均无统计学意义(P>0.05).正常组与乳腺癌组分别呈低灌注、高灌注状态,纤维腺瘤组及增生病组均呈较高灌注状态.[结论]64层螺旋CT作为先进的影像检查技术,其灌注成像能从血流动力学和影像学角度为各类乳腺疾病的进行较为准确的诊断.%[Objective] To study and evaluate multi-slice spiral CT perfusion imaging in the diagnosis of breast diseases the effect and value. [Methods] 61 patients through clinical examination or mammography of women with suspected breast disease patients with 64-slice spiral CT perfusion imaging. The pathology types were divided into three groups: hyperplasia group (n = 14), fibroadenoma group (n - 19) and breast cancer group (n = 20), and conlralaterai

  9. 低剂量对比剂在64排螺旋CT主动脉成像中的探讨%Exploration on the use of low dose contrast medium in 64-slice CT imaging of the aorta

    Institute of Scientific and Technical Information of China (English)

    付传明; 徐官珍; 陈伦刚; 徐霖; 龚晓虹; 邹建华; 陈杰

    2011-01-01

    Objective The aim of this study was to explore the effect of different dosees of contrast medium ( CM ) according to different weight indexes in 64-slice CT imaging of the thoraco - abdominal aorta.Methods 40 suspicious patients for aortic disorders were divided into two groups. In the group A, 20 patients with body weight > 60 kg were injected 60 ml contrast medium and 40 ml physiological saline.In the group B, 20 patients with body weight ≤ 60 kg were injected contrast medium in a dose of 1 ml/kg and an appropriate amount of physiological saline. Both groups were injected at the same speed and CM concentration. The body weight, height, blood pressure and heart rate were measured before CT scanning, and the patients received real -time monitoring and triggering scan to measure the CT values and diameters of the aortic intersecting surface at the levels of ascendening aorta, descendening aorta (T7,L2), and aoric bifurcation. Two experienced senior imaging diagnostic doctors evaluated the CT images,and the measured data were statistically analyzed. Results the mean CT values of ascending aorta, thoracic aorta (T7), lumbar aorta (L2) and aortic bifurcation were 331.10 Hu, 342.52 Hu, 308.71 Hu,299.75 Hu and 337. 10 Hu, 325.59 Hu, 322.06 Hu, 308.34 Hu, respectively. The mean diameter ofthe aorta at the four levels were 37.40 mm, 25.12 mm, 17.91 mm, 15.50 mm and 35.20 mm, 23.08 mm,12. 37 mm, 11.80 mm, respectively. The body weights were 72.50 kg and 49.50 kg, the heights were 175.70 cm and 150.50 cm, the systolic blood pressure were 130/78 mmHg and 124/78 mmHg, the heart rates were 76.5 beat/min and 74.6 beat/min, respectively. The intensified CT values of the two groups were not significantly different ( P > 0.05 ), the clarity of the recombined blood vessel branches were not significantly different. The mean diameters of different aortic segments were significantly different ( P < 0.05 ). The body weights and heights were significantly different ( P < 0

  10. 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

    Energy Technology Data Exchange (ETDEWEB)

    Brodoefel, H. [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)], E-mail: h.brodoefel@t-online.de; Reimann, A. [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Burgstahler, C. [Department of Cardiology, Eberhard-Karls-University, Otfried-Mueller-Str. 10, 72076 Tuebingen (Germany); Schumacher, F. [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Herberts, T. [Department of Medical Biometry, Westbahnhofstr. 55, 72070 Tuebingen (Germany); Tsiflikas, I. [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Schroeder, S. [Department of Cardiology, Eberhard-Karls-University, Otfried-Mueller-Str. 10, 72076 Tuebingen (Germany); Claussen, C.D.; Kopp, A.F.; Heuschmid, M. [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)

    2008-04-15

    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.

  11. Congenital Left Circumflex Coronary Artery Atresia Detected by 64-Slice Computed Tomography: A Case Report

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Liu

    2007-06-01

    Full Text Available A variety of coronary artery disorders, including intramyocardial coronary segments and coronary artery anomalies, can result in sudden cardiac death, especially in young adults. The detection of structural coronary artery abnormalities is important in the management of patients at risk of sudden cardiac death. Coronary artery anomalies occur in about 1% of the population. Congenital absence of left circumflex coronary artery (LCX is a very rare vascular anomaly, and few cases have been reported in the literature, with a frequency of only 0.003% in all patients who underwent coronary angiography. Although coronary catheterization is the gold standard for the evaluation of coronary arterial patency disease, noninvasive computed tomography (CT is considered the diagnostic method of choice for the detection and evaluation of coronary artery anomaly. Herein, we report the case of a 17-year-old girl who presented with exertional dyspnea and chest pain and who was studied at our emergency department with the final diagnosis of LCX atresia detected by 64-slice CT. She may be the first case of congenital LCX atresia proved by multislice CT.

  12. 64层螺旋CT腹部扫描参数优化的个体化选择%Optimization of individualized abdominal scan protocol with 64-slice CT scanner

    Institute of Scientific and Technical Information of China (English)

    胡敏霞; 赵心明; 宋俊峰; 周纯武

    2012-01-01

    目的 探讨64层螺旋CT腹部扫描参数优化的个体化选择.方法 回顾性分析2010年9月至11月期间,3个月内因临床诊断或治疗需要行2次腹部CT平扫检查的连续患者100例资料.首次检查采用管电流274有效mAs(eff.mAs),第2次检查采用207 eff.mAs,分析评价2次检查的图像质量.记录受检者身高、体质量、体质量指数(BMI)、上腹部最大横径、上腹部前后径、上腹部平均最大径.3名阅片者对腹主动脉、门静脉主干、肝脏、脾脏、胆囊、胰腺、肾皮质、肾髓质等8个主要器官进行图像主观噪声评价,对肝门、胰腺、肾上极3个主要层面进行诊断接受率评价.采用散点图及Pearson相关分析显示各指标与腹主动脉噪声值(SD值)的线性关系,通过多因素线性回归分析评价各指标与腹主动脉SD值的相关性,利用最相关的指标指导腹部CT个性化参数扫描.结果 100例受试者体质量为(64.3±11.0) kg,BMI为(23.7±3.3)kg/m2,上腹最大横径为(29.8±2.3)cm,上腹前后径为(23.1±2.9)cm,上腹平均最大径为(26.5±2.5)cm,分别与主动脉SD值(11.7±3.0)呈中度或高度相关(r值分别为0.744、0.689、0.813、0.781、0.789,P值均<0.01),身高为(164.6±7.5)cm,与主动脉SD值基本不相关(r=0.292,P<0.01).上腹部最大横径与肝门层面腹主动脉SD值最相关且两者的线性关系具有统计学意义(Beta=0.487,P<0.01).上腹最大横径在27~32 cm范围内其肝门层面诊断接受率评价与上腹最大横径<27 cm或者>32 cm差异具有统计学意义(P值均<0.05).结论 管电流207 eff.mAs适用于上腹最大横径在27~32 cm范围内的受检者.%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

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

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Kozawa, Eito; Nishi, Naoko; Mizukoshi, Waka; Inoue, Kaiji; Nakajima, Reiko; Takahashi, Masahiro [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2013-01-15

    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.)

  14. Heart rate recovery after exercise and coronary atheroma in asymptomatic individuals with type 2 diabetes mellitus: a study using 64-slice coronary CT angiography.

    Science.gov (United States)

    Halon, David A; Dobrecky-Mery, Idit; Gaspar, Tamar; Azencot, Mali; Yaniv, Nisan; Peled, Nathan; Lewis, Basil S

    2010-11-05

    Impaired heart rate recovery after exercise (HRR) is a marker of autonomic dysfunction and a predictor of long-term mortality either directly or due to associated cardiovascular disease. In a cohort of 552 asymptomatic type 2 diabetics (age 63.2 ± 5.4 yr, 54.9% women) participating in a long-term prospective outcomes study, we examined the hypothesis that cardiac autonomic dysfunction, as demonstrated by HRR in the first minute after exercise, is an independent correlate of multivessel coronary artery atheroma. HRR1 was reduced in patients with any coronary plaque (p = 0.012), multivessel coronary plaque (p = 0.006), and coronary stenosis (p = 0.027). However, the association was not independent of the United Kingdom Prospective Diabetes Study risk score thus it appears to be related to the adverse risk profile of these patients.

  15. Coronary CT angiography and MR angiography of Kawasaki disease

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, 388-1 Poongnap-2dong, Songpa-gu, Seoul (Korea); Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee [University of Ulsan College of Medicine, Department of Paediatric Cardiology, Asan Medical Center, Seoul (Korea)

    2006-07-15

    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.)

  16. [Comparative assessment of ct-bypass angiography and invasive coronary angiography in patients after coronary bypass surgery in the late postoperative period].

    Science.gov (United States)

    Men'kov, I A; Trufanov, G E; Zhelezniak, I S; Rud', S D; Kniazev, E A

    2013-10-01

    The aim of the study was to evaluate the diagnostic accuracy of ct-bypass angiography in the evaluation of significant stenosis and occlusion of grafts, recipient and nongrafted vessels in patients after coronary bypass surgery in the late postoperative period. Ct-bypass angiography was performed on 64-slice ct scanner with a slice thickness of 0.5 mm and a gantry rotation time of 0.4 s. All results were compared with quantitative invasive coronary angiography. 43 patients with 113 grafts were included in the study. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy for the evaluation of significant stenosis were 94%, 95%, 88%, 98%, 95%, respectively. Diagnostic accuracy for the evaluation of significant stenosis in the recipient and nongrafted vessels were 91% and 90%, respectively. The diagnostic accuracy for the evaluation graft occlusion, recipient and nongrafted vessels was 100%, 100% and 98%, respectively. Ct-bypass angiography allows accurate non-invasive assessment of significant stenosis and occlusion of coronary bypass grafts and native coronary arteries in patients after coronary bypass surgery in the late postoperative period.

  17. The Analysis of Blood Flow Dynamics About 64-slice Spiral CT Perfusion Imaging for Primary Liver Cancer%原发性肝癌患者64层螺旋CT灌注成像血流动力学分析

    Institute of Scientific and Technical Information of China (English)

    孙建华

    2015-01-01

    目的:探讨原发性肝癌患者64层螺旋CT灌注成像血流动力学的表现。方法收集2012年8月~2013年7月来我院就诊的确诊为原发性肝癌的患者46例并将其作为观察组,选取2012年8月~2013年7月来我院进行健康体检的健康对象46例并将其作为对照组,血液流动力学表现采用64层螺旋CT灌注成像观察,检测并比较两组患者肝动脉灌注量、肝门静脉灌注量、总肝灌注量、肝动脉灌注指数。结果观察组肝动脉灌注量、肝动脉灌注指数高于对照组,肝门静脉灌注量、总肝灌注量低于对照组,两组差异有统计学意义(P<0.05)。结论原发性肝癌患者采用64层螺旋CT灌注成像诊断血液流动力学表现较为显著,具有较高的诊断价值。%Objective To Einvestigate the blood flow dynamics about 64-slice spiral CT perfusion imaging for primary liver cancer. Methods 46 patients with primary liver cancer diagnosed in our hospital were collected from August 2012 to July 2013 and taken as the observation group, 46 cases of health object for physical examination in our hospital were selected at the same time as the control group, observed the blood lfow dynamics performance used by 64-slice spiral CT perfusion imaging, the two groups were measured and compared about hepatic arterial perfusion, hepatic portal vein perfusion, total liver perfusion, hepatic perfusion index. Results Hepatic arterial perfusion, hepatic perfusion index of observation group were higher, the hepatic portal vein perfusion, total hepatic perfusion were lower than the control group, the difference was statistically significant (P<0.05). Conclusions Primary liver cancer patients use 64-slice spiral CT perfusion imaging in the diagnosis of blood lfow dynamics performance is more signiifcant, with high diagnostic value.

  18. CT angiography - abdomen and pelvis

    Science.gov (United States)

    Computed tomography angiography - abdomen and pelvis; CTA - abdomen and pelvis; Renal artery - CTA; Aortic - CTA; Mesenteric CTA ... belly or pelvis Masses and tumors in the abdomen or pelvis, including cancer, when needed to help ...

  19. Diagnostic value of 64-slice spiral CT on fatty liver combining with nodular diseases of the liver%64排螺旋CT在脂肪肝合并肝脏结节性疾病中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张志强; 李孟云

    2015-01-01

    Objective To evaluate the diagnostic value of 64-slice spiral computed tomography (CT) on fatty liver combining with nodular diseases of the liver. Methods From January 2013 to August 2014,78 patients suffered from fatty liver with nodular diseases of the liver who were visited our hospital for treatment were selected as research ob-jects.All patients were performed with conventional ultrasound and 64-slice spiral CT examination.The images were read by two senior radiological doctors,which were compared and analyzed by pathological outcomes by percutaneous liver puncture biopsy guided by surgery or ultrasound.The sensitivity,specificity,positive predictive value,negative pre-dictive value and accuracy of conventional ultrasound and 64-slice spiral CT were compared. Results Among 78 pa-tients,there were 86 foci,of which 27 cases were in benign accounting for 34.62% (32 foci for 37.21%) and the rest 51 cases belonged to malignant lesions accounting for 65.38% (54 foci for 62.79%).The sensitivity,specificity,positive pre-dictive value,negative predictive value and accuracy of conventional ultrasound on fatty liver combining with nodular diseases of the liver was 76.5%,59.3%,78.0%,57.1%,70.5%,respectively,and the rates by 64-slice spiral CT was 92.2%, 92.6%,95.9%,86.2%,and 92.3% accordingly.The indexes examined by 64-slice spiral CT were much higher than those by conventional ultrasound (P<0.05 or P<0.01). Conclusion Application of 64-slice spiral CT obtains a higher sensitiv-ity,specificity,and accuracy on treating fatty liver combining with nodular diseases of the liver,which is worthy of expan-sion in clinic.%目的:探讨64排螺旋CT在脂肪肝合并肝脏结节性疾病诊断中的价值。方法选取2013年1月~2014年8月因脂肪肝合并肝脏结节性疾病在本院就诊的78例患者为研究对象。所有病例均行常规超声和64排螺旋CT检查,由2名高年资影像科医生阅片,与外科手术或者超声引导下的经皮肝脏穿刺

  20. 螺旋64排 CT 灌注成像对局灶结节性良恶性增生的鉴别诊断价值%The identification effect of HCC and hepatic focal nodular hyperplasia of 64-slice spiral CT

    Institute of Scientific and Technical Information of China (English)

    耿欣; 肖世骞; 曹毅; 李健; 周鑫

    2015-01-01

    目的:探讨常规超声(US)检查与64层螺旋 CT(CT)检查在肝癌及肝脏局灶性结节增生临床诊断中应用价值。方法2013年1月至2015年1月对84例经肝细胞穿刺活检或术后病理组织检查确诊为肝脏局灶性病灶分别行 US 检查及 CT 检查,分析两种诊断方法准确率,病灶大小数目及患者在 US 及 CT 中的影像学特征。结果US 在诊断肝脏良性病变中的符合率与 CT 相当(P >0.05),而在肝癌诊断中 CT 组诊断准确率显著高于 US 组(P <0.05)。CT 组在直径≤1cm 微小肿瘤诊断中的符合率大于 US 组(P <0.05)。与肝炎型假瘤、肝局灶性增生结节、肝血管瘤患者相比,原发性肝癌、转移性肝癌患者 CT 始消时间及持续时间更长(P <0.05)。结论与 US 相比,CT 对肝癌的诊断率更加准确,更尽早分辨出恶性病灶及微小病灶。且不同性质的肝脏局灶性病灶在 CT 中表现出不同的增强方式,能有效鉴别不同种类的肝脏局灶性病灶。%Objective To investigate the examination application value of hepatic focal nodular hyperplasia of routine ultrasound (US)examination and 64-slice CT (CT)of liver cancer and clinical diagnostics.Methods 84 patients with liver cell or a pathological tissue biopsy diagnosed as focal liver lesions were underwented with US examination and CT examination from June 2013 to June 2015.The diagnostic methods,focus the size and number of patients in the US and imaging features of CT of two groups were analyzed.Results The benign liver lesions fairly consistent rate of US and CT were no different(P > 0.05),while the HCC diagnosis diagnostic accuracy of CT group was significantly higher than the US group(P <0.05).The rate in tumor diagnosis≤ 1cm small diameter of CT Group was greater than US group (P <0.05).Hepatitis type pseudotumor,liver focal nodular hyperplasia,hepatic hemangioma compared with pa-tients with primary liver

  1. Post-mortem CT-coronary angiography

    DEFF Research Database (Denmark)

    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...

  2. Value of 64-slice spiral CT perfusion imaging in estimating the efficacy of transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma%64排螺旋CT灌注成像在肝细胞癌介入治疗前后的评估价值

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Objective To discuss the clinical value of 64-slice spiral CT perfusion imaging(CTPI) in estimating the efficacy of transcatheter arterial chemoembolization ( TACE ) for hepatocellular carcinoma (HCC).Methods Using 64-slice spiral CT(GE LightSpeed VCT XT),all CT plain scan and perfusion scan were performed in 30 patients with HCC 1-3 days before and 30-40 days after TACE .Using deconvolution through Infusion Software analysis , hepatic blood flow ( BF ) , blood volume ( BV ) , the mean transit time ( MTT) , hepatic arterial fraction ( HAF ) , permeability surface ( PS ) were caculated to evaluate HCC embolization hemodynamic status .Results After TACE,the tumor was totally filled with lipiodol in 12 cases and partially filled with lipiodol in 18 cases.BF,BV,MTT,HAF and PS perfusion maps showed that lack of blood perfusion was found in lipiodol-filling areas, but sparsely or insufficiently lipiodol-filled areas were hyperperfusion.BF,BV,HAF and PS of HCC after TACE were lower than those of HCC before TACE (P0.05 ) .Conclusions 64-slice spiral CT liver perfusion imaging can be used to monitor the blood supply changes in non -iodized oil deposits area non-invasively ,dynamically ,quantitatively ,which was very important in judging the tumor tissue survival and played an important role in response evaluation of HCC interventional therapy and guiding the follow -up treatment.%目的:探讨64排螺旋CT灌注成像(CTPI)在原发性肝细胞癌(HCC)肝动脉插管化疗栓塞( TACE )术前、后疗效的评估价值。方法选取30例HCC 患者,于TACE术前1~3 d、术后30~40 d应用GE LightSpeed VCT XT(64排128层螺旋CT)分别行全肝常规平扫及灌注扫描,运用灌注软件进行分析,计算肝血流量(BF)、血容量(BV)、平均通过时间(MTT)、肝动脉灌注指数(HAF)、毛细血管通透性( PS )等,统计分析相关参数,以评价 HCC 介入治疗前后的血流动力学状态。结果 TACE

  3. Coronary CT angiography in coronary artery disease: Opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Zhonghua Sun

    2016-06-01

    Full Text Available Coronary CT angiography is widely recognised as a reliable imaging modality for the diagnosis of coronary artery disease. Coronary CT angiography not only provides excellent visualisation of anatomical changes in the coronary artery with high diagnostic value in the detection of lumen stenosis or occlusion, but also offers quantitative characterisation of coronary plaque components. Furthermore, coronary CT angiography allows myocardial perfusion imaging with diagnostic value comparable to the reference standard method. Coronary CT angiography-derived haemodynamic analysis has the potential to evaluate functional significance of coronary lesions. This review article aims to provide an overview of clinical applications of coronary CT angiography in coronary artery disease.

  4. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Prevalence of clinically important posterior fossa emissary veins on CT angiography

    Directory of Open Access Journals (Sweden)

    Yeliz Pekcevik

    2014-01-01

    Full Text Available Purpose: We assessed the prevalence of the clinically important posterior fossa emissary veins detected on computed tomography (CT angiography. Materials and Methods: A total of 182 consecutive patients who underwent 64-slice CT angiography were retrospectively reviewed to determine the clinically important posterior fossa emissary veins. Results: Of 166 patients, the mastoid emissary vein (MEV was not identified in 37 (22.3% patients. It was found bilaterally in 82 (49.4% and unilaterally in 47 (28.3% patients. Only six patients had more than one MEV that were very small (5 mm veins. The posterior condylar vein (PCV was not identified in 39 (23.5% patients. It was found bilaterally in 97 (58.4% and unilaterally in 30 (18.1% patients. Only 15 patients had a very large (>5 mm PCV. The petrosquamosal sinus (PSS was identified only in one patient (0.6% on the left side. The occipital sinus was found in two patients (1.2%. Conclusions: The presence of the clinically important posterior fossa emissary veins is not rare. Posterior fossa emissary veins should be identified and systematically reported, especially prior to surgeries involving the posterior fossa and mastoid region.

  6. Low-dose Imaging Technology and Its Application under New 64-Slice CT Generation%后64排CT时代的低剂量成像技术和应用现状

    Institute of Scientific and Technical Information of China (English)

    陈星; 张唯唯; 张华

    2013-01-01

    To keep radiation dose as low as reasonably low remains the most important and challenging strategy for the potential risk of cancer induction from CT scan. This paper reviews the latest techniques to effectively reduce the radiation dose and discuss the low dose management strategy for routine clinical applications.%维持CT扫描过程中的放射剂量在一个合理的低范围,从而减少致癌因素,是目前最重要和最具挑战性的课题.本文重点介绍了最新有效降低放射剂量的技术,以及讨论日常临床应用中有效低放射剂量的管理策略.

  7. 进展期非小细胞肺癌的首过法CT灌注可重复性研究%Advanced NSCLC First Pass Perfusion at 64-slice CT: Reproducibility of Volume-based Quantitative Measurement

    Institute of Scientific and Technical Information of China (English)

    单飞; 张志勇; 曾蒙苏; 胡洁; 白春学

    2010-01-01

    背景与目的 本研究旨在探讨进展期非小细胞肺癌(non-small cell lung cancer, NSCLC)首过法CT灌注(CT perfusion, CTP)的可重复性.方法 在本院行首过法CTP检查(8×5 mm层厚),且经病理证实的进展期NSCLC患者14例,肿瘤最大径≤3 cm及>3 cm各7例,均在24 h内行第二次CTP扫描.采用组内相关系数(intraclass correlationcoefficient, ICC)及Bland-Altman法评价CTP检查的可重复性.结果 两组进展期NSCLC的血流速度(blood flow, BF)、血容量(blood volume, BV)及表面通透性(permeability surface area product, PS)值的ICC均>0.75;对比剂的平均通过时间(mean transit time, MTT)的ICC均3 cm组的BF、BV、MTT及PS的RC及RC值95%变化区间依次为46%(-48%-45%)、30%(-33%-26%)、-59%(-54%-64%)、33%(-18%-48%).结论 去卷积法首过法CTP参数BF及BV可重复性较好,用于评价进展期NSCLC抗血管生成治疗疗效时,可根据肿瘤大小,应用不同的可重复性标准区别对待.

  8. Cardiac CT Angiography in Congestive Heart Failure.

    Science.gov (United States)

    Levine, Avi; Hecht, Harvey S

    2015-06-01

    Cardiac CT angiography has become an important tool for the diagnosis and treatment of congestive heart failure. Differentiation of ischemic from nonischemic cardiomyopathy; evaluation of myocardial perfusion; characterization of hypertrophic cardiomyopathy, left ventricular noncompaction, and arrhythmogenic right ventricular dysplasia; and delineation of congenital heart defects and valvular abnormalities are the primary diagnostic applications. Therapeutic use includes visualization of the coronary venous anatomy for optimal implementation of cardiac resynchronization therapy and evaluation of left ventricular assist devices and transplant vasculopathy.

  9. 64排螺旋CT功能成像技术在兔急性肾损伤诊断中的价值%Value of 64-slice spiral CT functional imaging techniques for diagnosis of acute kidney injury in rabbits

    Institute of Scientific and Technical Information of China (English)

    赵效新; 王新宇; 王文红; 李亚军; 孙浩然; 孟祥鹿; 顾程

    2016-01-01

    Objective To quantitatively assess renal hemodynamic changes in hypertensive acute kidney injury in rabbits induced by L-NAME using 64-slice spiral CT functional imaging techniques,and to explore the application of these techniques in evaluation of early kidney functional changes.Methods Fourteen female New Zealand white rabbits were randomly divided into normal control group (n=6)and L-NAME group (n=8).The control group was injected NaCl solution and the L-NAME group was injected the same amount of L-NAME solution to make hypertensive acute kidney injury model.64-slice spiral CT and SPECT were scanned af-ter injection.Blood samples were collected before and after injecting NaCl and L-NAME solution to detect serum creatinine (Cr).Cr level and CT perfusion parameters of the two groups were analyzed and compared with the pathology results.GFRCT detected by con-trast-enhanced CT and GFRSPECT detected by SPECT were analyzed by the rank correlation test.Results Renal blood volume,blood flow,permeability surface,time to peak,and peak value had statistically significant differences between the control and L-NAME group (P <0.05).GFRCT and GFRSPECT had obvious correlation.GFRCT of L-NAME group was obviously lower than that of the con-trol group.The kidneys of L-NAME group showed obviously injured under both light microscope and microscope.Conclusion 64-slice spiral CT functional imaging techniques can dynamically observe and quantitatively assess early hypertensive kidney dysfunc-tion,especially unilateral renal blood flow abnormalities.It is an effective examination in quantitatively assessing kidney function.%目的:利用64排螺旋 CT 功能成像技术定量分析 N-硝基-L-精氨酸甲酯(L-NAME)致兔高血压急性肾损伤后肾血流动力学变化,探讨该技术在评估早期肾功能损伤中的应用价值。方法将14只雌性新西兰大白兔随机分成正常对照组(n=6)和 L-NAME 组(n=8)。对照组注入氯化钠(NaCl)溶液,L-NAME

  10. Spiral CT angiography of renal arteries: comparison with angiography

    Energy Technology Data Exchange (ETDEWEB)

    Wittenberg, G.; Kenn, W.; Tschammler, A.; Sandstede, J.; Hahn, D. [Inst. fuer Roentgendiagnostik der Universitaet Wuerzburg (Germany)

    1999-04-01

    A prospective study was carried out to determine the accuracy of spiral CT angiography (CTA) in the detection of renal artery stenosis (RAS). Eighty-two patients with arterial hypertension underwent CTA and digital subtraction angiography (DSA) to exclude RAS. For CTA a contrast medium bolus of 100-150 ml (flow rate 3 ml/s) was injected. A 24 or 40 s CTA was started at the origin of the superior mesenteric artery after a delay time determined by test bolus injection (collimation = 2 mm, pitch = 1/1.5). For stenosis detection transverse images supported by maximum intensity projections (MIP) or multiplanar reconstruction projections were used. Of 197 renal arteries examined (including 33 accessory arteries), 34 RAS were visualized using DSA. With CTA, one hemodynamic RAS was missed and one additional hemodynamic RAS was found. Sensitivity/specificity was calculated to be 94 %/98 %. For hemodynamically relevant RAS (> 50 %) the sensitivity/specificity was 96 %/99 %. CTA additionally depicted five adrenal masses. The high accuracy rate of RAS detection thus allows the use of CTA as a screening method in patients with arterial hypertension to exclude a renovascular cause. (orig.) With 2 figs., 1 tab., 25 refs.

  11. Using the 64-slice Perfusion CT to Evaluate the Oxygen Tension(pO2) in the Rabbit VX2 Tumor Model: An Experimental Study%64层灌注CT评价兔VX2体部肿瘤模型氧分压的实验研究

    Institute of Scientific and Technical Information of China (English)

    孙昌进; 肖明勇; 阴俊; 于金明; 郞锦义; 王光辉; 李超; 李涛; 罗云秀; 吕海波; 张德康; 李彦; 黄建鸣

    2013-01-01

    Objective: To investigate the role of the 64-slice perfusion CT in the evaluation of the oxygen tension ( pO2 ) in the rabbit VX2 tumor model. Methods: Forty-five rabbit VX2 brain tumor model established successfully were examined with 64-detector row CT. Tumor specimens were assessed for the oxygen tension ( pO2 ) , perfusion, blood volume ( BV) , peak enhancement intensity ( PEI) and time to peak (TTP) , and Pearson correlation coefficients were conducted to represent the relationships between the perfusion parameters and pO2 of the tumor. pO2was measured by oxygen-sensitive electrodes guided by perfusion CT images. Results: Mean values for perfusion,BV,PEI, TTP and pO2 of the 45 tumors were 27. 102 ± 26. 723ml/min, 22. 1 96 ± 13. 680ml/100g,43. 456 ±28.73 HU, 38.823 ±14.759 sec,and 15.981 ± 14.815mmHg, respectively. BV,PEI, TTP were not significant correlated with pO2 (r =0.271, 0. 253 、- 0. 18 , P > 0. 05 ) , whereas positively correlation was found between perfusion with pO2 ( r = 0. 673, P = 0. 00 ). Conclusion: The perfusion value from 64-slice spiral CT perfusion imaging might to have ability to evaluate the tumor pO2%目的:利用64层灌注CT评价兔VX2肿瘤模型氧分压并与氧微电极法对照.方法:对45只成功建模兔VX2脑瘤模型行灌注CT检查.测量脑瘤兴趣区灌注值(perfusion)、血容量(blood volume,BV)、达峰时间(time to peak TTP)、最大峰值(peak enhancement intensity,PEI).结果与该兴趣区氧微电极法测得氧分压(PO2)对照.结果:45例成功建模兔VX2脑瘤兴趣区灌注值范围为1.3 ml/min~127.0 ml/min,平均为27.102 ml/min±26.723 ml/min;BV为1.2 ml/100g~53.1ml/100g,平均为22.196 ml/100g±13.680ml/100g,PEI为8.7 HU~124.6HU,平均为43.456 HU±28.73 HU; TTP为8.2 sec~62.5 sec,平均为38.823 sec±14.759 sec;对应区域PO2为0.14 mmHg~46.70mmHg,平均为15.981 mmHg±14.815mmHg.灌注值与对应区域PO2相关系数为0.673,有统计学意义(P=0.00).BV

  12. Application of 64-slice CT for Dental Panoramic Imaging in Orthodontic Treatment of Maxillary and Mandibular Embedded Teeth%64层螺旋CT全景齿科成像技术在上、下颌骨埋伏牙矫形中的应用

    Institute of Scientific and Technical Information of China (English)

    邓海平; 曹军; 李建胜

    2011-01-01

    Objective To explore the clinical value of 64-slice CT for dental panoramic imaging technology in orthodontic treatment of maxillary and mandibular embedded teeth. Methods Fifty patients with maxillary and mandibular embedded teeth underwent 64-slice spiral CT examination. By using Dentascan soft ware, multi-planar reconstruction (MPR), curved planar reconstruction (CPR), maximum intensity projection (MIP), volume rendering (VR) and shaded surface display (SSD) reconstruction, tooth section was observed from different angles and 3-D images were obtained to determine the shape of embedded teeth, labial side and palatine side location,the position of reconstruction window, eruption direction, incision direction, and their relationship with adjacent teeth. Results Among the 65 maxillary and mandibular embedded teeth of 50 patients, 38 impacted teeth were found in 38 patients and 27 embedded supernumerary teeth in 12 patients. Three-dimensional reconstruction of spiral CT images could accurately show the number of maxillary and mandibular embedded teeth,the shape of crowns and roots,labial side and palatine side location,eruption direction,and their anatomical relationship with adjacent teeth. Conclusion Multislice spiral CT for dental panoramic imaging technology is of great significance in di-agnosis of embedded teeth and can be clinically used as an effective examination for surgical treatment and orthodontic therapy of embedded teeth.%目的 探讨64层螺旋CT全景齿科成像技术在上、下颌骨埋伏牙矫形中的临床应用价值.方法 对50例上、下颌骨埋伏牙患者均行64层螺旋CT检查,并用Dentascan软件包及多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现(VR)及表面遮盖成像(SSD)重建图像,从不同的角度观察牙体断面及三维立体图像,从而获得埋伏牙的牙体形态、唇腭侧位置、开窗的位置、萌出方向、切口方向及与其邻牙关系.结果 50例患者中,

  13. Assessment of anemia during CT pulmonary angiography

    Energy Technology Data Exchange (ETDEWEB)

    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.

  14. Evaluation of coronal artery stent with 64-slice MDCT high definition scan mode: a comparison with conventional 64-slice MDCT%64层CT高清模式扫描对冠状动脉支架的评估价值——与传统64层CT的对照研究

    Institute of Scientific and Technical Information of China (English)

    郭小超; 邱建星; 蒋学祥; 王霄英

    2013-01-01

    Objective:To evaluate the improvement of display capability of coronary artery stent on High Definition CT (HDCT) with HI RES scan mode compared with conventional 64 slice CT. Methods: Thirty six patients (from Oct. 2010 to Dec. 2010) underwent coronary CT angiography using conventional 64 slice CT and 23 patients (from Mar. 2011 to Apr 2011) using HDCT (Discovery CT750 HD) were recruited in this study. All the patients had prior coronary stenting (73 stents for 64 slice CT;41 stents for HDCT). Seven patients of 23 (15 stents) had previous coronary artery imaging with conventional 64 slice CT. The image quality of stents was analyzed in three grades. All the images were interpreted in dependently by two experienced radiologists. Image quality,measured diameter of the stents were recorded for statistics. Im age noise and radiation dose of two CT scans were also analyzed. Results:Compared with the conventional CT,the ratios of grade 1 stent images and accessable images were higher using HDCT. The average measured diameter of stents was higher (19.9%) by using HDCT than by conventional 64 slice CT 0 = 4. 405 ,P = 0. 001). There was significant difference in ima ging quality of stents between the two CT scans (Z=-2. 830,P = 0. 005). The image noise and CTDIvol had no significant difference between the two CT scans (P>0. 05). The mean effective dose of HDCT and conventional 64 slice CT were 10. 54mSv and 13. 27mSv respectively (P = 0. 016). Conclusion:Compared with the conventional 64 slice CT,HDCT coro nary angiography with HI RES scan mode can improve the image quality of coronary stents and display the in stent lumen well with lower radiation dose.%目的:通过与传统64层CT比较,评价64层CT高清采集模式显示冠状动脉支架的价值.方法:回顾性搜集2010年10月-2010年12月于我院接受传统64层螺旋CT冠状动脉成像检查的冠状动脉支架置入术后患者36例(共73枚支架),以及2011年3月-2011年4月接受64层CT高清模式

  15. Tracheobronchial tumor:evaluation by using 64-slice spiral CT with multiplanar and three-dimensional reconstructions%64层螺旋CT三维重建在气管主支气管肿瘤诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    张蕴; 荐志洁; 赵婷婷; 石志红; 朱柏

    2012-01-01

    Objective To evaluate the roles of 64-slice spiral CT with multiplanar and three-dimensional reconstructions in the di-agnosis of tracheobronchial tumor. Methods 39 cases were undergone CT scan for chest using TOSHIBA Aquilion 64 or PHILIPS Brilliance 64 system. The post-processing techniques included volume rendering (VR), virtual bronchoscopy( VB) , multiplanar re-construction (MPR) , minimum intensity projection(MinIP) in Vitrea 2 workstation. The CT manifestations were analyzed, and compared with the results of the operation and bronchoscopy. Results The tumor located in trachea in 9 cases, right main bronchus in 15 cases, left main bronchus in 13 cases. The tumors were in large airway widely in 2 cases. All of cases showed the filling defect in airway. The degree of lumen stenosis was the first grade in 1 case, the second grade in 0 case, the third grade in 14 cases, the forth grade in 24 cases. The thickening of the walls of the trachea or bronchus in 14 cases, both thickening of the walls and extralu-minal extensions in 23 cases, there was not any thickening of the walls in 2 cases. The edge of the tumor showed smooth in 2 cases, irregular in 37 cases. Benign tumor was in 3 cases, including benign mesenchymoma, leiomyoma, and pleomorphic adenoma in 1 case,respectively. Malignant tumor was in 36 cases, including small cell carcinoma in 8 cases, adenocarcinoma in 1 case, squamous cell carcinoma in 25 cases, mucoepidermoid carcinoma in 1 case, papillary thyroid cancer in 1 case. The diagnostic accuracy was 97. 44% using of 64-slice spiral CT with multiplanar and three-dimensional reconstructions. Conclusion 64-slice spiral CT with multiplanar and three-dimensional reconstructions is a valuable method in the diagnosis and the differential diagnosis of the tracheobronchial benign and malignant tumors, stent planning and follow-up.%目的 探讨64层螺旋CT三维重建在气管、主支气管肿瘤诊断中的应用价值.方法 39例均接受64层螺旋CT胸部

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

    Energy Technology Data Exchange (ETDEWEB)

    Peng Yun [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China)], E-mail: ppengyun@yahoo.com; Zeng Jinjin [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China); Du Zhongdong [Pediatric Cardiovascular Department, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China); Sun Guoqiang [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China); Guo Huling [Pediatric Cardiovascular Department, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China)

    2009-03-15

    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.

  17. Multislice CT angiography of interrupted aortic arch

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Dong Hyun; Goo, Hyun Woo [Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Seo, Dong-Man; Yun, Tae-Jin; Park, Jeong-Jun [Asan Medical Center, University of Ulsan College of Medicine, Department of Paediatric Cardiac Surgery, Seoul (Korea); Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee [Asan Medical Center, University of Ulsan College of Medicine, Department of Paediatric Cardiology, Seoul (Korea)

    2008-01-15

    Interrupted aortic arch (IAA) is defined as complete luminal and anatomic discontinuity between the ascending and descending aorta. Because almost all patients with IAA become critically ill during the neonatal period, they should undergo urgent corrective surgery. This clinical urgency necessitates a fast and accurate noninvasive diagnostic method. Although echocardiography remains the primary imaging tool for this purpose, it is not always sufficient for planning surgical correction of IAA, principally due to a limited acoustic window and the inexperience of imagers. In this context, multislice CT angiography is regarded as an appropriate imaging technique complementary to echocardiography because it is fast, accurate, and objective for the diagnosis of IAA. In this article we describe what cardiac radiologists should know about IAA in their clinical practice, including clinicopathological features, CT features with contemporary surgical methods and postoperative complications, and differentiation from coarctation of the aorta and aortic arch atresia. (orig.)

  18. Can segmented 3D images be used for stenosis evaluation in coronary CT angiography?

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Chunliang [Linkoeping Univ., Center for Medical Image Science and Visualization, Linkoeping (Sweden); Linkoeping Univ., Div. of Radiological Sciences, Linkoeping (Sweden)], e-mail: chunliang.wang@liu.se; Persson, Anders; De Geer, Jakob; Smedby, Oerjan [Linkoeping Univ., Center for Medical Image Science and Visualization, Linkoeping (Sweden); Linkoeping Univ., Div. of Radiological Sciences, Linkoeping (Sweden); Linkoeping Univ. Hospital, Dept. of Radiology, Linkoeping (Sweden); Engvall, Jan [Linkoeping Univ., Center for Medical Image Science and Visualization, Linkoeping (Sweden); Linkoeping Univ. Hospital, Dept. of Clinical Physiology, Linkoeping (Sweden); Czekierda, Waldemar; Bjoerkholm, Anders [Linkoeping Univ. Hospital, Dept. of Radiology, Linkoeping (Sweden); Fransson, Sven-Goeran [Linkoeping Univ., Div. of Radiological Sciences, Linkoeping (Sweden); Linkoeping Univ. Hospital, Dept. of Radiology, Linkoeping (Sweden)

    2012-10-15

    Background Thanks to the development of computed tomography (CT) scanners and computer software, accurate coronary artery segmentation can be achieved with minimum user interaction. However, the question remains whether we can use these segmented images for reliable diagnosis. Purpose To retrospectively evaluate the diagnostic accuracy of coronary CT angiography (CCTA) using segmented 3D data for the detection of significant stenosis. Material and Methods CCTA data-sets from 30 patients were acquired with a 64-slice CT scanner and segmented using the region growing (RG) method and the 'virtual contrast injection' (VC) method. Three types of images of each patient were reviewed by different reviewers for the presence of stenosis with diameter reduction of 50% or more. The evaluation was performed on four main arteries of each patient (120 arteries in total). For the original series, the reviewer was allowed to use all the 2D and 3D visualization tools available (conventional method). For the segmented results from RG and VC, only maximum intensity projection was used. Evaluation results were compared with catheter angiography (CA) for each artery in a blinded fashion. Results Overall, 34 arteries with significant stenosis were identified by CA. The percentage of evaluable arteries, accuracy and negative predictive value for detecting stenosis were, respectively, 86%, 74%, and 93% for the conventional method, 83%, 71%, and 92% for VC, and 64%, 56%, and 93% for RG. Accuracy was significantly lower for the RG method than for the other two methods (P < 0.01), whereas there was no significant difference in accuracy between the VC method and the conventional method (P = 0.22). Conclusion The diagnostic accuracy for the RG-segmented 3D data is lower than those with access to 2D images, whereas the VC method shows diagnostic accuracy similar to the conventional method.

  19. Coronary CT angiography in symptomatic patients

    Energy Technology Data Exchange (ETDEWEB)

    Becker, C.R. [Inst. of Radiologic Diagnostic, Univ. of Munich, Klinikum Grosshadern, Munich (Germany)

    2005-02-01

    The currently best available spatial and temporal resolution for retrospectively ECG gated coronary multi-detector-row CT angiography is 0.4 mm and 165 ms, respectively. These acquisition parameters are already rather close to cardiac catheter. Studies so far compared non-invasive coronary CT and convention angiography for the detection of coronary artery stenoses. The most promising result reported by all authors was the high negative predictive value of the CTA. It now needs to be determined if CTA is a reliable tool to rule out coronary artery stenoses in a patient cohort with low likelihood of CAD, such as those with atypical chest pain or ambiguous stress test. CTA may furthermore establish as a rapid and widely available tool to detect vulnerable plaques or intracoronary thrombus in patients with acute coronary syndrome and unstable angina. In patients with chronic stable angina, tools that determine myocardial ischemia under stress such as SPECT and MRI are probably better suited to determine the relevance of coronary artery stenoses. In this particular cohort, by displaying the extent and morphology of coronary atherosclerosis, CTA may help to direct the therapy to either intervention or surgery. (orig.)

