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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  4. 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.)

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

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

    2008-03-15

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

  6. 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

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

    International Nuclear Information System (INIS)

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

  8. 64-slice multidetector coronary CT angiography: in vitro evaluation of 68 different stents

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

    2006-04-15

    The purpose of this study was to test a large sample of different coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in 64-slice multidetector-row computed tomography (MDCT) in vitro and to provide a catalogue of currently used coronary artery stents when imaged with state-of the-art MDCT. We examined 68 different coronary artery stents (57 stainless steel, four cobalt-chromium, one cobalt-alloy, two nitinol, four tantalum) in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70). Stents were imaged in axial orientation with standard parameters: 32x0.6 collimation, pitch 0.24, 680 mAs, 120 kV, rotation time 0.37 s. Four different image reconstructions were obtained with varying convolution kernels and section thicknesses: (1) soft, 0.6 mm, (2) soft, 0.75, (3) medium soft, 0.6, and (4) stent-optimized sharp, 0.6. To evaluate visualization characteristics of of the stent, the lumen diameter, intraluminal density and noise were measured. The high-resolution kernel offered significantly better average lumen visualization (57% {+-}10%) and more realistic lumen attenuation (222 HU {+-}66 HU) at the expense of increased noise (15.3 HU {+-}3.7 HU) compared with the soft and medium-soft CT angiography (CTA) protocol (p<0.001 for all). Stents with a lumen visibility of more than 66% were: Arthos pico, Driver, Flex, Nexus2, S7, Tenax complete, Vision (all 67%), Symbiot, Teneo (70%), and Radius (73%). Only ten stents showed a lumen visibility of less than 50%. Stent lumen visibility largely varies depending on the stent type. Even with the improved spatial resolution of 64-slice CT, a stent-optimized kernel remains beneficial for stent visualization when compared with the standard medium-soft CTA protocol. Using 64-slice CT and high-resolution kernel, the majority of stent products show a lumen visibility of more than 50% of the stent

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

    International Nuclear Information System (INIS)

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

  10. 64-Slice CT Angiography in the Detection of Intracranial Aneurysms: Comparison with DSA and Surgical Findings.

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

    2010-03-01

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

  11. 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.)

  12. 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.

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

    International Nuclear Information System (INIS)

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

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

    2012-09-15

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

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

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    "A. Arjmand Shabestari

    2005-08-01

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

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

    OpenAIRE

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

    2008-01-01

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

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

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

    2010-09-15

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

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

    International Nuclear Information System (INIS)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

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

  1. 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

  2. 64-slice CT imaging in a case of total anomalous pulmonary venous circulation

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2012-01-01

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

  4. 64-slice spiral CT in the diagnosis of Caroli disease

    International Nuclear Information System (INIS)

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

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    韩璐璐; 张锡海; 张爱霞; 王俊英; 董乐

    2015-01-01

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

  7. 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.)

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  10. 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

  11. 64排CT血管造影在动脉瘤性蛛网膜下腔出血的临床研究%Clinical research of 64-slice CT angiography in aneurysmal subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈立朝; 许民辉; 邹咏文; 杨东虹; 张云东; 徐伦山; 张溢华

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Alpa Bharati

    2012-01-01

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

  13. 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 arter...

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

    International Nuclear Information System (INIS)

    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

  15. 64层螺旋CT血管成像诊断大脑中动脉成窗变异%CT Angiography Features of Fenestration Variation in the Middle Cerebral Artery Using 64-slice Multidetector Spiral CT

    Institute of Scientific and Technical Information of China (English)

    袁飞; 刘银社; 常爱华; 赵军; 顾欣; 冯凯琳

    2011-01-01

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

  16. Application of Low Dose Contrast Medium in 64-slice Spiral CT Angiography of Craniocervical Arteries%低剂量对比剂在64排CT头颈部血管联合成像中的应用

    Institute of Scientific and Technical Information of China (English)