  20. Discordance between CT and angiography in the PIOPED II study.

    Science.gov (United States)

    Wittram, Conrad; Waltman, Arthur C; Shepard, Jo-Anne O; Halpern, Elkan; Goodman, Lawrence R

    2007-09-01

    To retrospectively evaluate the causes of discordant computed tomographic (CT)-angiographic readings from the Prospective Investigation of Pulmonary Embolism Diagnosis, or PIOPED, II study. Institutional review board approval was obtained for this HIPAA-compliant study. Of 1036 patients suspected of having pulmonary embolism who were examined with CT, 226 underwent angiography; 206 patients had concordant results and 20 had discordant results according to two independent readers. Of these 20 patients, 10 were men and 10 were women (mean age, 49 years). Among the 20 studies with discordant results, central readers identified seven cases as negative and 13 as positive for pulmonary embolism at CT; these findings were reversed at angiography. Side-by-side comparisons of discordant studies were performed in consensus. The time between CT and angiography and all locations of pulmonary embolism vascular territory were recorded. The McNemar binomial test was used. One patient had false-positive findings at angiography, 13 patients had false-negative findings at angiography, and two patients had false-negative findings at CT. Four patients had true-negative findings at CT; however, findings were positive for thrombus at angiography. The sensitivity for the detection of pulmonary embolism was 87% for CT and 32% for angiography (P=.007). The largest missed thrombus at angiography was subsegmental in eight patients, segmental in two patients, and lobar in three patients; at CT it was subsegmental in two patients. The mean time between CT and angiography was 40 hours+/-21 (standard deviation) (range, 10-97 hours). In the interval between CT and angiography, thrombi can remain the same, resolve, develop, or result from angiography. Copyright (c) RSNA, 2007.

  1. Moyamoya disease: diagnosis with three-dimensional CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, K. (Dept. of Radiology, National Defense Medical Coll., Saitama (Japan) Dept. of Radiology, Kyorin Univ. School of Medicine, Tokyo (Japan)); Makita, K. (Dept. of Radiology, National Defense Medical Coll., Saitama (Japan) Dept. of Radiology, Social Health Insurance Medical Center, Tokyo (Japan)); Furui, S. (Dept. of Radiology, National Defense Medical Coll., Saitama (Japan) Dept. of Diagnostic Radiology, Toranomon Kyosai Hospital, Tokyo (Japan))

    1994-08-01

    Our purpose was to assess the value of three-dimensional (3D) CT angiography in the diagnosis of moyamoya disease. We studied seven patients with moyamoya disease proved by conventional angiography. Three-dimensional (3D) CT angiography was performed using rapid sequence or helical (spiral) scanning in conjunction with a bolus injection of intravenous contrast medium. All seven patients could be diagnosed as having moyamoya disease on the basis of the following 3D CT angiographic findings: poor visualisation of the main trunks and/or major branches of anterior and middle cerebral arteries (7 patients); dilated leptomeningeal anastomotic channels from the posterior cerebral arteries (4); and demonstration of ''moyamoya vessels'' in the basal ganglia (2). Although conventional angiography remains the principal imaging technique for demonstrating anatomical changes in detail, less invasive 3D CT angiography provides a solid means of diagnosing moyamoya disease when it is suspected on CT, MRI, or clinical grounds. (orig.)

  2. Automatic detection of plaques with severe stenosis in coronary vessels of CT angiography

    Science.gov (United States)

    Dinesh, M. S.; Devarakota, Pandu; Kumar, Jitendra

    2010-03-01

    Coronary artery disease is the end result of the accumulation of atheromatous plaques within the walls of coronary arteries and is the leading cause of death worldwide. Computed tomography angiography (CTA) has been proved to be very useful for accurate noninvasive diagnosis and quantification of plaques. However, the existing methods to measure the stenosis in the plaques are not accurate enough in mid and distal segments where the vessels become narrower. To alleviate this, we propose a method that consists of three stages namely, automatic extraction of coronary vessels; vessels straightening; lumen extraction and stenosis evaluation. In the first stage, the coronary vessels are segmented using a parametric approach based on circular vessel model at each point on the centerline. It is assumed that centerline information is available in advance. Vessel straightening in the second stage performs multi-planar reformat (MPR) to straighten the curved vessels. MPR view of a vessel helps to visualize and measure the plaques better. On the straightened vessel, lumen and vessel wall are segregated using a nearest neighbor classification. To detect the plaques with severe stenosis in the vessel lumen, we propose a "Diameter Luminal Stenosis" method for analyzing the smaller segments of the vessel. Proposed measurement technique identifies the segments that have plaques and reports the top three severely stenosed segments. Proposed algorithm is applied on 24 coronary vessels belonging to multiple cases acquired from Sensation 64 - slice CT and initial results are promising.

  3. 周围型肺癌64层螺旋CT征象、病理分型与CCR7表达相关性研究%Studies on the correlation between the 64-slice CT features, pathologic classifications and expression of CCR7 in peripheral lung cancer

    Institute of Scientific and Technical Information of China (English)

    赵胜祥; 张琴; 陈朝晖

    2013-01-01

    Objective To explore the expression relationship between 64-slice CT features and the CCR7 (CC chemokine receptor 7) in peripheral lung cancer.Methods The data of 26 cases of peripheral lung cancer confirmed by operation and pathological classifications were clected.All patients had MSCT scan before operation,and without radiotherapy or chemotherapy.The expression of CCR7 was examined by means of SP immunohistochemical technology (Max Vision TM) in the 26 patients,and compared with the 64-slice CT features of lung cancer with the CCR7 immunohistochemical test results,data was analysed by SPSS 17.0 statistical software,the rate was compared with fisher exact method test,P <0.05 and the difference was statistically significant.Results ① The expression of CCR7 in the adenocarcinoma with positive expression rate was 75.0% (15/20),and in squamous cell carcinoma the positive expression rate was 33.3% (2/6),in the peripheral lung cancer,P <0.05,the difference was statistically significant; ② The expression of CCR7 in the cancer size of ≤3.0 cm the positive expression rate was 75.0% (15/20),and in the cancer size of > 3.0 cm the positive expression rate was 33.3% (2/6),P <0.05,the difference was statistically significant; ③ It was not associated between the expression of CCR7 and CT signs of the tumor deep lobulation,spiculate protuberance,vacuole sign,pleural indentation,spiculation,mediastinal lymph node metastasis,(P >0.05).Conclusion The positive expression of peripheral lung cancer of CCR7 is related to pathologic type,not associated with the diagnostic CT features.%目的 探讨周围型肺癌CT征象与CCR7(CC chemokine receptor 7,CC类趋化因子受体7)表达的关系.方法 收集资料完整并经手术、病理证实的周围型肺癌26例.全部患者术前均行64层螺旋CT平扫及增强扫描,术前未进行放射治疗或化疗.应用免疫组织化学染色(MaxVisionTM二步法)检测26例周围型肺癌中CCR7的表达水

  4. Multidetector CT angiography in Takayasu arteritis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Li, Qi; Li, Kewei; Xie, Peng [The First Affiliated Hospital, Chongqing Medical University, Department of Neurology, Chongqing (China); Lv, Fajin; Li, Yongmei; Luo, Tianyou [The First Affiliated Hospital, Chongqing Medical University, Department of Radiology, Chongqing (China)

    2009-09-15

    The purpose of our study was to compare the diagnostic performance of subtraction computed tomography angiography (CTA) with conventional nonsubtracted CTA and digital subtraction angiography (DSA) for the detection of intracranial aneurysms. A total of 76 patients underwent both subtraction CTA and conventional CTA for the detection and therapy planning of suspected intracranial aneurysms. Subtraction and conventional CTA images were independently assessed by two readers in a blinded manner. The possibility of endovascular treatment or surgical clipping was also assessed based on information provided by CT angiograms alone. In 64 patients, 75 aneurysms were present on DSA. On a per-aneurysm basis, the sensitivity of subtraction CTA was 98.6% for reader 1, and 100% for reader 2. However, sensitivity of conventional CTA was 94.6% for reader 1, and 93.3% for reader 2. Therapeutic decisions could be made regarding 63 patients based on information provided by subtraction CTA images. However, conventional CTA provided sufficient information to make this decision for 55 patients. Conventional CTA has limited sensitivity in detecting very small aneurysms as well as aneurysms adjacent to bone. Subtraction CTA performed on a 64-row multidetector CT is an accurate and promising diagnostic tool that seems to be equivalent to 2D DSA for the detection and pretreatment planning of intracranial aneurysms. (orig.)

  6. The Value of 64-slice Spiral CT with 3D Transparency Reconstruction in the Diagnosis of Inner ear Malformation:Analysis of 32 Cases%64排CT三维透明化重组在内耳畸形诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    王丹; 曹绍东; 申宝忠; 张同; 白荣杰; 王可铮; 徐艳

    2011-01-01

    目的 探讨三维透明化重组在内耳畸形诊断中的应用价值,为先天性内耳疾病提供准确的影像诊断和临床治疗信息.资料与方法 回顾32耳内耳畸形的64排高分辨率CT(HRCT)容积数据,行三维透明化重组处理,按内耳畸形分类总结三维透明化重组方法及影像表现.结果 32耳的三维透明化容积再现(VR)图像结合透明化多平面重组(MPR)图像均能很好揭示内耳畸形病变部位及程度,内耳病变整体显示方面及蜗窗、前庭窗、半规管等细节病变显示中透明化VR像及透明化MPR像明显优于轴位像及普通MPR像;在耳蜗内部结构的显示中,透明化MPR、轴位像及普通MPR像优于透明化VR像.32耳先天内耳发育畸形有以下几种:耳蜗未发育(2耳);共同腔畸形(4耳);不完全分隔Ⅰ型(2耳,2例患者对侧耳均为共同腔畸形);不完全分隔Ⅱ型(即Mondini型)(16耳,多合并前庭、半规管及前庭导水管畸形);单纯前庭-半规管畸形(2耳);单纯前庭导水管扩大(6耳).结论 三维透明化个性重组能准确}半价内耳先天性疾病的类型和程度,为临床治疗提供重要的参考依据.%Objective To investigate the role of 3D transparency reconstruction in displaying the inner ear malformation. Materials and Methods Thirty-two cases of inner ear malformation were analyzed retrospectively. The data of 64 slice HRCT were processed using 3D transparency reconstruction. The imaging findings were summarized according to the categorization of the disease. Results The malformations included cochlear aplasia(2 ears), Common cavity deformity (4 ears), incomplete partition Ⅰ (2 ears ), incomplete partition Ⅱ ( Mondini deformity ) ( 16 ears), vestibular and semicircular canal malformations(3 ears) and vestibular aqueduct dilate(6 ears). The site and degree of inner ear malformation were displayed clearly by 3D transparent reconstruction imaging and MPR transparent imaging. Transparent MPR and VR

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. The value of volume doubling time in diagnosis of solitry pulmonary nodules by 64-slice spiral CT%容积倍增时间在64层螺旋CT诊断孤立性肺结节中的价值

    Institute of Scientific and Technical Information of China (English)

    安彩霞; 王云生; 杨丽娟; 桑俊文; 张文莉; 王哲; 贺进军; 张凤艳; 刘静

    2011-01-01

    目的 探讨容积倍增时间( DTV)在64层螺旋CT诊断孤立性肺结节(SPN)中的价值.方法 初次胸部CT检查后,于第一个月末及第三个月末行2次以上随访的SPN患者46例,分别采用普通平扫横断面测量直径及LungCARE软件测定体积,计算所有结节的直径倍增时间(DTD)和DTV,比较两种测量方法对恶性肺结节的诊断价值;并用Mann-Whitney U非参数检验方法评价DTV在恶性SPN不同复查时期及不同病例类型之间的差异.结果 经临床和病理证实,46例SPN患者中,恶性肺结节29例(包括18例腺癌和11例鳞癌)、良性肺结节17例.DTV法与DTD法在恶性SPN诊断中的灵敏度、特异度、阳性预测率、阴性预测率和Youden指数分别为93.10%、94.11%、96.42%、88.89%和0.87 vs.79.31%、70.59%、82.14%、66.67%和0.50,DTV法的诊断价值显著优于DTD法(x2=10.211,P< 0.05).腺癌与鳞癌患者第一个月末与第三个月末的DTV比较,差异无统计学意义(U=0.127和U=0.066,P均>0.05).第一个月末及第三个月末,腺癌患者恶性肺结节的DTV显著大于鳞癌患者(U=-3.193和U=-2.810,P均<0.01).结论 DTV法在64层螺旋CT诊断SPN中的效能优于DTD法.DTV可作为观察指标,评估不同性质SPN的生长特征,为肺结节的早期随访及定性诊断提供帮助.%Objective To discuss the value of volume doubling time (DTV) in diagnosis of solitry pulmonary nodules (SPN) by 64-slice spiral CT.Methods There were 46 cases which were underwent repeated follow-up CT at the first month and at the third month after the initial chest CT.We evaluated the value of DTV calculated by LungCARE volumetry software and diameter doubling time (DTD) calculated by diameter method in the diagnosis of SPN.We compared the difference of DTV in different kinds of SPN and in different follow-up periods by Mann-Whitney U test.Results Twenty-nine malignant nodules and seventeen benign nodules were confirmed in forty-six SPN cases

  9. The evaluation of 64-slice spiral CT perfusion to hepatic fibrosis of dog model and the correlation research with pathologic and VEGF change%犬肝纤维化64排螺旋CT全肝灌注成像及与病理对照、VEGF表达的相关研究

    Institute of Scientific and Technical Information of China (English)

    胡跃群; 章雅琴; 李丛蕊; 骆雷; 容鹏飞; 王维

    2011-01-01

    目的 利用64排螺旋CT全肝灌注模式成像测定中华田园犬肝纤维化模型的相关灌注参数并与病理对照来反映肝纤维化程度,分析其与VEGF表达水平的相关性.方法 采用腹腔注射50%四氯化碳油溶液辅以高脂饮食,建立犬肝纤维化模型,定期行64排螺旋CT全肝灌注成像及肝穿活检.根据病理分期分析各组CT灌注参数,并与VEGF表达水平作对照研究.结果 成功获得各期肝纤维化模型.对照组HAP(28.25 ±2.19) ml/(min·100 g),PVP( 53.53±10.71) ml/( min ·100 g),TLP(81.78±18.56) ml/(min·100 g);随肝纤维化程度加重,PVP、TLP持续性下降(P<0.05),HAP总体略呈上升趋势.PVP值、TLP值与肝纤维化程度呈负相关(P<0.01);VEGF表达水平随着肝纤维化程度的加重而明显增高(P<0.05).结论 腹腔注射四氯化碳油溶液辅以高脂饮食可以成功模拟人类从肝细胞变性、肝纤维化至肝硬化的全过程.64排螺旋CT全肝灌注成像克服了以往灌注成像的不足,且能反映肝纤维化各期的血流动力学变化趋势,VEGF可能在慢性肝病所致肝纤维化过程中起重要作用.%Objective To measure the perfusion parameters of liver fibrosis of dog model with 64-slice spiral CT,and compare with positive control to reflect the degree of liver fibrosis,and analyze the correlation with VEGF values.Methods Liver fibrosis was induced in dogs by intraperitoneal injection of CC14 and high fat diet.CT perfusion scan and liver biopsies were performed.The perfusion parameters were measured according to the liver fibrosis models,and the correlation with VEGF values was analyzed.Results The animals in experimental group were successfully induced different degree of liver fibrosis.In normal group,the hepatic artery perfusion,portal vein perfusion and total hepatic blood flow were (28.25 ±2.19)ml/(min · 100 g),(53.53 ± 10.71)ml/(min · 100 g) and (81.78 ± 18.56) ml/(min · 100 g).The PVP and TLP values of the

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  11. Diagnostic accuracy of CT angiography in acute gastrointestinal bleeding.

    Science.gov (United States)

    Chua, A E; Ridley, L J

    2008-08-01

    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 2 x 2 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 (chi(2) = 3.5, P = 0.6) and (chi(2) = 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.

  12. CT angiography by means of intra-arterial contrast infusion

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Junichiro; Watanabe, Hiroshi; Shiogai, Toshiyuki; Konishi, Yoshifumi; Hara, Mitsuhiro (Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine)

    1983-10-01

    CT angiography (CT-AG) by means of intra-arterial contrast infusion was carried out, and its clinical usefulness was evaluated in various intracranial lesions. The practical and diagnostic merits of CT-AG are as follows: a selective enhancement of the cerebral vessels by an extremely small amount of the contrast substance, accompanied by a satisfactory resolution of fine arterioles and arteries. The excellent ability of the CT to detect differences in the X-ray absorption coefficients surpasses that of cerebral angiography. An intracranial aneurysm which was not visualized by the angiography appeared between arterial branches upon CT-AG. The three-dimensional configuration of the aneurysmal body and its related artery, the pointing direction of the aneurysm, and the angle between the aneurysmal axis and the afferent artery were clearly shown. The fine structure of arteriovenous malformation could be shown concurrently with the cerebral tissue and the ventricle. The axial view of the circle of Willis gives important information for surgical intervention. Concerning brain tumors, the structural correlation between the tumor and the cerebral arteries became apparent when the CT-AG was carried out immediately after a conventional contrast-enhancement. Such a ''double contrast'' allows safe surgical access to the intracranial tumor. CT-AG in the case of ''Moyamoya'' disease visualized fine moyamoya vessels extending all over the cerebral hemisphere; those vessels were less prominent in the ordinary angiograms. The vascular networks of the arteriovenous malformation, which were not evident in the ordinary angiograms, were also revealed by the CT-AG. For the patient with poor prospects, CT-AG will be were valid as a screening study than ordinary angiography because of its less invasive procedure using a small amount of the contrast substance. CT-AG on a dynamic scan mode possible optimal timing in the visualization of the

  13. Diagnostic yield and accuracy of CT angiography, MR angiography, and digital subtraction angiography for detection of macrovascular causes of intracerebral haemorrhage: prospective, multicentre cohort study

    OpenAIRE

    van Asch, Charlotte J. J.; Birgitta K Velthuis; Rinkel, Gabriël J E; Algra, Ale; de Kort, Gerard A. P.; Witkamp, Theo D.; de Ridder, Johanna C M; van Nieuwenhuizen, Koen M.; De Leeuw, Frank Erik; Schonewille, Wouter J.; de Kort, Paul L. M.; Dippel, Diederik W; Raaymakers, Theodora W M; Hofmeijer, Jeannette; Wermer, Marieke J. H.

    2015-01-01

    Study question What are the diagnostic yield and accuracy of early computed tomography (CT) angiography followed by magnetic resonance imaging/angiography (MRI/MRA) and digital subtraction angiography (DSA) in patients with non-traumatic intracerebral haemorrhage? Methods This prospective diagnostic study enrolled 298 adults (18-70 years) treated in 22 hospitals in the Netherlands over six years. CT angiography was performed within seven days of haemorrhage. If the result was negative, MRI/MR...

  14. Value of 64-slice spiral CT angiography in diagnosis of Takayasu's arteritis%64排螺旋CT血管成像在大动脉炎诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    徐崇明; 赵晓军

    2012-01-01

    目的 探讨64排螺旋CT血管成像(CTA)在大动脉炎临床诊断中的应用价值.方法 对临床拟诊大动脉炎的9例患者进行64排螺旋CT血管成像,图像后处理方法包括多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)、曲面重组(CPR)及血管分析,显示受累血管的部位、范围及程度.结果 64排螺旋CT血管成像清楚显示受累动脉不同程度的管壁增厚,管腔狭窄或闭塞,管腔狭窄具有向心性的特点,部分伴狭窄后扩张.后处理图像可以直观显示受累大血管及其分支血管的狭窄程度或闭塞情况以及侧支血管形成情况,依据Lupi-Herrea分类法包括I型5例,Ⅱ型1例,Ⅲ型3例,CT结果均与其临床表现相符.结论 64排CTA可清晰地显示大动脉炎累及主动脉及其分支的管壁变化,三维重建可更直观地显示病变的程度和范围,可以作为此病的首选影像学检查方法.

  15. CT Pulmonary Angiography and Suspected Acute Pulmonary Embolism

    Energy Technology Data Exchange (ETDEWEB)

    Enden, T.; Kloew, N.E. [Ullevaal Univ. Hospital, Oslo (Norway). Dept. of Cardiovascular Radiology

    2003-05-01

    Purpose: To evaluate the use and quality of CT pulmonary angiography in our department, and to relate the findings to clinical parameters and diagnoses. Material and Methods: A retrospective study of 324 consecutive patients referred to CT pulmonary angiography with clinically suspected pulmonary embolism (PE). From the medical records we registered clinical parameters, blood gases, D-dimer, risk factors and the results of other relevant imaging studies. Results: 55 patients (17%) had PE detected on CT. 39 had bilateral PE, and 8 patients had isolated peripheral PE. 87% of the examinations showing PE had satisfactory filling of contrast material including the segmental pulmonary arteries, and 60% of the subsegmental arteries. D-dimer test was performed in 209 patients, 85% were positive. A negative D-dimer ruled out PE detected at CT. Dyspnea and concurrent symptoms or detection of deep vein thrombosis (DVT), contraceptive pills and former venous thromboembolism (VTE) were associated with PE. The presence of only one clinical parameter indicated a negative PE diagnosis (p < 0.017), whereas two or more suggested a positive PE diagnosis (p < 0.002). CT also detected various ancillary findings such as consolidation, pleural effusion, nodule or tumor in nearly half of the patients; however, there was no association with the PE diagnosis. Conclusion: The quality of CT pulmonary angiography was satisfactory as a first-line imaging of PE. CT also showed additional pathology of importance in the chest. Our study confirmed that a negative D-dimer ruled out clinically suspected VTE.

  16. Time-resolved CT angiography in aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Meinel, Felix G., E-mail: felix.meinel@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Nikolaou, Konstantin, E-mail: konstantin.nikolaou@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Weidenhagen, Rolf, E-mail: rolf.weidenhagen@med.uni-muenchen.de [Department of Surgery, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Hellbach, Katharina, E-mail: katharina.hellbach@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Helck, Andreas, E-mail: andreas.helck@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Bamberg, Fabian, E-mail: fabian.bamberg@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Reiser, Maximilian F., E-mail: maximilian.reiser@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Sommer, Wieland H., E-mail: wieland.sommer@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany)

    2012-11-15

    Objectives: We performed this study to assess feasibility and additional diagnostic value of time-resolved CT angiography of the entire aorta in patients with aortic dissection. Materials and methods: 14 consecutive patients with known or suspected aortic dissection (aged 60 {+-} 9 years) referred for aortic CT angiography were scanned on a dual-source CT scanner (Somatom Definition Flash; Siemens, Forchheim, Germany) using a shuttle mode for multiphasic image acquisition (range 48 cm, time resolution 6 s, 6 phases, 100 kV, 110 mAs/rot). Effective radiation doses were calculated from recorded dose length products. For all phases, CT densities were measured in the aortic lumen and renal parenchyma. From the multiphasic data, 3 phases corresponding to a triphasic standard CT protocol, served as a reference and were compared against findings from the time-resolved datasets. Results: Mean effective radiation dose was 27.7 {+-} 3.5 mSv. CT density of the true lumen peaked at 355 {+-} 53 HU. Compared to the simulated triphasic protocol, time-resolved CT angiography added diagnostic information regarding a number of important findings: the enhancement delay between true and false lumen (n = 14); the degree of membrane oscillation (n = 14); the perfusion delay in arteries originating from the false lumen (n = 9). Other additional information included true lumen collapse (n = 4), quantitative assessment of renal perfusion asymmetry (n = 2), and dynamic occlusion of aortic branches (n = 2). In 3/14 patients (21%), these additional findings of the multiphasic protocol altered patient management. Conclusions: Multiphasic, time-resolved CT angiography covering the entire aorta is feasible at a reasonable effective radiation dose and adds significant diagnostic information with therapeutic consequences in patients with aortic dissection.

  17. Acute gastrointestinal bleeding: CT angiography with multi-planar reformatting.

    Science.gov (United States)

    Steiner, Kate; Gollub, Frank; Stuart, Sam; Papadopoulou, Anthie; Woodward, Nick

    2011-04-01

    Acute gastrointestinal bleeding is a common medical emergency, which carries a significant mortality. CT Angiography is an important non-invasive diagnostic tool, which can be used to plan subsequent endovascular or surgical management. The cases presented demonstrate that a meticulous and systematic approach to image interpretation is necessary, in particular, to detect focal sites of contrast extravasation and small pseudoaneurysms.

  18. Usefulness of 3D-CT angiography using multislice CT for diagnosing cardiovascular anomalies in infants

    Energy Technology Data Exchange (ETDEWEB)

    Kani, Hiroyuki; Matsuki, Mitsuru; Masuda, Kiyohiro; Narabayashi, Isamu; Katayama, Hiroshi; Mori, Yasuhiko; Tamai, Hiroshi [Osaka Medical Coll., Takatsuki (Japan)

    2003-05-01

    We compared three-dimensional computed tomographic angiography using multislice CT (3D-CTA) with echocardiography and angiography in terms of usefulness in the diagnosis of 13 infants with cardiovascular anomalies. 3D-CTA clearly depicted stenoses of the pulmonary artery and vein, and coarctation of the aorta in some cases, which could not be revealed by echocardiography and angiography. Moreover, it provided objectively more information on vascular morphologic characteristics and 3D anatomic relations than echocardiography and angiography. 3D-CTA is a noninvasive and convenient diagnostic technique for cardiovascular anomalies in infants. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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 ...

  1. Measurement of response of pulmonal tumors in 64-slice MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Sohns, Christian; Sossalla, Samuel (Dept. of Cardiology and Pneumology/Heart Center, Georg-August-Univ., Goettingen (Germany)), e-mail: christian.sohns@gmx.de; Mangelsdorf, Johanna; Obenauer, Silvia (Dept. of Radiology, Georg-August-Univ., Goettingen (Germany)); Konietschke, Frank (Dept. of Medical Statistics, Georg-August-Univ., Goettingen (Germany))

    2010-06-15

    Background: Advances in CT technology from single to multi-detector row CT (MDCT) permit a high resolution and volumetric presentation of pulmonary lesions. This implicates emerging measurement techniques that need to be contrasted with established methods. Purpose: To compare bidimensional, unidimensional, and volumetric methods for evaluation of treatment response in patients with lung lesions. Material and Methods: This study comprised 68 patients with pulmonary lesions who underwent a total of 276 64-MDCTs of chest at baseline and follow-up. RECIST and WHO criteria were used for unidimensional and bidimensional methods and region growing (RG) for volumetry. Patients were classified into four response categories. Respectively, two measurement techniques were contrasted and the kappa index was calculated. For intra-observer reproducibility the relative measurement error (RME) and kappa index with regard to agreement of response categories were evaluated. Results: Comparison of WHO und RECIST criteria achieves high correlation with kappa indices of 0.76 and 0.82. In particular, lesions with moderate increase of size in the range of 25-44% for bidimensional and 12-29% for unidimensional measurement result in different response categories when applying WHO and RECIST criteria. WHO criteria delivered PD more often than RECIST. kappa indices of 0.79 and 0.87 were attained in comparison of RECIST and RG, and 0.83 and 0.84 for WHO and RG. RME was 2.82% for RECIST, 7.53% for WHO, and 8.97% for RG. Intra-observer reproducibility was 95% for RECIST, 95% for WHO, and 96% for RG. Conclusion: The comparison of all methods resulted in no statistically significant differences. WHO criteria seemed to diverge the most, they declared several lesions prematurely as progression, and showed no benefit in comparison to RECIST. RG showed the best reproducibility, considered irregular lesions, was slightly superior to RECIST, and could be applied uniformly. Unidimensional measurement

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

    Energy Technology Data Exchange (ETDEWEB)

    Mo, Yuan Heng; Jaw, Fu Shan [National Taiwan University, Taipei, Taiwan (China); Wang, Yung Cheng; Jeng, Chin Ming [Fu Jen Catholic University, Taipei, Taiwan (China); Peng, Shinn Forng [National Taiwan University Hospital, Taipei, Taiwan (CN)

    2011-06-15

    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.

  3. [CT coronary angiography: indications, image acquisition, and interpretation].

    Science.gov (United States)

    Schoepf, U J; Thilo, C; Fernández, M J; Costello, P

    2008-01-01

    Intense scientific and clinical evaluation have brought about great improvements in cardiac CT. This is no longer merely an experimental technique, rather it has become a clinical application that is ready to fulfill its promise of replacing invasive cardiac catheterization in certain patient populations. Among the proven indications is the evaluation of patients with atypical chest pain, the morphological evaluation of the coronary arteries in cases of suspected congenital anomalies, and before surgical intervention, as well as the evaluation of coronary revascularizations. The use of CT angiography for the exhaustive evaluation of cardiac and non-cardiac pathology in patients with acute chest pain in the emergency department is currently being investigated. Because the heart is continuously moving, CT coronary angiography represents a greater technical challenge than other applications of CT. On the other hand, rapid technical development requires acquisition protocols to be adjusted constantly. However, users that know the general techniques of computed tomography can overcome these challenges. The aim of this article is to provide those interested and involved in CT angiography with a manual to enable them to follow our method step by step. We include considerations regarding the correct selection of patients, patient medication, radiological protection, contrast enhancement, acquisition and reconstruction parameters, image display, image analysis techniques, and the radiological report. Our recommendations are based on our experience, which runs from the evolution of multiple-row detector CT scanners for cardiac applications from its beginnings to the most modern presentations of advanced acquisition modalities, including dual-source CT, which we consider to be the precursor of this test in routine clinical practice.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Cardiac CT angiography in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Noninvasive detection of vertebral artery stenosis: a comparison of contrast-enhanced MR angiography, CT angiography, and ultrasound.

    Science.gov (United States)

    Khan, Sofia; Rich, Philip; Clifton, Andrew; Markus, Hugh S

    2009-11-01

    Vertebral stenosis is associated with a high risk of recurrent stroke, but noninvasive imaging techniques to identify it have lacked sensitivity. Contrast-enhanced MR angiography and CT angiography have been recently developed and appear to have better sensitivity. However, no prospective studies have compared both of these techniques with ultrasound against the gold standard of intra-arterial angiography in the same group of patients. Forty-six patients were prospectively recruited in whom intra-arterial angiography was being performed. Contrast-enhanced MR angiography, CT angiography, and duplex ultrasound were also performed. Angiographic images were analyzed blinded to patient identity by 2 experienced neuroradiologists. Contrast-enhanced MR angiography had the highest sensitivity and specificity (Radiologist 1, 0.83 and 0.91, respectively; Radiologist 2, 0.89 and 0.87) for detecting >or=50% stenosis. CT angiography had good sensitivity (Radiologist 1, 0.68; Radiologist 2, 0.58) and excellent specificity (Radiologist 1, 0.92; Radiologist 2, 0.93), whereas duplex had low sensitivity (0.44) but excellent specificity (0.95). For vertebral origin stenosis >or=50%, sensitivities were similar for contrast-enhanced MR angiography (Radiologist 1, 0.91; Radiologist 2, 0.82) but relatively higher for CT angiography (Radiologist 1, 0.82; Radiologist 2, 0.82) and duplex (0.67). Contrast-enhanced MR angiography is the most sensitive noninvasive technique to detect vertebral artery stenosis and also has high specificity. CT angiography has good sensitivity and high specificity. In contrast, ultrasound has low sensitivity and will miss many vertebral stenoses.

  7. Coronary CT angiography-derived quantitative markers for predicting in-stent restenosis

    NARCIS (Netherlands)

    Tesche, Christian; De Cecco, Carlo N.; Vliegenthart, Rozemarijn; Duguay, Taylor M.; Stubenrauch, Andrew C.; Rosenberg, Russell D.; Varga-Szemes, Akos; Bayer, Richard R.; Yang, Junjie; Ebersberger, Ullrich; Baguet, Moritz; Jochheim, David; Hoffmann, Ellen; Steinberg, Daniel H.; Chiaramida, Salvatore A.; Schoepf, U. Joseph

    2016-01-01

    Objective: To evaluate quantitative markers derived from coronary CT angiography (coronary CTA) performed prior to percutaneous coronary intervention (PCI) with stent placement for predicting in-stent restenosis (ISR) as defined by quantitative coronary angiography (QCA). Materials and methods: We

  8. 3D-CT angiography. Intracranial arterial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Asato, Mikio; Tong, X.Q.; Tamura, Shozo [Miyazaki Medical Coll., Kiyotake (Japan)] [and others

    1997-06-01

    Since its introduction, three dimensional CT angiography (3D-CTA) on spiral (helical) CT has played an important role in clinical imaging. Initially it was reported to be useful in depicting aortic abnormalities, afterwards the merit in detecting intracranial aneurysm by 3D-CTA was also described. We have investigated the usefullness of 3D-CTA in detecting patients of intracranial aneurysm as well as arterio-venous malformation (AVM), Moyamoya disease and stenosis of middle cerebral artery, meanwhile the MR angiography (MRA) and digital subtraction angiography (DSA) examination of these patients were also studied as comparison to the 3D-CTA results. The sensitivity and specificity on investigating intracranial aneurysm were similar with other reports so far. 3D-CTA was possible to identify the feeding artery, nidus and draining vein of AVM, although DSA showed higher detectability. Occlusion of internal carotid artery and post-operative anastomosis in Moyamoya disease were all demonstrated by 3D-CTA, however the Moyamoya collaterals were shown better on MRA. 3D-CTA revealed the site of stenosis of middle cerebral artery in all of our cases, but in general maximum intensity projection (MIP) images can provide more exact information about the degree of stenosis. Five years has passed since the emergence of spiral CT and utilizing of 3D-CTA in clinical applications. With the development of hard and soft ware in the near future, it is possible to delineate more small vessels by 3D-CTA. We predict that 3D-CTA would be widely used for detecting vasculature of the whole body, and may take the place of conventional angiography in many cases. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  10. High-pitch dual-source CT angiography of supra-aortic arteries: assessment of image quality and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Korn, A.; Fenchel, M.; Bender, B.; Danz, S.; Ernemann, U. [Department of Diagnostic und Interventional Neuroradiology, Tuebingen (Germany); Thomas, C.; Ketelsen, D.; Claussen, C.D.; Heuschmid, M. [Department of Diagnostic und Interventional Radiology, Tuebingen (Germany); Moonis, G. [Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA (United States); Krauss, B. [Siemens AG, Imaging and Therapy Division, Forchheim (Germany); Brodoefel, H. [Department of Diagnostic und Interventional Radiology, Tuebingen (Germany); Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA (United States); Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA (United States)

    2013-04-15

    High-pitch CT angiography (CTA) is a recent innovation that allows significant shortening of scan time with volume coverage of 43 mm per second. The aim of our study was to assess this technique in CTA of the head and neck. CTA of supra-aortic arteries was performed in 50 patients using two acquisition protocols: conventional single-source 64-slice (pitch 1.2) and high-pitch dual-source 128-slice CT (pitch 3.2). Subjective and objective image quality of supra-aortic vessel ostia as well as intra- and extra-cranial segments was retrospectively assessed by blinded readers and radiation dose compared between the two protocols. Conventional and high-pitch CTA achieved comparable signal-to-noise ratios in arterial (54.3 {+-} 16.5 versus 57.3 {+-} 14.8; p = 0.50) and venous segments (15.8 {+-} 6.7 versus 18.9 {+-} 8.9; p = 0.21). High-pitch scanning was, however, associated with sharper delineation of vessel contours and image quality significantly improved at the level of supra-aortic vessel ostia (p < 0.0001) as well as along the brachiocephalic trunk (p < 0.0001), the subclavian arteries (p < 0.0001), proximal common carotid arteries (p = 0.01), and vertebral V1 segments (p < 0.0001). Using the high-pitch mode, the dose-length product was reduced by about 35 % (218.2 {+-} 30 versus 141.8 {+-} 20 mGy x cm). Due to elimination of transmitted cardiac motion, high-pitch CTA of the neck improves image quality in the proximity of the aortic arch while significantly lowering radiation dose. The technique thus qualifies as a promising alternative to conventional spiral CTA and may be particularly useful for identification of ostial stenosis. (orig.)

  11. Dynamic CT head phantom for perfusion and angiography studies

    Science.gov (United States)

    Russell, K.; Blazeski, A.; Dannecker, K.; Lee, Q. Y.; Holscher, C.; Donahue, C.; van Kampen, W.

    2010-03-01

    Contrast imaging is a compelling enhancement for the portable, flat panel-based brain CT scanner currently under development at Xoran. Due to the relative low temporal resolution of flat panel detectors, enabling tomographic imaging on such platform requires optimizing the imaging and injection protocols. A dynamic CT head phantom was designed to facilitate this task. The Dynamic Perfusion and Angiography Model (PAM), mimics tissue attenuation in CT images, provides physiological timing for angiography and perfusion studies, and moves fluid with properties similar to those of blood. The design consists of an arterial system, which contains bifurcating vessels that feed into perfusion chambers, mimicking blood flow through capillaries and smaller vessels, and a venous system, which is symmetrical to the arterial side and drains the perfusion chambers. The variation of geometry and flow rate in the phantom provides the physiological total time that fluid spends in the head, and the difference in material densities correlates to CT numbers for biological tissues. This paper discusses the design of Dynamic PAM and shows experimental results demonstrating its ability to realistically simulate blood flow. Results of dynamic imaging studies of the phantom are also presented.

  12. Diagnostic accuracy of 64 slice multidetector coronary computed tomographic angiography in left ventricular systolic dysfunction

    Directory of Open Access Journals (Sweden)

    Danny Lee

    2015-09-01

    Conclusion: Sixty-four slice multidetector CCTA is a very sensitive and fairly specific noninvasive diagnostic procedure for detecting coronary stenosis in patients with chest pain regardless of LV systolic function at presentation.

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

    Directory of Open Access Journals (Sweden)

    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

  14. CT angiography in patients with spontaneous intracerebral hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Dae Young; Shim, Joo Eun; Yi, Jeong Geun; Kim, Ho Chul; Choi, Chul Soon; Bae, Sang Hoon [Hallym University College of Medicine, Choonchun (Korea, Republic of)

    1998-01-01

    The purpose of this study was to assess the usefulness of CT angiography (CTA) in patients with intracerebral hematoma. Eighteen patients with spontaneous intracerebral hematoma underwent CTA; 20-30 seconds after the onset of an injection of contrast media (100mL), with the use of a power injector, at a rate of 3mL/sec, scanning (30-second continuous exposure and 60-90mm length) was performed with a table speed of 2-3 mm/sec and section thickness of 2mm. The starting point selected was the floor of the sella turcica. The resulting data were reformatted by maximum intensity projection (MIP) after reconstruction at 1-mm intervals, and CTA findings were compared with those of conventional angiography (n=17), surgery (n=6), and postcontrast CT(n=10). The diagnostic findings of CTA included five arteriovenous malformations, two aneurysms, one venous angioma, and one venous sinus occlusion, while the remaining nine patients had no vascular lesion. In all cases, CTA findings correlated well with those of postcontrast CT. In one cases of arteriovenous malformation, however, the feeding artery and draining vein were not definite on CTA, and in one case of sinus occlusion, the full length of the superior sagittal sinus could not be delineated. In patients with spontaneous intracerebral hematoma, CTA is a valuable screening method. (author). 15 refs., 4 figs.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Three dimensional reconstruction of the liver and the abdominal blood vessels based on the 64-slice spiral CT data%64排螺旋CT扫描数据的肝脏及腹腔血管三维重建的研究

    Institute of Scientific and Technical Information of China (English)

    朱新勇; 方驰华; 焦培峰; 全显跃; 唐海亮; 鲍苏苏; 钟世镇

    2008-01-01

    目的 探讨利用64排螺旋CT扫描数据进行肝脏及其内部管道和腹腔血管的计算机辅助三维重建的准确性及临床意义.方法 利用64排螺旋CT薄层扫描正常人肝脏二维图像数据集,采用自主研发的医学图像处理系统对二维图像数据进行肝脏及其肝内管道、腹腔血管系统三维可视化重建,并对重建肝脏模型的体积与肝脏实际体积以及重建门静脉与64排螺旋CT后处理工作站采用容积再现法重建的门静脉进行对比研究.结果 肝动脉、门静脉和肝静脉系统三维效果逼真,立体感强,可任意角度旋转、观察;能够显示肝内各主要管道系统的空间位置关系,并准确地反映肝脏实际体积及肝内管道系统的真实情况.通过调节肝脏的透明度可同时显示肝脏和肝内动静脉、门静脉分支和腹腔动脉系统.计算机重建后的门静脉与螺旋CT后处理工作站容积再现法重建的门静脉完全一致.结论 计算机辅助的三维肝脏及其管道和腹腔血管系统能准确反映人体的真实结构,为肝脏的虚拟手术设计提供了可靠和真实的虚拟器官和血管系统.%Objective To explore the accuracy and practical significance of the 3-dimensional (3D) reconstruction of the liver and the abdominal blood vessels based on the data of 64-slice spiral computerized tomography (64S-SCT). Methods The 2D images of the liver and the abdominal blood vessels were collected after TLC-scanning with 64S-SCT. The 3D images of the liver, hepatic internal duct system and the abdominal blood vessels were reconstructed by the medical image processing system. The volume of the 3D reconstructed liver was compared with that of the actual liver measured by the 64S-SCT, and the portal vein of the reconstructed liver model was compared with that reconstructed by the Mxview workstation based on the 64S-SCT data. Results The 3D models of the liver, hepatic internal duct system and abdominal blood

  17. Multidetector CT angiography for acute gastrointestinal bleeding: technique and findings.

    Science.gov (United States)

    Artigas, José M; Martí, Milagros; Soto, Jorge A; Esteban, Helena; Pinilla, Inmaculada; Guillén, Eugenia

    2013-01-01

    Acute gastrointestinal bleeding is a common reason for emergency department admissions and an important cause of morbidity and mortality. Factors that complicate its clinical management include patient debility due to comorbidities; intermittence of hemorrhage; and multiple sites of simultaneous bleeding. Its management, therefore, must be multidisciplinary and include emergency physicians, gastroenterologists, and surgeons, as well as radiologists for diagnostic imaging and interventional therapy. Upper gastrointestinal tract bleeding is usually managed endoscopically, with radiologic intervention reserved as an alternative to be used if endoscopic therapy fails. Endoscopy is often less successful in the management of acute lower gastrointestinal tract bleeding, where colonoscopy may be more effective. The merits of performing bowel cleansing before colonoscopy in such cases might be offset by the resultant increase in response time and should be weighed carefully against the deficits in visualization and diagnostic accuracy that would result from performing colonoscopy without bowel preparation. In recent years, multidetector computed tomographic (CT) angiography has gained acceptance as a first-line option for the diagnosis and management of lower gastrointestinal tract bleeding. In selected cases of upper gastrointestinal tract bleeding, CT angiography also provides accurate information about the presence or absence of active bleeding, its source, and its cause. This information helps shorten the total diagnostic time and minimizes or eliminates the need for more expensive and more invasive procedures.

  18. 64 Slice Spiral CT and Mammography for the Diagnosis of Comparative Study of Breast Carcinoma in Imaging%64排螺旋CT与钼靶摄影在影像诊断乳腺癌中的对比研究

    Institute of Scientific and Technical Information of China (English)

    赵宝贵

    2014-01-01

    Objective To explore the application value of multislice spiral CT and mammography in the diagnosis of breast cancer. Methods Retrospective analysis of the 60 cases of breast cancer confirmed by pathology and plain scan, enhanced and image reconstruction. Results In 60 cases of breast cancer were mass type,57 cases showed irregular shape,48 cases of edge see burr,8 cases of skin changes,4 cases of skin retraction,surrounding invasion in 12 cases, axillary lymph nodes seen in 32 cases,mediastinal lymph nodes and lung metastasis. Enhanced masses enhanced obviously, the increase of CT value (18~83) Hu,parallel reconstruction makes mass surrounding structure is stereoscopic display. Conclusion Multi slice spiral CT examination has certain application value in the diagnosis of breast cancer.%目的:探讨多层螺旋 CT 及钼靶摄影在乳腺癌诊断中的应用价值。方法回顾性分析经病理证实的60例乳腺癌平扫,增强及重建图像。结果60例乳腺癌均为肿块型,57例表现为不规则形,48例边缘见毛刺,8例皮肤改变,4例皮肤内陷,周围侵犯12例,32例见腋窝淋巴结,纵隔淋巴结及肺内转移。增强后肿块强化明显,CT 值升高(18~83)hu,并行重建使肿块周边结构呈立体显示。结论多层螺旋 CT 检查在乳腺癌定性诊断中有一定的应用价值。

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

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Kyung; Kim, Jeong Ho; Hwang, Kyung Hoon; Choi, In Suck; Choi, Soo Jin; Choe, Won Sick [Gachon University Gil Hospital, Incheon (Korea, Republic of); Yoon, Min Ki [Good Samaritan Hospital, Pohang (Korea, Republic of)

    2010-06-15

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  1. MR imaging compared with CT, angiography, and myelography supplemented with CT in the diagnosis of spinal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hasuo, Kanehiro; Uchino, Akira; Matsumoto, Shunichi; Fujii, Kiyotaka; Fukui, Masashi; Masuda, Kouji (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine)

    To clarify the significance of MR imaging and the present status of CT, angiography, and myelography supplemented by CT (M-CTM), the radiological findings of 50 spinal tumors were reviewed and analyzed. MR imaging was most effective for visualizing morphological features such as the margins and/or inner structures of the tumors. CT was also effective for imaging 'dumbbell' neurinomas and extradural tumors. Angiography was necessary in one hemangioblastoma and in cervical extradural tumors. M-CTM visualized the morphology of intradural extramedullary tumors and extradural tumors, but provided no new information in most of these cases. It was concluded that when using MR the indications for CT, angiography, and M-CTM are limited and that CT or angiography should be performed only in selected cases. M-CTM appeared to be unnecessary. (author).

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  4. Usefulness of helical CT angiography for diagnosis of anomalous origin of coronary artery. Comparison with coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Shinozaki, Hitoshi; Kondo, Takeshi; Ishikawa, Emiko [Fujita Health Univ., Toyoake, Aichi (Japan)] [and others

    1998-07-01

    Usefulness of helical CT angiography with reconstruction image of diastolic phase synchronized with electrocardiogram was compared with that of coronary angiography for diagnosis of anomalous origin of coronary artery. Patients were 2 males and 3 females, and average age was 66.4 year. Three cardiologists judged images and did not confirmed the origin and direction of coronary artery in 60% of cases. Helical CT was carried out with heartbeat <60/min by oral administration of propranolol (10-20 mg) one hour before the test. Half image was reconstructed by using data of diastolic phase which is 600 msec back from R-wave of an electrocardiogram. Multiplanar reconstruction (MPR) image and 3D image were provided. Two radiologists judged these images. A judgment was completed with 4 cases among 5 cases, and two judgments agreed well. For diagnosis of anomalous origin of coronary artery, helical CT had good accuracy and was more sensitive than coronary angiography. (K.H.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Pulmonary embolism during pregnancy: diagnosis with lung scintigraphy or CT angiography?

    Science.gov (United States)

    Revel, Marie-Pierre; Cohen, Stéphanie; Sanchez, Olivier; Collignon, Marie-Anne; Thiam, Rokhaya; Redheuil, Alban; Meyer, Guy; Frija, Guy

    2011-02-01

    To evaluate the rate of positive, negative, and indeterminate results and the agreement between initial and expert readings for lung scintigraphy and computed tomographic (CT) angiography performed in patients suspected of having pulmonary embolism (PE) during pregnancy. Institutional review board approval was obtained. The authors retrospectively analyzed the images from lung scintigraphy and CT angiography performed in pregnant patients during the past 9 years. Images from 46 CT angiographic examinations performed in 43 patients and 91 of 94 lung scintigraphic examinations were reviewed by experts, whose readings were then compared with the initial reports. For CT angiography, the quality of opacification was graded as good, suboptimal, or poor and intraarterial attenuation was measured. The rates of positive findings (seven of 43 patients [16%] with CT angiography and 10 of 91 patients [11%] with scintigraphy, P = .36), negative findings (28 of 43 patients [65%] with CT angiography and 64 of 91 patients [70%] with scintigraphy, P = .54), and indeterminate findings (eight of 43 patients [19%] with CT angiography and 17 of 91 patients [19%] with scintigraphy, P = .99) were similar for CT angiography and lung scintigraphy. There were four discrepancies between initial and expert readings for CT angiography (κ = 0.84; confidence interval: 0.68, 0.99) and 14 for lung scintigraphy (κ = 0.75; 95% confidence interval: 0.63, 0.87). Opacification was classified as good for only 23 of the 46 CT angiographic examinations (50%). Attenuation values were significantly different among the groups with good, suboptimal, or poor opacification. Alternative diagnoses unsuspected at chest radiography were demonstrated at CT angiography in five of the 43 patients (12%). The mean maternal radiation dose was 0.9 mSv for lung scintigraphy and 7.3 mSv for CT angiography. Lung scintigraphy and CT angiography have comparable performances for PE diagnosis during pregnancy. Interobserver

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  9. 64层CT对心外膜脂肪组织与冠心病相关性的研究进展%Progress of 64-slice spiral CT study on the relationship between epicar-dial adipose tissue and coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    何彪; 郭庆乐

    2015-01-01

    近年来,越来越多的研究表明,心外膜脂肪组织在结构和功能上对冠心病有着重要的影响,其中CT测量心外膜脂肪组织体积因其准确度高于超声测量心外膜脂肪组织厚度,且成本低、效率高,优于MRI而被广泛应用。早期通过影像学检查方法对心外膜组织进行评估,对避免后续心血管疾病的发生具有一定的临床实践意义。%Recent evidences suggest that,epicardical adipose tissue can mechanically and functionally affect the heart and vascular tissue.The accuracy of epicardical adipose tissue volume measured by CT is higher than epicardical adi-pose tissue thickness measured by cardiac ultrasound,and the low cost,high efficiency is better than that of MRI,there-fore is widely used.It may be important to evaluate the epicardical adipose tissue earlier with examination of imageology to avoid the development of cardiovascular disease.

  10. Angiography-based C-arm CT for the assessment of extrahepatic shunting before radioembolization

    Energy Technology Data Exchange (ETDEWEB)

    Heusner, Till Alexander; Hahn, S.; Forsting, M.; Antoch, G. [Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitaetsklinik Essen (Germany); Hamami, M.E.; Poeppel, T.; Bockisch, A. [Klinik fuer Nuklearmedizin, Universitaetsklinik Essen (Germany); Ertle, J.; Hilgard, P. [Klinik fuer Gastroenterologie, Universitaetsklinik Essen (Germany)

    2010-07-15

    Purpose: to retrospectively assess the accuracy of angiography-based C-arm CT for the detection of extrahepatic shunting before SIRT. Materials and methods: 30 patients (mean age: 64 {+-} 12 years) with hypervascularized hepatic tumors underwent hepatic angiography, coil embolization of gastrointestinal collaterals and 99mTc-macroaggregated albumin (MAA) SPECT/CT before SIRT. Before MAA injection via a microcatheter from the intended treatment position, an angiography and angiography-based C-arm CT (XperCT trademark, Philips Healthcare) were acquired. Angiographies and XperCT trademark were performed from 48 microcatheter positions followed by MAA injections and MAA-SPECT/CT. MAA-SPECT/CT served as the reference standard for determining the accuracy of hepatic arteriography and C-arm CT for the detection of extrahepatic shunting. Results: MAA-SPECT/CT revealed extrahepatic shunting in 5 patients (17%). Hepatic arteriography yielded a true negative in 22 (73%), a false negative in 5 (17%), and an unclear result in 3 patients (10%). C-arm CT yielded a true positive in 3 (10%), true negative in 24 (80%), false positive in 1 (3%), and false negative in 2 patients (7%). The specificity and the NPV of hepatic arteriography for the detection of extrahepatic shunting were 88% and 81%, respectively. For C-arm CT the sensitivity, specificity, PPV, NPV, and accuracy for the detection of extrahepatic shunting were 60%, 96%, 75%, 92%, and 90%, respectively. Conclusion: C-arm CT offers additional information to angiography when assessing SIRT patients for extrahepatic shunting. More accurate detection of extrahepatic shunting may optimize the workflow in SIRT preparations by avoiding unnecessary repeat angiographies. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Hanson, Eric H. [Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); University of Nevada Las Vegas, Department of Health Physics and Diagnostic Sciences, 4505 Maryland Parkway, Box 453037, Las Vegas, NV (United States); Amigenics, Inc, Las Vegas, NV (United States); Roach, Cayce J. [Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); University of Nevada Las Vegas, School of Life Sciences, Las Vegas, NV (United States); Ringdahl, Erik N. [University of Nevada Las Vegas, Department of Psychology, Las Vegas, NV (United States); Wynn, Brad L. [Family Medicine Spokane, Spokane, WA (United States); DeChancie, Sean M.; Mann, Nathan D. [Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); Diamond, Alan S. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); Orrison, William W. [Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); University of Nevada Las Vegas, Department of Health Physics and Diagnostic Sciences, 4505 Maryland Parkway, Box 453037, Las Vegas, NV (United States); CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); University of Nevada School of Medicine, Department of Medical Education, Reno, NV (United States)

    2011-05-15

    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.)

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 64层螺旋CT三维重建活体肝静脉的研究及临床意义%3D-reconstruction of hepatic vein by 64-Slice Spiral Computed Tomography and its significance

    Institute of Scientific and Technical Information of China (English)

    杨新文; 王剑华; 周庭永; 吕发金; 洪永华

    2009-01-01

    目的:探讨64层螺旋CT应用于正常人活体体肝静脉研究的可行性,观察三维重建肝静脉的一般形态及走行规律.方法:153例正常受试者经肘正中静脉注射造影剂后,使用64层螺旋CT进行上腹部扫描,图像采集后经容积再现(volume rendering,VR)技术重建肝静脉.结果:重建图像清晰,可显示出6~8级血管及与周围组织间的关系.其中153例肝静脉的分型结果如下:①3分支型,占35.3%(54例);②中左共干型,占41.8%(64例);③中左合干型,占20.9%(32例);④中右共干型,占2.0%(3例).结论:64层螺旋CT可以作为研究活体肝静脉形态的有效手段,三维重建能更准确、全方位地显示肝静脉的正常解剖类型和发现变异,而且图像清晰,对于活体肝静脉的研究有较好的临床应用价值.%Objective: To explore the feasibility of 64-Slice spiral computed tomography (CT) on reconstructing hepatic vein according to its morphology and distribution. Methods: After injecting contrast materials through median cubital vein, 153 voluneers underwent contrast-enhanced CT angiography of epigastric zone utilizing 64-Slice spiral computed tomography. Images were collected and dealt with the technique of volume rendering (VR),and then hepatic vein were reconstructed into 3D-images. Results: On reconstructed images, the vessels of the 6th and the 8th level, and their surrounding structures can be identified.According to the reconstruction images of 153 eases, hepatic.vein can be divided as follow types: ①Trifurcate type with the pencentage of 35.3% (54eases): left, middle and right hepatic veins drained into the inferior vena eava separately; ②Common trunk type of middle and left veins, 41.8% (64 cases): right hepatic vein drained into the inferior vena cava, however, left and middle hepatic veins confluened before their draining into the inferior vena cava; ③Common trunk type of left and right hepatic vein, 20.9% (32eases): left and middle

  14. Assessment Of Coronary Arterial Stents By Multislice-CT Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Maintz, D.; Fallenberg, E. M.; Heindel, W.; Fischbach, R. [Univ. of Muenster (Germany). Dept. of Clinical Radiology; Grude, M. [Univ. of Muenster (Germany). Dept. of Cardiology and Angiology

    2003-11-01

    Purpose: To assess patency and lumen visibility of coronary artery stents by multislice-CT angiography (MSCTA) in comparison with conventional coronary angiography as the standard of reference. Material and Methods: 47 stents of 13 different types were evaluated in 29 patients. MSCTA was performed on a 4-slice scanner with a standard coronary protocol (detector collimation 4 x 1 mm; table feed 1.5 mm/rotation, 400 mAs, 120 kV). Image evaluation was performed by two readers who were blinded to the reports from the catheter angiography. MIP reconstructions were evaluated for image quality on a 4-point scale (1 = poor, 4 = excellent) and stent patency (contrast distal to the stent as an indirect patency sign). Axial images and multiplanar reformations through the stents were used for assessment of stent lumen visibility (measurement of the visible stent lumen diameter) and detection of relevant in-stent stenosis (50%). Results: Image quality was fair to good on average (score 2.64 {+-} 1.0) and depended on the heart rate (heart rate 45-60: average score 3.2, heart rate 61-70: average score 2.8, heart rate >71: average score 1.4). Thirty-seven stents were correctly classified as patent, 1 was correctly classified as occluded and 9 stents were not assessable due to insufficient image quality because of triggering artifacts. Parts of the stent lumen could be visualized in 30 cases. On average, 20-40% of the stent lumen diameter was visible. Twenty-five stents were correctly classified as having no stenosis, 1 was falsely classified as stenosed, 1 was correctly classified as occluded. In 20 stents lumen visibility was not sufficient for stenosis evaluation. Conclusion: Although the stent lumen may be partly visualized in most stents, a reliable evaluation of in-stent stenoses does not seem practical by 4-slice MSCT. Nevertheless, for stent patency evaluation, MS-CTA might provide valuable clinical information. With submillimeter MSCT (e.g. 16-slice scanners) and more

  15. Anatomic distribution of embolus at CT pulmonary angiography in patients suspected acute pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    朱力

    2013-01-01

    Objective To summarize and analyze the morphology and distribution of embolus in patients suspected acute pulmonary embolism. Methods The CT pulmonary angiography(CTPA) imagings of 279 patients suspected acute pulmonary embolism were analyzed retrospectively in

  16. Clinical utility and cost-effectiveness of CT-angiography in the diagnosis of nontraumatic subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Jabbarli, Ramazan; Shah, Mukesch; Hippchen, Beate; Velthoven, Vera van [University Hospital of Freiburg, Department of Neurosurgery, Freiburg/Breisgau (Germany); Taschner, Christian [University Hospital of Freiburg, Department of Neuroradiology, Freiburg (Germany); Kaier, Klaus [University Hospital of Freiburg, Institute for Medical Biometry and Medical Informatics, Freiburg (Germany)

    2014-10-15

    CT-angiography gains an increasing role in the initial diagnosis of patients with nontraumatic subarachnoid hemorrhage (SAH). However, the implementation of CT-angiography does not always exclude the necessity of conventional angiography. Our objective was to determine the practical utility and cost-effectiveness of CT-angiography. All patients with nontraumatic subarachnoid hemorrhage admitted to our university hospital after implementation of CT-angiography between June 1, 2011 and June 30, 2012 were retrospectively analyzed in regard to factors of treatment flow, radiation exposure, harms of contrast medium loading, and diagnostic costs. A control group of the same size was assembled from previously admitted SAH patients, who did not undergo pretreatment CT-angiography. Furthermore, cost-effectiveness analysis was performed. The final analysis consisted of 93 patients in each group. Of 93 patients with pretreatment CT-angiography, 74 had to undergo conventional angiography for diagnostic and/or therapeutic purposes. CT-angiography had significant impact on the reduction of collective effective radiation dose by 4.419 mSv per person (p = 0.0002) and was not associated with additional harms. Despite the significantly earlier detection of aneurysms with CT-angiography (p < 0.0001), there were no significant differences in the timing of aneurysm repair and duration of ICU and general hospital stay. There was an increase of diagnostic costs - the cost-effectiveness analysis showed, however, that benefits of CT-angiography in respect to radiation exposure and risk of conventional angiography-related complications justify the additional costs of CT-angiography. Although the implementation of CT-angiography in SAH diagnosis cannot completely replace conventional angiography, it can be approved in regard to radiation hygiene and cost-effectiveness. (orig.)

  17. Improved dynamic CT angiography visualization by flow territory masking

    Directory of Open Access Journals (Sweden)

    Søren Christensen

    2015-01-01

    Full Text Available Backgound and Purpose: Computerized tomography (CT perfusion (or CTP source images from CT scanners with small detector widths can be used to create a dynamic CT angiogram (CTA similar to digital subtraction angiography (DSA. Because CTP studies use a single intravenous injection, all arterial territories enhance simultaneously, and individual arterial territories [i.e., anterior cerebral artery (ACA, middle cerebral artery (MCA, and posterior cerebral artery (PCA] cannot be delineated. This limits the ability to assess collateral flow patterns on dynamic CTAs. The aim of this study was to devise and test a postprocessing method to selectively color-label the major arterial territories on dynamic CTA. Materials and Methods: We identified 22 acute-stroke patients who underwent CTP on a 320-slice CT scanner within 6 h from symptom onset. For each case, two investigators independently generated an arterial territory map from CTP bolus arrival maps using a semiautomated method. The volumes of the arterial territories were calculated for each map and the average relative difference between these volumes was calculated for each case as a measure of interrater agreement. Arterial territory maps were superimposed on the dynamic CTA to create a vessel-selective dynamic CTA with color-coding of the main arterial territories. Two experts rated the arterial territory maps and the color-coded CTAs for consistency with expected arterial territories on a 3-point scale (excellent, moderate, poor. Results: Arterial territory maps were generated for all 22 patients. The median difference in arterial territory volumes between investigators was 2.2% [interquartile range (IQR 0.6-8.5%]. Based on expert review, the arterial territory maps and the vessel-selective dynamic CTAs showed excellent consistency with the expected arterial territories in 18 of 22 patients, moderate consistency in 2 patients, and poor consistency in another 2 patients. Conclusion: Using a

  18. Improved diagnosis of actively bleeding aneurysm on CT angiography using delayed CT images

    Energy Technology Data Exchange (ETDEWEB)

    Kathuria, Sudhir, E-mail: skathur2@jhmi.edu [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Division of Interventional Neuroradiology, Department of Neurology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Deveikis, John P.; Westesson, Per-Lennart [Division of Diagnostic and Interventional Neuroradiology, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642 (United States); Gandhi, Dheeraj [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Division of Interventional Neuroradiology, Department of Neurology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD (United States)

    2011-08-15

    Computed tomographic angiography (CTA) is being increasingly utilized in the non-invasive diagnosis of aneurysmal subarachnoid hemorrhage (SAH). There are emerging reports of diagnosis of active aneurysmal bleeding on CTA, furthering our understanding of imaging features of active extravasation on cross-sectional studies. We demonstrate imaging characteristics of two such cases of active contrast extravasation from intracranial aneurysms. Additionally, we demonstrate that delayed CT images greatly improve the confidence of this diagnosis by demonstrating pooling of contrast in the subarachnoid space. Prompt recognition and management can improve prognosis of this potentially lethal condition.

  19. Cardiac carcinoid: tricuspid delayed hyperenhancement on cardiac 64-slice multidetector CT and magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Martos, R

    2012-02-01

    INTRODUCTION: Carcinoid heart disease is a rare condition in adults. Its diagnosis can be easily missed in a patient presenting to a primary care setting. We revised the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing this condition. MATERIALS AND METHODS: We studied a 65-year-old patient with carcinoid heart disease and right heart failure using transthoracic Doppler-echocardiogram, cardiac MDCT and MRI. Cardiac echocardiogram revealed marked thickening and retraction of the tricuspid leaflets with dilated right atrium and ventricle. Cardiac MDCT and MRI demonstrated fixation and retraction of the tricuspid leaflets with delayed contrast hyperenhancement of the tricuspid annulus. CONCLUSION: This case demonstrates fascinating imaging findings of cardiac carcinoid disease and highlights the increasing utility of contrast-enhanced MRI and cardiac MDCT in the diagnosis of this interesting condition.

  20. Timing-Invariant CT Angiography Derived from CT Perfusion Imaging in Acute Stroke : A Diagnostic Performance Study

    NARCIS (Netherlands)

    Smith, E. J.; Vonken, E. -J.; Meijer, F. J. A.; Dankbaar, J. W.; Horsch, A. D.; van Ginneken, B.; Velthuis, B.; van der Schaaf, I.; Prokop, M.

    2015-01-01

    BACKGROUND AND PURPOSE: Timing-invariant (or delay-insensitive) CT angiography derived from CT perfusion data may obviate a separate cranial CTA in acute stroke, thus enhancing patient safety by reducing total examination time, radiation dose, and volume of contrast material. We assessed the diagnos

  1. Titanium plate artefact mimicking popliteal artery dissection on digital subtraction CT angiography.

    Science.gov (United States)

    Woodacre, Timothy; Wienand-Barnett, Sophie

    2013-04-05

    Titanium plates used for the internal fixation of long bone fractures cause significant artefact on CT scans but have not been reported to affect digital subtraction CT angiography. We present a patient with clinical suspicion of popliteal artery injury following a high tibial osteotomy. The osteotomy was stabilised with a titanium locking plate. During the digital subtraction process used to produce reconstruction CT angiography, removal of artefact caused by the titanium plate produced CT images mimicking the appearance of a popliteal artery dissection. The imaging inaccuracy was realised prior to the patient undergoing further intervention. We highlight the potential error caused by titanium plates on digital subtraction CT angiography and recommend careful analysis of such images prior to further treatment.

  2. Intravenous flat detector CT angiography for non-invasive visualisation of intracranial flow diverter: technical feasibility.

    Science.gov (United States)

    Struffert, Tobias; Saake, Marc; Ott, Sabine; Engelhorn, Tobias; Gölitz, Philipp; Kloska, Stephan; Doelken, Marc; Doerfler, Arnd

    2011-08-01

    To demonstrate the feasibility of intravenous Flat Detector CT Angiography (FD-CTA) for visualisation of intracranial Flow Diverting Devices. Flow Diverting Devices are used increasingly for treatment of intracranial aneurysms. A close follow up is necessary because it becomes obvious that a significant proportion of aneurysms treated with these devices remain patent. A minimally invasive method is highly desirable. In two patients treated with flow diverters a Flat Detector CT (FD-CT) with intravenous contrast medium application was performed. Post-processing was performed using commercially available software. In both patients the lumen of the device and the lumen of the aneurysm could be clearly evaluated. Some beam hardening artefacts due to the marker wires of the device were obvious. Flat Detector CT with intravenous contrast material application to evaluate flow-diverting devices seems to be feasible. Further studies are necessary to perform comparative evaluation of FD-CTA with angiography and other techniques like MRA or conventional CT angiography.

  3. Radiological findings of dissecting aneurysm -a correlative study of CT with angiography-

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Tae Yeong; Park, Jae Hyung; Kim, Seung Hyup; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1987-06-15

    This study comprised 16 patients with aortic dissecting aneurysm who were admitted to Seoul National University Hospital from May 1984 to January 1987. CT findings in 16 cases of aortic dissecting aneurysm were correlated with angiographic findings retrospectively. The results were analysed. 1. Number of male was 11 and that of female was 5. Male patients in fifties were most common and 4 in number. 13 patients had hypertension or history of hypertension among 14 patients. There were one case of Marfan's syndrome, preeclampsia and Takayasu's arteritis respectively. 2. There were 5 cases of DeBakey type I, 1 case of type II and 9 cases of types III dissecting aneurysm. Type III was most common. 3. CT confirmed as superior vena cava which was not identified whether it was superior vena cava or unopacified false lumen by angiography in one case. Regarding distal extent, authors defined A whose extent was proximal to diaphragm and B beyond it for convenience sake. There was one false negative case in CT among 16 cases which was diagnosed as dissecting aneurysm type IIIB by angiography and confirmed as type III surgically. One case was diagnosed as type IB by CT and as type IIIB by angiography and confirmed as type I surgically. Extent was more accurate in CT than angiography. One case was diagnosed as type II by CT but misdiagnosed as right atrial tumor by angiography. 4. Diagnostic sensitivities of CT and angiography in this study were 94% (15/16) respectively. CT was more advantageous in hemothorax, hemopericardium, hemomediastinum, unopacified false lumen, aortic wall calcification and getting information about mediastinum. In angiography aortic regurgitation and tear site and involvement of abdominal vessels could be observed.

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

    Science.gov (United States)

    Wu, Lian-Ming; Xu, Jian-Rong; Yin, Yan; Qu, Xin-Hua

    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 they compared CT angiography to a reference standard of upper GI endoscopy, colonoscopy, angiography or surgery in the diagnosis of acute GI bleeding. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristic. RESULTS: A total of 9 studies with 198 patients were included in this meta-analysis. Data were used to form 2 × 2 tables. CT angiography showed pooled sensitivity of 89% (95% CI: 82%-94%) and specificity of 85% (95% CI: 74%-92%), without showing significant heterogeneity (χ2 = 12.5, P = 0.13) and (χ2 = 22.95, P = 0.003), respectively. Summary receiver operating characteristic analysis showed an area under the curve of 0.9297. CONCLUSION: CT angiography is an accurate, cost-effective tool in the diagnosis of acute GI bleeding and can show the precise location of bleeding, thereby directing further management. PMID:20712058

  5. Dynamic cone beam CT angiography of carotid and cerebral arteries using canine model

    OpenAIRE

    Cai, Weixing; zhao,binghui; Conover, David; Liu, Jiangkun; Ning, Ruola

    2012-01-01

    Purpose: This research is designed to develop and evaluate a flat-panel detector-based dynamic cone beam CT system for dynamic angiography imaging, which is able to provide both dynamic functional information and dynamic anatomic information from one multirevolution cone beam CT scan.

  6. Automatic coronary calcium scoring in cardiac CT angiography using convolutional neural networks

    NARCIS (Netherlands)

    Wolterink, Jelmer M.; Leiner, Tim; Viergever, Max A.; Isgum, I

    2015-01-01

    The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular events. Non-contrast enhanced cardiac CT is considered a reference for quantification of CAC. Recently, it has been shown that CAC may be quantified in cardiac CT angiography (CCTA). We present

  7. The clinical application of combined dualenergy CT pulmonary angiography and indirect venography

    Institute of Scientific and Technical Information of China (English)

    富青

    2013-01-01

    Objective To assess the usefulness of combined dual-energy CT pulmonary angiography (DE-CTPA) and indirect CT venography(CTV) in the diagnosis of venous thromboembolism(VTE). Methods Forty-nine patients with leg swelling suspected of pulmonary embolism(PE) underwent both DE-CTPA combined with CTV and lower

  8. Multidetector-row CT angiography of upper- and lower-extremity peripheral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Willmann, J.K.; Wildermuth, S. [Inst. of Diagnostic Radiology, Univ. Hospital Zurich, Zurich (Switzerland)

    2005-11-15

    With the introduction of multidetector-row CT (MDCT) technology indications for MDCT angiography have expanded to include assessment of the peripheral arteries of the upper and lower extremities. Combined with patient- and scanner-adjusted CT data acquisition and contrast medium application strategies, an accurate and reliable evaluation of the peripheral arteries of the upper and lower extremities is possible. MDCT angiography is cost-effective and accurate for detection of arterial stenosis and occlusion in patients with peripheral arterial disease (PAD). MDCT angiography allows postoperative assessment of peripheral arterial bypass grafts, including bypass graft stenosis and occlusion, as well as presence of aneurysms or arteriovenous fistulas. In addition, MDCT angiography is helpful in particular for visualization of arterial bypass grafts with a complicated extra-anatomical course. Furthermore, pre-operative peripheral vascular mapping can be performed by using MDCT angiography. Finally, due to the integration of MDCT scanners in many trauma centres, MDCT angiography is increasingly being used for assessment of traumatic arterial injuries. This article gives an overview of technical aspects of peripheral MDCT angiography, including scanning parameters, contrast medium application, image postprocessing and radiation exposure, and summarizes the most frequent acute and non-acute indications of MDCT angiography for assessment of the upper- and lower-extremity peripheral arteries. (orig.)

  9. Minimally invasive post-mortem CT-angiography in a case involving a gunshot wound.

    Science.gov (United States)

    Ruder, Thomas D; Ross, Steffen; Preiss, Ulrich; Thali, Michael J

    2010-05-01

    Non-contrast post-mortem computed tomography (pm-CT) is useful in the evaluation of bony pathologies, whereas minimally invasive pm-CT-angiography allows for the detection of subtle vascular lesions. We present a case of an accidentally self-inflicted fatal bullet wound to the chest where pm-CT-angiography revealed a small laceration of the anterior interventricular branch of the left coronary artery and a tiny disruption of the right ventricle with pericardial and pleural effusion. Subsequent autopsy confirmed our radiological findings. Post-mortem CT-angiography has a great potential for the detection of vascular lesions and can be considered equivalent to autopsy for selected cases in forensic medicine.

  10. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

    Energy Technology Data Exchange (ETDEWEB)

    Seeters, Tom van; Schaaf, Irene C. van der; Dankbaar, Jan Willem; Horsch, Alexander D.; Niesten, Joris M.; Luitse, Merel J.A.; Mali, Willem P.T.M.; Velthuis, Birgitta K. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Biessels, Geert Jan; Kappelle, L.J. [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Majoie, Charles B.L.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Vos, Jan Albert [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Schonewille, Wouter J. [St. Antonius Hospital, Department of Neurology, Nieuwegein (Netherlands); Walderveen, Marianne A.A. van [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Wermer, Marieke J.H. [Leiden University Medical Center, Department of Neurology, Leiden (Netherlands); Duijm, Lucien E.M. [Catharina Hospital, Department of Radiology, Eindhoven (Netherlands); Keizer, Koos [Catharina Hospital, Department of Neurology, Eindhoven (Netherlands); Bot, Joseph C.J. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Visser, Marieke C. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Lugt, Aad van der [Erasmus MC University Medical Center, Department of Radiology, Rotterdam (Netherlands); Dippel, Diederik W.J. [Erasmus MC University Medical Center, Department of Neurology, Rotterdam (Netherlands); Kesselring, F.O.H.W. [Rijnstate Hospital, Department of Radiology, Arnhem (Netherlands); Hofmeijer, Jeannette [Rijnstate Hospital, Department of Neurology, Arnhem (Netherlands); Lycklama a Nijeholt, Geert J. [Medical Center Haaglanden, Department of Radiology, The Hague (Netherlands); Boiten, Jelis [Medical Center Haaglanden, Department of Neurology, The Hague (Netherlands); Rooij, Willem Jan van [St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Kort, Paul L.M. de [St. Elisabeth Hospital, Department of Neurology, Tilburg (Netherlands); Roos, Yvo B.W.E.M. [Academic Medical Center, Department of Neurology, Amsterdam (Netherlands); Meijer, Frederick J.A. [Radboud University Medical Center, Department of Radiology, Nijmegen (Netherlands); Pleiter, C.C. [St. Franciscus Hospital, Department of Radiology, Rotterdam (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: Dutch acute stroke study (DUST) investigators

    2016-04-15

    We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R{sup 2} was assessed to determine the additional value of CTA and CTP. At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82-0.87); p < 0.001) and was even higher after addition of CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001) and combined CTA/CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001). For infarct volume, adding combined CTA/CTP measures (R{sup 2} = 0.58) was superior to patient characteristics and non-contrast CT alone (R{sup 2} = 0.44) and to addition of CTA alone (R{sup 2} = 0.55) or CTP alone (R{sup 2} = 0.54; all p < 0.001). In the acute stage, CTA and CTP have additional value over patient characteristics and non-contrast CT for predicting infarct presence and infarct volume on follow-up imaging. These findings could be applied for patient selection in future trials on ischemic stroke treatment. (orig.)

  11. The Efficacy of Iopamidol (Pamiray 370) in Aortic and Extremity CT Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoo Jin; Lee, Jong Min; Lee, Hui Joong; Park, Ji Won [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2010-01-15

    To evaluate the clinical safety and radiological feasibility of a domestic iopamidol-based contrast media (Pamiray 370) during an aortic and extremity CT angiography. Between August and December of 2008, 100 patients (M:F=51:49; mean age, 59 years) underwent an aortic and extremity CT angiography using Pamiray 370 based with informed consent. All changes in vital signs, clinical symptoms, and adverse reactions to the contrast media were monitored. Two radiologists assessed the image quality of the CT angiography. A statistical comparison was conducted using an independent t-test and a Mann-Whitney test based on the 100-patient group studied using Optiray 350. The contrast enhancement of the descending aorta in the arterial phase showed a statistically greater efficacy (p<0.001) of Pamiray 370 compared to Optiray 350, which was the routine contrast media for CT angiography for our institute. Adverse reaction signs were evident in 3%(3/100) of the subjects. All of them showed mild and transient reactions such as vomiting (n=2) and coughing (n=1), with no medical treatment required. Contrast media related symptoms including dizziness (n=7), nausea (n=3), headaches (n=2), and injection site pain (n=1), were noted in 12%(12/100). The clinical efficacy of Pamiray 370 was acceptable for the aortic and extremity CT angiography, in terms of clinical safety, tolerance, and image quality.

  12. Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Tom van Seeters

    Full Text Available BACKGROUND AND PURPOSE: Good reliability of methods to assess the extent of ischemia in acute stroke is important for implementation in clinical practice, especially between observers with varying experience. Our aim was to determine inter- and intra-observer reliability of the 1/3 middle cerebral artery (MCA rule and the Alberta Stroke Program Early CT Score (ASPECTS for different CT modalities in patients suspected of acute ischemic stroke. METHODS: We prospectively included 105 patients with acute neurological deficit due to suspected acute ischemic stroke within 9 hours after symptom onset. All patients underwent non-contrast CT, CT perfusion and CT angiography on admission. All images were evaluated twice for presence of ischemia, ischemia with >1/3 MCA involvement, and ASPECTS. Four observers evaluated twenty scans twice for intra-observer agreement. We used kappa statistics and intraclass correlation coefficient to calculate agreement. RESULTS: Inter-observer agreement for the 1/3 MCA rule and ASPECTS was fair to good for non-contrast CT, poor to good for CT angiography source images, but excellent for all CT perfusion maps (cerebral blood volume, mean transit time, and predicted penumbra and infarct maps. Intra-observer agreement for the 1/3 MCA rule and ASPECTS was poor to good for non-contrast CT, fair to moderate for CT angiography source images, and good to excellent for all CT perfusion maps. CONCLUSION: Between observers with a different level of experience, agreement on the radiological diagnosis of cerebral ischemia is much better for CT perfusion than for non-contrast CT and CT angiography source images, and therefore CT perfusion is a very reliable addition to standard stroke imaging.

  13. Pre-test probability of obstructive coronary stenosis in patients undergoing coronary CT angiography: Comparative performance of the modified diamond-Forrester algorithm versus methods incorporating cardiovascular risk factors.

    Science.gov (United States)

    Ferreira, António Miguel; Marques, Hugo; Tralhão, António; Santos, Miguel Borges; Santos, Ana Rita; Cardoso, Gonçalo; Dores, Hélder; Carvalho, Maria Salomé; Madeira, Sérgio; Machado, Francisco Pereira; Cardim, Nuno; de Araújo Gonçalves, Pedro

    2016-11-01

    Current guidelines recommend the use of the Modified Diamond-Forrester (MDF) method to assess the pre-test likelihood of obstructive coronary artery disease (CAD). We aimed to compare the performance of the MDF method with two contemporary algorithms derived from multicenter trials that additionally incorporate cardiovascular risk factors: the calculator-based 'CAD Consortium 2' method, and the integer-based CONFIRM score. We assessed 1069 consecutive patients without known CAD undergoing coronary CT angiography (CCTA) for stable chest pain. Obstructive CAD was defined as the presence of coronary stenosis ≥50% on 64-slice dual-source CT. The three methods were assessed for calibration, discrimination, net reclassification, and changes in proposed downstream testing based upon calculated pre-test likelihoods. The observed prevalence of obstructive CAD was 13.8% (n=147). Overestimations of the likelihood of obstructive CAD were 140.1%, 9.8%, and 18.8%, respectively, for the MDF, CAD Consortium 2 and CONFIRM methods. The CAD Consortium 2 showed greater discriminative power than the MDF method, with a C-statistic of 0.73 vs. 0.70 (pMDF method. Adoption of these scores may improve disease prediction and change the diagnostic pathway in a significant proportion of patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Preoperative evaluation of the artery of adamkiewicz by MR angiography and CT angiography in patients with a thoracic aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Niinuma, Hiroyuki; Ohira, Atsushi; Makita, Shinji; Moriai, Yoshiteru; Hiramori, Katsuhiko [Iwate Medical Univ., Morioka (Japan). School of Medicine; Yoshioka, Kunihiro; Nakajima, Takayuki; Kawazoe, Kohei [Iwate Medical Univ., Morioka (Japan). Memorial Heart Center

    2002-08-01

    Paraplegia is known as an extremely serious and important complication of surgical repair in patients with a thoraco-abdominal aortic aneurysm. It is important to evaluate the artery of Adamkiewicz (AdA) before surgical repair to prevent paraplegia. But the AdA is difficult to visualize by the invasive and hazardous, conventional selective angiography. The aim of this study was to visualize AdA by MR angiography (MRA) and CT angiography (CTA). Twenty-one consecutive patients with a thoracic aortic aneurysm underwent both gadolinium-enhanced, three-dimensional MRA and CTA using multislice helical CT. The AdA was successfully visualized in 15 of the 21 patients (71.4%) by MRA, and in 17 of those 21 patients (80.9%) by CTA. Its continuity was depicted in 12 of 15 patients (80%) by MRA, and in 9 of 17 patients (47%) by CTA. AdA was visualized at 85.7% by MRA or CTA, respectively. This study shows that CTA is a much more sensitive method to detect AdA than MRA. On the other hand, MRA is better to evaluate the continuity of AdA from the descending aorta to the anterior spinal artery, than CTA. Therefore, MRA and CTA are both useful for a preoperative evaluation of AdA and its detailed vascular anatomy from the aorta to the anterior spinal artery. (author)

  15. Multidetector CT angiography of renal vasculature: normal anatomy and variants

    Energy Technology Data Exchange (ETDEWEB)

    Tuerkvatan, Aysel; Oezdemir, Mustafa; Cumhur, Turhan; Oelcer, Tuelay [Tuerkiye Yueksek ihtisas Hospital, Department of Radiology, Sihhiye, Ankara (Turkey)

    2009-01-15

    Knowledge of the variations in renal vascular anatomy is important before laparoscopic donor or partial nephrectomy and vascular reconstruction for renal artery stenosis or abdominal aortic aneurysm. Recently, multidetector computed tomographic (MDCT) angiography has become a principal imaging investigation for assessment of the renal vasculature and has challenged the role of conventional angiography. It is an excellent imaging technique because it is a fast and non-invasive tool that provides highly accurate and detailed evaluation of normal renal vascular anatomy and variants. The number, size and course of the renal arteries and veins are easily identified by MDCT angiography. The purpose of this pictorial essay is to illustrate MDCT angiographic appearance of normal anatomy and common variants of the renal vasculature. (orig.)

  16. Cerebral artery evaluation of dual energy CT angiography with dual source CT

    Institute of Scientific and Technical Information of China (English)

    MA Rui; LIU Cheng; DENG Kai; SONG Shao-juan; WANG Dao-ping; HUANG Ling

    2010-01-01

    Background Conventional computed tomography angiography (CTA) is time consuming, user-dependent and has poor image quality in skull base region. This study assessed the feasibility of a new method, dual energy CTA for depicting the cerebral artery.Methods Phantom scan was done with head CTA sequences on dual source CT and 64 spiral CT for radiation dose calculation. Dual energy CTA was done with dual source CT on 36 patients who were suspected of having cerebral vascular disease. Three series axial images in 0.75 mm thick, 0.4 mm increment were acquired, which were named with 80 kV, 140 kV and merged images; 80 kV and 140 kV images were transferred into dual energy software, and maximum intensity projection (MIP) image was generated quickly by dual energy bone remove (DEBR group); merged images were transferred into In Space software to acquire MIP image through manual conventional bone remove (CoBR group). Post processing time and reading time were compared. Image qualities of the two groups were compared, mainly focusing on skull base segments of internal carotid artery and bone subtraction. ANOVA and SNK tests were applied for radiation dose comparison. Student's t test and Wilcoxon rank sum test were applied for assessing differences between data for significance. Cohen's kappa was used for interobserver agreement. Results Radiation dose of phantom scan showed dual energy CTA was between digital bone subtraction and conventional CTA. The post processing time and reading time were much shorter in DEBR than CoBR, and image quality in skull base was much higher in DEBR than CoBR (P0.5). Interobserver agreement for all vessel segments was excellent (kappa=0.97). Conclusions Dual energy CTA is a reliable, new modality for depicting cerebral artery, overcoming the limitation of conventional CTA in the skull base region. It can save much time in post processing and reading than conventional CTA.

  17. Diagnostic performance of CT angiography in neck vessel trauma: systematic review and meta-analysis.

    Science.gov (United States)

    Morales-Uribe, Carlos; Ramírez, Ana; Suarez-Poveda, Tatiana; Ortiz, Margarita; Sanabria, Alvaro

    2016-10-01

    This study was conducted in order to define the diagnostic performance of CT angiography for vascular injuries compared with angiography in patients with neck trauma. CT angiography is the cornerstone of diagnosis for hemodynamically stable patients with wounds suspicious of vascular trauma in the limbs, chest, or abdomen. Available evidence for the use of CT angiography in neck vascular trauma comes from small case series and few randomized controlled trials, and high-quality information does not exist regarding its performance. A protocol using the recommendations of the Cochrane Collaboration was designed. A systematic search of diagnostic studies without limits on language or time was carried out to December 2014. Studies including patients with neck trauma with retrospective or prospective data collection that assessed CT angiography compared with other methods were selected. Methodological quality was assessed using the QUADAS-2 tool. A hierarchical model ROC curve and a bivariate random effects model were used for the pooled analysis. Sixteen studies were selected and reviewed, and nine studies with 693 patients were included in this review. The overall sensitivity was 97 % (95 % CI 0.77-1.00; I (2) = 65.7 % (41.4-90.0)), while the overall specificity was 99 % (95 % CI 0.93-1.00; I (2) = 0). The hierarchic ROC curve showed an area under the curve of 0.99. Publication bias was not identified in this study. CT angiography can be stated as the gold standard for diagnosing vascular injuries in hemodynamically stable patients with neck trauma.