    杨春燕; 侯新川; 梅友泉

    2012-01-01

    目的 评价低剂量对比剂在头颈部CT血管联合成像中的动脉分级能力及图像质量效果.资料与方法 搜集1183例行64排CT头颈部血管联合成像患者的资料,按对比剂注射剂量不同将患者分为低剂量组(n=708)和常规剂量组(n=475).观察容积重建图像上患者颈总动脉、颈内动脉颈段、颈内动脉岩骨段至颅内段、大脑前动脉及其主要分支血管的显示情况,根据最大密度投影上血管质量评分判定图像质量.结果 两组头颈部动脉血管及脑内较大分支在容积重建图像上显示良好,且最大密度投影图像上多数血管显示清晰,边缘光滑锐利.低剂量组和常规剂量组各段血管的显示率及图像质量评分差异均无统计学意义(P>0.05).结论 低剂量对比剂在CT头颈部联合成像上可以很好地显示颅内血管,且具有较高的图像质量.%Purpose To assess the effect of low dose contrast medium in arteries grades and the scoring of image quality in CT angiography of craniocervical arteries. Materials and Methods Imaging data of 1183 patients with 64-slice spiral CT angiography of craniocervical arteries were randomly divided into two groups: low dose contrast medium group (708 cases) and conventional dose contrast medium group (475 cases). Display of the vessels on volume rendering images were observed, including common carotid arteries, cervical segment of internal carotid arteries, petrous segment to cerebral segment of internal carotid arteries, anterior cerebral arteries and their main branches. The image quality was evaluated on maximum intensity projection images. Results The craniocervical arteries and greater rami of cerebral arteries of the two groups were well displayed on volume rendering images. On maximum intensity projection, most of the arteries showed clearly with glabrous and sharp borders. There was no significant difference in revealing rate of arteries grades and image quality scores between

  17. 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

  18. 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...

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

    Institute of Scientific and Technical Information of China (English)

    陈红; 曹成瑛; 朱友义; 王生元; 罗焕; 周署泉

    2011-01-01

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

  20. Evaluation of Carotid Atherosclerosis Using 64-slice CT Angiography and Contrast enhanced Ultrasound%64层螺旋CT血管造影及超声造影评价颈动脉斑块

    Institute of Scientific and Technical Information of China (English)

    杨晓燕; 胡元明; 魏玮; 胡正明; 游勇

    2012-01-01

    目的 探讨64层螺旋CT血管造影(MSCTA)及超声造影(CEUS)在评价颈动脉斑块中的价值.资料与方法 37例颈动脉斑块狭窄患者于1周内分别行MSCTA及CEUS检查,分析颈动脉内中膜厚度/颈动脉管壁厚度、狭窄比率、斑块表面形态,采用CEUS观察斑块内新生血管情况,将斑块分为内中膜增厚型、稳定型及易损斑块.结果 37例共51处病变血管,MSCTA:颈动脉管壁增厚9处;斑块42处,其中稳定斑块27处,易损斑块15处.CEUS:颈动脉内中膜增厚11处;斑块40处,其中稳定斑块23处,易损斑块17处.MSCTA:轻度狭窄21处,中度狭窄15处,重度狭窄12处,闭塞3处;CEUS:轻度狭窄20处,中度狭窄16处,重度狭窄13处,闭塞2处.MSCTA与CEUS对颈动脉斑块狭窄(Kappa=0.71,P< 0.05)及斑块稳定性(Kappa=0.69,P<0.05)评价一致性较好.结论 MSCTA与CEUS对评价颈动脉斑块狭窄及斑块稳定性具有较好的一致性.%Purpose To explore the value of 64-slice CT angiography (MSCTA) and contrast-enhanced ultrasound (CEUS) in the diagnosis of carotid atherosclerosis. Materials and Methods 37 patients with carotid atherosclerosis underwent MSCTA and CEUS within one week. Intima-media thickness (IMT), carotid artery wall thickness (CAWT), carotid artery percent stenosis and surface morphology of the atherosclerotic plaques were analyzed. The neo-vasculization in the plaques after CEUS were observed, and plaques were further divided into IMT thickening, stable plaque and vulnerable plaque. Results 51 pathological changes of 37 patients were observed. MSCTA showed 9 carotic artery wall thickening and 42 plaques including 27 stable plaques and 15 vulnerable plaques. CEUS showed 11 intima-media thickening and 40 plaques, 23 stable and 16 vulnerable. MSCTA showed 21 mild stenoses, 15 moderate stenoses, 12 severe stenoses, and 3 occlusions; CEUS showed 20 mild stenoses, 16 moderate stenoses, 13 severe stenoses, and 2 occlusions. MSCT and CEUS had good

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

    International Nuclear Information System (INIS)

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

  2. 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.