  18. Image Quality in Reduced-Dose Coronary CT Angiography

    NARCIS (Netherlands)

    Gagarina, Nina V.; Irwan, Roy; Gordina, Galina; Fominykh, Ekaterina; Sijens, Paul E.

    2011-01-01

    Rationale and Objectives: Concerns for patient's risk of radiation-induced cancer have increased demand for reduced-dose coronary computed tomography angiography (CCTA). Previous comparisons of full and reduced-dose CCTA were not conclusive, because results were compared in different groups of patie

  19. A newly developed technique involving the optimization of flow velocity compensation for lower extremity CT angiography

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lei; XU Dong; LI KunCheng; JIN ErHu; BARNES Bret

    2013-01-01

    Advanced computed tomography (CT) technology has allowed for faster and more robust imaging.However,it has been a technical challenge to correctly synchronize CT acquisition with adequate and uniform arterial enhancement in the entire peripheral arterial tree.In this summary,we introduce a method of injection/acquisition optimization strategy based on a velocity-compensated CT angiography technique for the peripheral artery system,which is currently used in the United States.We believe that this imaging technique will provide additional information for our daily CT services in China.

  20. Preliminary study of the clinical value of 64- slice spiral CT angiography in the diagnosis of Takayasu arteritis in children%儿童多发性大动脉炎64层螺旋CT 血管成像临床诊断价值初探

    Institute of Scientific and Technical Information of China (English)

    胡迪; 彭芸

    2013-01-01

    目的:探讨多层螺旋CT血管成像(MSCTA)对儿童多发性大动脉炎的诊断价值.方法:回顾性分析本院37例多发性大动脉炎患儿的MSCTA资料,图像后处理方法包括多平面重组(MPR)、最大密度投影(MIP)和容积再现(VR)技术.结果:37例按Lupi-Herrea 分类法,Ⅰ型2例,Ⅱ型18例,Ⅲ型15例,Ⅳ型2例.初诊时MSCTA检查显示所有受累血管共150支,狭窄-阻塞型37支,其中5支管腔闭塞,4支伴有细小侧支循环形成,1支伴局部血栓形成;扩张型11支,部分管壁伴有钙化;其余为混合型.狭窄血管中17支轻度狭窄、102支中度狭窄、15支重度狭窄、5支完全闭塞.不同时期受累血管均有不同程度的管壁增厚(2.0~7.0mm),活动期3.4~7.0mm,非活动期1.1~3.2mm.活动期CT平扫可见受累血管壁有环形低密度水肿状态带,增强扫描血管壁不均匀强化;非活动期局部血管可呈囊样扩张,管壁密度增高,部分可见钙化,增强扫描无强化.治疗后受累较轻血管可以完全恢复正常血管状态.结论:MSCTA在多发性大动脉炎的诊断方面有很高的准确性,可以作为多发性大动脉炎早期诊断的首选影像检查方法.

  1. A new approach to the assessment of lumen visibility of coronary artery stent at various heart rates using 64-slice MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Groen, J.M.; Greuter, M.J.W.; Ooijen, P.M.A. van; Oudkerk, M. [University Medical Center Groningen, University of Groningen, Department of Radiology, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands)

    2007-07-15

    Coronary artery stent lumen visibility was assessed as a function of cardiac movement and temporal resolution with an automated objective method using an anthropomorphic moving heart phantom. Nine different coronary stents filled with contrast fluid and surrounded by fat were scanned using 64-slice multi-detector computed tomography (MDCT) at 50-100 beats/min with the moving heart phantom. Image quality was assessed by measuring in-stent CT attenuation and by a dedicated tool in the longitudinal and axial plane. Images were scored by CT attenuation and lumen visibility and compared with theoretical scoring to analyse the effect of multi-segment reconstruction (MSR). An average increase in CT attenuation of 144 {+-} 59 HU and average diminished lumen visibility of 29 {+-} 12% was observed at higher heart rates in both planes. A negative correlation between image quality and heart rate was non-significant for the majority of measurements (P > 0.06). No improvement of image quality was observed in using MSR. In conclusion, in-stent CT attenuation increases and lumen visibility decreases at increasing heart rate. Results obtained with the automated tool show similar behaviour compared with attenuation measurements. Cardiac movement during data acquisition causes approximately twice as much blurring compared with the influence of temporal resolution on image quality. (orig.)

  2. Whole-brain dynamic CT angiography and perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Orrison, W.W. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Department of Medical Education, University of Nevada School of Medicine, Reno, NV (United States); Snyder, K.V.; Hopkins, L.N. [Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, Buffalo, NY (United States); Roach, C.J. [School of Life Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Ringdahl, E.N. [Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV (United States); Nazir, R. [Shifa International Hospital, Islamabad (Pakistan); Hanson, E.H., E-mail: eric.hanson@amigenics.co [College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States)

    2011-06-15

    The availability of whole brain computed tomography (CT) perfusion has expanded the opportunities for analysing the haemodynamic parameters associated with varied neurological conditions. Examples demonstrating the clinical utility of whole-brain CT perfusion imaging in selected acute and chronic ischaemic arterial neurovascular conditions are presented. Whole-brain CT perfusion enables the detection and focused haemodynamic analyses of acute and chronic arterial conditions in the central nervous system without the limitation of partial anatomical coverage of the brain.

  3. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel S.); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment str

  4. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment stra

  5. Feasibility of low contrast media volume in CT angiography of the aorta

    NARCIS (Netherlands)

    Seehofnerová, Anna; Kok, Madeleine; Mihl, Casper; Douwes, Dave; Sailer, Anni; Nijssen, Estelle; de Haan, Michiel J W; Wildberger, Joachim E; Das, Marco

    2015-01-01

    OBJECTIVES: Using smaller volumes of contrast media (CM) in CT angiography (CTA) is desirable in terms of cost reduction and prevention of contrast-induced nephropathy (CIN). The purpose was to evaluate the feasibility of low CM volume in CTA of the aorta. METHODS: 77 patients referred for CTA of th

  6. Bilateral internal carotid agenesis: value of CT angiography and correlation to embryogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Pilleul, F.; Rouviere, O. [Dept. of Radiology, Hopital Edouard Herriot, Lyon (France); Guibaud, L.; Pracros, J.P. [Dept. of Pediatric Imaging, Hopital Debrousse, Lyon (France); Badinand, N. [Dept. of Pediatric Neurology, Hopital Debrousse, Lyon (France)

    2001-05-01

    Bilateral internal carotid artery agenesis is an uncommon disease, difficult to differentiate from bilateral carotid artery thrombosis. A few case reports have described the contribution of conventional angiogram to make the diagnosis and recognize the anatomic details of this rare malformation. Advantages of CT angiography as a non-invasive radiologic tool are discussed in this case report. (orig.)

  7. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment stra

  8. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel S.); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment str

  9. Preoperative planning for endovascular aortic repair of abdominal aortic aneurysms: feasibility of nonenhanced MR angiography versus contrast-enhanced CT angiography.

    Science.gov (United States)

    Goshima, Satoshi; Kanematsu, Masayuki; Kondo, Hiroshi; Kawada, Hiroshi; Kojima, Toshihisa; Sakurai, Kota; Watanabe, Haruo; Shimabukuro, Katsuya; Matsuno, Yukihiro; Ishida, Narihiro; Takemura, Hirofumi; Bae, Kyongtae T

    2013-06-01

    To compare vascular measurements to determine stent types and configurations for abdominal endovascular aneurysm repair (EVAR) by comparing results of contrast material-enhanced computed tomographic (CT) angiography and nonenhanced magnetic resonance (MR) angiography. This prospective study was institutional review board approved, and all patients provided written informed consent. Fifty patients (45 men and five women; mean age, 76.0 years) admitted for elective abdominal EVAR underwent preoperative abdominal CT angiography (triplanar reformatted images; section thickness of 1-3 mm) and nonenhanced MR angiography (triplanar two-dimensional single-shot turbo field-echo images; section thickness of 6 mm). Two observers independently completed standard measurement and device selection forms for endovascular stent planning for CT and MR angiography. Pearson and intraclass correlation coefficients were calculated to evaluate intermodality and interobserver differences. No significant difference was found in aortic neck diameter (observer 1: CT, 18.5 mm; MR, 19.0 mm; P = .43) (observer 2: CT, 19.6 mm; MR, 19.3 mm; P = .59), aortic neck diameter 15 mm distal to the lowest renal artery (observer 1: CT, 19.2 mm; MR, 19.2 mm; P = .38) (observer 2: CT, 19.6 mm; MR, 19.6 mm; P = .91), aortic neck length (observer 1: CT, 43.6 mm; MR, 43.6 mm; P = .85) (observer 2: CT, 44.4 mm; MR, 44.0 mm; P = .93), or other key vascular measurements (P = .23-.99) for preoperative planning. These included aneurysm diameter, lowest renal artery to aortic bifurcation length, aortic bifurcation diameter, common iliac artery diameters, external iliac artery diameters, length between orifices of lower renal and internal iliac arteries, and iliac artery sealing length. CT and MR angiography measurements showed very strong correlation (r = 0.92-0.99). Intraclass correlation coefficients between observers ranged from 0.90 to 0.98. Stent types and configurations determined with CT measurements remained

  10. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography

    Directory of Open Access Journals (Sweden)

    Weintraub Nealw F

    2009-04-01

    Full Text Available Abstract We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  11. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography.

    Science.gov (United States)

    Rahman, Shahid; Abdul-Waheed, Mohammed; Helmy, Tarek; Huffman, Lynn C; Koshal, Vipin; Guitron, Julian; Merrill, Walter H; Lewis, David F; Dunlap, Stephanie; Shizukuda, Yukitaka; Weintraub, Neal L; Meyer, Christopher; Cilingiroglu, Mehmet

    2009-04-01

    We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  12. Intravenous flat detector CT angiography for non-invasive visualisation of intracranial flow diverter: technical feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Struffert, Tobias; Saake, Marc; Ott, Sabine; Engelhorn, Tobias; Goelitz, Philipp; Kloska, Stephan; Doelken, Marc; Doerfler, Arnd [University of Erlangen-Nuremberg, Department of Neuroradiology, Erlangen (Germany)

    2011-08-15

    To demonstrate the feasibility of intravenous Flat Detector CT Angiography (FD-CTA) for visualisation of intracranial Flow Diverting Devices. Flow Diverting Devices are used increasingly for treatment of intracranial aneurysms. A close follow up is necessary because it becomes obvious that a significant proportion of aneurysms treated with these devices remain patent. A minimally invasive method is highly desirable. In two patients treated with flow diverters a Flat Detector CT (FD-CT) with intravenous contrast medium application was performed. Post-processing was performed using commercially available software. In both patients the lumen of the device and the lumen of the aneurysm could be clearly evaluated. Some beam hardening artefacts due to the marker wires of the device were obvious. Flat Detector CT with intravenous contrast material application to evaluate flow-diverting devices seems to be feasible. Further studies are necessary to perform comparative evaluation of FD-CTA with angiography and other techniques like MRA or conventional CT angiography. (orig.)

  13. Three-dimensional CT angiography with volume rendering for the dignosis of multiple intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    FANG Bing; LI Tie-lin; ZHANG Jian-min; DUAN Chuan-zhi; WANG Qiu-jing; ZAO Qing-ping

    2004-01-01

    Objective:To evaluate the importance of 3D-CTA with volume rendering for the diagnosis of multiple intracranial aneurysms. Methods: Axial source images were obtained by helical CT scanning and reconstruction of 3D-CTA images was done by volume rendering technique in conjunction with multiplanar reformation. Results: In the past one year,there were 10 patients diagnosed as having multiple intracranial aneurysms by 3D-CTA and altogether 24 aneurysms were visualized,including 10 small aneurysms(≤5mm.Three dimensional CT angiography with volume rendering demonstrated aneurysms very well and provided useful information concerning the site,shape,size and spatial relationship with the surrounding vessels and bone anatomy. Conclusion: Three-dimensional CT angiography with volume rendering is a quick,reliable,and relatively noninvasive method for diagnosing multiple intracranial aneurysms.It delineates detailed aneurysmal morphology,and provides useful information for planning microsurgical approaches.

  14. Detection of hemorrhage source: the diagnostic value of post-mortem CT-angiography.

    Science.gov (United States)

    Palmiere, C; Binaghi, S; Doenz, F; Bize, P; Chevallier, C; Mangin, P; Grabherr, S

    2012-10-10

    The aim of this study was to compare the diagnostic value of post-mortem computed tomography angiography (PMCTA) to conventional, ante-mortem computed tomography (CT)-scan, CT-angiography (CTA) and digital subtraction angiography (DSA) in the detection and localization of the source of bleeding in cases of acute hemorrhage with fatal outcomes. The medical records and imaging scans of nine individuals who underwent a conventional, ante-mortem CT-scan, CTA or DSA and later died in the hospital as a result of an acute hemorrhage were reviewed. Post-mortem computed tomography angiography, using multi-phase post-mortem CTA, as well as medico-legal autopsies were performed. Localization accuracy of the bleeding was assessed by comparing the diagnostic findings of the different techniques. The results revealed that data from ante-mortem and post-mortem radiological examinations were similar, though the PMCTA showed a higher sensitivity for detecting the hemorrhage source than did ante-mortem radiological investigations. By comparing the results of PMCTA and conventional autopsy, much higher sensitivity was noted in PMCTA in identifying the source of the bleeding. In fact, the vessels involved were identified in eight out of nine cases using PMCTA and only in three cases through conventional autopsy. Our study showed that PMCTA, similar to clinical radiological investigations, is able to precisely identify lesions of arterial and/or venous vessels and thus determine the source of bleeding in cases of acute hemorrhages with fatal outcomes.

  15. 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

    Directory of Open Access Journals (Sweden)

    Elif Ergun

    2011-03-01

    Full Text Available 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 DSA reader was the angiographer who performed the DSA. The results of the CTA were compared with the DSA results and/or intraoperative findings in order to determine the diagnostic efficacy of CTA in detecting intracranial aneurysms. Results: Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CTA in detecting aneurysms were 92.8%, 83.3%, 96.2%, 71.4% and 91.2% respectively. The diagnostic value of CTA in detecting intracranial aneurysms was found to be equal to DSA by Mcnemar test. Conclusion: CTA is invaluable in detecting intracranial aneurysms. It may be used as a first line modality in SAH, and DSA may be reserved for patients with negative or equivocal CTA results.

  16. Prevalence of non-cardiovascular findings on CT angiography in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Malik, Archana [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); St. Christopher' s Hospital for Children, Department of Radiology, Philadelphia, PA (United States); Hellinger, Jeffrey C. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); New York Cardiovascular Institute at Lenox Hill Radiology, New York, NY (United States); Servaes, Sabah; Keller, Marc S. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Schwartz, Mathew C. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Levine Children' s Hospital, Sanger Heart and Vascular Institute, Charlotte, NC (United States); Epelman, Monica [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Nemours Children' s Health System/Nemours Children' s Hospital, Department of Medical Imaging/Radiology, Orlando, FL (United States)

    2017-03-15

    CT angiography is gaining broader acceptance in the evaluation of children with known or suspected congenital heart disease. These studies include non-cardiovascular structures such as the mediastinum, lung parenchyma and upper abdominal organs. It is important to inspect all these structures for potential abnormalities that might be clinically important and, in some cases, may impact care plans. To determine the prevalence of non-cardiovascular findings in CT angiography of children with congenital heart disease. During 28 months, 300 consecutive children (170 males; mean age: 7.1 years, age range: 6 h-26 years), referred from a tertiary pediatric cardiology center, underwent clinically indicated CT angiography to evaluate known or suspected congenital heart disease. Slightly more than half (n = 169) of the patients were postoperative or post-intervention. Examinations were retrospectively reviewed, and non-cardiovascular findings were recorded and tabulated by organ system, congenital heart disease and operative procedure in conjunction with outcomes from medical charts. Non-cardiovascular findings were identified in 83% (n = 250 / 300) of the studies for a total of 857 findings. In 221 patients (n = 73.7% of 300) a total of 813 non-cardiovascular findings were clinically significant, while in 9.7% (n = 29 / 300) of patients, 5.1% (n = 44 / 857) of the findings were nonsignificant. In 38.3% (n = 115 / 300) of patients with significant non-cardiovascular pathology, the findings were unexpected and directly impacted patient care plans. Commonly involved organs with non-cardiovascular findings were the lungs with 280 non-cardiovascular findings in 176 / 300 (58.7%) of patients, the airway with 139 non-cardiovascular findings in 103 / 300 (34.3%) of patients and the liver with 108 non-cardiovascular findings in 72 / 300 (24.0%) of patients. Syndromic associations were noted in 22% (n = 66 / 300) of the patients. Non-cardiovascular findings are common in children with

  17. CT coronary angiography in patients with atrial fibrillation; CT-Koronarangiographie bei Patienten mit Vorhofflimmern

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, A.; Sommer, T.; Leiss, A.; Naehle, P.; Schild, H.; Flacke, S. [Universitaetsklinikum Bonn, Radiologische Klinik (Germany); Probst, C.; Welz, A. [Universitaetsklinikum Bonn, Klinik fuer Herzchirurgie (Germany)

    2005-12-15

    Purpose: Reliable visualization of the coronary arteries with multislice spiral CT angiography (MSCTA) in patients with atrial fibrillation (AF) remains a challenge despite retrospective ECG gating. A recently developed new algorithm automatically compensates dynamic changes in the heart rate during the scan, thus reducing misregistration and motion artifacts. The HeartBeat-RT algorithm combines a fixed percent delay determined from the first R wave and the fixed offset delay based on the second R wave in the ECG cycle. The purpose of this study was to find out the optimal reconstruction window in MSCTA in patients with AF for each of the three major coronary arteries during the cardiac cycle. Materials and methods: 20 patients with permanent AF were imaged on a 16-slice scanner (slice collimation: 16 x 0.75 mm; rotation time 0.42 s; 140 kV; 380 mAs; 120 ml Ultravist 370 {sup registered} i.v.). The patients had not received any previous drugs for heart frequency regulation. Acquisition was started after bolus tracking of a biphasic bolus of 120 ml Ultravist 370 injected intravenously. Each coronary segment was reconstructed at 0%-90% of the cardiac cycle in increments of 10%. For image analysis we used coronary segments as defined by the American Heart Association. Two blinded independent readers assessed the image quality in terms of visibility and artifacts (five-point rating scale 1=very poor, 2=poor, 3=fair, 4=good and 5=excellent) and the degree of stenosis (five-point rating scale 1=0%, 2=1%-49%, 3=50%-74%, 4=75%-99%, 5=100%) on axial slices, multiplanar reconstructions and three-dimensional volume-rendered images. (orig.)

  18. Spiral-CT angiography after intraarterial iliac stent placement; Spiral-CT-Angiographie nach arterieller iliakaler Stentapplikation

    Energy Technology Data Exchange (ETDEWEB)

    Freund, M. [Kiel Univ. (Germany). Klinik fuer Radiologische Diagnostik; Palmie, S. [Kiel Univ. (Germany). Klinik fuer Radiologische Diagnostik; Wesner, F. [Kiel Univ. (Germany). Klinik fuer Radiologische Diagnostik; Heller, M. [Kiel Univ. (Germany). Klinik fuer Radiologische Diagnostik

    1995-10-01

    In a prospective study 32 patients underwent CT-A after stent placement in the iliac arteries. The vascular morphology was analyzed regarding neointimal hyperplasia and calcification pattern. The results were compared with those of clinical findings (walking distance), Doppler ultrasound (ankle-brachial index) and DSA. All 47 stents were visible and patent (100%). One misplacement was identified. A good correlation was found between an improved ankle-brachial index and CT-A (88.5%) and extension of the walking distance and CT-A (92.3%). Concerning location, number and grade of stenoses the results between CT-A and DSA matched in 42.1%. An exact mapping of calcified plaques was possible in all cases. (orig./MG) [Deutsch] Nach perkutaner transluminaler Angioplastie (PTA) und Stenteinlage wurden 32 Patienten prospektiv mittels CT-A untersucht. Es erfolgte eine Analyse der Gefaessmorphologie hinsichtlich neointimaler Hyperplasien und Verkalkungsmuster. Weiterhin wurden die Ergebnisse mit denen der intraarteriellen digitalen Subtraktionsangiographie (i.a. DSA), dem klinischen Befund (Gehstrecke) und der Doppler-Ultraschalluntersuchung (Arm-Knoechel-Index/AKI) verglichen. Alle 47 Stents konnten in der CT-A exakt lokalisiert und als offen identifiziert werden (100%). Eine Stentfehllage wurde diagnostiziert. Der Nachweis neointimaler Hyperplasie gelang aufgrund von Metallartefakten im Stentniveau nicht. Verkalkungen waren in allen Faellen nachweisbar. Eine Uebereinstimmung zwischen DSA und CT-A hinsichtlich des Schweregrades, der Anzahl und Lokalisation von Stenosen fand sich nur in 42,1%. In 88,5% der Faelle bestand eine Uebereinstimmung zwischen CT-morphologischem Befund und verbessertem AKI, in 92,3% mit verlaengerter Gehstrecke. (orig./MG)

  19. Prediction of outcome in patients with suspected acute ischaemic stroke with CT perfusion and CT angiography: the Dutch acute stroke trial (DUST) study protocol

    NARCIS (Netherlands)

    Seeters, T. van; Biessels, G.J.; Schaaf, I.C. van der; Dankbaar, J.W.; Horsch, A.D.; Luitse, M.J.; Niesten, J.M.; Mali, W.P.Th.; Kappelle, L.J.; Graaf, Y. van der; Velthuis, B.K.; Dijk, E.J. van

    2014-01-01

    BACKGROUND: Prediction of clinical outcome in the acute stage of ischaemic stroke can be difficult when based on patient characteristics, clinical findings and on non-contrast CT. CT perfusion and CT angiography may provide additional prognostic information and guide treatment in the early stage. We

  20. Evaluation of spinal cord vessels using multi-slice CT angiography

    Institute of Scientific and Technical Information of China (English)

    陈爽; 钱建国; 冯晓源

    2004-01-01

    @@ Compared with the large number of head and neck vascular studies, computer tomography (CT) angiography of spinal vascular lesions has received relatively little attention. Several series and a few isolated cases of spinal vascular malformations demonstrated with magnetic resonance (MR) angiography have been reported.1-3 Selective digital subtraction angiography (DSA) is gold standard for diagnosis of spinal vascular lesions.4 However, it is invasive, time consuming, expensive, and dependent on the skills of the operator. Based on the DSA appearance and the surgical findings, spinal vascular malformations are generally, although not universally, classified as intradural (intramedullary and/or extramedullary) arteriovenous malformation (AVM) or arteriovenous fistula (AVF), and dural AVF. Recommended treatments of dural AVF consist of surgical obliteration and/or embolization.5-8

  1. One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Yamasaki, Yuzo; Kamitani, Takeshi; Sagiyama, Koji; Yamanouchi, Torahiko; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan); Nagao, Michinobu; Kawanami, Satoshi [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Fukuoka (Japan); Sakamoto, Ichiro [Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Fukuoka (Japan); Yamamura, Kenichiro [Kyushu University, Department of Pediatrics, Graduate School of Medical Sciences, Fukuoka (Japan); Yabuuchi, Hidetake [Kyushu University, Department of Health Sciences, Graduate School of Medical Sciences, Fukuoka (Japan)

    2017-02-15

    To investigate the feasibility and accuracy of measurement of the pulmonary to systemic blood flow ratio (Qp/Qs) and defect and rim sizes in secundum atrial septal defects (ASDs) using 256-slice CT, compared to the reference transoesophageal echocardiography (TEE) and right heart catheterization (RHC) measurements. Twenty-three consecutive adult patients with secundum ASDs who underwent retrospective ECG-gated coronary CT angiography (CCTA), TEE and RHC were enrolled in this study. Right ventricular (RV) and left ventricular (LV) stroke volumes (SV) were calculated by biventricular volumetry of CCTA. Qp/Qs-CT was defined as RVSV/LVSV. The sizes of the defect and rim were measured by multi-planar reconstruction CT images. Correlations between Qp/Qs-CT and Qp/Qs-RHC and between the defect diameter obtained by CT and TEE were analyzed by Pearson's coefficient analysis. Rim sizes by CT and TEE were compared by paired t-test. Qp/Qs-CT was significantly correlated with Qp/Qs-RHC (r = 0.83, p < 0.0001), and the defect diameter by CT was significantly correlated with that by TEE (r = 0.95, p < 0.0001). There was no significant difference between CT and TEE in measurements of rim size. 256-slice CCTA allows measuring Qp/Qs and size of defects and rims in patients with secundum ASDs, accomplishing pretreatment evaluation non-invasively and comprehensively. (orig.)

  2. Multislice CT angiography in the selection of patients with ruptured intracranial aneurysms suitable for clipping or coiling

    NARCIS (Netherlands)

    Westerlaan, H. E.; Gravendeel, J.; Fiore, D.; Metzemaekers, J. D. M.; Groen, R. J. M.; Mooij, J. J. A.; Oudkerk, M.

    2007-01-01

    Introduction We sought to establish whether CT angiography (CTA) can be applied to the planning and performance of clipping or coiling in ruptured intracranial aneurysms without recourse to intraarterial digital subtraction angiography (IA-DSA). Methods Over the period April 2003 to January 2006 in

  3. Changes in Medical Management after Coronary CT Angiography

    Directory of Open Access Journals (Sweden)

    Vânia Mairi Naue

    2015-01-01

    Full Text Available Abstract Introduction: Coronary computed tomography angiography (CCTA allows for non-invasive coronary artery disease (CAD phenotyping. There are still some uncertainties regarding the impact this knowledge has on the clinical care of patients. Objective: To determine whether CAD phenotyping by CCTA influences clinical decision making by the prescription of cardiovascular drugs and their impact on non-LDL cholesterol (NLDLC levels. Methods: We analysed consecutive patients from 2008 to 2011 submitted to CCTA without previous diagnosis of CAD that had two serial measures of NLDLC, one up to 3 months before CCTA and the second from 3 to 6 months after. Results: A total of 97 patients were included, of which 69% were men, mean age 64 ± 12 years. CCTA revealed that 18 (18% patients had no CAD, 38 (39% had non-obstructive (< 50% lesions and 41 (42% had at least one obstructive ≥ 50% lesion. NLDLC was similar at baseline between the grups (138 ± 52 mg/dL vs. 135 ± 42 mg/dL vs. 131 ± 44 mg/dL, respectively, p = 0.32. We found significative reduction in NLDLC among patients with obstrctive lesions (-18%, p = 0.001. We also found a positive relationship between clinical treatment intensification with aspirin and cholesterol reducing drugs and the severity of CAD. Conclusion: Our data suggest that CCTA results were used for cardiovascular clinical treatment titration, with especial intensification seen in patients with obstructive ≥50% CAD.

  4. Changes in Medical Management after Coronary CT Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Naue, Vânia Mairi, E-mail: vania_naue@yahoo.com.br; Camargo, Gabriel; Sabioni, Letícia Roberto; Lima, Ronaldo de Souza Leão; Derenne, Maria Eduarda; Lorenzo, Andréa Rocha de; Freire, Monica Di Calafiori; Azevedo Filho, Clério Francisco; Resende, Elmiro Santos; Gottlieb, Ilan [CDPI - Clínica de Diagnóstico por Imagem (Brazil)

    2015-10-15

    Coronary computed tomography angiography (CCTA) allows for non-invasive coronary artery disease (CAD) phenotyping. There are still some uncertainties regarding the impact this knowledge has on the clinical care of patients. To determine whether CAD phenotyping by CCTA influences clinical decision making by the prescription of cardiovascular drugs and their impact on non-LDL cholesterol (NLDLC) levels. We analysed consecutive patients from 2008 to 2011 submitted to CCTA without previous diagnosis of CAD that had two serial measures of NLDLC, one up to 3 months before CCTA and the second from 3 to 6 months after. A total of 97 patients were included, of which 69% were men, mean age 64 ± 12 years. CCTA revealed that 18 (18%) patients had no CAD, 38 (39%) had non-obstructive (< 50%) lesions and 41 (42%) had at least one obstructive ≥ 50% lesion. NLDLC was similar at baseline between the grups (138 ± 52 mg/dL vs. 135 ± 42 mg/dL vs. 131 ± 44 mg/dL, respectively, p = 0.32). We found significative reduction in NLDLC among patients with obstrctive lesions (-18%, p = 0.001). We also found a positive relationship between clinical treatment intensification with aspirin and cholesterol reducing drugs and the severity of CAD. Our data suggest that CCTA results were used for cardiovascular clinical treatment titration, with especial intensification seen in patients with obstructive ≥50% CAD.

  5. Hybrid CT angiography and quantitative (15)O-water PET for assessment of coronary artery disease

    DEFF Research Database (Denmark)

    Thomassen, Anders; Petersen, Henrik; Diederichsen, Axel C P;

    2013-01-01

    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 combinati...... of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by (15)O-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses....

  6. Diagnosis of Persistent Primitive Olfactory Artery Using CT Angiography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yeo, Soo Hyun; Rho, Byung Hak; Kim, Eal Maan; Chang, Hyuk Won [Keimyung University College of Medicine, Daegu (Korea, Republic of); Sohn, Chul Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2009-09-15

    A persistent primitive olfactory artery is a rare vascular anomaly and is incidentally found without any associated symptom for the most part. However, it has clinical significance in view of its high association with the development of cerebral aneurysms occurring at the hairpin turn. We present a case of a persistent primitive olfactory artery incidentally diagnosed by a CT angiography as well as a literature review of related previous articles

  7. Arteriovenous fistula complicating iliac artery pseudo aneurysm: diagnosis by CT angiography.

    Science.gov (United States)

    Huawei, L; Bei, D; Huan, Z; Zilai, P; Aorong, T; Kemin, C

    2002-01-01

    Fistula formation to the inferior vena cava is a rare complication of aortic aneurysm which is often misdiagnosed clinically. In one hundred of reported arteriocaval fistulae, none was originating from the right common iliac artery. We report a case of ileo-caval fistula due to a iatrogenic pseudoaneurysm. High resolution 3D imaging using breath-hold CT angiography is highly specific in identifying the location, extent of the aortocaval fistula as well as the neighbouring anatomic structures.

  8. Multilevel segmentation of intracranial aneurysms in CT angiography images

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yan [Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94122 and University of Lyon, CREATIS, CNRS UMR 5220, INSERM U1206, UCB Lyon1, INSA Lyon, Lyon 69100 (France); Zhang, Yue, E-mail: y.zhang525@gmail.com [Veterans Affairs Medical Center, San Francisco, California 94121 and University of Lyon, CREATIS, CNRS UMR 5220, INSERM U1206, UCB Lyon1, INSA Lyon, Lyon 69100 (France); Navarro, Laurent [Ecole Nationale Superieure des Mines de Saint-Etienne, Saint-Etienne 42015 (France); Eker, Omer Faruk [CHU Montpellier, Neuroradiologie, Montpellier 34000 (France); Corredor Jerez, Ricardo A. [Ecole Polytechnique Federale de Lausanne, Lausanne 1015 (Switzerland); Chen, Yu; Zhu, Yuemin; Courbebaisse, Guy [University of Lyon, CREATIS, CNRS UMR 5220, INSERM U1206, UCB Lyon1, INSA Lyon, Lyon 69100 (France)

    2016-04-15

    Purpose: Segmentation of aneurysms plays an important role in interventional planning. Yet, the segmentation of both the lumen and the thrombus of an intracranial aneurysm in computed tomography angiography (CTA) remains a challenge. This paper proposes a multilevel segmentation methodology for efficiently segmenting intracranial aneurysms in CTA images. Methods: The proposed methodology first uses the lattice Boltzmann method (LBM) to extract the lumen part directly from the original image. Then, the LBM is applied again on an intermediate image whose lumen part is filled by the mean gray-level value outside the lumen, to yield an image region containing part of the aneurysm boundary. After that, an expanding disk is introduced to estimate the complete contour of the aneurysm. Finally, the contour detected is used as the initial contour of the level set with ellipse to refine the aneurysm. Results: The results obtained on 11 patients from different hospitals showed that the proposed segmentation was comparable with manual segmentation, and that quantitatively, the average segmentation matching factor (SMF) reached 86.99%, demonstrating good segmentation accuracy. Chan–Vese method, Sen’s model, and Luca’s model were used to compare the proposed method and their average SMF values were 39.98%, 40.76%, and 77.11%, respectively. Conclusions: The authors have presented a multilevel segmentation method based on the LBM and level set with ellipse for accurate segmentation of intracranial aneurysms. Compared to three existing methods, for all eleven patients, the proposed method can successfully segment the lumen with the highest SMF values for nine patients and second highest SMF values for the two. It also segments the entire aneurysm with the highest SMF values for ten patients and second highest SMF value for the one. This makes it potential for clinical assessment of the volume and aspect ratio of the intracranial aneurysms.

  9. CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli.

    Directory of Open Access Journals (Sweden)

    Andrew J Schissler

    Full Text Available BACKGROUND: It is unknown whether the observed increase in computed tomography pulmonary angiography (CTPA utilization has resulted in increased detection of pulmonary emboli (PEs with a less severe disease spectrum. METHODS: Trends in utilization, diagnostic yield, and disease severity were evaluated for 4,048 consecutive initial CTPAs performed in adult patients in the emergency department of a large urban academic medical center between 1/1/2004 and 10/31/2009. Transthoracic echocardiography (TTE findings and peak serum troponin levels were evaluated to assess for the presence of PE-associated right ventricular (RV abnormalities (dysfunction or dilatation and myocardial injury, respectively. Statistical analyses were performed using multivariate logistic regression. RESULTS: 268 CTPAs (6.6% were positive for acute PE, and 3,780 (93.4% demonstrated either no PE or chronic PE. There was a significant increase in the likelihood of undergoing CTPA per year during the study period (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.04-1.07, P<0.01. There was no significant change in the likelihood of having a CTPA diagnostic of an acute PE per year (OR 1.03, 95% CI 0.95-1.11, P = 0.49. The likelihood of diagnosing a less severe PE on CTPA with no associated RV abnormalities or myocardial injury increased per year during the study period (OR 1.39, 95% CI 1.10-1.75, P = 0.01. CONCLUSIONS: CTPA utilization has risen with no corresponding change in diagnostic yield, resulting in an increase in PE detection. There is a concurrent rise in the likelihood of diagnosing a less clinically severe spectrum of PEs.

  10. Efficiency of ultrasonography and CT angiography in follow-up studies of carotid stent and percutaneous transluminal angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Lee, Byung Hee; Chung, Bong Sub; Ahn, Jung Yong; Heo, Kyung; Kho, Young Sik [Pundang CHA General Hospital, Pochon CHA Univ. College of Medicine, Pochon (Korea, Republic of)

    1999-12-01

    The aim of this study was to determine a more appropriate method for follow-up of carotid stenting by comparing the efficiency of US and CT angiography. Eleven carotid arteries of seven patients(men:5, women:2, mean age:56.4years) who underwent stent placement and percutaneous transluminal angioplasty(PTA) because of carotid stenosis were studied. The follow-up periods ranged from three to eleven (mean, five) months, and US and CT angiography were performed in one day. Color duplex sonography was performed with a 10 MHz linear array transducer. After spiral CT scan were obtained, MPR images were reconstructed on a workstation. Retrospective imaging analysis specifically focused on [1] stent configuration, [2] the accuracy of internal diameter measurement, [3] the detection of blood flow and the measurement of blood flow velocity, [4] the presence of atheroma and intraluminal thrombi, [5] the measurement of stent location, and [6] artifacts. US was more accurate than CT angiography for measuring internal diameter. In all cases, US and CT angiography were able to detect the blood flow at carotid artery, and utilizing the Doppler spectrum, flow velocity was measured. US showed atheromas in all cases but CT angiography demonstrated calcified atheromas in three cases only. In six cases, US failed to determine stent location, though in this respect CT angiography was successful in all cases. Artifacts of US were small reverberation artifact(11/11) of the stent and a defective color Doppler signal caused by acoustic shadowing of atheroma calcification(3/11). Artifacts of CT angiogrpahy were hardbeam artifact of the stent(11/11) and motion artifact(3/11). US was superior to CT angiography in accuracy of measuring stent diameter, hemodynamic assessment, high-resolution views of the luminal state of the stent and minimal artifacts for the non-invasive follow-up studies of carotid stenting.

  11. Multi-detector CT angiography for lower gastrointestinal bleeding: Can it select patients for endovascular intervention?

    Science.gov (United States)

    Foley, P T; Ganeshan, A; Anthony, S; Uberoi, R

    2010-02-01

    This is a retrospective review of the results at our institution of using multi-detector CT angiography (CTA) to localise lower gastrointestinal (GI) bleeding. We hypothesised that in our patient population: (i) CTA was unlikely to demonstrate bleeding in patients who were haemodynamically stable; (ii) in haemodynamically unstable patients in whom CTA was undertaken, the results could be used to select patients who would benefit from catheter angiography; and (iii) in haemodynamically unstable patients in whom CTA was undertaken, a subgroup of patients could be identified who would benefit from primary surgical treatment, avoiding invasive angiography completely. A retrospective review was conducted of the clinical records of all patients undergoing CTA for lower GI haemorrhage at our institution between 1 January 2005 and 30 June 2007. Out of the 20 patients examined, 10 had positive CTAs demonstrating the bleeding site. Nine were haemodynamically unstable at the time of the study. Four patients with positive CT angiograms were able to be treated directly with surgery and avoided invasive angiography. Ten patients had negative CTAs. Four of these were haemodynamically unstable, six haemodynamically stable. Only one required intervention to secure haemostasis, the rest stopped spontaneously. No haemodynamically stable patient who had a negative CTA required intervention. CTA is a useful non-invasive technique for localising the site of lower GI bleeding. In our patient population, in the absence of haemodynamic instability, the diagnostic yield of CTA was low and bleeding was likely to stop spontaneously. In haemodynamically unstable patients, a positive CTA allowed patients to be triaged to surgery or angiography, whereas there was a strong association between a negative CTA and spontaneous cessation of bleeding.

  12. The evaluation of image quality using optimized low-dose contrast injection protocols on 64-slice spiral CT in coronary artery angiography%64层螺旋CT冠状动脉成像中优化对比剂注射技术对图像质量的影响

    Institute of Scientific and Technical Information of China (English)

    王妍焱; 吴国庚; 谭晔; 焦晟; 巴凯; 武凤菊; 周诚

    2010-01-01

    目的:比较常规固定对比剂注射方案和依据患者体重选择对比剂用量和流率技术对64层螺旋CT冠状动脉成像质量的影响.方法:研究中分别采用两种不同的对比剂应用方案,方案1:固定对比剂用量(70ml Iopamidol 370),方案2:依据患者的体重选择对比剂用量(0.8ml/kg).100位行前瞻性心电门控冠状动脉检查的患者随机分为2组(50人/组),分别采用上述不同的对比剂方案.对横断面图像、多平面重组图像的图像质量进行评价(5分优,1分差),并选择冠状动脉不同节段处测量对比剂增强水平.统计分析两种方案下的图像质量、对比剂增强水平和对比剂用量.结果:方案1和方案2条件下的图像质量评分分别为4.17±0.23和4.24±0.18,无统计学差异(P>0.05).对比剂平均增强水平存在统计学差异,方案1增强水平为(446±75)HU,而方案2为(387±69)HU.对比剂用量同样存在统计学差异,分别为70ml和53 1ml.结论:与固定对比剂应用方案相比,在冠状动脉成像中依据患者体重选择对比剂用量技术可以获得令人满意的图像,能够显著降低对比剂的用量,同时有助于获得更佳并且更为一致性的对比剂增强水平.

  13. Peripheral arterial occlusive disease: diagnostic performance and effect on therapeutic management of 64-section CT angiography.

    Science.gov (United States)

    Napoli, Alessandro; Anzidei, Michele; Zaccagna, Fulvio; Cavallo Marincola, Beatrice; Zini, Chiara; Brachetti, Giulia; Cartocci, Gaia; Fanelli, Fabrizio; Catalano, Carlo; Passariello, Roberto

    2011-12-01

    To evaluate the diagnostic performance and effect on therapeutic management of 64-section computed tomographic (CT) angiography in the assessment of steno-occlusive disease in patients with peripheral arterial disease (PAD), with conventional digital subtraction angiography (DSA) as the reference standard. The study protocol was approved by the institutional review board, and written informed consent was obtained from all patients. A total of 212 patients with symptomatic PAD underwent CT angiography and subsequent DSA. For stenosis analysis (≥ 70% stenosis), the arterial bed was divided into 35 segments and evaluated by three readers. Interobserver agreement was determined with generalized κ statistics. Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated. In addition, according to the TransAtlantic Inter-Society Consensus (TASC) Document on Management of Peripheral Arterial Disease guidelines, treatment recommendations based on CT angiographic and DSA findings were compared. McNemar test was used to prove significant differences between CT angiographic and DSA findings. A total of 7420 arterial segments were evaluated, with excellent agreement between readers (κ ≥ 0.928). On a segmental basis, both sensitivity and specificity for stenosis of 70% or more were at least 96% (3072 of 3113 segments and 4141 of 4279 segments, respectively), with an accuracy of 98% (7213 of 7392 segments), a PPV of 96% (3072 of 3187 segments), an NPV of 99% (3141 of 3187 segments), a PLR of 36.7, and an NLR of 0.013. There was no significant difference between CT angiographic and DSA findings (P = .62-.87). In accordance with TASC II guidelines, 49 patients were referred for conservative treatment, 87 underwent endovascular procedures, 38 underwent surgery, and 17 received hybrid treatment. Therapy recommendations based on CT angiographic findings

  14. CT perfusion imaging and CT subtraction angiography in the diagnosis of ischemic cerebrovascular disease within 24 hours

    Institute of Scientific and Technical Information of China (English)

    管小亭; 于学英; 刘翔; 龙洁; 戴建平

    2003-01-01

    Objective To evaluate the value of the clinical use of CT perfusion imaging (CTPI) and CT subtraction angiography (CTSA) for diagnosing acute ischemic cerebrovascular disease (AICVD). Methods Twenty-four patients with AICVD onset within 24 hours were examined with regular CT, CTPI, and CTSA. Some cases received CTPI, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), digital subtraction angiography (DSA) or single photon emission computer tomography (SPECT) during follow-up examinations.Results Of the 24 cases, 11 had negative results from regular CT scans 3-6 hours after onset of stroke in 6 cases, 6-12 hours in 3 cases, and 12-24 hours in 2 cases. Ten of these cases were then confirmed by CTPI as having ischemic lesions, 2 with middle cerebral artery occlusion (MCAO), and 1 case with transient ischemic attack (TIA) with CTPI negative. Of the 24 cases, 13 had positive results from regular CT, 9 were diagnosed with ischemic lesions larger by using CTPI than regular CT, 1 case had MCAO and 1 had internal carotid artery occlusion (ICAO). There were 4 cases with ischemic lesions observed with regular CT having nearly the same range as that of lacunar infarctions using CTPI. Another 4 cases had more than 2 lesion areas. The peak time (PT), mean transit time (MTT) and relative flow (RF) of 24 cases were markedly different. The sides of ischemic lesions compared to each other and the core of the lesion compared to peripheral zones were also altered significantly (P<0.01).Conclusions Combined CTPI with CTSA can detect acute ischemic lesions at early and hyper-early stages and could distinguish between TIA, lacunar infarction and a larger area of infarction. Using semiquantitative blood perfusion analysis status, CTPI with CTSA could define position, area and range of the ischemic lesion and penumbra. These scans can also analyze the brain blood perfusion status. It is important to early diagnose the occlusion of the entire division of the internal

  15. Clinical contributions of 64-slice computed tomography in the evaluation of cardiomyopathy of unknown origin.

    Science.gov (United States)

    Boulmier, Dominique; Audinet, Caroline; Heautot, Jean-François; Larralde, Antoine; Veillard, David; Hamonic, Stéphanie; Bedossa, Marc; Leurent, Guillaume; Garreau, Mireille; Le Breton, Hervé

    2009-10-01

    Meta-analyses have confirmed the high performance of multislice computed tomography (MSCT) in coronary stenosis detection. Recent reports have described the study of left ventricular anatomy and function and coronary venous anatomy with MSCT. We sought to compare, in patients with cardiomyopathy of unknown origin, the performance of MSCT versus angiography for significant coronary artery disease detection and versus transthoracic echocardiography (TTE) for left ventricular anatomy and function evaluation, and to assess its ability to characterize coronary venous anatomy. Fifty-nine patients with cardiomyopathy (left ventricular ejection fraction [LVEF] less than or equal to 40%) of unknown origin, in sinus rhythm, underwent MSCT, TTE and coronary angiography. Twenty-four (3%) of 724 analysable coronary segments (97%) and 12 (20%) patients had significant coronary artery disease. MSCT sensitivity, specificity, and positive and negative predictive values for coronary artery disease detection were 87.5%, 98.5%, 67.7% and 99.6% in the per-segment assessment and 100%, 91%, 75% and 100% in the per-patient evaluation, respectively. Statistical analyses showed good agreement between MSCT and TTE in LVEF measurement (33+/-10% vs 32+/-11%, p=0.4, mean difference=0.7%, limits of agreement+/-13.6%) and a small LVED diameter overestimation (65.0+/-9.3mm vs 63.6+/-9.4mm, p=0.03). MSCT allowed detection of the posterolateral vein in 86% of cases. In selected patients presenting with idiopathic cardiomyopathy, MSCT is accurate for coronary artery disease detection and is a useful coronary venous imaging tool. MSCT studies of left ventricular function and morphology were mostly concordant with TTE measurements.

  16. Use of coronary CT angiography in the diagnosis of patients with suspected coronary artery disease: findings and clinical indications

    Institute of Scientific and Technical Information of China (English)

    Zhong-Hua Sun; Yu-Pin Liu; Dong-Jin Zhou; Yan Qi

    2012-01-01

    Objective To investigate the clinical applications of coronary CT angiography in patients with suspected coronary artery disease and identify factors that affect CT findings. Methods Medical records of patients suspected of coronary artery disease over a period of 12 months from a tertiary teaching hospital were retrospectively reviewed. Patient age, sex (male/female), duration of symptoms and abnormal rates of coronary CT angiography scans were analysed to investigate the relationship among these parameters. The patients by age were duration of symptoms was also classified into five groups: less than one week, one week to one month, one to three months, three to six months and more than six months. Results Of the 880 patient records reviewed, 800 met the above study criteria. Five hundred and forty nine patients demonstrated abnormal CT findings (68.6%). There was no significant difference in the percentage of abnormal CT findings based on patient sex and the duration of symptoms (P = 0.14). The abnormal rates of coronary CT angiography, however, increased significantly with increasing age (P < 0.001); with patients over 65 years of age 2.5 times more likely to have an abnormal CT scan relative to a patient under 45 years. A significant difference was found between abnormal coronary CT angiography and the duration of symptoms (P = 0.012). Conclusions Our results indicate coronary CT angiography findings are significantly related to the patient age group and duration of symptoms. Clinical referral for coronary CT angiography of patients with suspected coronary artery disease needs to be justified with regard to the judicious use of this imaging modality.

  17. Multidetector CT angiography in acute gastrointestinal bleeding: why, when, and how.

    Science.gov (United States)

    Geffroy, Yann; Rodallec, Mathieu H; Boulay-Coletta, Isabelle; Jullès, Marie-Christine; Fullès, Marie-Christine; Ridereau-Zins, Catherine; Zins, Marc

    2011-01-01

    Acute gastrointestinal (GI) bleeding remains an important cause of emergency hospital admissions, with substantial related morbidity and mortality. Bleeding may relate to the upper or lower GI tract, with the dividing anatomic landmark between these two regions being the ligament of Treitz. The widespread availability of endoscopic equipment has had an important effect on the rapid identification and treatment of the bleeding source. However, the choice of upper or lower GI endoscopy is largely dictated by the clinical presentation, which in many cases proves misleading. Furthermore, there remains a large group of patients with negative endoscopic results or failed endoscopy, in whom additional techniques are required to identify the source of GI bleeding. Multidetector computed tomography (CT) with its speed, resolution, multiplanar techniques, and angiographic capabilities allows excellent visualization of both the small and large bowel. Multiphasic multidetector CT allows direct demonstration of bleeding into the bowel and is helpful in the acute setting for visualization of the bleeding source and its characterization. Thus, multidetector CT angiography provides a time-efficient method for directing and planning therapy for patients with acute GI bleeding. The additional information provided by multidetector CT angiography before attempts at therapeutic angiographic procedures leads to faster selective catheterization of bleeding vessels, thereby facilitating embolization. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.313105206/-/DC1.

  18. Correlation between abdominal perforator vessels identified with preoperative CT angiography and intraoperative fluorescent angiography in the microsurgical breast reconstruction patient.

    Science.gov (United States)

    Pestana, Ivo A; Zenn, Michael R

    2014-01-01

    CT angiography (CTA) has become a reliable method of perforator vessel identification. Indocyanine green fluorescent angiography (ICGLA) produces a real-time image of large- and small-caliber blood vessels. The aim of this prospective study was to compare ICGLA with CTA to evaluate its reliability of vessel identification and correlation to perforator vessel size and number determined preoperatively by CTA. The effect of both imaging techniques on flap design or intraoperative plan was also evaluated. Over a 1-year period, patients presenting for free-tissue transfer breast reconstruction underwent preoperative CTA mapping of abdominal perforators followed by intraoperative ICGLA. Using visualization software, scaling factors were calculated so CTA and ICGLA data could be compared. Eighteen patients (24 breast reconstructions) were included. Larger CTA perforator size was associated with larger actual size (P = 0.04). The largest CTA perforator or largest actual perforator was used 78% of the time. Increasing body mass index was not associated with larger CTA perforator size (P = 0.67) or more intense ICGLA blushes (P = 0.13). No significant correlation was found between CTA perforator location and ICGLA skin blush location, size, or intensity. CTA or SPY guided intraoperative procedure adjustments in 72% of patients. ICGLA identified poor soft-tissue perfusion and guided flap resection in 46% of patients. ICGLA skin blush location, size, and intensity do not correlate with CTA-identified perforating vessel location or actual perforating vessel size. Despite this, the ICGLA information was useful for evaluation of soft-tissue perfusion and flap design.

  19. Determining the organ of origin of large pelvic masses in females using multidetector CT angiography and three-dimensional volume rendering CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Li, YangKang; Chen, JunWei; Chen, XueYin; Lin, JianBang; Cai, AiQun; Zhou, XiuGuo [Cancer Hospital, Shantou University Medical College, Department of Radiology, Shantou, Guangdong Province (China); Zheng, Yu [Cancer Hospital, Shantou University Medical College, Department of Clinical Pharmacology, Shantou (China)

    2015-04-01

    To study the value of tumour feeding arteries and the ovarian vein in determining the organ of origin of large pelvic tumours in females using multidetector CT. One hundred and thirty patients with 131 pathologically proven tumours (>6.5 cm) were retrospectively reviewed. Conventional CT images and CT angiography were evaluated, with focus on assessing the value of tumour feeding arteries and the ovarian vein in differentiating ovarian from non-ovarian tumours. For 97 ovarian tumours, the feeding arteries included the ovarian artery (n = 51) and the ovarian branch of uterine artery (n = 64). For 34 non-ovarian tumours, the feeding arteries included the ovarian artery (n = 2), the uterine artery (n = 21), the mesenteric artery (n = 5), and the internal iliac artery (n = 1). The ovarian vein was identified in 86 ovarian tumours and 12 non-ovarian tumours. When the feeding arteries and the ovarian vein were combined to confirm ovarian origin, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.8 %, 84.2 %, 93.8 %, 94.1 %, and 93.9 %, respectively. The accuracy was significantly higher than that of independently using the ovarian vein or the ovarian feeding arteries. Combined application of tumour feeding arteries and the ovarian vein is valuable to differentiate large ovarian from non-ovarian tumours. (orig.)

  20. Learning-based automatic detection of severe coronary stenoses in CT angiographies

    Science.gov (United States)

    Melki, Imen; Cardon, Cyril; Gogin, Nicolas; Talbot, Hugues; Najman, Laurent

    2014-03-01

    3D cardiac computed tomography angiography (CCTA) is becoming a standard routine for non-invasive heart diseases diagnosis. Thanks to its high negative predictive value, CCTA is increasingly used to decide whether or not the patient should be considered for invasive angiography. However, an accurate assessment of cardiac lesions using this modality is still a time consuming task and needs a high degree of clinical expertise. Thus, providing automatic tool to assist clinicians during the diagnosis task is highly desirable. In this work, we propose a fully automatic approach for accurate severe cardiac stenoses detection. Our algorithm uses the Random Forest classi cation to detect stenotic areas. First, the classi er is trained on 18 CT cardiac exams with CTA reference standard. Then, then classi cation result is used to detect severe stenoses (with a narrowing degree higher than 50%) in a 30 cardiac CT exam database. Features that best captures the di erent stenoses con guration are extracted along the vessel centerlines at di erent scales. To ensure the accuracy against the vessel direction and scale changes, we extract features inside cylindrical patterns with variable directions and radii. Thus, we make sure that the ROIs contains only the vessel walls. The algorithm is evaluated using the Rotterdam Coronary Artery Stenoses Detection and Quantication Evaluation Framework. The evaluation is performed using reference standard quanti cations obtained from quantitative coronary angiography (QCA) and consensus reading of CTA. The obtained results show that we can reliably detect severe stenosis with a sensitivity of 64%.

  1. Multislice CT angiography in aortic stent grafting: Relationship between image noise and body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Sun Zhonghua [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, GPO Box U1987, Perth, Western Australia 6845 (Australia)]. E-mail: z.sun@curtin.edu.au

    2007-03-15

    Purpose: To investigate the correlation between image noise and body mass index (BMI) in multislice CT angiography (MSCT) for patients with abdominal aortic aneurysm (AAA) treated with endovascular stent grafts. Materials and methods: Seventeen patients who underwent MSCT following endovascular repair of AAA were included in the study. Image noise (standard deviation of the CT attenuation: S.D.) and signal to noise ratio (SNR) were plotted against BMI to demonstrate the correlation using a linear regression method. Image quality of 3D reconstructions was correlated to the SNR and BMI. Results: The r-value of linear regression between S.D. and BMI was 0.578 (p < 0.05), 0.835 and 0.802 (p < 0.001), respectively, at the level of renal artery, aortic aneurysm and common iliac artery. The r-value of linear regression between SNR and BMI was 0.332, 0.516 and 0.552 (p < 0.05), respectively, at above three levels. Image quality of 3D reconstructions was compromised in five patients and diagnosis was affected in two patients with BMI more than 30. Conclusion: A significant correlation was observed between image noise and BMI in MSCT angiography of endovascular repair of AAA. Our findings are valuable for optimisation of MSCT angiography scanning protocols and reduction of radiation dose in MSCT examinations.

  2. Arterial enhancement at abdominal CT angiography: Low- versus high-osmolality contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, O.; Berger, P.; Pangaud, C.; Lyonnet, D. [Hopital E. Herriot, Lyon (France). Dept. of Vascular and Genitourinary Radiology; Ecochard, R. [Hospices Civils de Lyon (France). Dept of Biostatistics; Fontaine, B. [Laboratoire Guerbet, Roissy (France)

    2000-09-01

    Purpose: To evaluate the effects of contrast media pharmokinetic differences on aortic enhancement at abdominal CT angiography and to determine whether these effects are of clinical relevance. Material and Methods: Two hundred and twelve patients referred for abdominal CT angiography were included in the study. All abdominal CT angiograms were performed with the same parameters (collimation 3 mm, pitch ratio 1.7, scan delay 30 s) after i.v. injection of 120 ml of contrast medium at 3 ml/s. After randomization, patients received either iobitridol 300 (low-osmolar, 300 mg I/ml), iobitridol 350 (low-osmolar, 350 mg I/ml) or ioxithalamate 350 (high-osmolar, 350 mg I/ml). The time attenuation curves obtained with the three contrast media were compared. Results: The time attenuation curve obtained with ioxithalamate 350 was not parallel to those obtained with iobitridol 300 and iobitridol 350. Mean peak enhancements obtained with iobitridol 350 and ioxithalamate 350 were not significantly different but iobitridol 350 provided higher mean peak enhancement than iobitridol 300. Mean delays of the peak enhancements were the same with the three contrast media. After peak enhancement, the decrease of aortic opacification under a selected threshold of 200 HU was significantly slower with iobitridol 350 than with iobitridol 300 and ioxithalamate 350, whereas iobitridol 300 and ioxithalamate 350 showed no significant differences. Conclusion: For a given iodine concentration, low-osmolality contrast media provide longer aortic opacification and may be recommended for CT angiography when long acquisition times are needed.

  3. CT-angiography source images indicate less fatal outcome despite coma of patients in the Basilar Artery International Cooperation Study

    NARCIS (Netherlands)

    Pallesen, Lars P.; Khomenko, Andrei; Dzialowski, Imanuel; Barlinn, Jessica; Barlinn, Kristian; Zerna, Charlotte; van der Hoeven, Erik J R J; Algra, Ale; Kapelle, L. Jaap; Michel, Patrik; Bodechtel, Ulf; Demchuk, Andrew M.; Schonewille, Wouter; Puetz, Volker

    2017-01-01

    Background: Coma is associated with poor outcome in patients with basilar artery occlusion. Aims: We sought to assess whether the posterior circulation Acute Stroke Prognosis Early CT Score and the Pons-Midbrain Index applied to CT angiography source images predict the outcome of comatose patients

  4. Dynamic cone beam CT angiography of carotid and cerebral arteries using canine model

    Energy Technology Data Exchange (ETDEWEB)

    Cai Weixing; Zhao Binghui; Conover, David; Liu Jiangkun; Ning Ruola [Department of Imaging Sciences, University of Rochester, 601 Elmwood Avenue, Rochester, New York 14642 (United States); Department of Radiology, Shanghai 6th People' s Hospital, 600 Yishan Road, Xuhui, Shanghai (China); Koning Corporation, Lennox Tech Enterprise Center, 150 Lucius Gordon Drive Suite 112, West Henrietta, New York 14586 (United States); Department of Imaging Sciences, University of Rochester, 601 Elmwood Avenue, Rochester, New York 14642 (United States); Department of Imaging Sciences, University of Rochester, 601 Elmwood Avenue, Rochester, New York 14642 (United States) and Koning Corporation, Lennox Tech Enterprise Center, 150 Lucius Gordon Drive Suite 112, West Henrietta, New York 14586 (United States)

    2012-01-15

    Purpose: This research is designed to develop and evaluate a flat-panel detector-based dynamic cone beam CT system for dynamic angiography imaging, which is able to provide both dynamic functional information and dynamic anatomic information from one multirevolution cone beam CT scan. Methods: A dynamic cone beam CT scan acquired projections over four revolutions within a time window of 40 s after contrast agent injection through a femoral vein to cover the entire wash-in and wash-out phases. A dynamic cone beam CT reconstruction algorithm was utilized and a novel recovery method was developed to correct the time-enhancement curve of contrast flow. From the same data set, both projection-based subtraction and reconstruction-based subtraction approaches were utilized and compared to remove the background tissues and visualize the 3D vascular structure to provide the dynamic anatomic information. Results: Through computer simulations, the new recovery algorithm for dynamic time-enhancement curves was optimized and showed excellent accuracy to recover the actual contrast flow. Canine model experiments also indicated that the recovered time-enhancement curves from dynamic cone beam CT imaging agreed well with that of an IV-digital subtraction angiography (DSA) study. The dynamic vascular structures reconstructed using both projection-based subtraction and reconstruction-based subtraction were almost identical as the differences between them were comparable to the background noise level. At the enhancement peak, all the major carotid and cerebral arteries and the Circle of Willis could be clearly observed. Conclusions: The proposed dynamic cone beam CT approach can accurately recover the actual contrast flow, and dynamic anatomic imaging can be obtained with high isotropic 3D resolution. This approach is promising for diagnosis and treatment planning of vascular diseases and strokes.

  5. 64层锥束CT扫描的优化系统%Optimization of System Design for 64-slice Cone Beam Computed Tomography

    Institute of Scientific and Technical Information of China (English)

    谢强; Eugene Williams; Charlie Shaughnessy; 唐向阳

    2005-01-01

    The technology for x-ray computed tomography (CT) has experienced tremendous growth in recent years. Since the introduction of 4-slice helical scanners in 1998, rapid improvement has been made on CT scanners in terms of the volume coverage, spatial resolution, scan speed, and the number of slices. These advancements not only significantly impact clinical applications, but also bring huge challenges to the CT system design. Because of the complexity of the volumetric CT (VCT) system, various strategies have to be utilized in the design process. These methodologies include theoretical analysis, computer simulation for system performance prediction, bench-top experiments for analysis confirmation, automated image analysis tools for automatically evaluating image performance, and double-blind tests with human observers for parameter optimization. In this paper, we present some of the system design considerations and optimization processes for a 64-slice scanner. These design processes ensure the optimal performance of the cone beam CT scanner. Initial clinical feedback has demonstrated the effectiveness of our approach.%近年来X射线断层成像(CT)技术获得了突飞猛进的发展,自1998年推出4层螺旋CT后,CT扫描设备在容积覆盖,空间分辨率,扫描速度,切片数方面取得了长足进展.这不仅给医学应用带来了深远的影响,同时也给CT系统设计提出了巨大的挑战.容积CT(VCT)的设计过程引入了各种策略来战胜其复杂性.这些方法学包括:理论分析,系统性能预测的图像分析工具,各种基于专家背对背评价的参数优化.本文论述了64层CT系统设计中的一些考虑因素及优化过程.这些设计过程保证了锥束CT的优化性能.首批客户的应用反馈显示了我们设计实践的有效率性.

  6. Pitfalls in post-mortem CT-angiography--intravascular contrast induces post-mortem pericardial effusion.

    Science.gov (United States)

    Berger, Nicole; Martinez, Rosita; Winklhofer, Sebastian; Flach, Patricia M; Ross, Steffen; Ampanozi, Garyfalia; Gascho, Dominic; Thali, Michael J; Ruder, Thomas D

    2013-11-01

    We present a case where multi-phase post-mortem computed tomography angiography (PMCTA) induced a hemorrhagic pericardial effusion during the venous phase of angiography. Post-mortem non-contrast CT (PMCT) suggested the presence of a ruptured aortic dissection. This diagnosis was confirmed by PMCTA after pressure controlled arterial injection of contrast. During the second phase of multi-phase PMCTA the presence of contrast leakage from the inferior cava vein into the pericardial sac was noted. Autopsy confirmed the post-mortem nature of this vascular tear. This case teaches us an important lesson: it underlines the necessity to critically analyze PMCT and PMCTA images in order to distinguish between artifacts, true pathologies and iatrogenic findings. In cases with ambiguous findings such as the case reported here, correlation of imaging findings with autopsy is elementary.

  7. The role of CT angiography in the evaluation of pediatric renovascular hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Kurian, Jessica [The Perelman School of Medicine, University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); The Children' s Hospital at Montefiore, Bronx, NY (United States); Epelman, Monica [The Perelman School of Medicine, University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Darge, Kassa; Nijs, Els [The Perelman School of Medicine, University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Meyers, Kevin [The Perelman School of Medicine, University of Pennsylvania, Division of Nephrology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Hellinger, Jeffrey C. [The Perelman School of Medicine, University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); New York Cardiovascular Institute and Lenox Hill Radiology, New York, NY (United States)

    2013-04-15

    Historically, the evaluation of renovascular hypertension has been accomplished by US, renal scintigraphy and digital subtraction angiography. Based on its high accuracy reported in adults renal CT angiography (CTA) with pediatric-appropriate low radiation dose techniques has become an important tool in the workup of renovascular hypertension in children. Renal CTA has several advantages over more conventional imaging modalities, including rapid and non-invasive acquisition, high resolution and easy reproducibility. Additionally, in our experience high-quality renal CTA can be performed using low-dose radiation exposures and can be acquired without sedation in most instances. This article illustrates by examples the usefulness of renal CTA for diagnosis of childhood renovascular hypertension and provides an overview of renal CTA findings in the most common childhood renovascular diseases. (orig.)

  8. Diagnostic accuracy of dual energy CT angiography in patients with diabetes mellitus; Diagnostische Genauigkeit der Dual-energy-CT-Angiographie bei Patienten mit Diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Schabel, C.; Bongers, M.N.; Syha, R. [Klinikum der Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Klinikum der Eberhard-Karls-Universitaet, Sektion fuer Experimentelle Radiologie der Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Ketelsen, D.; Homann, G.; Notohamiprodjo, M.; Nikolaou, K.; Bamberg, F. [Klinikum der Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Thomas, C. [Universitaetsklinikum Duesseldorf, Abteilung fuer Diagnostische und Interventionelle Radiologie, Duesseldorf (Germany)

    2015-04-01

    Peripheral arterial disease (PAD) represents a major and highly prevalent complication in patients with diabetes mellitus. The diagnostic, non-invasive work-up by computed tomography angiography (CTA) is limited in the presence of extensive calcification. The aim of the study was to determine the diagnostic accuracy of dual energy CTA (DE-CTA) for the detection and characterization of PAD in patients with diabetes mellitus. In this study 30 diabetic patients with suspected or known PAD were retrospectively included in the analysis. All subjects underwent DE-CTA (Somatom Definition Flash, Siemens Healthcare, Erlangen, Germany) prior to invasive angiography, which served as the reference standard. Blinded analysis included assessment of the presence and degree of peripheral stenosis on curved multiplanar reformatting (MPR) and maximum intensity projections (MIP). Conventional measures of diagnostic accuracy were derived. Among the 30 subjects included in the analysis (83 % male, mean age 70.0 ± 10.5 years, 83 % diabetes type 2), the prevalence of critical stenosis in 331 evaluated vessel segments was high (30 %). Dual energy CT identified critical stenoses with a high sensitivity and good specificity using curved MPR (100 % and 93.1 %, respectively) and MIP images (99 % and 91.8 %, respectively). In stratified analysis, the diagnostic accuracy was higher for stenosis pertaining to the pelvic and thigh vessels as compared with the lower extremities (curved MPR accuracy 97.1 % vs. 99.2 vs. 90.9 %; respectively, p < 0.001). The use of DE-CTA allows reliable detection and characterization of peripheral arterial stenosis in patients with diabetes mellitus with higher accuracy in vessels in the pelvic and thigh regions compared with the vessels in the lower legs. (orig.) [German] Die periphere arterielle Verschlusskrankheit (PAVK) ist eine wesentliche Komplikation des Diabetes mellitus und stellt aufgrund ausgepraegter Gefaessverkalkungen eine diagnostische

  9. High-pitch coronary CT angiography with third generation dual-source CT: limits of heart rate.

    Science.gov (United States)

    Gordic, Sonja; Husarik, Daniela B; Desbiolles, Lotus; Leschka, Sebastian; Frauenfelder, Thomas; Alkadhi, Hatem

    2014-08-01

    To determine the average heart rate (HR) and heart rate variability (HRV) required for diagnostic imaging of the coronary arteries in patients undergoing high-pitch CT-angiography (CTA) with third-generation dual-source CT. Fifty consecutive patients underwent CTA of the thoracic (n = 8) and thoracoabdominal (n = 42) aorta with third-generation dual-source 192-slice CT with prospective electrocardiography (ECG)-gating at a pitch of 3.2. No β-blockers were administered. Motion artifacts of coronary arteries were graded on a 4-point scale. Average HR and HRV were noted. The average HR was 66 ± 11 beats per minute (bpm) (range 45-96 bpm); the HRV was 7.3 ± 4.4 bpm (range 3-20 bpm). Interobserver agreement on grade of image quality for the 642 coronary segments evaluated by both observers was good (κ = 0.71). Diagnostic image quality was found for 608 of the 642 segments (95%) in 43 of 50 patients (86%). In 14% of the patients, image quality was nondiagnostic for at least one segment. HR (p = 0.001) was significantly higher in patients with at least one non-diagnostic segment compared to those without. There was no significant difference (p > 0.05) in HRV between patients with nondiagnostic segments and those with diagnostic images of all segments. All patients with a HR CT allows for coronary angiography in the prospectively ECG-gated high-pitch mode with diagnostic image quality at HR up to 70 bpm. HRV is not significantly related to image quality of coronary CTA.

  10. CT Angiography for Living Kidney Donors: Accuracy, Cause of Misinterpretation and Prevalence of Variation

    Energy Technology Data Exchange (ETDEWEB)

    Chai, Jee Won; Lee, Whal; Yin, Yong Hu; Jae, Hwan Jun; Chung, Jin Wook; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Hyeon Hoe [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-08-15

    To determine the accuracy of the use of multi-detector row CT (MDCT) to predict vascular anatomy in living kidney donors and to reveal the prevalence of vascular variations in a Korean population. A total of 153 living kidney donors that had undergone preoperative CT and nephrectomy, either with open or laparoscopic surgery, were selected retrospectively. The initial CT results were compared with the surgical findings and repeated review sessions of CT scans were performed to determine the causes of mismatches in discordant cases. The accuracy of CT angiography was 95% to predict the number of renal vessels. Four arteries and two veins were missed during the initial CT interpretation due to perception errors (for two arteries and two veins) and technical limitations (two arteries). The prevalence of multiple renal arteries and veins, early branching of a renal artery and late confluence of a renal vein were 31%, 5%, 12%, 17%, respectively. The circumaortic renal vein and the bilateral inferior vena cava were found in two cases each (1.3%). One case (0.7%) each of a retroaortic renal vein and a supradiaphragmatic originated renal artery were found. MDCT provides a reliable method to evaluate the vascular anatomy and variations of living kidney donors.

  11. 多层螺旋CT对孤立性肠系膜上动脉夹层的诊断价值及与数字减影血管造影的对比分析%Comparison of diagnostic value between multislice CT and digital subtraction angiography in isolated supe-rior mesenteric artery dissection

    Institute of Scientific and Technical Information of China (English)

    张杨贵; 何旭升; 温志玲; 陈珊红; 高振华; 许俊丽

    2016-01-01

    目的:探讨64层螺旋CT血管成像及后处理技术对孤立性肠系膜上动脉夹层(SISMAD)的诊断价值,及与数字减影血管造影对比分析。方法回顾分析17例使用64层螺旋CT及数字减影血管造影(DSA)所发现的孤立性肠系膜上动脉夹层,结合横断位原始图像及各后处理方法重建图像,分析其影像征像。结果64层螺旋CT血管成像动脉期能清晰显示肠系膜上动脉及其低密度的内膜片,真假腔及破裂口显示良好,夹层累及范围,是否存在血栓及累及分支血管,术后追踪观察方便、准确。结论多层螺旋CT能清晰显示孤立性肠系膜上动脉夹层的病变特征,其检出率、并发症显示优于DSA,并能较好地指导DSA介入治疗及预后观察,是孤立性肠系膜上动脉夹层首选的无创检查方法。%Objective To compare the diagnostic value between 64-slice CT and digital subtraction angiogra-phy (DSA) in isolated superior mesenteric artery (SISMAD) dissection. Methods Retrospective study was taken in 17 patients with SMA Dissection, evidenced by both 64-slice CT and DSA,analyze the eikonic signs according to trans-verse view and reconstruction images. Results In artetial phase, multislice CT could clearly showed superior mesen-teric artery, its hypodense intimal orifice, true and false double lumen and oral cleft, intercalated bed range involved, with or without thrombus and lateral branch blood vessels could be indicated well, which had great convenience to follow-up postoperative. Conclusion Multislice CT, an atraumatic mothod for SMA dissection, could clearly present its pathological changes. It also has better detection rate and less complication compared with DAS. Moreover, multi-slice CT could help to direct treatment by DSA.

  12. Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique

    Energy Technology Data Exchange (ETDEWEB)

    Klass, Oliver; Jeltsch, Martin; Feuerlein, Sebastian; Brunner, Horst; Brambs, Hans-Juergen; Hoffmann, Martin H.K. [University Hospital of Ulm, Department of Diagnostic and Interventional Radiology, Ulm (Germany); Nagel, Hans-Dieter [Philips Healthcare, Department of Science and Technology, Hamburg (Germany); Walker, Matthew J. [CT Clinical Science, Philips Healthcare, Cleveland, OH (United States)

    2009-04-15

    To assess image quality and radiation exposure with prospectively gated axial CT coronary angiography (PGA) compared to retrospectively gated helical techniques (RGH). Forty patients with suspected coronary artery disease (CAD) and a stable heart rate below 65 bpm underwent CT coronary angiography (CTCA) using a 64-channel CT system. The patient cohort consisted of 20 consecutive patients examined using a PGA technique and 20 patients examined using a standard RGH technique. Both groups were matched demographically according to age, gender, body mass index, and heart rate. For both groups, two independent observers assessed image quality for all coronary segments on an ordinal scale from 1 (nonassessable) to 5 (excellent quality). Image quality and radiation exposure were compared between patient groups. There were no significant differences in vessel-based image quality between the two groups (P > 0.05). Mean ({+-} SD) effective radiation exposure in the PGA group was 3.7 {+-} 0.8 mSv compared to 18.9 {+-} 3.8 mSv in the RGH group without ECG-based tube current modulation (P < 0.001). Preliminary experience shows PGA technique to be a promising approach for CTCA resulting in a substantial reduction in radiation exposure with image quality comparable to that of standard RGH technique. (orig.)

  13. Diagnostic performance of 320-detector CT coronary angiography in patients with atrial fibrillation: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Lei; Yang, Lin; Fan, Zhanming; Yu, Wei; Lv, Biao; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China)

    2011-05-15

    To evaluate the feasibility, diagnostic accuracy, and radiation dose of CT coronary angiography (CTCA) in patients with atrial fibrillation (AF) using 320-detector CT. Thirty-seven patients with persistent AF and suspected coronary artery disease (CAD) were enrolled. All patients underwent both 320-detector CTCA and conventional coronary angiography (CCA). CT image quality and the presence of significant ({>=}50%) stenosis were evaluated by two radiologists blinded to the results of CCA. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using CCA as the reference standard. Differences in detection of coronary artery stenosis between 320-detector CTCA and CCA were evaluated with McNemar's test. Patient radiation dose was calculated by multiplying dose length product by conversion coefficient of 0.017. In total 474 evaluated coronary segments, 459 (96.8%) segments were diagnostically evaluable. On per-segment analysis, sensitivity, specificity, PPV and NPV were 90.0% (18 of 20), 99.3% (436 of 439), 85.7% (18 of 21) and 99.5% (436 of 438). No significant difference was found between 320-detector CTCA and CCA on the detection of significant stenosis (P = 1.000). Effective doses of 320-detector CTCA was 13.0 {+-} 4.7 mSv. 320-detector CTCA is feasible and accurate in excluding CAD in patients with AF. (orig.)

  14. Volume rendering versus maximum intensity projection in CT angiography: what works best, when, and why.

    Science.gov (United States)

    Fishman, Elliot K; Ney, Derek R; Heath, David G; Corl, Frank M; Horton, Karen M; Johnson, Pamela T

    2006-01-01

    The introduction and widespread availability of 16-section multi-detector row computed tomographic (CT) technology and, more recently, 64-section scanners, has greatly advanced the role of CT angiography in clinical practice. CT angiography has become a key component of state-of-the-art imaging, with applications ranging from oncology (eg, staging of pancreatic or renal cancer) to classic vascular imaging (eg, evaluation of aortic aneurysms and renal artery stenoses) as well as newer techniques such as coronary artery imaging and peripheral runoff studies. With an average of 400-1000 images in each volume data set, three-dimensional postprocessing is crucial to volume visualization. Radiologists now have workstations that provide capabilities for evaluation of these data sets by using a range of software programs and processing tools. Although different systems have unique capabilities and functionality, all provide the options of volume rendering and maximum intensity projection for image display and analysis. These two postprocessing techniques have different advantages and disadvantages when used in clinical practice, and it is important that radiologists understand when and how each technique should be used. Copyright RSNA, 2006.

  15. Bolus timing in high-pitch CT angiography of the aorta

    Energy Technology Data Exchange (ETDEWEB)

    Beeres, Martin, E-mail: beeres@gmx.net [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Loch, Matthias, E-mail: MatthiasLoch@gmx.net [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Schulz, Boris, E-mail: boris.schell@googlemail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Kerl, Matthias, E-mail: matthias.kerl@gmail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Al-Butmeh, Firas, E-mail: Firas.Albutmeh@gmail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Bodelle, Boris, E-mail: bbodelle@googlemail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Herrmann, Eva, E-mail: Herrmann@Med.Uni-Frankfurt.de [Clinic of the Goethe University, Department of Biostatistics, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Gruber-Rouh, Tatjana, E-mail: tatjanagruber2004@yahoo.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Lee, Clara, E-mail: Clara.Lee@kgu.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Jacobi, Volkmar, E-mail: Volkmar.Jacobi@kgu.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Vogl, Thomas J., E-mail: T.Vogl@em.uni-frankfurt.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); and others

    2013-06-15

    Objective: To investigate the bolus geometry in high-pitch CT angiography (CTA) of the aorta without ECG synchronisation in comparison to single-source CT. Methods: Overall 160 consecutive patients underwent CTA either in conventional single-source mode with a pitch of 1.2 (group 1), or in dual-source mode with a pitch of 3.0 (groups 2, 3 and 4) using different contrast media timings with bolus triggering at 140 HU (5 s, group 1; 10 s, group 2; 12 s, group 3; 14 s, group 4). Contrast material, saline flush, flow rate and kV/mAs settings were kept equal for optimum comparability. Aortic attenuation was measured along the z-axis of the patient at different anatomic landmarks and subjective image quality was compared. Results: The most homogeneous enhancement of the aorta was reached with a delay of 10 s after reaching the trigger threshold. The imaging length was not significantly different, but the examination time was significantly (p < 0.001) shorter in the high-pitch group (7.7 s vs. 1.7 s for group 1 vs. 2, 3 and 4). Conclusion: In high-pitch CT angiography using a start delay of 10 s after a trigger threshold of 140 HU in the descending aorta is reached, a homogenous contrast along the z-axis is accomplished.

  16. The frequency of intracranial arterial fenestrations: A study with 64-detector CT-angiography

    Energy Technology Data Exchange (ETDEWEB)

    Bayrak, Aylin Hasanefendioglu, E-mail: aylin_has@yahoo.com [Dicle University, School of Medicine, Radiology Department, Diyarbakir (Turkey); Senturk, Senem, E-mail: ssenturk@dicle.edu.tr [Dicle University, School of Medicine, Radiology Department, Diyarbakir (Turkey); Akay, Hatice Ozturkmen, E-mail: hozturkmen@gmail.com [Veni Vidi Hospital, Diyarbakir (Turkey); Ozmen, Cihan Akgul, E-mail: cihanakgul@dicle.edu.tr [Dicle University, School of Medicine, Radiology Department, Diyarbakir (Turkey); Bukte, Yasar, E-mail: ybukte@dicle.edu.tr [Dicle University, School of Medicine, Radiology Department, Diyarbakir (Turkey); Nazaroglu, Hasan, E-mail: hnazarog@dicle.edu.tr [Dicle University, School of Medicine, Radiology Department, Diyarbakir (Turkey)

    2011-03-15

    Fenestration is a vascular variation that begins with a common origin, then splits into two parallel luminal channels and rejoins distally. Potential association between anomalies of cerebral circulation and increased occurrence of aneurysm makes intracranial arterial fenestrations important. The planning of intracranial arterial interventions may be complicated if a fenestration occurs proximal to the site of intended treatment. This study is planned to determine the frequency of fenestrations on CT angiography and to search whether there is relationship between aneurysms and fenestrations. CT angiographies of 395 consecutive patients, performed by 64-detector CT, were retrospectively reviewed for aneurysms and fenestrations. Overall fenestration frequency, fenestration frequency in patients with and without aneurysm, and aneurysm frequency in patients with and without fenestration were searched. Demographic characteristics of patients were also compared. Overall fenestration frequency was 12.9%. Vertebrobasilar system (5.56%) and anterior communicating region (5.32%) were the two most frequent sites of fenestration. The rate of fenestrations was not significantly different between patients who had and did not have aneurysms. Mean age was significantly higher, and females were predominant in patients with aneurysms. However our results did not show significant difference in age and sex of patients with fenestrations. The frequency of fenestrations in this study is higher than in previously published radiological studies, suggesting that fenestrations are relatively common. There is no significant relationship between the frequency of aneurysms and fenestrations.

  17. Digital subtraction angiography in the diagnosis of invasive hydatidiform mole. Comparison with PAG, CT and USG

    Energy Technology Data Exchange (ETDEWEB)

    Ikuma, Kenichiro; Daimon, Michiko; Muranaka, Junko; Suno, Shigeo; Takayasu, Yukio; Shibahara, Hiroaki; Sawai, Hideaki

    1987-11-01

    Pelvic angiography (PAG) by Seldinger is one of the most useful examinations for the diagnosis of trophoblastic disease and also for the assessment of the therapeutic results. This technique, however, causes some stress to the patient. Therefore, noninvasive method, such as computed tomography (CT) and ultrasonography (USG) have recently been introduced. In the 1980s, digital subtraction angiography (DSA) was developed. It is now being used increasingly in the fields of Obstetrics and Gynecology as a substitute for the conventional PAG. In this report, the results of DSA, PAG, CT and USG which were carried out before and after chemotherapy in a patient with invasive hydatidiform mole were compared. In terms of the location, size and shape of the lesion, the CT findings were almost the same as those of USG. In terms of the angiographic findings in the affected area, intravenous DSA (IVDSA) was a sufficiently substitutional examination for conventional PAG. With IVDSA, arterial images can be obtained following the intravenous injection of a contrast medium. Therefore, this technique is excellent in terms of simplicity and safety. From now on, DSA will be utilized instead of PAG as an effective diagnostic method for trophoblastic disease and for follow-up such cases.

  18. Cone-beam CT angiography of the thorax. An experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Katsuya; Shimada, Kazuhiro [Chiba Univ. (Japan). School of Medicine; Tadokoro, Hiroyuki (and others)

    1999-10-01

    The authors recently developed a cone-beam computed tomography (CT) scanner and this report presents their evaluation of its potential for thoracic vascular imaging. An X-ray tube and a video-fluoroscopic system were rotated around the objects and 360 projected images were collected in a 12-s scan. Each image was digitized and a 3 dimensional (D) image (256 x 256 x 256 voxel volume with a voxel dimension of 0.9 x 0.9 x 0.9 mm) was reconstructed. Two different 3D-CT angiographies were investigated in 2 pigs: right atriography and thoracic aortography. Each pig was anesthetized, mechanically ventilated and positioned within the scanner. Contrast agent was infused through the right atrium or the aortic root at a rate of 3 ml/s during the scan. The right atriography scan clearly delineated the anatomy of the pulmonary artery, heart chambers and thoracic aorta. The thoracic aortography scan also clearly delineated the aortic anatomy including the internal thoracic and intercostal arteries. In conclusion, cone-beam CT angiography is potentially useful for thoracic vascular imaging. (author)

  19. Dose reduction during CT coronary angiography; La reduction de dose en coroscanographie

    Energy Technology Data Exchange (ETDEWEB)

    Willoteaux, S.; Sibileau, E.; Caroff, J.; Nedelcu, C.; Thouveny, F. [Service de Radiologie, Hopital Larrey, CHU d' Angers, 49 - Angers (France); Abi Kalil, W.; Delepine, S. [Service de Cardiologie, Hopital Larrey, CHU d' Angers, 49 - Angers (France)

    2010-11-15

    Dose delivery during CT coronary angiography with retrospective ECG gating is high especially due to the important slice overlapping. Optimization of the acquisition parameters is necessary to reduce patient exposure. First, the height of the scan field should be limited to the heart. Both kV and mA should be adjusted based on patient morphology. ECG gated exposure modulation with mA reduction during systole, a technique most applicable for patients with slow and regular heart rate, can result in a dose reduction up to 50%. The use of prospective ECG gating can also reduce patient dose. This technique also requires patients with slow and regular heart rate. (authors)

  20. Preoperative diagnosis of the thoracic aortic aneurysm by three-dimensional CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Hideo; Ino, Takashi; Ide, Hirofumi; Mizuhara, Akihiro; Yamaguchi, Atsushi; Kawahito, Koji; Kobayashi, Yasuyuki; Nagai, Jun (Jichi Medical School, Minamikawachi, Tochigi (Japan))

    1993-09-01

    Serial eight patients with thoracic aortic aneurysms were evaluated by a newly developed three-dimensional CT angiography (3D-CT) from December 1992 to January 1993. The patients include 3 aortic dissections, 3 aortic arch aneurysms, one descending aortic aneurysm and one thoraco-abdominal aortic aneurysm. The surgical treatment was performed after the evaluation of 3D-CT, and the operative findings were compared to the three-dimensional images reconstructed by 3D-CT in all patients. Three-dimensional displays were achieved using the unique method of data collection of the helical (spinal) scanner with continuous tube rotation and continuous table feed. An intravenous contrast material was used to image the thoracic aorta and major aortic branches with the single-breath-hold technique. Two and three-dimensional images reconstructed by 3D-CT were displayed within 10-20 minutes after the scanning. These three-dimensional images of the aortic lesions could be displayed in any angle we chose. Three-dimensional structures of the thoracic aorta and major aortic branches were clearly visualized and easily recognized by 3D-CT. These images were similar to the intraoperative findings and were quite useful to determine the operative procedure. The successful repair of thoracic aortic aneurysm was achieved in all cases. 3D-CT is a new and attractive modality to assess the vascular system. Although our experience is limited, 3D-CT may be a useful and powerful diagnostic method for the surgical treatment of thoracic aortic aneurysm. (author).

  1. Comparative Study on 16-slice CT Coronary Angiography vs Conventional Coronary Angiography-A Report of 38 Cases

    Institute of Scientific and Technical Information of China (English)

    Yan CHEN; Ping HAN; Bo LIANG; Huimin LIANG; Ziqiao LEI; Zhiliang TIAN; Gansheng FENG; Jie XIAO

    2008-01-01

    The clinical application of 16-slice CT coronary angiography (CTCA) and the impact of plaques differently characterized on assessing coronary artery stenosis were evaluated. Thirty-eight patients with coronary artery disease diagnosed by conventional coronary angiography (CAG) un- derwent 16-slice CTCA (collimation: 16×0.75 mm; rotation time: 420 msec; kernel: 35f; effective current: 500 mAs; tube voltage: 120 kV). The interval between CTCA and CAG was within one month. CTCA was evaluated by consensus of two independent experienced radiologists unknowing CAG findings. Original images, maximum intensity projections and multiplanar reconstructions were used to assess coronary artery stenosis. For a determined plaque an attenuation value≥130 HU was considered as calcified, and <130 HU noncalcified. The plaques were then classified into significant calcification (extensive calcification), medium calcification (small isolated calcification) and noncal- cification. The diagnostic accuracy of 16-slice CTCA findings as well as to detect ≥50% stenoses caused by plaques was evaluated respectively regarding CAG as the standard of reference. In com- parison with CAG findings, the sensitivity, specificity, positive and negative predictive value derived from CTCA for mild stenosis (<50%) were 72.7%, 38.5%, 50%, 62.5%, respectively; for moderate stenosis (50%-75%) 82.4%, 72.7%, 70%, 84.2%, resepctively; and for severe coronary stenosis (>75%) 85%, 90.5%, 81%, 92.7% respectively. With the increase of stenoses degree, the value of CTCA was greater. For the classification of the plaque calcification with ≥50% stenosis CTCA at- tained the sensitivity, specificity, positive and negative predictive value for severe calcificatoin 73.3%, 22.2%, 61.1% and 33.3%, respectively; for moderate calcification 70%, 55.6%, 63.6% and 62.5%, respectively; for noncalcification 93.8%, 85.7%, 93.8% and 85.7% respectively. CTCA was restricted in assessing coronary artery stenosis in the

  2. Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography

    DEFF Research Database (Denmark)

    Gutte, Henrik; Mortensen, Jann; Jensen, Claus Verner

    2009-01-01

    The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation-perfusion (V/Q) scintigraphy or pulmonary multidetector CT (MDCT) angiography. Both V/Q SPECT and MDCT angiography seem to have...... high diagnostic accuracy. However, only limited data directly comparing these 2 modalities are available. Hybrid gamma-camera/MDCT systems have been introduced and allow simultaneous 3-dimensional lung V/Q SPECT and MDCT angiography, suitable for diagnosing PE. The aim of our study was to compare...

  3. A LabVIEW Platform for Preclinical Imaging Using Digital Subtraction Angiography and Micro-CT.

    Science.gov (United States)

    Badea, Cristian T; Hedlund, Laurence W; Johnson, G Allan

    2013-01-01

    CT and digital subtraction angiography (DSA) are ubiquitous in the clinic. Their preclinical equivalents are valuable imaging methods for studying disease models and treatment. We have developed a dual source/detector X-ray imaging system that we have used for both micro-CT and DSA studies in rodents. The control of such a complex imaging system requires substantial software development for which we use the graphical language LabVIEW (National Instruments, Austin, TX, USA). This paper focuses on a LabVIEW platform that we have developed to enable anatomical and functional imaging with micro-CT and DSA. Our LabVIEW applications integrate and control all the elements of our system including a dual source/detector X-ray system, a mechanical ventilator, a physiological monitor, and a power microinjector for the vascular delivery of X-ray contrast agents. Various applications allow cardiac- and respiratory-gated acquisitions for both DSA and micro-CT studies. Our results illustrate the application of DSA for cardiopulmonary studies and vascular imaging of the liver and coronary arteries. We also show how DSA can be used for functional imaging of the kidney. Finally, the power of 4D micro-CT imaging using both prospective and retrospective gating is shown for cardiac imaging.

  4. Diagnosis of the thoracic aortic aneurysm by three-dimensional CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Hideo; Ino, Takafumi; Kobayashi, Yasuyuki; Nagai, Jun; Ide, Hirofumi; Mizuhara, Akihiro; Yamaguchi, Atsushi; Kawahito, Koji (Jichi Medical School, Minamikawachi, Tochigi (Japan))

    1993-07-01

    Twenty patients with thoracic aortic aneurysms were evaluated by a newly developed three-dimensional CT angiography (3D-CT) from December 1992 to February 1993. The patients included 12 aortic dissections, 7 true thoracic aortic aneurysms and one thoraco-abdominal aortic aneurysm. Three-dimensional displays were achieved rapidly in all cases using helical (spinal) CT which is a new technology with continuous tube rotation and continuous table feed. An intravenous contrast material was used to image the thoracic aortic aneurysm and the major aortic branches with single-breath-hold technique. Surgical treatment was performed in eight of 20 patients, and the aortic lesions in three cases were confirmed intraoperatively. Three-dimensional structures of the thoracic aorta and major branches were clearly visualized by 3D-CT and these images were useful to determine the operative procedure in surgical cases. 3D-CT is a new modality of evaluating the vascular system and may be a powerful and useful diagnostic method for the surgical intervention of thoracic aortic aneurysm. (author).

  5. Computed tomographic appearance of the anterior diaphragm: evaluation with 64-slice MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bum Sang; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Han, Gi Seok; Bae, Il Hun; Lee, Seung Young; Jeon, Min Hee [College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju (Korea, Republic of)

    2007-09-15

    To re-evaluate the appearance of the anterior diaphragm by the use of MDCT. We performed a retrospective review of 81 consecutive patients that underwent chest CT by using 64 channel MDCT. We classified the anterior diaphragm as three types (types 1-3) based on 5 mm axial scans: a line behind the xiphoid, a discontinuity and opening anteriorly, and the presence of broad and poorly defined bands. We also classified the anterior diaphragm as three types (types A-C) using 2 mm sagittal reformation images, based on the shape of the anterior diaphragmatic fibers traveling from the base of the pericardium to the xiphoid: a downward slope, an upward slope, and a flat shape, and compared the two groups using a correlation determined by statistical analysis. We could classify the appearance of the anterior diaphragm for all cases on the axial scans and sagittal reformation images. The number of types 1, 2, 3 on the axial scans was 30.9%, 38.3%, and 30.9% and the number of types A, B, C on the sagittal reformation images was 33.3%, 22.2%, and 44.4%, respectively. Type A was seen for 92% of type 1 cases, type C was seen for 88% of type 3 cases, and type B was seen for 54.8% of type 2 cases. The types seen between the axial and sagittal reformation images showed a significant agreement (r = 0.868, {rho} < 0.01). The shape of the anterior diaphragm correlated with the relationship between the base of the pericardium and the xiphoid.

  6. CT coronary angiography: new risks for low-risk chest pain.

    Science.gov (United States)

    Radecki, Ryan Patrick

    2013-10-01

    Widespread conservative management of low-risk chest pain has motivated the development of a rapid triage strategy based on CT coronary angiography (CTCA) in the Emergency Department (ED). Recently, three prominent trials using this technology in the ED setting have presented results in support of its routine use. However, these studies fail to show the incremental prognostic value of CTCA over clinical and biomarker-based risk-stratification strategies, demonstrate additional downstream costs and interventions, and result in multiple harms associated with radio-contrast and radiation exposure. Observing the widespread overdiagnosis of pulmonary embolism following availability of CT pulmonary angiogram as a practice pattern parallel, CTCA use for low-risk chest pain in the ED should be advanced only with caution.

  7. From 3D to 4D: Integration of temporal information into CT angiography studies.

    Science.gov (United States)

    Haubenreisser, Holger; Bigdeli, Amir; Meyer, Mathias; Kremer, Thomas; Riester, Thomas; Kneser, Ulrich; Schoenberg, Stefan O; Henzler, Thomas

    2015-12-01

    CT angiography is the current clinical standard for the imaging many vascular illnesses. This is traditionally done with a single arterial contrast phase. However, advances in CT technology allow for a dynamic acquisition of the contrast bolus, thus adding temporal information to the examination. The aim of this article is to highlight the clinical possibilities of dynamic CTA using 2 examples. The accuracy of the detection and quantification of stenosis in patients with peripheral arterial occlusive disease, especially in stadium III and IV, is significantly improved when performing dynamic CTA examinations. The post-interventional follow-up of examinations of EVAR benefit from dynamic information, allowing for a higher sensitivity and specificity, as well as allowing more accurate classification of potential endoleaks. The described radiation dose for these dynamic examinations is low, but this can be further optimized by using lower tube voltages. There are a multitude of applications for dynamic CTA that need to be further explored in future studies.

  8. Anomalous origin of coronary artery: the role of multislice CT Angiography: a case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Rabelo, Daniel Rocha; Barros, Marcio Vinicius Lins; Nunes, Maria do Carmo Pereira; Siqueira, Maria Helena Albernaz, E-mail: marciovlbarros@uol.com.br [Hospital Mater Dei, Belo Horizonte, MG (Brazil)

    2012-07-15

    Anomalous origin of coronary arteries is a relatively rare entity and can present different clinical forms. Recently, CT angiography of the coronary arteries have demonstrated an important role in the diagnosis and management of these anomalies. We present the case of a young female without significant comorbidities who presented with cardiopulmonary arrest, being revived by a team of customer service mobile emergency. After completion of multislice CT angiography of the coronary arteries was observed anomalous origin of left main coronary artery in the right coronary artery, no signs of extrinsic compression. Patient received a defibrillator and had an uneventful follow-up performed. Multislice CT angiography is minimally invasive diagnostic methods to detect the origin and trajectory of the coronary arteries, allowing an alternative to cardiac catheterization for evaluation of patients with anomalous origin of coronary arteries. (author)

  9. Non-ECG-gated CT pulmonary angiography and the prediction of right ventricular dysfunction in patients suspected of pulmonary embolism

    DEFF Research Database (Denmark)

    Gutte, Henrik; Mortensen, Jann; Mørk, Mette Louise;

    2016-01-01

    PURPOSE: Right ventricular dysfunction (RVD) is an important prognostic factor of 30-day mortality in patients with acute pulmonary embolism (PE). The aim of our study was to evaluate whether non-electrocardiogram (ECG)-gated cardiovascular parameters attained during computed tomography pulmonary...... angiography (CTPA) could predict RVD in patients suspected of PE using ECG-gated cardiac CT angiography as reference. METHODS: Consecutive patients suspected of PE were referred to a ventilation/perfusion single-photon emission tomography (V/Q-SPECT) as first-line imaging procedure. Patients had a V....../Q-SPECT/CT, a CTPA and an ECG-gated cardiac CT angiography performed the same day. RESULTS: A total of 71 patients were available for analysis. Seventeen patients (24%) had RVD. The non-ECG-gated dimensions of left and right ventricle and the major vessels were correlated with ECG-gated cardiac dimensions. The size...

  10. Effect of saline flush on enhancement of proximal and distal segments using 320-row coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Tomizawa, Nobuo, E-mail: tomizawa-tky@umin.ac.jp [Department of Radiology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Suzuki, Fumio; Akahane, Masaaki [Department of Radiology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Torigoe, Rumiko [Toshiba Medical Systems Corporation, Tokyo Metropolitan Regional Office, 1-6, Tsukuda 2-Chome, Chuo-ku, Tokyo 104-0051 (Japan); Kiryu, Shigeru [Department of Radiology, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Ohtomo, Kuni [Department of Radiology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan)

    2013-08-15

    Objective: To investigate the effect of saline flush on coronary CT angiography of proximal, middle, and distal coronary artery segments, using 320-row CT, and to compare two injection duration protocols as to amount of contrast in the right heart chambers. Methods: This retrospective study was approved by the local ethics committee, and the requirement for informed consent to participate in this study was waived. The final study group included 108 patients who underwent coronary CT angiography. The first 36 patients received contrast medium without saline flush (group 1); the next 36 patients received contrast medium for 14 s and saline flush (group 2); the last 36 patients received contrast medium for 12 s and saline flush (group 3). The CT number, noise, contrast-to-noise ratio (CNR), and number of segments with a CT number greater than 325 Hounsfield units (HU) were recorded for proximal, middle, and distal segments. Results: The CT numbers and the CNR in groups 2 and 3 were significantly higher than that in group 1 (p < 0.005); the difference between groups 2 and 3 was not significant. The proportion of segments greater than 325 HU improved with saline flush (p < 0.05), with a larger improvement in the distal segments. Conclusions: Saline flush improves enhancement and CNR of coronary arteries, particularly of distal segments, in coronary CT angiography using 320-row CT. An average contrast medium injection of 44 mL was feasible using a saline flush.

  11. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France); University Bordeaux Segalen, Bordeaux Cedex (France); Bullier, Eric; Riviere, Annalisa [Hopital Haut-Leveque, CHU Bordeaux, Department of Nuclear Medicine, Pessac (France); Dromer, Claire [Hopital Haut-Leveque, CHU Bordeaux, Department of Respiratory Diseases, Pessac (France); Picard, Francois [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiology, Pessac (France); Billes, Marc-Alain [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiac Surgery, Pessac (France); Corneloup, Olivier [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France)

    2014-01-15

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  12. The clinical application of multi-slice spiral CT angiography in abdominal aortic disease

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the clinical application of multi-slice spiral CT angiography(MSCTA) in the assessment of abdominal aortic disease. Methods: Fifty-four patients underwent multi-slice spiral CT angiography of abdomen. Contrast agent (Omnipaque 300 I g/L) 1.5 ml/kg was injected and the injection rate was 3 ml/s. The delay time was determined by bolus tracking technique,Tll level abdominal aorta was set as the target vessel and the threshold was 180-200 Hu, slice width was 3 mm and with a pitch of 4-6.Original data were transferred to working-station to perform functional reconstruction. Results: Ten cases were normal, twenty-eight cases were abdominal aortic aneurysms, five abdominal aortic dissecting aneurysms (Debakay type Ⅲ ) and eleven aortic sclerosis. SSD showed the body of aneurysm and the relationship between aneurysm and adjacent blood vessel, MIP better displayed calcification of blood vessel wall and condition of the stent, MPR demonstrated true and false lumen, rupture site of abdominal aorta intima and mural thrombus. Conclusion: MSCTA axial and reconstruction image can show the extent of abdominal aortic disease and the relationship with adjacent blood vessels. It is a safe, simple and non-invasive examination method.

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

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Lawrence Chia Wei; Devapalasundaram, Ashwini; Ardley, Nicholas [Monash Health, Department of Diagnostic Imaging, Clayton, Victoria (Australia); Lau, Kenneth K. [Monash Health, Department of Diagnostic Imaging, Clayton, Victoria (Australia); Monash University, Department of Medicine, Faculty of Medicine, Nursing, and Health Sciences, Victoria (Australia); Buchan, Kevin [Phillips Healthcare, Clinical Science, PO Box 312, Mont Albert, Victoria (Australia); Huynh, Minh [RMIT University, School of Mathematical and Geospatial Sciences, Victoria (Australia)

    2014-12-15

    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.)

  14. Sixty-four-slice CT angiography to determine the three dimensional relationships of vascular and soft tissue wounds in lower extremity war time injuries.

    Science.gov (United States)

    Smith, Jennifer M; Fox, Charles J; Brazaitis, Michael P; Via, Kathy; Garcia, Roman; Feuerstein, Irwin M

    2010-01-01

    This article analyzes the use and benefits of the 64-slice CT scanner in determining the 3D relationships of vascular and soft tissue wounds in lower extremity war time injuries. A brief overview of CT scanning is given as well as the techniques used to produce the images needed for diagnosis. The series follows two similar cases of war time injury patients at the Walter Reed Army Medical Center. The first case is a 30-year-old active duty male, who presented with multiple trauma from a motor vehicle accident because of an improvised explosive device (IED) blast, sustaining substantial lower extremity injuries. The second case is a 34-year-old active duty male, who presented with multiple trauma blast injuries. Both cases were of interest because the vasculature was found to be very close to the surface of the wound, which put the arteries at risk for rupture and for iatrogenic injury during repeated debridements.

  15. Current State and Progress of Coronary Angiography in Multi-slice Spiral Computed Tomography Imaging Techniques%多排螺旋CT在冠状动脉成像技术中的现状与进展

    Institute of Scientific and Technical Information of China (English)

    胡斌; 徐文坚; 陈海松

    2012-01-01

    多层螺旋CT( mulil slice spiral CT,MSCT)技术的进步为无创性冠状动脉造影提供了广阔的前景,临床应用备受关注.特别是64层CT的出现,空间分辨率、时间分辨率大大提高,心电门控技术及三维后处理技术拓宽了CT在冠状动脉成像中的应用范围.本文阐述了CT在冠状动脉成像技术及影响因素,并对其现状及进展情况作综述.%Multi-detector row CT imaging techniques has great potential for development of noninvasive imaging of the coronary arteries. Coronary CT angiography in clinical utility field was paid highly attention to. Especially current computed tomography (64 slice CT) techniques combine high speed and spatial resolution with electrocardiography synchronization and three-dimensional post processing technology, the scope of coronary CT angiography was widen. This review article will describe the coronary angiography technology of multi-detector row CT and the factors as they relate to the current and future role of coronary CT angiography.

  16. Optimal sequence timing of CT angiography and perfusion CT in patients with stroke

    Energy Technology Data Exchange (ETDEWEB)

    Morhard, D., E-mail: morhard@nrad.de [Institute of Clinical Radiology, University of Munich, Munich (Germany); Institute of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Klinikum Muenchen-Harlaching, Munich (Germany); Wirth, C.D. [Institute of Clinical Radiology, University of Munich, Munich (Germany); Department of General Internal Medicine, University Hospital Inselspital, University of Bern, Bern (Switzerland); Reiser, M.F. [Institute of Clinical Radiology, University of Munich, Munich (Germany); Schulte-Altedorneburg, G. [Institute of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Klinikum Muenchen-Harlaching, Munich (Germany); Ertl-Wagner, B. [Institute of Clinical Radiology, University of Munich, Munich (Germany)

    2013-06-15

    Objective: Standard stroke CT protocols start with non-enhanced CT followed by perfusion-CT (PCT) and end with CTA. We aimed to evaluate the influence of the sequence of PCT and CTA on quantitative perfusion parameters, venous contrast enhancement and examination time to save critical time in the therapeutic window in stroke patients. Methods and materials: Stroke CT data sets of 85 patients, 47 patients with CTA before PCT (group A) and 38 with CTA after PCT (group B) were retrospectively analyzed by two experienced neuroradiologists. Parameter maps of cerebral blood flow, cerebral blood volume, time to peak and mean transit time and contrast enhancements (arterial and venous) were compared. Results: Both readers rated contrast of brain-supplying arteries to be equal in both groups (p = 0.55 (intracranial) and p = 0.73 (extracranial)) although the extent of venous superimposition of the ICA was rated higher in group B (p = 0.04). Quantitative perfusion parameters did not significantly differ between the groups (all p > 0.18), while the extent of venous superimposition of the ICA was rated higher in group B (p = 0.04). The time to complete the diagnostic CT examination was significantly shorter for group A (p < 0.01). Conclusion: Performing CTA directly after NECT has no significant effect on PCT parameters and avoids venous preloading in CTA, while examination times were significantly shorter.

  17. Blunt polytrauma: evaluation with 64-section whole-body CT angiography.

    Science.gov (United States)

    Dreizin, David; Munera, Felipe

    2012-01-01

    Blunt polytrauma remains a leading cause of death and disability worldwide. With the major advances in computed tomography (CT) technology over the past decade, whole-body CT is increasingly recognized as the emerging standard for providing rapid and accurate diagnoses within the narrow therapeutic window afforded to trauma victims with multiple severe injuries. With a single continuous acquisition, whole-body CT angiography is able to demonstrate all potentially injured organs, as well as vascular and bone structures, from the circle of Willis to the symphysis pubis. As its use becomes more widespread, the large volume of information inherent to whole-body CT poses new challenges to radiologists in providing efficient and timely interpretation. An awareness of trauma scoring systems and injury mechanisms is essential to maintain an appropriate level of suspicion in the search for multiple injuries, and the use of multiplanar reformation and three-dimensional postprocessing techniques is important to maximize efficiency in the search. Knowledge of the key injuries that require urgent surgical or percutaneous intervention, including major vascular injuries and active hemorrhage, diaphragmatic rupture, unstable spinal fractures, pancreatic injuries with ductal involvement, and injuries to the mesentery and hollow viscera, is also necessary.

  18. Prostatic arterial supply: demonstration by multirow detector Angio CT and Catheter Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Bilhim, Tiago [Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon (Portugal); Hospital Saint Louis, Interventional Radiology, Lisbon (Portugal); Pisco, Joao M. [Hospital Saint Louis, Interventional Radiology, Lisbon (Portugal); Universidade Nova de Lisboa, Departamento Universitario de Radiologia, Faculdade de Ciencias Medicas, Lisbon (Portugal); Furtado, Andrea; Casal, Diogo; Pais, Diogo; O' Neill, Joao E.G. [Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon (Portugal); Campos Pinheiro, Luis [Universidade Nova de Lisboa, Departamento Universitario de Urologia, Faculdade de Ciencias Medicas, Lisbon (Portugal)

    2011-05-15

    To evaluate the prostatic arterial supply with multidetector Angio CT and Digital Subtraction Angiography (DSA). DSA was performed in 21 male patients (7 of these also underwent Pelvic Angio CT); a further 4 patients only underwent Angio CT. Prostatic arteries were classified according to their origin, direction, number of pedicles, termination and anastomoses with surrounding arteries in 50 pelvic sides. The most frequent origin was the internal pudendal artery (n = 28; 56%) with the common gluteal-pudendal trunk the next commonest (n = 14; 28%). Less frequent origins were the obturator artery (n = 6; 12%) or the inferior gluteal artery (n = 2; 4%). Two separate vascular pedicles were found in 12 pelvic sides (24%). There were anastomoses with the termination of the internal pudendal artery in 24% of cases (n = 12), with the contra-lateral prostatic arteries in 6 cases (12%), and to the superior vesical artery in 4 cases (8%). Defining prostatic artery origin and direction is paramount to allow selective catheterisation. Angio CT is very useful as a pre-intervention tool. The number of independent vascular pedicles and the presence of anastomoses with surrounding arteries should be taken into account when planning prostatic arterial embolisation. (orig.)

  19. Impact of image noise levels, scout scan dose and lens shield on image quality and radiation exposure in z-axis dose-modulated neck MSCT on 16- and 64-slice Toshiba Aquilion scanners.

    Science.gov (United States)

    Bauknecht, Hans-Christian; Jach, Cornelia; Bohner, Georg; Meyer, Henning; Scheurig, Christian; Siebert, Eberhard; Klingebiel, Randolf

    2010-02-01

    Assessing the impact of image noise (IN) levels, scout scan dose and lens shield use on image quality and radiation exposure in neck multislice CT (MSCT) when using z-axis dose modulation (DM). Neck MSCT phantom studies with/without z-axis DM were performed by using different IN levels (S.D. 7.5-30HU) and scout scan tube currents (7.5-50mA) on Toshiba Aquilion scanners (16-/64-slice). Image quality indices were evaluated by two radiologists and radiation exposure parameters calculated. Cadaveric phantom measurements elucidated lens shield interactions with DM efficacy. The lowest dose scan protocol with diagnostic image quality was introduced into the clinical imaging routine and retrospectively evaluated in 20 age-matched patients undergoing neck MSCT with/without DM. The highest image noise level in DM neck studies with comparable image quality to standard neck CT amounted to 20HU, resulting in a mean tube current of 50mAs (CTDI(w) 6.3mGy). DM reduced effective dose by 35% and organ dose figures (lens, thyroid) by 33%. Scout scan dose lowering to 20mA resulted in an effective dose (ED) decrease of 0.06mSv (5%). Avoiding lens shield placement during scout scan effected an organ dose decrease of 20%. Overall contour sharpness and image contrast did not differ significantly (DM/without DM) whereas image noise was rated higher in DM neck CT studies (pz-Axis dose modulation, as assessed on 16- and 64-slice Toshiba Aquilion scanners, is effective and mandatory in neck MSCT. DM efficacy can be enhanced by optimising scout scan doses and lens shield use. Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.

  20. Combined CT Angiography and CT Venography in Thromboembolic disease: clinical impact; Angio TC y flebo TC combinados en el diagnostico de la enfermedad tramboembolica: impacto clinico

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    Bouzas, R.; Migueles, Y.; Gomez, S.; Mallo, R.; Garcia-Tejedor, J. L.; Diaz Vega, M. J. [Complejo Hospitalario Xerar-Cies. Vigo. Pontevedra (Spain)

    2002-07-01

    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.

  1. The Interobserver Agreement between Residents and Experienced Radiologists for Detecting Pulmonary Embolism and DVT with Using CT Pulmonary Angiography and Indirect CT Venography

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    Yavas, Ulas Savas; Calisir, Cuneyt; Ozkan; Ibrahim Ragip [Eskisehir Osmangazi University, Eskisehir (Turkmenistan)

    2008-12-15

    We wanted to prospectively evaluate the interobserver agreement between radiology residents and expert radiologists for interpreting CT images for making the diagnosis of pulmonary embolism (PE). We assessed 112 consecutive patients, from April 2007 to August 2007, who were referred for combined CT pulmonary angiography and indirect CT venography for clinically suspected acute PE. CT scanning was performed with a 64x0.5 collimation multi-detector CT scanner. The CT studies were initially interpreted by the radiology residents alone and then the CT images were subsequently interpreted by a consensus of the resident plus an experienced general radiologist and an experienced chest radiologist. Two of the 112 CTs were unable to be interpreted (1.7%). Pulmonary artery clots were seen on 36 of the thoracic CT angiographies (32%). The interobserver agreement between the radiology residents and the consensus interpretation was good (a kappa index of 0.73). All of the disagreements (15 cases) were instances of overcall by the resident on the initial interpretation. Deep venous thrombosis was detected in 72% (26 of 36) of the patients who had PE seen on thoracic CT. The initial and consensus interpretations of the CT venography images disagreed for two cases (kappa statistic: 0.96). It does not seem adequate to base the final long-term treatment of PE on only the resident's reading, as false positives occurred in 13% of such cases. Timely interpretation of the CT pulmonary angiography and CT venography images should be performed by experienced radiologists for the patients with suspected PE.

  2. Prospectively ECG Gated CT pulmonary angiography versus helical ungated CT pulmonary angiography: Impact on cardiac related motion artifacts and patient radiation dose

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    Shuman, William P., E-mail: wshuman@u.washington.edu [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Leipsic, Jonathon A., E-mail: JLeipsic@providencehealth.bc.ca [University of British Columbia and St. Paul' s Hospital, Department of Radiology, 1081 Burrard Street, Vancouver, BC, V6Z1Y6 (Canada); Busey, Janet M., E-mail: jbonny@u.washington.edu [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Green, Douglas E., E-mail: dougreen@uw.edu [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Pipavath, Sudhakar N., E-mail: snjp@u.wwashington.edu [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Hague, Cameron J., E-mail: cjhague@interchange.ubc.ca [University of British Columbia and St. Paul' s Hospital, Department of Radiology, 1081 Burrard Street, Vancouver, BC, V6Z1Y6 (Canada); Koprowicz, Kent M., E-mail: kentk@u.washington.edu [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States)

    2012-09-15

    Objective: To compare prospectively ECG gated CT pulmonary angiography (CTPA) with routine helical ungated CTPA for cardiac related motion artifacts and patient radiation dose. Subjects and methods: Twenty patients with signs and symptoms suspicious for pulmonary embolism and who had a heart rate below 85 were scanned with prospectively ECG gated CTPA. These gated exams were matched for several clinical parameters to exams from twenty similar clinical patients scanned with routine ungated helical CTPA. Three blinded independent reviewers subjectively evaluated all exams for overall pulmonary artery enhancement and for several cardiac motion related artifacts, including vessel blurring, intravascular shading, and double line. Reviewers also measured pulmonary artery intravascular density and image noise. Patient radiation dose for each technique was compared. Fourteen clinical prospectively ECG gated CTPA exams from a second institution were evaluated for the same parameters. Results: Prospectively ECG gated CTPA resulted in significantly decreased motion-related image artifact scores in lung segments adjacent to the heart compared to ungated CTPA. Measured image noise was not significantly different between the two types of CTPA exams. Effective dose was 28% less for prospectively ECG gated CTPA (4.9 mSv versus 6.8 mSv, p = 0.02). Similar results were found in the prospectively ECG gated exams from the second institution. Conclusion: Compared to routine helical ungated CTPA, prospectively ECG gated CTPA may result in less cardiac related motion artifact in lung segments adjacent to the heart and significantly less patient radiation dose.

  3. Dose reduction in spiral CT angiography of thoracic outlet syndrome by anatomically adapted tube current modulation

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    Mastora, I.; Remy-Jardin, M.; Remy, J. [Dept. of Radiology, University Center Hospital Calmette, Lille (France); Medical Research Group, Lille (France); Suess, C.; Scherf, C. [Siemens Medical Systems, Forcheim (Germany); Guillot, J.P. [Dept. of Radiology, University Center Hospital Calmette, Lille (France)

    2001-04-01

    The aim of this study was to evaluate dose reduction in spiral CT angiography of the thoracic outlet by on-line tube-current control. Prospectively, 114 patients undergoing spiral CT angiography of the subclavian artery for thoracic outlet arterial syndromes were evaluated with and without tube-current modulation at the same session (scanning parameters for the two successive angiograms, one in the neutral position and one after the postural maneuver): 140 kV; 206 mA; scan time 0.75 s; collimation 3 mm; pitch = (1). The dose reduction system was applied in the neutral position in the first 92 consecutive patients and after postural maneuver in the remaining 22 consecutive patients. Dose reduction and image quality were analyzed in the overall study group (group 1; n = 114). The influence of the arm position was assessed in 44 of the 114 patients (group 2), matched by the transverse diameter of the upper thorax. The mean dose reduction was 33 % in group 1 (range 22-40 %) and 34 % in group 2 (range 26-40 %). In group 2 the only difference in image quality was a significantly higher frequency of graininess on low-dose scans compared with reference scans whatever the patient's arm position, graded as minimal in 38 of the 44 patients (86 %). When the low-dose technique was applied after postural maneuver in group 2: (a) the mean dose reduction was significantly higher (35 vs 32 % in the neutral position; p = 0.006); (b) graininess was less frequent (82 vs 91 % in the neutral position); and (c) the percentage of graininess graded as minimal was significantly higher (83 vs 70 % in the neutral position; p = 0.2027). On-line tube-current modulation enables dose reduction on high-quality, diagnostic spiral CT angiograms of the thoracic outlet and should be applied during data acquisition in the neutral position and after postural maneuver for optimal use. (orig.)

  4. Low-dose CT pulmonary angiography on a 15-year-old CT scanner: a feasibility study

    Directory of Open Access Journals (Sweden)

    Moritz Kaup

    2016-12-01

    Full Text Available Background Computed tomography (CT low-dose (LD imaging is used to lower radiation exposure, especially in vascular imaging; in current literature, this is mostly on latest generation high-end CT systems. Purpose To evaluate the effects of reduced tube current on objective and subjective image quality of a 15-year-old 16-slice CT system for pulmonary angiography (CTPA. Material and Methods CTPA scans from 60 prospectively randomized patients (28 men, 32 women were examined in this study on a 15-year-old 16-slice CT scanner system. Standard CT (SD settings were 100 kV and 150 mAs, LD settings were 100 kV and 50 mAs. Attenuation of the pulmonary trunk, various anatomic landmarks, and image noise were quantitatively measured; contrast-to-noise ratios (CNR and signal-to-noise ratios (SNR were calculated. Three independent blinded radiologists subjectively rated each image series using a 5-point grading scale. Results CT dose index (CTDI in the LD series was 66.46% lower compared to the SD settings (2.49 ± 0.55 mGy versus 7.42 ± 1.17 mGy. Attenuation of the pulmonary trunk showed similar results for both series (SD 409.55 ± 91.04 HU; LD 380.43 HU ± 93.11 HU; P = 0.768. Subjective image analysis showed no significant differences between SD and LD settings regarding the suitability for detection of central and peripheral PE (central SD/LD, 4.88; intra-class correlation coefficients [ICC], 0.894/4.83; ICC, 0.745; peripheral SD/LD, 4.70; ICC, 0.943/4.57; ICC, 0.919; all P > 0.4. Conclusion The LD protocol, on a 15-year-old CT scanner system without current high-end hardware or post-processing tools, led to a dose reduction of approximately 67% with similar subjective image quality and delineation of central and peripheral pulmonary arteries.

  5. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study

    NARCIS (Netherlands)

    I. Cho (Iksung); H.-J. Chang (Hyuk-Jae); B.T. Hartaigh (Bríain ó); S. Shin (Sanghoon); J.M. Sung (Ji Min); F.Y. Lin (Fay); S. Achenbach (Stephan); R. Heo (Ran); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); M. Al-Mallah (Mouaz); F. Cademartiri (Filippo); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); A.M. Dunning (Allison M.); A. Delago (Augustin); T.C. Villines (Todd); M. Hadamitzky (Martin); J. Hausleiter (Jörg); J. Leipsic (Jonathon); L.J. Shaw (Leslee); P.A. Kaufmann (Philipp A.); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); E. Maffei (Erica); G.L. Raff (Gilbert); G. Pontone (Gianluca); D. Andreini (Daniele); J.K. Min (James K.)

    2015-01-01

    textabstractAim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified b

  6. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study

    NARCIS (Netherlands)

    I. Cho (Iksung); H.-J. Chang (Hyuk-Jae); B.T. Hartaigh (Bríain ó); S. Shin (Sanghoon); J.M. Sung (Ji Min); F.Y. Lin (Fay); S. Achenbach (Stephan); R. Heo (Ran); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); M. Al-Mallah (Mouaz); F. Cademartiri (Filippo); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); A.M. Dunning (Allison M.); A. Delago (Augustin); T.C. Villines (Todd); M. Hadamitzky (Martin); J. Hausleiter (Jörg); J. Leipsic (Jonathon); L.J. Shaw (Leslee); P.A. Kaufmann (Philipp A.); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); E. Maffei (Erica); G.L. Raff (Gilbert); G. Pontone (Gianluca); D. Andreini (Daniele); J.K. Min (James K.)

    2015-01-01

    textabstractAim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified b

  7. Impact of routine cerebral CT angiography on treatment decisions in infective endocarditis.

    Directory of Open Access Journals (Sweden)

    Marwa Sayed Meshaal

    Full Text Available Infective endocarditis (IE is commonly complicated by cerebral embolization and hemorrhage secondary to intracranial mycotic aneurysms (ICMAs. These complications are associated with poor outcome and may require diagnostic and therapeutic plans to be modified. However, routine screening by brain CT and CT angiography (CTA is not standard practice. We aimed to study the impact of routine cerebral CTA on treatment decisions for patients with IE.From July 2007 to December 2012, we prospectively recruited 81 consecutive patients with definite left-sided IE according to modified Duke's criteria. All patients had routine brain CTA conducted within one week of admission. All patients with ICMA underwent four-vessel conventional angiography. Invasive treatment was performed for ruptured aneurysms, aneurysms ≥ 5 mm, and persistent aneurysms despite appropriate therapy. Surgical clipping was performed for leaking aneurysms if not amenable to intervention.The mean age was 30.43 ± 8.8 years and 60.5% were males. Staph aureus was the most common organism (32.3%. Among the patients, 37% had underlying rheumatic heart disease, 26% had prosthetic valves, 23.5% developed IE on top of a structurally normal heart and 8.6% had underlying congenital heart disease. Brain CT/CTA revealed that 51 patients had evidence of cerebral embolization, of them 17 were clinically silent. Twenty-six patients (32% had ICMA, of whom 15 were clinically silent. Among the patients with ICMAs, 11 underwent endovascular treatment and 2 underwent neurovascular surgery. The brain CTA findings prompted different treatment choices in 21 patients (25.6%. The choices were aneurysm treatment before cardiac surgery rather than at follow-up, valve replacement by biological valve instead of mechanical valve, and withholding anticoagulation in patients with prosthetic valve endocarditis for fear of aneurysm rupture.Routine brain CT/CTA resulted in changes in the treatment plan in a significant

  8. Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score : systematic review and meta-analysis

    NARCIS (Netherlands)

    den Dekker, Martijn; de Smet, K.; de Bock, G.H.; Tio, R.A.; Oudkerk, M.; Vliegenthart, R.

    2012-01-01

    Objectives A systematic review and meta-analysis to assess sensitivity and specificity of coronary CT angiography (CCTA) for significant stenosis at different degrees of coronary calcification. Methods A literature search was performed including studies describing test characteristics of CCTA for

  9. A practical approach for a patient-tailored dose protocol in coronary CT angiography using prospective ECG triggering

    NARCIS (Netherlands)

    Dijk, van J.D.; Huizing, E.D.; Jager, P.L.; Ottervanger, J.P.; Knollema, S.; Slump, C.H.; Dalen, van J.A.

    2015-01-01

    To derive and validate a practical patient-specific dose protocol to obtain an image quality, expressed by the image noise, independent of patients’ size and a better radiation dose justification in coronary CT angiography (CCTA) using prospective ECG triggering. 43 patients underwent clinically ind

  10. Cardiovascular CT angiography in neonates and children : Image quality and potential for radiation dose reduction with iterative image reconstruction techniques

    NARCIS (Netherlands)

    Tricarico, Francesco; Hlavacek, Anthony M.; Schoepf, U. Joseph; Ebersberger, Ullrich; Nance, John W.; Vliegenthart, Rozemarijn; Cho, Young Jun; Spears, J. Reid; Secchi, Francesco; Savino, Giancarlo; Marano, Riccardo; Schoenberg, Stefan O.; Bonomo, Lorenzo; Apfaltrer, Paul

    To evaluate image quality (IQ) of low-radiation-dose paediatric cardiovascular CT angiography (CTA), comparing iterative reconstruction in image space (IRIS) and sinogram-affirmed iterative reconstruction (SAFIRE) with filtered back-projection (FBP) and estimate the potential for further dose

  11. Cardiovascular CT angiography in neonates and children : Image quality and potential for radiation dose reduction with iterative image reconstruction techniques

    NARCIS (Netherlands)

    Tricarico, Francesco; Hlavacek, Anthony M.; Schoepf, U. Joseph; Ebersberger, Ullrich; Nance, John W.; Vliegenthart, Rozemarijn; Cho, Young Jun; Spears, J. Reid; Secchi, Francesco; Savino, Giancarlo; Marano, Riccardo; Schoenberg, Stefan O.; Bonomo, Lorenzo; Apfaltrer, Paul

    2013-01-01

    To evaluate image quality (IQ) of low-radiation-dose paediatric cardiovascular CT angiography (CTA), comparing iterative reconstruction in image space (IRIS) and sinogram-affirmed iterative reconstruction (SAFIRE) with filtered back-projection (FBP) and estimate the potential for further dose reduct

  12. Whole-brain CT digital subtraction angiography of cerebral dural arteriovenous fistula using 320-detector row CT

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    Fujiwara, Hirokazu; Momoshima, Suketaka; Kuribayashi, Sachio [Keio University, Department of Diagnostic Radiology, School of Medicine, Tokyo (Japan); Akiyama, Takenori [Keio University, Department of Neurosurgery, School of Medicine, Tokyo (Japan)

    2013-07-15

    The purpose of this study was to evaluate the usefulness of CT digital subtraction angiography (CTDSA) by using 320-detector row CT in the diagnosis and classification of cerebral dural arteriovenous fistula (dAVF) and comparing it with DSA as the standard reference. A total of 29 CTDSA/DSA from 25 patients with dAVF were retrospectively evaluated by two neuroradiologists. The presence, Cognard classification, and feeding arteries of dAVFs on CTDSA were assessed according to DSA. DSA depicted 33 dAVFs in 28 cases. By consensus reading, CTDSA correctly detected 32 dAVFs in 27 cases and properly graded 31 lesions. The intermodality agreement for the presence and classification of dAVFs was excellent (kappa = 0.955 and 0.921, respectively). CTDSA detected 77 of 109 feeding arteries (70.6 %) in 25 cases. The intermodality agreement for the feeding arteries was good (kappa = 0.713). Although CTDSA is limited in temporal and spatial resolution in comparison with DSA, it is an effective non-invasive tool for the detection and classification of dAVF. (orig.)

  13. Performance of turbo high-pitch dual-source CT for coronary CT angiography: first ex vivo and patient experience

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    Morsbach, Fabian; Gordic, Sonja; Husarik, Daniela; Frauenfelder, Thomas; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Desbiolles, Lotus; Leschka, Sebastian [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Kantonsspital St. Gallen, Divison of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Schmidt, Bernhard; Allmendinger, Thomas [Siemens AG, Healthcare Sector, Forchheim (Germany); Wildermuth, Simon [Kantonsspital St. Gallen, Divison of Radiology and Nuclear Medicine, St. Gallen (Switzerland)

    2014-08-15

    To evaluate image quality, maximal heart rate allowing for diagnostic imaging, and radiation dose of turbo high-pitch dual-source coronary computed tomographic angiography (CCTA). First, a cardiac motion phantom simulating heart rates (HRs) from 60-90 bpm in 5-bpm steps was examined on a third-generation dual-source 192-slice CT (prospective ECG-triggering, pitch 3.2; rotation time, 250 ms). Subjective image quality regarding the presence of motion artefacts was interpreted by two readers on a four-point scale (1, excellent; 4, non-diagnostic). Objective image quality was assessed by calculating distortion vectors. Thereafter, 20 consecutive patients (median, 50 years) undergoing clinically indicated CCTA were included. In the phantom study, image quality was rated diagnostic up to the HR75 bpm, with object distortion being 1 mm or less. Distortion increased above 1 mm at HR of 80-90 bpm. Patients had a mean HR of 66 bpm (47-78 bpm). Coronary segments were of diagnostic image quality for all patients with HR up to 73 bpm. Average effective radiation dose in patients was 0.6 ± 0.3 mSv. Our combined phantom and patient study indicates that CCTA with turbo high-pitch third-generation dual-source 192-slice CT can be performed at HR up to 75 bpm while maintaining diagnostic image quality, being associated with an average radiation dose of 0.6 mSv. (orig.)

  14. Influence of observer experience and training on proficiency in coronary CT angiography interpretation

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    Herzog, Christopher [Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425 (United States); Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Radiologie München, Burgstraße 7, 80331 Munich (Germany); Kerl, J. Matthias [Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425 (United States); Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); De Rosa, Salvatore [Department of Cardiology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Tekin, Tuna [Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Boehme, Eike [Department of Cardiology, Bayerwaldklinik, Cham, Klinikstraße 22, 93413 Cham (Germany); Liem, Sven [Kardiologie am Rotkreuzplatz, Volkartstr. 5, 80634 Munich (Germany); Scheuchenzuber, Miriam [Radiologie München, Burgstraße 7, 80331 Munich (Germany); Kim, He-Ri [Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Bauer, Ralf W. [Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425 (United States); Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Silverman, Justin R. [Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425 (United States); and others

    2013-08-15

    Purpose: To assess the influence of experience and training on the proficiency in coronary CT angiography (CCTA) interpretation of practitioners with different levels of experience. Methods and materials: Nine radiologist and cardiologist observers with varying prior CCTA experience ranging from novice to expert independently analyzed two case series of 50 catheter-correlated CCTA studies for coronary artery stenosis (0%, ≤49%, 50–74%, 75–99%, or 100%). Results of the first case series were unblinded and presented along with catheter angiography results to each reader before proceeding to the second series. Diagnostic accuracy on a per-segment basis was compared for all readers and both case series, respectively. Results: Correlation coefficients between CCTA and catheter angiography initially ranged between good (r = 0.87) and poor (r = 0.26), depending on reader experience, and significantly (p < 0.05) improved in the second case series (range: r = 0.42 to r = 0.91). Diagnostic accuracy was significantly (p < 0.05) higher for more experienced readers (range: 96.5–97.8%) as compared to less experienced observers (range: 90.7–93.6%). After completion of the second case series for less experienced readers sensitivity and PPV significantly (p < 0.05) improved (range: 62.7–67.8%/51.4–84.1%), but still remained significantly (p < 0.05) lower as compared to more experienced observers (range: 89.8–93.3%/80.6–93.3%). Conclusion: The level of experience appears to be a strong determinant of proficiency in CCTA interpretation. Limited one-time training improves proficiency in novice readers, but not to clinically satisfactory levels.

  15. Diagnostic accuracy of dual-source CT coronary angiography in patients with atrial fibrillation: Meta analysis

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    Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Min [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jiang, Zhi-wei [Department of Health Statistics, School of Public Health, Fourth Military Medical University, No. 169, Changle West Road, Xi’an, Shaanxi 710032 (China); Xu, Lin [Department of Medical Cardiology, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Peng, Zhao-hui; Ding, Juan; Li, Li [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jin, Zhi-tao [Department of Cardiology, General Hospital of the Second Artillery, Beijing 100088 (China)

    2013-10-01

    Rationale and objective: To synthesize the available data to underscore the diagnostic accuracy of dual-source CT (DSCT) coronary angiography in patients with atrial fibrillation (AF). Materials and methods: We searched in the electronic databases of PubMed for all published studies that examined patients with AF using DSCT. We used an exact binomial rendition of the bivariate mixed-effects regression model to synthesize the diagnostic data. Results: The positive and negative likelihood ratios (LRs) at the patient level were 6.0 (CI, 3.6–10.1) and 0.03(CI, 0.004–0.2), respectively. The negative predictive values higher than 90% were available for a CAD prevalence <78%. The pooled vessel- and segment-level estimates showed higher positive and negative LRs than the patient-level estimates (15.3 [CI, 9.8–23.9] and 0.1 [CI, 0.07–0.3]; 25.1 [CI, 10.8–58.5] and 0.2 [CI, 0.2–0.3], respectively). No statistically significant heterogeneity between studies and publication bias were found at the patient level estimate. A sensitivity analysis showed that no study influenced the pooled results larger than 0.02. Conclusions: Cardiac angiography with DSCT can be applied as an imaging test for ruling out CAD in patient with AF. However, DSCT angiography may be not an effective tool for risk stratification for the high negative LR at the artery and segment levels.

  16. Low tube voltage and low contrast material volume cerebral CT angiography

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    Luo, Song [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Xuzhou Medical College, School of Medical Imaging, Xuzhou, Jiangsu (China); Zhang, Long Jiang; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Meinel, Felix G.; McQuiston, Andrew D. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Zhou, Chang Sheng; Qi, Li [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2014-07-15

    To evaluate the image quality, radiation dose and diagnostic accuracy of low kVp and low contrast material volume cerebral CT angiography (CTA) in intracranial aneurysm detection. One hundred twenty patients were randomly divided into three groups (n = 40 for each): Group A, 70 ml iodinated contrast agent/120 kVp; group B, 30 ml/100 kVp; group C, 30 ml/80 kVp. The CT numbers, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in the internal carotid artery (ICA) and middle cerebral artery (MCA). Subjective image quality was evaluated. For patients undergoing DSA, diagnostic accuracy of CTA was calculated with DSA as reference standard and compared. CT numbers of ICA and MCA were higher in groups B and C than in group A (P < 0.01). SNR and CNR in groups A and B were higher than in group C (both P < 0.05). There was no difference in subjective image quality among the three groups (P = 0.939). Diagnostic accuracy for aneurysm detection among these groups had no statistical difference (P = 1.00). Compared with group A, the radiation dose of groups B and C was decreased by 45 % and 74 %. Cerebral CTA at 100 or 80 kVp using 30 ml contrast agent can obtain diagnostic image quality with a low radiation dose while maintaining the same diagnostic accuracy for aneurysm detection. (orig.)

  17. Clinical evaluation of automatic tube voltage selection in chest CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Niemann, Tilo; Henry, Simon; Faivre, Jean-Baptiste; Yasunaga, Kanna; Bendaoud, Sofiane; Simeone, Ariana; Remy, Jacques [University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); Duhamel, Alain [University Lille Nord de France, Department of Medical Statistics (EA 2694), Lille (France); Flohr, Thomas [Siemens Medical Systems, Department of Research and Development, Forchheim (Germany); Remy-Jardin, Martine [Hospital Calmette, Department of Thoracic Imaging, Lille cedex (France)

    2013-10-15

    To evaluate the clinical impact of automatic tube voltage selection on chest CT angiography (CTA). Ninety-three patients were prospectively evaluated with a CT protocol aimed at comparing two successive CTAs acquired under similar technical conditions except for the kV selection: (1) the initial CTA was systematically obtained at 120 kVp and 90 ref mAs; (2) the follow-up CTA was obtained with an automatic selection of the kilovoltage (Care KV; Siemens Healthcare) for optimised CTA. At follow-up, 90 patients (97 %) underwent CTA with reduced tube voltage, 100 kV (n = 26; 28 %) and 80 kV (n = 64; 69 %), resulting in a significant dose-length-product reduction (follow-up: 87.27; initial: 141.88 mGy.cm; P < 0.0001; mean dose reduction: 38.5 %) and a significant increase in the CNR at follow-up (follow-up: 11.5 {+-} 3.5 HU; initial: 10.9 {+-} 3.7 HU; P = 0.03). The increase in objective image noise at follow-up (follow-up: 23.2 {+-} 6.7 HU vs. 17.8 {+-} 5.1 HU; P < 0.0001) did not alter the diagnostic value of images. Automatic tube voltage selection reduced the radiation dose delivered during chest CT angiograms by 38.5 % while improving the contrast-to-noise ratio of the examinations. (orig.)

  18. Interleaving cerebral CT perfusion with neck CT angiography. Pt. II. Clinical implementation and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Marcel T.H.; Meijer, Frederick J.A.; Woude, Willem-Jan van der; Smit, Ewoud J.; Ginneken, Bram van; Manniesing, Rashindra; Prokop, Mathias [Radboud University Medical Centre, Department of Radiology and Nuclear Medicine, P.O. Box 9101, Nijmegen (Netherlands)

    2017-06-15

    Feasibility evaluation of the One-Step Stroke Protocol, which is an interleaved cerebral computed tomography perfusion (CTP) and neck volumetric computed tomography angiography (vCTA) scanning technique using wide-detector computed tomography, and to assess the image quality of vCTA. Twenty patients with suspicion of acute ischaemic stroke were prospectively scanned and evaluated with a head and neck CTA and with the One-Step Stroke Protocol. Arterial enhancement and contrast-to-noise ratio (CNR) in the carotid arteries was assessed. Three observers scored artefacts and image quality of the cervical arteries. The total z-coverage was evaluated. Mean enhancement in the carotid bifurcation was rated higher in the vCTA (595 ± 164 HU) than CTA (441 ± 117 HU). CNR was rated higher in vCTA. Image quality scores showed no significant difference in the region of the carotid bifurcation between vCTA and CTA. Lower neck image quality scores were slightly lower for vCTA due to artefacts, although not rated as diagnostically relevant. In ten patients, the origin of the left common carotid artery was missed by 1.6 ± 0.8 cm. Mean patient height was 1.8 ± 0.09 m. Carotid bifurcation and origin of vertebral arteries were covered in all patients. The One-Step Stroke Protocol is feasible with good diagnostic image quality of vCTA, although full z-coverage is limited in tall patients. (orig.)

  19. Dual-energy direct bone removal CT angiography for evaluation of intracranial aneurysm or stenosis: comparison with conventional digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Yoshiyuki [National Cardiovascular Center, Department of Radiology, Osaka (Japan); St. Luke' s International Hospital, Department of Radiology, Tokyo (Japan); Uotani, Kensuke; Nakazawa, Tetsuro; Higashi, Masahiro; Yamada, Naoaki; Hori, Yoshiro; Kanzaki, Suzu; Fukuda, Tetsuya; Naito, Hiroaki [National Cardiovascular Center, Department of Radiology, Osaka (Japan); Itoh, Toshihide [Siemens Asahi Medical Technologies, Tokyo (Japan)

    2009-04-15

    Dual-energy CT can be applied for bone elimination in cerebral CT angiography (CTA). The aim of this study was to compare the results of dual-energy direct bone removal CTA (DE-BR-CTA) with those of digital subtraction angiography (DSA). Twelve patients with intracranial aneurysms and/or ICA stenosis underwent a dual-source CT in dual-energy mode. Post-processing software selectively removed bone structures using the two energy data sets. Three-dimensional images with and without bone removal were reviewed and compared to DSA. Dual-energy bone removal was successful in all patients. For 10 patients, bone removal was good and CTA maximum-intensity projection (MIP) images could be used for vessel evaluation. For two patients, bone removal was moderate with some bone remnants, but this did not inhibit the three-dimensional visualization. Three aneurysms adjacent to the skull base were only partially visible in conventional CTA but were fully visible in DE-BR-CTA. In five patients with ICA stenosis, DE-BR-CTA revealed the stenotic lesions on the MIP images. The correlation between DSA and DE-BR-CTA was good (R {sup 2}=0.822), but DE-BR-CTA led to an overestimation of stenosis. DE-BR-CTA was able to eliminate bone structure using only a single CT data acquisition and is useful to evaluate intracranial aneurysms and stenosis. (orig.)

  20. Clinical application of 64-slice spiral computed tomography perfusion imaging technology in kidney disease%64层CT灌注成像技术在肾脏疾病中的应用价值

    Institute of Scientific and Technical Information of China (English)

    唐烨真; 杜涛明; 唐光才; 兰永树; 涂永波; 林伟

    2013-01-01

    Objective: To investigate the clinical application value of 64-slice spiral CT perfusion imaging in kidney diseases diagnosis. Methods: Totally 40 patients met the case criteria, 64-slice spiral CT was used for renal perfusion scan. To observe the sharp of TDC, to records and count BF、BV、MTT and PS of every group. Results: To the same client, the perfusion parameters, index of BF, BV and PS averages and standard deviations of both sides of the kidney had no significant difference (P>0. 05). The BF, BV, MTT and PS among group of renal tumor, cirrhosis, hypertension and control had statistical differences ( P <0. 05). Conclusion: CTPI technologies can evaluate renal function in many aspects, with a promising application prospect.%目的:探讨64层CT灌注扫描技术在肾脏疾病诊断中的临床应用价值.方法:对40例符合入选标准的受检者行双肾灌注扫描,观察TDC形态,记录各组血流量(blood flow,BF)、血容量(blood volume,BV)、平均通过时间(mean transit time,MTT)、表面渗透性(permeability surface,PS)值,并进行统计学分析.结果:同一受检者两侧肾脏BF、BV和PS等参数差异无统计学意义(P>0.05).肾脏肿瘤、肝硬化、高血压及正常组各组间BF、BV及PS差异均有统计学意义(P<0.05).结论:CT灌注成像能从多方面对肾功能进行评价,具有良好的应用前景.

  1. Coexistent coronary artery disease or myocardial bridging in patients with hypertrophic cardiomyopathy using coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Hwan; Chun, Eun Ju; Kim, Yeo Koon; Yoo, Jin Young; Choi, Sang Il; Choi, Dong Ju [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-07-15

    To evaluate the prevalence of coexistent coronary artery disease (CAD) or myocardial bridging (MB) in patients with hypertrophic cardiomyopathy (HCM) using coronary CT angiography (CCTA) and assess the role of CCTA. The prevalence of obstructive CAD (> 50% luminal reduction) and MB (partial and full encasement) were assessed in 150 patients with HCM diagnosed by clinical findings, electrocardiography, and echocardiography of 19588 consecutive patients who underwent CCTA for suspected CAD. The overall feasibility of coronary artery visualization was 98.9% with CCTA. In patients with HCM, the prevalence of obstructive CAD and MB (14.7% partial and 28.0% full encasement) were 23.3% and 42.7%, respectively. Age, hypertension, family history of premature CAD, Framingham risk score and severe chest pain were associated with CAD, whereas male gender and septal type were associated with MB (all p < 0.05). In comparison to invasive coronary angiography (n = 37), the diagnostic accuracy of CCTA for the detection of CAD and full encasement MB was 89.2% and 86.5%, respectively. One-quarter of patients with HCM had coexistent obstructive CAD or full encasement MB. CCTA can be a feasible and accurate noninvasive imaging modality for the detection of CAD and MB in patients with HCM.

  2. Differentiation of total occlusion and high-grade stenosis in coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Erffa, J. von; Ropers, D.; Pflederer, T.; Schmid, M.; Marwan, M.; Daniel, W.G.; Achenbach, S. [University of Erlangen, Department of Internal Medicine 2, Erlangen (Germany)

    2008-12-15

    In coronary CT angiography (CTA), both high-grade stenoses and total occlusions of a coronary artery may appear as a complete interruption of the contrast-enhanced lumen. Parameters to differentiate between occlusions and stenoses have not been systematically assessed. We evaluated 40 consecutive patients with a lesion demonstrating complete interruption of the contrast-enhanced lumen in coronary CTA and in whom invasive coronary angiography was available. Length of the vessel segment without luminal contrast enhancement; luminal enhancement proximal, in and distal to the lesion; degree of coronary remodelling; and the degree of lesion calcification were assessed by a blinded observer unaware of the invasive angiogram. Mean length of complete occlusions (n = 20; range 4-54 mm; mean 16.6 {+-} 3.5 mm) was significantly longer than for high-grade stenoses (n = 20; 2-8 mm; mean 4.6 {+-} 1.7 mm, p < 0.001). A lesion length {>=} 9 mm was 100% specific and 70% sensitive for an occlusion. No significant differences were found for vessel enhancement in or distal to the lesion, remodelling index or degree of calcification. Lesion length is the only parameter that may differentiate complete occlusions and high-grade stenoses in coronary CTA. For lesions {>=} 9 mm, an occlusion is very likely. (orig.)

  3. CT angiography for evaluation of cerebral vasospasm following acute subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Shankar, Jai Jai Shiva [Dalhousie University, Division of Neuroradiology, Department of Diagnostic Imaging, QEII Health Sciences Center, Halifax (Canada); Tan, Irene Y.L.; Krings, Timo; Terbrugge, Karel; Agid, Ronit [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario (Canada)

    2012-03-15

    Cerebral vasospasm (CV) is one of the most dreaded complications in patients who survive acute subarachnoid haemorrhage (SAH), and conventional cerebral angiography (DSA) is the gold standard for its diagnosis. We evaluated CT angiography (CTA) as a non-invasive alternative for diagnosis of CV and assessed if CTA could have a role in choosing appropriate treatment. Consecutive patients with SAH and suspected vasospasm were included when DSA was performed within 24 h from CTA. Two neuro-radiologists retrospectively analysed CTA and DSA studies independently. Assessment included presence of central and peripheral vasospasm and grading of severity of central CV. A treatment recommendation based on CTA was compared to actual treatment received. Final analysis included 34 patients. CTA was more accurate for diagnosis of central then for peripheral CV with high sensitivity (reader 1, 91%; reader 2, 92%), specificity (reader 1, 73%; reader 2, 90%), accuracy, positive predictive value and negative predictive value for central vasospasm. For grading the severity of CV CTA's sensitivity, specificity and accuracy were high for most central arteries. The reader's recommendation of angioplasty according to CTA was significantly predictive of actual receipt of angioplasty but overestimated actual receipt of triple H treatment. CTA is adequate for detecting central vasospasm in symptomatic SAH patients. A negative result should not prevent further investigation especially when evaluating arterial segments adjacent to metal artefacts from coils or clips. CTA is helpful in treatment decision making specifically regarding the need for balloon angioplasty. (orig.)

  4. Is urgent CT angiography necessary in cases of acute lower gastrointestinal bleeding?

    Science.gov (United States)

    Díaz, A Martín; Rodríguez, L Fernández; de Gracia, M Martí

    2017-01-06

    Acute lower gastrointestinal bleeding usually presents as hematochezia, rectal bleeding or melena and represents 1-2% of the medical appointments in the Emergency Services. Mortality reaches the 30-40% and it is highly related with the severity and associated comorbidity. Most clinical practice guidelines include colonoscopy at some point in the diagnostic and therapeutic process (urgent for severe cases and ambulatory for mild ones) and look for predictors of severity. In the last years, there have been numerous studies where is clear the relevance and complementarity of advanced diagnostic imaging techniques, gradually incorporated as an alternative or second step in severe cases. Therefore, we have made a review of current scientific evidence to establish a clinical prediction rule for optimal indication of CT angiography in these patients. However, future studies providing greater robustness and level of evidence are necessary.

  5. Helical CT angiography of renal arteries: two-years of experience; Angioscanographie helicoidale des arteres renales

    Energy Technology Data Exchange (ETDEWEB)

    Beregi, J.P.; Louvegny, S.; Ceugnart, L.; Willoteaux, S.; Elkohen, M.; Desmoucelle, F.; Deklunder, G.; Wattinne, L. [Centre Hospitalier Universitaire, 59 - Lille (France)

    1997-08-01

    To evaluate the role of helical CT angiography (CTA) in the detection of renal artery stenosis in hypertensive patients. We studied 300 hypertensive patients (50 prospectively and 250 consecutively) with CTA and arteriography (n = 118). Helical acquisition (collimation 3 mm; pitch = 1, 20 seconds acquisition time) was performed 20-45 seconds after contrast injection (300 mgl/ml; 120 ml, 4 ml/sec). Transverse axial views and 3D reconstructions were analysed (360 deg interpolation algorithm, 1 mm overlapped). In the prospective series, CTA sensibility was 100 % for main renal artery stenoses and specificity was 98.2 %; however 7/32 renal accessory arteries were not visualized. In the 300 patients studies, seventy-four stenoses were detected. There were 5 false-positive and 5 false-negative studies. Secondary hypertension was detected in 26 % of patients (including 14 cases of adrenal hyperplasia). CTA is a promising technique for the detection of renal artery stenosis in hypertensive patients. (authors).

  6. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnosis with CT Angiography

    Directory of Open Access Journals (Sweden)

    Guray Oncel

    2013-01-01

    Full Text Available Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA is a rare congenital anomaly. It is associated with early infant mortality and sudden death in adults. Traditionally, ALCAPA has been diagnosed by angiography or autopsy; however, the development of cardiac computed tomography (CT and magnetic resonance imaging (MRI has allowed noninvasive evaluation of the coronary anatomy by direct visualization of the origin of the left coronary artery (LCA from the pulmonary artery. We report a case of 10-year-old girl who has been on follow up for dilated cardiomyopathy for 4 years. The definitive diagnosis of ALCAPA is reached by multislice computed tomography (MSCT. The MSCT scan showed an anomalous origin of LCA from the pulmonary trunk, with a tortuous and dilated right coronary artery and right-to-left collateralization. Consequently, the patient was successfully treated with surgery.

  7. Automatic segmentation of vertebral arteries in CT angiography using combined circular and cylindrical model fitting

    Science.gov (United States)

    Lee, Min Jin; Hong, Helen; Chung, Jin Wook

    2014-03-01

    We propose an automatic vessel segmentation method of vertebral arteries in CT angiography using combined circular and cylindrical model fitting. First, to generate multi-segmented volumes, whole volume is automatically divided into four segments by anatomical properties of bone structures along z-axis of head and neck. To define an optimal volume circumscribing vertebral arteries, anterior-posterior bounding and side boundaries are defined as initial extracted vessel region. Second, the initial vessel candidates are tracked using circular model fitting. Since boundaries of the vertebral arteries are ambiguous in case the arteries pass through the transverse foramen in the cervical vertebra, the circle model is extended along z-axis to cylinder model for considering additional vessel information of neighboring slices. Finally, the boundaries of the vertebral arteries are detected using graph-cut optimization. From the experiments, the proposed method provides accurate results without bone artifacts and eroded vessels in the cervical vertebra.

  8. Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Rajaram, Smitha; Swift, Andrew J; Capener, David; Telfer, Adam; Davies, Christine; Hill, Catherine; Condliffe, Robin; Elliot, Charles; Hurdman, Judith; Kiely, David G; Wild, Jim M

    2012-02-01

    To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE-MRA) and the added benefit of unenhanced proton MR angiography compared with CT pulmonary angiography (CTPA) in patients with chronic thromboembolic disease (CTE). A 2 year retrospective study of 53 patients with chronic thromboembolic pulmonary hypertension who underwent CTPA and MRI for suspected pulmonary hypertension and a control group of 36 patients with no CT evidence of pulmonary embolism. The MRI was evaluated for CTE and the combined diagnostic accuracy of ce-MRA and unenhanced proton MRA was determined. CE-MRA generated lung perfusion maps were also assessed. The overall sensitivity and specificity of CE-MRA in diagnosing proximal and distal CTE were 98% and 94%, respectively. The sensitivity improved from 50% to 88% for central vessel disease when CE-MRA images were analysed with unenhanced proton MRA. The CE-MRA identified more stenoses (29/18), post-stenosis dilatation (23/7) and occlusions (37/29) compared with CTPA. The CE-MRA perfusion images showed a sensitivity of 92% for diagnosing CTE. CE-MRA has high sensitivity and specificity for diagnosing CTE. The sensitivity of CE-MRA for visualisation of adherent central and lobar thrombus significantly improves with the addition of unenhanced proton MRA which delineates the vessel wall.

  9. Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Rajaram, Smitha [Unit of Academic Radiology, University of Sheffield, Sheffield (United Kingdom); Academic Unit of Radiology, C Floor, Royal Hallamshire Hospital, Sheffield (United Kingdom); Swift, Andrew J.; Wild, Jim M. [Unit of Academic Radiology, University of Sheffield, Sheffield (United Kingdom); Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom); Capener, David; Telfer, Adam [Unit of Academic Radiology, University of Sheffield, Sheffield (United Kingdom); Davies, Christine; Hill, Catherine [Sheffield Teaching Hospitals Trust, Department of Radiology, Sheffield (United Kingdom); Condliffe, Robin; Elliot, Charles; Kiely, David G. [Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (United Kingdom); Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom); Hurdman, Judith [Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (United Kingdom)

    2012-02-15

    To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE-MRA) and the added benefit of unenhanced proton MR angiography compared with CT pulmonary angiography (CTPA) in patients with chronic thromboembolic disease (CTE). A 2 year retrospective study of 53 patients with chronic thromboembolic pulmonary hypertension who underwent CTPA and MRI for suspected pulmonary hypertension and a control group of 36 patients with no CT evidence of pulmonary embolism. The MRI was evaluated for CTE and the combined diagnostic accuracy of ce-MRA and unenhanced proton MRA was determined. CE-MRA generated lung perfusion maps were also assessed. The overall sensitivity and specificity of CE-MRA in diagnosing proximal and distal CTE were 98% and 94%, respectively. The sensitivity improved from 50% to 88% for central vessel disease when CE-MRA images were analysed with unenhanced proton MRA. The CE-MRA identified more stenoses (29/18), post-stenosis dilatation (23/7) and occlusions (37/29) compared with CTPA. The CE-MRA perfusion images showed a sensitivity of 92% for diagnosing CTE. CE-MRA has high sensitivity and specificity for diagnosing CTE. The sensitivity of CE-MRA for visualisation of adherent central and lobar thrombus significantly improves with the addition of unenhanced proton MRA which delineates the vessel wall. (orig.)

  10. Small vessel stents for intracranial angioplasty: in vitro evaluation of in-stent stenoses using CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Trossbach, M.; Hartmann, M.; Braun, C.; Sartor, K.; Haehnel, S. [Division of Neuroradiology of the Department of Neurology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg (Germany)

    2004-06-01

    Our aim was to determine whether CT angiography is suitable for the evaluation of in-stent restenoses in small vessel stents for intracranial angioplasty. Therefore, we simulated stenoses with degrees of 25, 50, 75 and 90% in a total of 12 stents with different designs (MEDTRONIC AVE; ABBOT BioDivYsio, GUIDANT Neurolink, TERUMO Tsunami, COOK V-Flex Plus) and sizes (3.0 mm, 4.0 mm). For each stenosis, the apparent stenotic degree (ASD) was measured by CT angiography. Subjective (viewing at the CT images) and objective (acquisition of a density profile) evaluations were made after the stents were filled with a solution of 0.9% NaCl and with a diluted contrast medium. It was not possible to visualize the patent lumen in any of the stenotic stent segments by viewing at the CT images. After objective evaluation, the degree of the stenoses was generally overestimated. In the group with the 3.0-mm stents, ASD ranged from 73.6 to 100% in 25% degree stenoses. With the exception of one stent, stenoses with a degree of more than 25% appeared as vessel obstruction (ASD =100%) in the 3.0-mm group. In the 4.0-mm group, the mean ASD was 60% for 25% degree stenoses, 76% for 50% degree stenoses, 91% for 75% degree stenoses and 96% for 95% degree stenoses. The minimum diameter of stents for differentiation between in-stent restenosis and vessel occlusion using CT angiography is 4.0 mm. In CT angiography, the degrees of in-stent stenoses are generally overestimated. The evaluation of in-stent restenoses only seems to be possible when CT angiographic images before and after contrast application are evaluated objectively by density profiles. (orig.)

  11. Deformable known component model-based reconstruction for coronary CT angiography

    Science.gov (United States)

    Zhang, X.; Tilley, S.; Xu, S.; Mathews, A.; McVeigh, E. R.; Stayman, J. W.

    2017-03-01

    Purpose: Atherosclerosis detection remains challenging in coronary CT angiography for patients with cardiac implants. Pacing electrodes of a pacemaker or lead components of a defibrillator can create substantial blooming and streak artifacts in the heart region, severely hindering the visualization of a plaque of interest. We present a novel reconstruction method that incorporates a deformable model for metal leads to eliminate metal artifacts and improve anatomy visualization even near the boundary of the component. Methods: The proposed reconstruction method, referred as STF-dKCR, includes a novel parameterization of the component that integrates deformation, a 3D-2D preregistration process that estimates component shape and position, and a polyenergetic forward model for x-ray propagation through the component where the spectral properties are jointly estimated. The methodology was tested on physical data of a cardiac phantom acquired on a CBCT testbench. The phantom included a simulated vessel, a metal wire emulating a pacing lead, and a small Teflon sphere attached to the vessel wall, mimicking a calcified plaque. The proposed method was also compared to the traditional FBP reconstruction and an interpolation-based metal correction method (FBP-MAR). Results: Metal artifacts presented in standard FBP reconstruction were significantly reduced in both FBP-MAR and STF- dKCR, yet only the STF-dKCR approach significantly improved the visibility of the small Teflon target (within 2 mm of the metal wire). The attenuation of the Teflon bead improved to 0.0481 mm-1 with STF-dKCR from 0.0166 mm-1 with FBP and from 0.0301 mm-1 with FBP-MAR - much closer to the expected 0.0414 mm-1. Conclusion: The proposed method has the potential to improve plaque visualization in coronary CT angiography in the presence of wire-shaped metal components.

  12. Utility of CT angiography in cervical spine trauma: analysis of radiation and cost

    Directory of Open Access Journals (Sweden)

    Waqas Shuaib

    2014-12-01

    Full Text Available Purpose: Vertebral artery injuries (VAIs can be seen in cervical injuries. This investigation was conducted to assess the impact of head and neck computed tomography (CT angiography (CTA on planning treatment of vertebral artery injuries, if these tests were ordered appropriately, and to estimate cost and associated exposure to radiation and contrast material. Methods: This retrospective review included all patients who underwent CT of the cervical spine and CTA of the head and neck from March 2011 to October 2012 at a single institution. Patients were divided into two groups, those with and those without cervical spine fracture appreciated on CT of the cervical spine. The frequency of vascular injury on CTA in those with a cervical fracture was assessed. The frequency of vascular injury treatment and modifications owed to a positive CTA of head and neck were also assessed. A study was considered appropriate if it was ordered in accordance with the modified Denver Screening criteria. Effective radiation dose (mSv was calculated by multiplying dose length product (DLP from the scanner with the standard conversion coefficient (k (k = 0.0021 mSv/mGy x cm.Results: In the 387 CTAs of head and neck, a cervical injury was recorded in 128 patients. Twenty CTA scans were correctly ordered for non-spinal indications, and 19 were ordered off protocol. CTA was found positive in 1 patient for whom the imaging was off protocol and 1 for whom the clinical indication was non-cervical. There were 19 positive CTA cases of head and neck, none of which underwent surgical intervention. CTA was positive in 13 of 48 patients who had suffered a C2 fracture; this accounted for 13 of the 19 positive CTA studies (p < 0.01. Estimated fee for CTA was $3783, and radiation exposure was 4 mSv with a standard deviation (±1.3. Conclusion: CTA of head and neck ordered off an institutional imaging protocol has a low probability of being positive. Adherence to protocols for CTA of

  13. Perfusion CT in acute stroke; Stellenwert der CT-Perfusion fuer die Therapie des Schlaganfalls

    Energy Technology Data Exchange (ETDEWEB)

    Eckert, Bernd [Asklepios Klinik Altona (Germany). Radiologie und Neuroradiologie; Roether, Joachim [Asklepios Klinik Altona (Germany). Neurologische Abt.; Fiehler, Jens [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neuroradiologische Diagnostik und Intervention; Thomalla, Goetz [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neurologie, Kopf- und Neurozentrum

    2015-06-15

    Modern multislice CT scanners enable multimodal protocols including non-enhanced CT, CT angiography, and CT perfusion. A 64-slice CT scanner provides 4-cm coverage. To cover the whole brain, a 128 - 256-slice scanner is needed. The use of perfusion CT requires an optimized scan protocol in order to reduce exposure to radiation. As compared to non-enhanced CT and CT angiography, the use of CT perfusion increases detection rates of cerebral ischemia, especially small cortical ischemic lesions, while the detection of lacunar and infratentorial stroke lesions remains limited. Perfusion CT enables estimation of collateral flow in acute occlusion of large intra- or extracranial arteries. Currently, no established reliable thresholds are available for determining infarct core and penumbral tissue by CT perfusion. Moreover, perfusion parameters depend on the processing algorithms and the software used for calculation. However, a number of studies point towards a reduction of cerebral blood volume (CBV) below 2 ml/100 g as a critical threshold that identifies infarct core. Large CBV lesions are associated with poor outcome even in the context of recanalization. The extent of early ischemic signs on non-enhanced CT remains the main parameter from CT imaging to guide acute reperfusion treatment. Nevertheless, perfusion CT increases diagnostic and therapeutic certainty in the acute setting. Similar to stroke MRI, perfusion CT enables the identification of tissue at risk of infarction by the mismatch between infarct core and the larger area of critical hypoperfusion. Further insights into the validity of perfusion parameters are expected from ongoing trials of mechanical thrombectomy in stroke.

  14. Spiral CT angiography and surgical correlations in the evaluation of intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Preda, L.; Di Maggio, E.M.; La Fianza, A.; Dore, R.; Fulle, I.; Solcia, M.; Campani, R. [Istituto di Radiologia, IRCCS Policlinico S. Matteo, p.le C. Golgi, 2, I-27 100 Pavia (Italy); Gaetani, P.; Rodriguez y Baena, R. [Neurosurgery, Istituto Clinico ``Humanitas``, I-20089 Rozzano (Midway Islands) (Italy); Cecchini, A. [Servizio di Radiodiagnostica, IRCCS Policlinico S. Matteo, p.le C. Golgi, 2, I-27 100 Pavia (Italy); Infuso, L. [Neurochirurgia, Dipartimento di Chirurgia, IRCCS Policlinico S. Matteo, p.le C. Golgi, 2, I-27 100 Pavia (Italy)

    1998-06-02

    We investigated the accuracy of spiral computed tomography angiography (CTA) in the detection and study of intracranial aneurysms by comparing CTA with selective angiograms and surgical findings. Twenty-six patients (9 men and 17 women; mean age 53.1 {+-} 1.8 years) with suspected intracranial aneurysms were submitted to CTA (1- to 2-mm slices, pitch 1:1, 24 s, RI = 1) after a conventional CT examination showing subarachnoid hemorrhage (SAH) in 19 cases and during neuroradiological investigations performed for other reasons in 7 cases. One hundred twenty to 150 ml iodate contrast agent (0.3-0.4 gI/ml) were injected intravenously at 5 ml/s rate and with 12- to 25-s delay calculated with a preliminary test bolus. Three-dimensional shaded surface display (3D SSD) and maximum intensity projection (MIP) reconstructions were obtained from axial images. Then, within 48 h, all patients were submitted to digital subtraction angiography (DSA), with separate assessment of CTA and DSA findings. Twenty-two aneurysms shown by CTA were confirmed at DSA and surgery (true positives), whereas the vascular lesion was not confirmed at DSA in 2 cases (false positives). The presence of intracranial aneurysms was excluded at both CTA and subsequent DSA in 7 cases (true negatives) and there were no false negatives; sensitivity was 100 %, specificity 77.8 %, and diagnostic accuracy 93.5 %. Computed tomography angiography aneurysm location was confirmed at surgery in all cases, with very high accuracy in assessing the presence of an aneurysm neck (100 %). Computed tomography angiography accurately depicted the aneurysm shape in 20 of 22 cases, but failed to depict its multilobed nature in 2 cases. The mean aneurysm diameter calculated at CTA was 0.99 {+-} 0.12 cm vs 1.09 {+-} 0.11 cm at surgery (p < 0.01). The present results suggest that the high sensitivity of CTA, if confirmed by further studies, might help in avoiding having to resort to arteriography after negative CTA in SAH patients

  15. Multimodality evaluation of dural arteriovenous fistula with CT angiography, MR with arterial spin labeling, and digital subtraction angiography: case report.

    Science.gov (United States)

    Alexander, Matthew; McTaggart, Ryan; Santarelli, Justin; Fischbein, Nancy; Marks, Michael; Zaharchuk, Greg; Do, Huy

    2014-01-01

    Dural arteriovenous fistulae (DAVF) are cerebrovascular lesions with pathologic shunting into the venous system from arterial feeders. Digital subtraction angiography (DSA) has long been considered the gold standard for diagnosis, but advances in noninvasive imaging techniques now play a role in the diagnosis of these complex lesions. Herein, we describe the case of a patient with right-side pulsatile tinnitus and DAVF diagnosed using computed tomography angiography, magnetic resonance with arterial spin labeling, and DSA. Implications for imaging analysis of DAVFs and further research are discussed.

  16. Stent-assisted intracranial angioplasty: potentials and limitations of pre- and postinterventional CT angiography; Stentgestuetzte intrakranielle Angioplastie: Moeglichkeiten und Grenzen der prae- und postinterventionellen CT-Angiografie

    Energy Technology Data Exchange (ETDEWEB)

    Schloetzer, W.; Schmitz, B.L. [Universitaetsklinikum Ulm (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Huber, R. [Universitaetsklinikum Ulm (Germany). Klinik fuer Neurologie

    2009-02-15

    CT angiography (CTA) is a noninvasive technique for evaluating intracranial arterial stenoses and for following up on intracranial stents. We analyzed a series of patients to assess the capabilities of CTA with respect to preinterventional und postinterventional diagnostic imaging for stent-assisted intracranial angioplasty. We examined 8 patients with 9 symptomatic intracranial arterial stenoses before and after stent placement with CTA. CT angiographies were compared to the periprocedural conventional angiography with regard to the quality of the visualization as well as the dimensions of the identified stenoses and the implanted stents. The extent of the preinterventional intracranial stenoses identified with CTA differed between -15 % to + 12 % from conventional angiography. In any case we were able to assess stent position, expansion, and perfusion with postinterventional CTA. The mean residual stenosis after stent placement was 33 % (13 - 48 %) measured with conventional angiography and it was accurately estimated with a difference of {+-} 15 % in 5 of 9 stents by CTA. 4 residual stenoses were underestimated or overestimated between -20 % and + 26 %. Further CTA controls of several patients showed good visualization of in-stent neointimal hyperplasia. CTA is useful for stent planning and follow-up of symptomatic intracranial stenoses. Intracranial stents and their lumina are adequately visualized by CTA, especially in vertebrobasilar vessels. However, residual stenosis and restenosis especially in the intracranial internal carotid artery and in the presence of calcified plaques may be incorrectly estimated by CTA. In case of doubt patients must undergo invasive angiography. In summary the use of CTA is a possibility for the primary follow-up of intracranial stents. It cannot generally prevent further diagnostics, but it is a potential method for reducing invasive angiography. (orig.)

  17. The effect of equipment set up on patient radiation dose in conventional and CT angiography of the renal arteries.

    Science.gov (United States)

    Kemerink, G J; De Haan, M W; Vasbinder, G B C; Frantzen, M J; Schultz, F W; Zoetelief, J; Jansen, J Th M; Van Engelshoven, J M A

    2003-09-01

    Patient radiation dose in angiography of the renal arteries was assessed and optimized after installing new radiological equipment. In three separate studies (n=50, 25 and 20) patient exposure was monitored in detail. For the first study default factory settings were used, for the second the number of digital subtraction angiography (DSA) images was halved and the X-ray beam filtering during fluoroscopy was increased, and for the third study filtering during DSA was increased as well. Standard projections were derived and used in Monte Carlo simulations to derive dose conversion coefficients to calculate effective dose from the dose-area product (DAP). Dose conversion coefficients were also calculated for CT angiography (CTA). Using default factory settings on the new angiography system, DAP, number of images and effective dose were much higher than on the replaced unit. For the studies given above, DAP was reduced from 144 Gy cm(2) to 65 Gy cm(2) to 32 Gy cm(2), and effective dose from 22 mSv to 11 mSv to 9.1 mSv, respectively. Effective dose due to CTA was 5.2 mSv. It is concluded that modern angiography systems, resulting in high customer satisfaction, may readily cause much higher patient exposure than older systems. These doses may also be much higher than necessary. Optimization before putting such systems into use is absolutely essential. Internationally accepted recommendations for image quality and technique factors in angiography would be of great help.

  18. Diagnosis of lower gastrointestinal bleeding by multi-slice CT angiography: A meta-analysis.

    Science.gov (United States)

    He, Bosheng; Yang, Jushun; Xiao, Jing; Gu, Jinhua; Chen, Feixiang; Wang, Lin; Zhao, Chengjin; Qian, Junbo; Gong, Shenchu

    2017-08-01

    To estimate the diagnostic value of multi-slice spiral CT angiography (CTA) in lower gastrointestinal bleeding by a meta-analysis. The relevant clinical studies on the diagnostic value of CTA were searched on PubMed, Embase and other electronic documents databases with the deadline of 2016 September. Language was limited to English. A diagnostic meta-analysis was performed by using Meta-DiSc software. The effect sizes included sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) and 95% confidence interval (CI). The Cochran-Q test and I(2) statistic based on χ(2) test were used for estimation of the heterogeneity. Meta-regression was performed to explore the source of heterogeneity. SROC curve was established. A total of 14 articles including 549 patients with lower gastrointestinal bleeding were enrolled in the meta-analysis. The combined PLR, NLR and DOR were respectively 8.149, 0.158 and 56.213. There were significant heterogeneities in all estimations but we could not find the sources by meta-regression based on study design, study location, CT slices and sample size. The AUC and Q index under the fixed effect model was respectively 0.9463 and 0.8856. The multi-slice CTA has high diagnostic value for lower gastrointestinal bleeding. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Prospective ECG-gated 320-row CT angiography of the whole aorta and coronary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yu.; Fan, Zhanming; Xu, Lei; Yang, Lin; Xin, Haiyan; Zhang, Nan [Capital Medical University, Department of Radiology, Beijing An Zhen Hospital, Beijing (China); Capital Medical University, Ministry of Education, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Beijing (China); Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing An Zhen Hospital, Beijing (China)

    2012-11-15

    To investigate the feasibility of using a prospective ECG-gated wide-volume protocol in CT angiography (CTA) of the whole aorta and coronary arteries (CA). A total of 61 consecutive patients with suspected acute aortic diseases underwent CTA of the whole aorta using a prospective ECG-gated wide-volume CT protocol without heart rate (HR) control. The exposure window was set at 40-50 % of R-R interval (HR {>=}70 bpm) or 70-80 % of R-R interval (HR <70 bpm) in a single heartbeat. The image quality of the ascending aorta, aortic valve and CA was evaluated for motion artefacts. The mean attenuation was measured at different levels of the aorta. The radiation dose and contrast medium volume were recorded. All of the examinations were performed successfully. The image quality was acceptable in the ascending aorta, aortic valve (100 %) and CA (94.4 %). The mean radiation dose was 18.42 {+-} 5.02 mSv. Of 61 patients, 14 were diagnosed with aortic aneurysm and 35 were diagnosed with aortic dissection or intramural haematoma. Coronary artery stenosis was detected in 12 patients. For patients with aortic diseases, CTA of the whole aorta using a prospective ECG-gated wide-volume protocol has the potential to provide additional information about the CA and aortic valve with lower radiation exposure. (orig.)

  20. Characteristics of coronary artery disease in symptomatic type 2 diabetic patients: evaluation with CT angiography

    Directory of Open Access Journals (Sweden)

    Zhu Zhi-yu

    2010-11-01

    Full Text Available Abstract Background Coronary artery disease (CAD is a common and severe complication of type 2 diabetes mellitus (DM. The aim of this study is to identify the features of CAD in diabetic patients using coronary CT angiography (CTA. Methods From 1 July 2009 to 20 March 2010, 113 consecutive patients (70 men, 43 women; mean age, 68 ± 10 years with type 2 DM were found to have coronary plaques on coronary CTA. Their CTA data were reviewed, and extent, distribution and types of plaques and luminal narrowing were evaluated and compared between different sexes. Results In total, 287 coronary vessels (2.5 ± 1.1 per patient and 470 segments (4.2 ± 2.8 per patient were found to have plaques, respectively. Multi-vessel disease was more common than single vessel disease (p p p p p = 0.855. Extent of CAD, types of plaques and luminal narrowing were not significantly different between male and female diabetic patients. Conclusions Coronary CTA depicted a high plaque burden in patients with type 2 DM. Plaques, which were mainly calcified, were more frequently detected in the proximal segment of the LAD artery, and increased attention should be paid to the significant prevalence of obstructive stenosis. In addition, DM reduced the sex differential in CT findings of CAD.

  1. Role of Early Arterial Phase Multislice Helical CT Angiography in Evaluation of Hepatocellular Carcinoma

    Institute of Scientific and Technical Information of China (English)

    TANGBinghang; HEYaqi; LILiangcai; HUANGDecheng; WURenguo; YUYuanlong

    2005-01-01

    Objective: To investigate the clinical application of early arterial phase multislice CT angiography (MSCTA) of hepatic vessels in evaluation of middle or advanced stage hepatocellular carcinoma.Methods: Trigger Bolus program was used to carry out MSCTA in early and late arterial phases and portal vein phase with single breath holding. Hepatic vessels were reconstructed from the original images of early arterial phase by post processing. The blood supply of tumor and normal liver tissue and the appearances of venous thrombosis and arteriovenous shunts were analyzed. Results: The MSCTA with early arterial phase could perfectly display the origin, shape and amount of feeding vessels to normal liver tissue and tumor in middle or advanced stage hepatocellular carcinoma. It had the ability of displaying the arteriovenous shunts better than that in conventional dual phased liver scanning. Conclusion: MSCTA of hepatic vessels with early arterial phase acquisition using multislice helical CT in middle or advance stage hepatocellular carcinoma has favorable and promising application. It can be used as an imaging method for comprehensive assessment of the hepatocellular carcinoma before treatment.

  2. Procedural success of CTO recanalization: Comparison of the J-CTO score determined by coronary CT angiography to invasive angiography.

    Science.gov (United States)

    Li, Yuehua; Xu, Nan; Zhang, Jiayin; Li, Minghua; Lu, Zhigang; Wei, Meng; Lu, Bin; Zhang, Yang

    2015-01-01

    The J-CTO score is based on invasive angiography, combines several parameters of chronic total coronary occlusions (CTO), and is well established to predict the likelihood of success of percutaneous recanalization. The purpose of this study was to evaluate and validate a J-CTOCT score derived from coronary computed tomography angiography (coronary CTA). Between April 2011 and December 2014, 159 consecutive patients were retrospectively included. All had at least one CTO in invasive angiography, had coronary CTA performed at an interval of no more than one week from invasive angiography, and had an attempt at percutaneous coronary intervention (PCI) following coronary CTA In parallel to the angiographic J-CTO score, the J-CTOCT score was determined by awarding one point each for a blunt vessel stump, bending > 45°, occlusion length ≥ 20 mm, presence of calcium covering > 50% of any vessel cross-section within the occlusion, or a previously failed attempt at PCI. a. Both scores were compared regarding their ability to predict successful recanalization. A total of 171 CTO lesions were analyzed. Intraobserver (k = 0.814, p CTO score (mean: 1.8 ± 1.3, r = 0.856, p CTO score (area under curve: 0.868, p CTO score. . Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  3. MULTIDETECTOR CT ANGIOGRAPHY V/S COLOUR DOPPLER ULTRASONOGRAPHY IN THE DIAGNOSIS OF PERIPHERAL ARTERIAL DISEASES OF LOWER EXTREMITIES

    Directory of Open Access Journals (Sweden)

    Rezia Udinoor Peedikayil

    2016-08-01

    ultrasound, CT angiography is used prior to any vascular intervention is required in peripheral arterial diseases.

  4. Prevalence and clinical significance of extravascular incidental findings in patients undergoing CT cervico-cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Crockett, Matthew Thomas, E-mail: crockettmt@gmail.com; Murphy, Blathnaid, E-mail: blathnaidmurphy@hotmail.com; Smith, Jennifer, E-mail: jennifer.js.smith@gmail.com; Kavanagh, Eoin Carl, E-mail: kavanaghec@gmail.com

    2015-08-15

    Highlights: • CT cervico-cerebral angiography (CTCCA) is a commonly performed study for assessment of vascular pathologies of head and neck. • This study assessed the prevalence, clinical significance and management of extravascular incidental findings detected on CTCCA. • This study demonstrated the presence of clinically significant incidental findings in 14% of patients undergoing CTCCA with 8% of these findings deemed to be highly significant. 19% of patients with highly clinically significant findings did not receive appropriate follow up. • A standardised method of reporting incidental findings, such as that used in this paper is suggested to aid radiologists and referring physicians in recording and communicating these findings. - Abstract: Introduction: CT cervico-cerebral angiography (CTCCA) is now the first line diagnostic imaging modality for the majority of vascular pathologies of the head and neck with diagnostic value comparable to or better than traditional angiographic techniques. The aim of this study was to assess the prevalence, clinical significance and management of extravascular incidental findings detected on CTCCA. Materials and methods: A retrospective review of the CTCCA reports of 302 consecutive patients from 2009 to 2013 was undertaken. Extravascular incidental findings were classified, according to an adaptation of the CT colonography data and reporting system (CRADS), as EV1–EV4. EV1 = no incidental findings, EV2 = clinically insignificant incidental finding, EV3 = incidental finding of intermediate clinical significance, EV4 = highly clinically significant finding. Follow up of the electronic medical records of patients with EV3 or EV4 findings was undertaken to determine subsequent management. Results: Potentially clinically significant findings were demonstrated in 14.2% of patients with 8.6% of patients having a highly clinically significant finding. 4 incidental findings were confirmed to be malignant lesions and 5

  5. Comparative Study in the Diagnosis of Intracranial Aneurysms with 64 Slice CTA-and 3D DSA%64层CTA-MIP、CTA-VR与3D-DSA对颅内动脉瘤诊断价值的对比研究

    Institute of Scientific and Technical Information of China (English)

    刘善平

    2012-01-01

    目的 对比评价64层螺旋CT最大密度投影(CTA-MIP),CTA容积再现(CTA-VR)与三维数字血管造影(3D-DSA)对颅内动脉瘤(CA)的诊断价值.资料与方法 回顾性分析32例经手术及DSA确诊的CA 64层CT血管成像资料,并与DSA进行对照.结果 32例共40个动脉瘤,CTA-MIP发现35个动脉瘤,CTA-VR发现37个动脉瘤,3D-DSA发现39个动脉瘤.40个动脉瘤中11个位于后交通动脉,16个位于大脑中动脉,4个位于基底动脉,1个位于椎动脉,2个位于大脑前动脉,3个位于大脑后动脉,3个位于颈内动脉.3 D-DSA与CTA比较,差异无统计学意义.结论 在CA影像学诊断上,CTA-MIP、CTA-VR和3D-DSA各有优势,CTA可作为外科治疗或介入治疗的筛选方法.%Objective To evaluate the role of 64 slice computed tomography angiography maximum intensity projection (CTA,MIP) , computed tomography angiography volume rendering (CTA,VR) and 3 dimensional digital subtraction angiogtaphy(3D-DSA) ) in the diagnosis of intracranial aneurysms. Materials and Methods The CT and DSA imaging findings of 32 patients with aneurysms were retrospectively analyzed and compared. Results 40 aneurysms in 32 patients were found by DSA and/or operation. 35 aneurysms were found by CTA MIP. 37 aneurysms were found by CTA VR. 39 aneurysms were found by DSA. 11 aneurysms were at posterior communicating artery, 16 aneurysms at middle cerebral artery, 4 aneurysms at basilar artery, 1 aneurysms at vertebary artery, 2 aneurysms at anterior cerebral artery, 3 aneurysms at posterior cerebral artery, 3 aneurysms at internal carotid artery. There was no significant difference in detecting aneurysms between CTA and 3D DSA. Conclusion CTA MIP, CTA VR and 3D-DSA examination have their own advantage in diagnosis of intracranial aneurysms. CTA can be used as the method in screening intracranial aneurysms for surgery and interventional therapy.

  6. Evaluation of exposure dose reduction in multislice CT coronary angiography (MS-CTA) with prospective ECG-gated helical scan

    Science.gov (United States)

    Ota, Takamasa; Tsuyuki, Masaharu; Okumura, Miwa; Sano, Tomonari; Kondo, Takeshi; Takase, Shinichi

    2008-03-01

    A novel low-dose ECG-gated helical scan method to investigate coronary artery diseases was developed. This method uses a high pitch for scanning (based on the patient's heart rate) and X-rays are generated only during the optimal cardiac phases. The dose reduction was obtained using a two-level approach: 1) To use a 64-slice CT scanner (Aquilion, Toshiba, Otawara, Tochigi, Japan) with a scan speed of 0.35 s/rot. to helically scan the heart at a high pitch based on the patient's heart rate. By changing the pitch from the conventional 0.175 to 0.271 for a heart rate of 60 bpm, the exposure dose was reduced to 65%. 2) To employ tube current gating that predicts the timing of optimal cardiac phases from the previous cardiac cycle and generates X-rays only during the required cardiac phases. The combination of high speed scanning with a high pitch and appropriate X-ray generation only in the cardiac phases from 60% to 90% allows the exposure dose to be reduced to 5.6 mSv for patients with a heart rate lower than 65 bpm. This is a dose reduction of approximately 70% compared to the conventional scanning method recommended by the manufacturer when segmental reconstruction is considered. This low-dose protocol seamlessly allows for wide scan ranges (e.g., aortic dissection) with the benefits of ECG-gated helical scanning: smooth continuity for longitudinal direction and utilization of data from all cardiac cycles.

  7. Coronary CT angiography for acute chest pain triage: Techniques for radiation exposure reduction; 128 vs. 64 multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Goitein, Orly; Eshet, Yael; Konen, Eli (Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel)), email: orly.goitein@sheba.health.gov.il; Matetzky, Shlomi (Heart Inst., Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel)); Goitein, David (Surgery C, Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel)); Hamdan, Ashraf; Di Segni, Elio (Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel); Heart Inst., Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel))

    2011-10-15

    Background. Coronary CT angiography (CCTA) is used daily in acute chest pain triage, although exposing patients to significant radiation dosage. CCTA using prospective ECG gating (PG CCTA) enables significant radiation reduction Purpose. To determine whether the routine use of 128 vs. 64 multidetector CT (MDCT) can increase the proportion of patients scanned using PG CCTA technique, lowering radiation exposure, without decreasing image quality. Material and Methods. The study comprised 232 patients, 116 consecutive patients scanned using 128 MDCT (mean age 49 years, 79 men, BMI 28) and 116 consecutive patients (mean age 50 years, 75 men, BMI 28) which were scanned using 64 MDCT. PG CCTA was performed whenever technically permissible by each type of scanner: 64 MDCT = stable heart rate (HR) <60/min and weight <110 kg; 128 MDCT = stable HR < 70/min and weight <140 kg. All coronary segments were evaluated for image quality using a visual scale of 1-5. An estimated radiation dose was recorded. Results. PC CCTA was performed in 84% and 49% of the 128 and 64 MDCT groups, respectively (P < 0.0001). Average image quality score were 4.6 +- 0.3 and 4.7 +- 0.1 for the 128 and 64 MDCT, respectively (P = 0.08). The mean radiation dose exposure was 6.2 +- 4.8 mSv and 10.4 +- 7.5 mSv for the 128 and 64 MDCT, respectively (P = 0.008). Conclusion. The 128 MDCT scanner enables utilization of PG CCTA technique in a greater proportion of patients, thereby decreasing the related radiation significantly, without hampering image quality

  8. Transthoracic Doppler echocardiography to predict optimal tube pulsing window for coronary artery CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Min, E-mail: limin22000@yahoo.com.cn [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jiang, Xiang-sen, E-mail: jiangxiangsen123@126.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Li, E-mail: leely1976@yahoo.com.cn [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Peng, Zhao-hui, E-mail: zhaohuipeng_R@163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Mu, Nan-nan, E-mail: munannan22000@sohu.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China)

    2012-09-15

    Rationale and objective: To evaluate the feasibility of transthoracic Doppler echocardiography to determine the optimal pulsing windows for CT coronary angiography to narrow the pulsing windows further, especially in higher heart rate. Materials and methods: Doppler was performed on 135 patients before CT scanning. For Doppler, the intervals with minimal motion were evaluated during both systole and diastole integrating electrocardiogram (ECG) intervals. For CT scanning, the retrospective ECG-gating was applied and the optimal reconstruction intervals were determined. The accuracy of Doppler analysis to predict the optimal reconstruction intervals was tested. The predicted length of pulsing windows was compared between Doppler analysis and traditional prospective ECG-gating protocol (heart rate ≦ 65 bpm, 60–76%; 66–79 bpm, 30–77%; ≧80 bpm, 31–47%). Results: According to Doppler analysis, the mean length of intervals with minimal motion in systole was 106.4 ± 39.2 ms and 125.2 ± 92.0 ms in diastole. When the intervals with minimal motion during diastole > 90 ms, the optimal reconstruction intervals were located at diastole; otherwise, at systole (P < 0.001). The optimal reconstruction intervals in 93.8% (132/135) patients could be predicted accurately by Doppler analysis. If the optimal reconstruction intervals predicted by Doppler were applied as the exposure windows, the mean length of pulsing windows should has been 105.2 ± 69.4 ms (range: 26.9–510.3 ms), which was significantly shorter than that of traditional prospective ECG-gating protocol (232.0 ± 120.2 ms, range: 93.2–427.3 ms, P < 0.001). Conclusion: Doppler can help detecting the optimal pulsing windows accurately. Prospective ECG-gating incorporating Doppler analysis may narrow pulsing windows significantly while maintaining image quality.

  9. Multidetector spiral CT renal angiography in the diagnosis of renal artery fibromuscular dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Sabharwal, Rohan [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia)]. E-mail: rohan50000@yahoo.com; Vladica, Philip [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia); Coleman, Patrick [Department of Renal Medicine, Westmead Hospital, Sydney, NSW (Australia)

    2007-03-15

    Objective: The aim of this study was to evaluate the role and detection rate of multidetector spiral CT renal angiography (CTA) as compared with conventional angiography (CA), the commonly accepted gold standard, in the diagnosis of renal artery fibromuscular dysplasia (FMD). In addition, the role of CTA reconstructions (multiplanar reformatted images (MPR), maximum intensity projections (MIP) and shaded-surface display (SSD)) in the detection of FMD was also evaluated. Materials and methods: CTA results were retrospectively reviewed in 21 hypertensive patients with CA-proven FMD. Clinical indications for referral included resistant hypertension (requiring greater than three antihypertensive medications), labile hypertension, hypertension in combination with renal impairment and the presence of abdominal bruits in the context of systemic hypertension. In some cases, these clinical indications were supplemented by positive results in other tests, including plasma renin assay, captopril scintigraphy and/or Doppler ultrasound. The findings of CA in these 21 patients were compared to CTA. Results: Mean patient age was 62.33 + 14.32 years (range 24-85 years). CTA identified all 42 main renal arteries (100%) and all 10 accessory renal arteries (100%) visualized on CA. In the diagnosis of FMD, CTA detected all 40 (100%) lesions detected by CA. No single CTA reconstruction technique was able to detect all lesions noted on corresponding CA, however, upon review of all CTA reconstructions (MPR, MIP and SSD) in each case, every lesion was correctly identified by CTA. Conclusion: Our experience suggests that CTA is a non-invasive, reliable and accurate method for the diagnosis of renal artery fibromuscular dysplasia. Moreover, in our experience CTA has many advantages as a diagnostic screening tool over CA, including accessibility, speed, lower complication profile, versatility and cost-effectiveness. CTA shows great potential as a guiding tool for directing subsequent

  10. Diagnostic accuracy of dual-source CT coronary angiography with prospective ECG-triggering on different heart rate patients

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Ming-li; Lu, Bin; Han, Lei; Liu, Gang; Yu, Fang-Fang; Hou, Zhi-hui; Gao, Yang; Wang, Hong-yu; Jiang, Shiliang [Peking Union Medical College, Department of Radiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing (China); Wu, Run-ze; Johnson, Laura [CT Research Collaboration, Siemens Healthcare, Shang Hai (China); Yang, Yue-jin; Qiao, Shu-bin [Chinese Academy of Medical Sciences, Peking Union Medical College, Department of Cardiology, Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, Beijing (China)

    2011-08-15

    To evaluate the diagnostic accuracy of dual-source CT (DSCT) prospective ECG-triggering coronary angiography in patients with different heart rate (HR). 103 patients with suspected coronary artery disease underwent DSCT prospective ECG-triggered coronary angiography and invasive coronary angiography (ICA). The patients were grouped by HR during CT scans: low HR ({<=}60 bpm, n = 34); medium HR (60 < HR {<=} 70 bpm, n = 36) and high HR (>70 bpm, n = 33). The sensitivity and specificity of DSCT in detecting {>=}50% stenosis were compared among subgroups where ICA was the gold standard. Image quality was scored using a 4-point scale. A total of 1,580 (95.9%) coronary artery segments were evaluable. Sensitivity and specificity were 82.8% and 98.4%, 88.3% and 98.7%, and 80.3% and 98.6% for different subgroups (all p > 0.05). The overall area under the curve of the receiver-operating characteristic analysis was 0.94. The image quality scores were 3.1 {+-} 0.3, 3.1 {+-} 0.3 and 3.0 {+-} 0.4 for subgroups (p > 0.05). The overall average effective radiation dose was 3.60 {+-} 1.60 mSv. DSCT coronary angiography with prospective ECG-triggering could be just as accurate in patients with medium to high HR compared to those with low HR. (orig.)

  11. 320-Multidetector row whole-head dynamic subtracted CT angiography and whole-brain CT perfusion before and after carotid artery stenting: Technical note

    Energy Technology Data Exchange (ETDEWEB)

    San Millan Ruiz, Diego, E-mail: dsanmil1@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Murphy, Kieran, E-mail: KMURPHY@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Gailloud, Philippe, E-mail: pgailloud@cerebrovascular.ne [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States)

    2010-06-15

    Introduction: Multidetector CT (MDCT) is increasingly used for the investigation of neurovascular disorders, but restricted z-axis coverage (3.2 cm for 64-MDCT) currently limits perfusion to a small portion of the brain close to the circle of Willis, and precludes dynamic angiographic appreciation of the entire brain circulation. We illustrate the clinical potential of recently developed 320-MDCT extending the z-axis coverage to 16 cm in a patient with symptomatic carotid artery stenosis. Methods: In a 74-year-old patient presenting with critical symptomatic stenosis of the left CCA, pre- and post-carotid artery stenting whole-head subtracted dynamic MDCT angiography and perfusion were obtained in addition to CT angiography of the supra-aortic trunks. Both whole-head subtracted MDCT angiography and perfusion demonstrated delayed left ICA circulation, which normalized after carotid stenting. Discussion: 320-MDCT offers unprecedented z-axis coverage allowing for whole-brain perfusion and subtracted dynamic angiography of the entire intracranial circulation. These innovations can consolidate the role of MDCT as a first intention imaging technique for cerebrovascular disorders, in particular for the acute management of stroke.

  12. 64层VCT首过期灌注成像对肺部结节的诊断价值%First pass phase of perfusion imaging with 64-slice VCT in diagnosis of pulmonary nodules

    Institute of Scientific and Technical Information of China (English)

    舒圣捷; 黄晗; 刘白鹭; 王非; 赵雁鸣; 申秀芬

    2011-01-01

    Objective: To evaluate the diagnostic ability of first pass phase of perfusion imaging with 64-slice VCT between benign and malignant pulmonary nodules. Methods; A total of 108 patients with pulmonary nodules underwent perfusion scan with 64 slice spiral CT scanner. The parameters of CT perfusion. Including blood volume (BV), blood flow (BF). Mean transit time (MTT). Permeability surface (PS). And time-density curve (TDC). Were analyzed. The CT perfusion and enhanced parameters were compared with vascular endothelial growth factor (VEGF) expression by immunohis-tochemistry. Results: These parameter values in pulmonary malignancy nodules were highter than those in pulmonary benign nodules. The TDC appeared different for malignant and benign nodules. Conclusion: Perfusion CT can provide quantitative information about blood flow perfusion of nodules and it is meaningful to the diagnosis and differential diagnosis of pulmonary nodules.%目的:探讨首过期的64层VCT肺灌注成像对肺部结节的诊断意义.方法:对108例肺结节患者进行CT灌注扫描,测定肺结节的时间-密度曲线(TDC)、血容积(BV)、血流量(BF)、平均通过时间(MTT)和表面通透性(PS)的数值,并测量肺结节增强前的CT值、增强值和结节-动脉增强值之比(S/A).标定结节的血管内皮生长因子(VEGF),评价肺结节CT灌注和增强指数与VEGF表达的相关性.结果:肺癌的灌注指数高于肺良性结节.良、恶性结节的TDC形态不同.结论:CT肺灌注成像可定量的评价肺结节的血流灌注特点,对肺部结节有较大的诊断及鉴别诊断意义.

  13. Is CT angiography of the pulmonary arteries indicated in patients with high clinical probability of pulmonary embolism?

    Science.gov (United States)

    Martínez Montesinos, L; Plasencia Martínez, J M; García Santos, J M

    2017-06-30

    When a diagnostic test confirms clinical suspicion, the indicated treatment can be administered. A problem arises when the diagnostic test does not confirm the initially suspected diagnosis; when the suspicion is grounded in clinically validated predictive rules and is high, the problem is even worse. This situation arises in up to 40% of patients with high suspicion for acute pulmonary embolism, raising the question of whether CT angiography of the pulmonary arteries should be done systematically. This paper reviews the literature about this issue and lays out the best evidence about the relevant recommendations for patients with high clinical suspicion of acute pulmonary embolism and negative findings on CT angiography. It also explains the probabilistic concepts derived from Bayes' theorem that can be useful for ascertaining the most appropriate approach in these patients. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Catheter Angiography

    Medline Plus

    Full Text Available ... you! Do you have a personal story about radiology? Share your patient story here Images × Image Gallery ... Contrast Materials CT Angiography (CTA) X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to ...

  15. Catheter Angiography

    Medline Plus

    Full Text Available ... using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, a thin plastic tube, ... blood flow to the brain and cause a stroke. identify a small aneurysm or arteriovenous malformation (abnormal ...

  16. Triple-rule-out CT angiography for evaluation of acute chest pain and possible acute coronary syndrome.

    Science.gov (United States)

    Halpern, Ethan J

    2009-08-01

    Triple-rule-out (TRO) computed tomographic (CT) angiography can provide a cost-effective evaluation of the coronary arteries, aorta, pulmonary arteries, and adjacent intrathoracic structures for the patient with acute chest pain. TRO CT is most appropriate for the patient who is judged to be at low to intermediate risk for acute coronary syndrome (ACS) and whose symptoms may also be attributed to acute pathologic conditions of the aorta or pulmonary arteries. Although a regular cardiac rhythm remains an important factor in coronary CT image quality, newer CT scanners with 64 or more detector rows afford rapid electrocardiographically (ECG) gated imaging to provide high-quality TRO CT studies in patients with a heart rate of up to 80 beats per minute. Injection of iodinated contrast material ( 300 HU) and in the pulmonary arteries (> 200 HU). To limit radiation exposure, the TRO CT examination does not include the entire chest but is constrained to incorporate the aortic arch down through the heart. Scanning parameters, including prospective ECG tube current modulation and prospective ECG gating with the "step-and-shoot" technique, are tailored to reduce radiation exposure (optimally, 5-9 mSv). When performed with appropriate attention to timing and technique, TRO CT provides coronary image quality equal to that of dedicated coronary CT angiography and pulmonary arterial images that are free of motion artifact related to cardiac pulsation. In an appropriately selected emergency department patient population, TRO CT can safely eliminate the need for further diagnostic testing in over 75% of patients.

  17. Focal changes of the spleen in one case of Gaucher disease - assessed by ultrasonography, CT, MRI and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Aspestrand, F.; Charania, B.; Scheel, B.; Kolmannskog, F.; Jacobsen, M. (Rikshospitalet, Oslo (Norway). Dept. of Diagnostic Radiology)

    1989-11-01

    Focal lesions of the spleen in one case of Gaucher disease are demonstrated by ultrasonography, CT, MRI and angiography. The sonographic and angiographic features differ from the findings presented in previous reports. The Gaucher manifestations in the spleen as demonstrated by CT, do not seem to have been reported previously. An earlier report on the MR findings in the liver and spleen in this disease did not disclose any focal abnormalities. In this case, ultrasonography and MRI revealed a targetlike configuration of the focal lesions. An attempt is made to analyze the more complex patterns disclosed by MRI against the background of the manifestations by the other imaging modalities and previous reports. (orig.).

  18. Placing two parallel catheters by Seldinger`s approach through the femoral artery for CT angiography and CT during arterioportography. Evaluation of efficacy and safety

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Kazuhiro; Goto, Yasuyuki; Saito, Toshitaka [Musashino Red Cross Hospital, Tokyo (Japan); Wakabayashi, Yukari; Abe, Kimihiko

    1998-02-01

    The purpose of this study was to evaluate the efficacy and safety of placing two parallel catheters by Seldinger`s approach through the femoral artery for CT angiography (CTA) and CT during arterioportography (CTAP). We performed an analysis of 30 patients. Two introducers were successfully placed in all cases. Only one minor complication was observed, a localized inguinal hematoma. The CTA/CTAP procedures were successful in all patients except six who had anatomical variations of the hepatic arterial supply. Our methods proved to be useful and safe for patients with standard hepatic arterial supply. (author)

  19. Dual-energy CT angiography of the lung in patients with suspected pulmonary embolism. Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Fink, C.; Michaely, H.J. [Inst. fuer Klinische Radiologie und Nuklearmedizin, Universitaetsklinikum Mannheim, Univ. Heidelberg (Germany); Inst. fuer Klinische Radiologie, Campus Grosshadern, Klinikum der Univ. Muenchen (Germany); Johnson, T.R.; Morhard, D.; Becker, C.; Reiser, M.; Nikolaou, K. [Inst. fuer Klinische Radiologie, Campus Grosshadern, Klinikum der Univ. Muenchen (Germany)

    2008-10-15

    To evaluate the feasibility of dual-energy CT angiography (CTA) of the lung in patients with suspected pulmonary embolism (PE). 24 patients with suspected PE were examined with a single-acquisition, dual-energy CTA protocol (A-system: 140 kV/65 mAsref, B-system: 80 kV/190 mAsref) on a dual-source CT system. Lung perfusion was visualized by color-coding voxels containing iodine and air using dedicated dual-energy post-processing software. Perfusion defects were classified by two blinded radiologists as being consistent or non-consistent with PE. Subjective image quality of perfusion maps and CTA was rated using a 5-point scale (1: excellent, 5: poor). The reading of a third independent radiologist served as the standard of reference for the diagnosis of PE. In all patients with PE (n = 4), perfusion defects classified as being consistent with PE were identified in lung areas affected by PE. Both readers did not record perfusion defects classified as being consistent with PE in any of the patients without PE. Thus, on a per patient basis the sensitivity and specificity for the assessment of PE was 100% for both readers. On a per segment basis the sensitivity and specificity ranged between 60 - 66.7% and 99.5 - 99.8%. The interobserver agreement was good (k = 0.81). Perfusion defects rated as non-consistent with PE were most frequently caused by streak artifacts from dense contrast material in the great thoracic vessels. The median score of the image quality of both the perfusion maps and CTA was 2. In conclusion, dual-energy CTA of pulmonary embolism is feasible and allows the assessment of perfusion defects caused by pulmonary embolism. Further optimization of the injection protocol is required to reduce artifacts from dense contrast material. (orig.)

  20. 3D-CT angiography in high-grade aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Kenji; Suda, Yoshitaka; Shioya, Hitoshi; Shindo, Kenjiro [Yuri Kumiai General Hospital, Honjo, Akita (Japan)

    1998-03-01

    We analyzed the role of 3D-CT angiography (3D-CTA) in the management of high-grade patients with severe subarachnoid hemorrhage (SAH) who were classified as Grade 5 by the Hunt-Kosnik grading system. From February 1995 to January 1997, 86 out of 92 patients with SAH were studied using 3D-CTA. There were 30 Grade 5 SAH patients (32.6%) including 5 patients who arrived in cardiopulmonary arrest (CPA). There were 13 men and 17 women, ranging in age from 46 to 89 years. Two-thirds were older than age 65 years. All patients underwent CT scan and were diagnosed with SAH. Excluding 5 CPA patients and one other patient, the remaining 24 patients successfully underwent 3D-CTA. As a result, ruptured aneurysms responsible for the SAH were clearly delineated in 19 patients (79.2%), and their anatomical relationships to the surrounding vessels were easily assessed. There were 8 patients with ICA aneurysms, 5 with MCA aneurysms, 2 with ACoA aneurysms, 2 with VA aneurysms, 1 with distal ACA aneurysm and 1 with distal PICA aneurysm. Intracranial vessels were not seen in 4 patients, 3 of whom had huge intracerebral hematomas associated with severe SAH. Proximal clipping was performed in a 46-years-old man with dissecting VA aneurysm. He later gained consciousness and became a surgical candidate. A 62-years-old woman underwent coil embolization for the large ICPC aneurysm after the level of her consciousness improved slightly following ventricular drainage. In conclusion, 3D-CTA can be performed safely and has a high detection rate of ruptured aneurysm even in patients with severe SAH. The results from these studies may gain further insight into epidemiology of SAH and ruptured aneurysms. (author)

  1. Development and validation of intracranial thrombus segmentation on CT angiography in patients with acute ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Emilie M M Santos

    Full Text Available Thrombus characterization is increasingly considered important in predicting treatment success for patients with acute ischemic stroke. The lack of intensity contrast between thrombus and surrounding tissue in CT images makes manual delineation a difficult and time consuming task. Our aim was to develop an automated method for thrombus measurement on CT angiography and validate it against manual delineation.Automated thrombus segmentation was achieved using image intensity and a vascular shape prior derived from the segmentation of the contralateral artery. In 53 patients with acute ischemic stroke due to proximal intracranial arterial occlusion, automated length and volume measurements were performed. Accuracy was assessed by comparison with inter-observer variation of manual delineations using intraclass correlation coefficients and Bland-Altman analyses.The automated method successfully segmented the thrombus for all 53 patients. The intraclass correlation of automated and manual length and volume measurements were 0.89 and 0.84. Bland-Altman analyses yielded a bias (limits of agreement of -0.4 (-8.8, 7.7 mm and 8 (-126, 141 mm3 for length and volume, respectively. This was comparable to the best interobserver agreement, with an intraclass correlation coefficients of 0.90 and 0.85 and a bias (limits of agreement of -0.1 (-11.2, 10.9 mm and -17 (-216, 185 mm3.The method facilitates automated thrombus segmentation for accurate length and volume measurements, is relatively fast and requires minimal user input, while being insensitive to high hematocrit levels and vascular calcifications. Furthermore, it has the potential to assess thrombus characteristics of low-density thrombi.

  2. Electrocardiogram-gated coronary CT angiography dose estimates using ImPACT.

    Science.gov (United States)

    Kobayashi, Masanao; Asada, Yasuki; Matsubara, Kosuke; Suzuki, Shouichi; Koshida, Kichiro; Matsunaga, Yuta; Haba, Tomonobu; Kawaguchi, Ai; Toyama, Hiroshi; Kato, Ryouichi

    2016-07-08

    The primary study objective was to assess radiation doses using a modified form of the Imaging Performance Assessment of Computed Tomography (CT) scanner (ImPACT) patient dosimetry for cardiac applications on an Aquilion ONE ViSION Edition scanner, including the Ca score, target computed tomography angiography (CTA), prospective CTA, continuous CTA/cardiac function analysis (CFA), and CTA/CFA modulation. Accordingly, we clarified the CT dose index (CTDI) to determine the relationship between heart rate (HR) and X-ray exposure. As a secondary objective, we compared radiation doses using modified ImPACT, a whole-body dosimetry phantom study, and the k-factor method to verify the validity of the dose results obtained with modified ImPACT. The effective dose determined for the reference person (4.66 mSv at 60 beats per minute (bpm) and 33.43 mSv at 90bpm) were approximately 10% less than those determined for the phantom study (5.28 mSv and 36.68 mSv). The effective doses according to the k-factor (0.014 mSv•mGy-1•cm-1; 2.57 mSv and 17.10 mSv) were significantly lower than those obtained with the other two methods. In the present study, we have shown that ImPACT, when modified for cardiac applications, can assess both absorbed and effective doses. The results of our dose comparison indicate that modified ImPACT dose assessment is a promising and practical method for evaluating coronary CTA.

  3. Spontaneous obliteration of MRI-silent cerebral angiomatosis revealed by CT angiography in a patient with Sturge-Weber syndrome.

    Science.gov (United States)

    Aguglia, Umberto; Latella, Maria Adele; Cafarelli, Franco; Le Piane, Emilio; Gangemi, Antonio; Labate, Angelo; Gambardella, Antonio; Quattrone, Aldo

    2008-01-15

    Type I Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome characterized by facial port wine stain and ipsilateral leptomeningeal angiomatosis. It is commonly complicated by glaucoma and neurological disturbances including seizures, hemiparesis, transient stroke-like deficits, and behavioral problems. Gadolinium-enhanced MRI is the study of choice for demonstrating the leptomeningeal angiomatosis, and is particularly useful for making the diagnosis. Cerebral hematoma and spontaneous obliteration of cerebral angiomatosis have never been reported in SWS. We describe a patient with type I SWS in which a hemorrhage in the left temporal lobe was caused by an underlying angiomatosis. No arteriovenous malformations were detected by brain CT or gadolinium-enhanced MRI, whereas a small angiomatous nidus draining into an ectasic venous collector near the hematoma was disclosed by brain CT angiography. Carotid angiography, performed 3 years after the hemorrhage, demonstrated the spontaneous obliteration of the angioma. This description expands the phenotypic spectrum of type I SWS in which the occurrence of cerebral hemorrhage and MRI-silent cerebral angiomatosis should be included, and emphasizes the need of performing a brain CT angiography in SWS patients whose routine neuroimaging studies fail to detect potentially harmful vessel malformation.

  4. High-pitch dual-source CT angiography of the whole aorta without ECG synchronisation: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Beeres, Martin; Schell, Boris; Mastragelopoulos, Aristidis; Kerl, Josef Matthias; Gruber-Rouh, Tatjana; Lee, Clara; Siebenhandl, Petra; Bodelle, Boris; Zangos, Stephan; Vogl, Thomas J.; Jacobi, Volkmar; Bauer, Ralf W. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Herrmann, Eva [Clinic of the Goethe University, Department of Biostatistics, Frankfurt (Germany)

    2012-01-15

    To investigate the feasibility, image quality and radiation dose for high-pitch dual-source CT angiography (CTA) of the whole aorta without ECG synchronisation. Each group of 40 patients underwent CTA either on a 16-slice (group 1) or dual-source CT device with conventional single-source (group 2) or high-pitch mode with a pitch of 3.0 (group 3). The presence of motion or stair-step artefacts of the thoracic aorta was independently assessed by two readers. Subjective and objective scoring of motion and artefacts were significantly reduced in the high-pitch examination protocol (p < 0.05). The imaging length was not significantly different, but the imaging time was significantly (p < 0.001) shorter in the high-pitch group (12.2 vs. 7.4 vs. 1.7 s for groups 1, 2 and 3). The ascending aorta and the coronary ostia were reliably evaluable in all patients of group 3 without motion artefacts as well. High-pitch dual-source CT angiography of the whole aorta is feasible in unselected patients. As a significant advantage over regular pitch protocols, motion-free imaging of the aorta is possible without ECG synchronisation. Thus, this CT mode bears potential to become a standard CT protocol before trans-catheter aortic valve implantation (TAVI). (orig.)

  5. Multi-parametric ultrasound criteria for internal carotid artery disease - comparison with CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Barlinn, Kristian; Kepplinger, Jessica; Siepmann, Timo; Pallesen, Lars-Peder; Bodechtel, Ulf; Reichmann, Heinz; Puetz, Volker [Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neurology, Dresden (Germany); Floegel, Thomas [Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neurology, Dresden (Germany); Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neuroradiology, Dresden (Germany); Kitzler, Hagen H. [Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neuroradiology, Dresden (Germany); Alexandrov, Andrei V. [The University of Tennessee Health Science Center, Department of Neurology, Memphis, TN (United States)

    2016-09-15

    The German Society of Ultrasound in Medicine (known by its acronym DEGUM) recently proposed a novel multi-parametric ultrasound approach for comprehensive and accurate assessment of extracranial internal carotid artery (ICA) steno-occlusive disease. We determined the agreement between duplex ultrasonography (DUS) interpreted by the DEGUM criteria and CT angiography (CTA) for grading of extracranial ICA steno-occlusive disease. Consecutive patients with acute cerebral ischemia underwent DUS and CTA. Internal carotid artery stenosis was graded according to the DEGUM-recommended criteria for DUS. Independent readers manually performed North American Symptomatic Carotid Endarterectomy Trial-type measurements on axial CTA source images. Both modalities were compared using Spearman's correlation and Bland-Altman analyses. A total of 303 acute cerebral ischemia patients (mean age, 72 ± 12 years; 58 % men; median baseline National Institutes of Health Stroke Scale score, 4 [interquartile range 7]) provided 593 DUS and CTA vessel pairs for comparison. There was a positive correlation between DUS and CTA (r{sub s} = 0.783, p < 0.001) with mean difference in degree of stenosis measurement of 3.57 %. Bland-Altman analysis further revealed widely varying differences (95 % limits of agreement -29.26 to 22.84) between the two modalities. Although the novel DEGUM criteria showed overall good agreement between DUS and CTA across all stenosis ranges, potential for wide incongruence with CTA underscores the need for local laboratory validation to avoid false screening results. (orig.)

  6. Optimal iodine dose for 3-dimensional multidetector-row CT angiography of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Ichikawa, Tomoaki, E-mail: ichikawa@yamanashi.ac.jp [Department of Radiology, University of Yamanashi, Yamanashi (Japan); Motosugi, Utaroh; Morisaka, Hiroyuki; Sou, Hironobu; Onohara, Kojiro; Sano, Katsuhiro; Araki, Tsutomu [Department of Radiology, University of Yamanashi, Yamanashi (Japan)

    2012-09-15

    Purpose: To clarify the optimal iodine dose of contrast material for 3-dimensional multidetector-row CT angiography (3D-MDCTA) of the venous vasculature of the liver using volume rendering technique. Materials and methods: This study included 103 patients who were randomly assigned to 5 contrast-enhanced MDCT protocol groups with different body-weight-tailored doses of contrast material: 500, 600, 630, 650, and 700 mgI/kg body weight. The arterial, portal, and hepatic parenchymal phases were obtained to evaluate enhancement values of the aorta, portal vein, and hepatic vein. Visualization of the portal and hepatic veins on the volume-rendering images of 3D-MDCTA was evaluated using a 5-point grade. Dunnett's test was used to compare the mean enhancement value and mean grades of image quality (700 mgI/kg dose group was control). Results: The mean enhancement values of portal and hepatic vein in the group with 500 and 600 mgI/kg were significantly lower than those of the control group. During visual assessment, a significantly lower mean grades were observed in 500 mgI/kg groups for the portal vein, and 500 and 600 mgI/kg groups for hepatic vein. There were no significant intergroup differences in mean enhancement values and visual assessment among the groups using 630 mgI/kg or more. Conclusion: Iodine doses of 630 mgI/kg was recommended for 3D-MDCTA.

  7. Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.

    Science.gov (United States)

    Ridge, Carole A; McDermott, Shaunagh; Freyne, Bridget J; Brennan, Donal J; Collins, Conor D; Skehan, Stephen J

    2009-11-01

    The purpose of this study was to retrospectively compare the diagnostic adequacy of lung scintigraphy with that of pulmonary CT angiography (CTA) in the care of pregnant patients with suspected pulmonary embolism. Patient characteristics, radiology report content, additional imaging performed, final diagnosis, and diagnostic adequacy were recorded for pregnant patients consecutively referred for lung scintigraphy or pulmonary CTA according to physician preference. Measurements of pulmonary arterial enhancement were performed on all pulmonary CTA images of pregnant patients. Lung scintigraphy and pulmonary CTA studies deemed inadequate for diagnosis at the time of image acquisition were further assessed, and the cause of diagnostic inadequacy was determined. The relative contribution of the inferior vena cava to the right side of the heart was measured on nondiagnostic CTA images and compared with that on CTA images of age-matched nonpregnant women, who were the controls. Twenty-eight pulmonary CTA examinations were performed on 25 pregnant patients, and 25 lung scintigraphic studies were performed on 25 pregnant patients. Lung scintigraphy was more frequently adequate for diagnosis than was pulmonary CTA (4% vs 35.7%) (p = 0.0058). Pulmonary CTA had a higher diagnostic inadequacy rate among pregnant than nonpregnant women (35.7% vs 2.1%) (p lung scintigraphy was more reliable than pulmonary CTA in pregnant patients. Transient interruption of contrast material by unopacified blood from the inferior vena cava is a common finding at pulmonary CTA of pregnant patients.

  8. Evaluation of intracranial aneurysms with CT angiography: current status and future direction

    Science.gov (United States)

    Sato, Yutaka; Sickels, William; Quets, Jerome; Crosby, Daniel; Chang, Shereen; Cook-Granroth, Janice; Hoffman, Eric A.

    1997-05-01

    Purpose: To develop a valid, reliable and accurate system of measurement of intracranial aneurysm geometry using volumetric data obtained by CT angiography. Materials and methods: A simple model of lateral saccular aneurysm was created. Three models were prepared with different size of aneurysm sac and neck. Volumetric data was acquired using a Toshiba Xpress SX helical scanner. Geometry of an aneurysm model obtained by workstation linked to the scanner applying volume rendering display and dedicated UNIX based computer applying MPR based method. These results were compared with actual caliper measurements of the model. A clinical case of lateral aneurysm arising from the supraclinoid internal carotid artery was also studied. Results: Both the volume rendered image based method and MPR based method provided accurate geometric information of an aneurysm sac and its neck. Conclusions: Volume rendering technique requires editing by a well-informed operator and subjective, while the MPR based method is more objective and better suited for quantitative analysis. Using these mutually complimentary tools, critical geometric information of an aneurysm can be extracted from volumetric data provided by CTA.