  3. 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

  4. 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.

  5. 64排螺旋CT冠状动脉成像与冠状动脉造影对心肌桥诊断的比较研究%Diagnosis Comparison of Myocardial Bridge by 64-slice CT Coronary Angiography and Conventional Coronary Angiography

    Institute of Scientific and Technical Information of China (English)

    施斌斌; 吴晶涛; 征锦; 叶靖; 王守安

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

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

  11. 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

  12. 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.

  13. 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.

  14. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-04-21

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

  16. 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).

  17. Diagnosis of fetal origin of posterior cerebral artery and variation of arteries nearby with 64-slice spiral CT angiography%64层螺旋C TA在胚胎型大脑后动脉及其邻近血管变异诊断中的运用

    Institute of Scientific and Technical Information of China (English)

    彭泽标; 吴宗山; 林承露; 郭磊

    2014-01-01

    Objective To investigate the value of 64-slice spiral CT angiography(CTA)in the diagnosis of fetal origin of posterior cerebral artery (FTP)and the variations of the artery nearby.Methods All images were reconstructed with maximum intensity projection (MIP),volume rendering(VR),multiplanar reconstruction(MPR)and curve planar reconstruction(CPR).Thirty-seven patients with an FTP diagnosed by CTA were analyzed retrospectively to assess the value of CTA in the diagnosis of FTP and the variation of arteries nearby.Re-sults Nine cases variation of the A1 segment of anterior cerebral artery(ACA)and 1 2 cases of variation of the vertebral-basilar artery were found in the 37 patients with FTP.Dysplasia or deficiency of the posterior cerebral artery(PCA)originated from the basilar artery(BA)were demonstrated in all the 37 patients with FTP.Conclusions Patients with FTP are frequently complicated with a variation of the artery nearby and almost all the FTP complicated with the dysplasia or deficiency of the PCA originated from the BA.%目的:探讨64层螺旋CT血管成像(CTA)在诊断胚胎型大脑后动脉(FTP)及其邻近血管变异中的价值。方法采用最大密度投影(MIP),容积再现技术(VR)和曲面重建(CPR)对所采集的头颈血管源图像进行影像重建并回顾性分析37例CTA诊断的FTP影像学资料,研究CTA在FTP的诊断和FTP邻近血管的改变。结果37例FTP中,合并大脑前动脉(ACA)A1段变异9例,合并椎-基底动脉变异12例,所有37例FTP病例同侧基底动脉起源的大脑后动脉(B-PCA)均有不同程度发育不良或缺如。结论 FTP患者常合并邻近血管的变异,几乎所有FTP患者同侧B-PCA发育不良或缺如。

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  19. Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis

    NARCIS (Netherlands)

    N. Carrabba (Nazario); J.D. Schuijf (Joanne); F.R. de Graaf (Fleur); G. Parodi (Guido); E. Maffei (Erica); R. Valenti (Renato); A. Palumbo (Alessandro); A.C. Weustink (Annick); N.R.A. Mollet (Nico); G. Accetta (Gabriele); F. Cademartiri (Filippo); D. Antoniucci (David); J.J. Bax (Jeroen)

    2010-01-01

    textabstractBackground: We sought to evaluate the diagnostic accuracy of 64-slice multi-detector row computed tomography (MDCT) compared with invasive coronary angiography for in-stent restenosis (ISR) detection. Methods: MEDLINE, Cochrane library, and BioMed Central database searches were performed

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dinesh Sharma

    2012-01-01

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

  3. 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.)

  4. 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.

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

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

    Institute of Scientific and Technical Information of China (English)

    王洪生; 徐新文; 王辉; 杨昭伟; 王鹏; 赵佩林; 王阳春

    2011-01-01

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

  7. 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.

  8. 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.

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  11. Low kV CT pulmonary angiography at 64-slice CT for standard body type:a feasibility study%对标准体型病人行低管电压CT肺动脉成像的可行性研究

    Institute of Scientific and Technical Information of China (English)

    赵磊; 杨晓光; 包丽丽; 刘挨师

    2016-01-01

    Objebtive The purpose of this study was to compare image quality and radiation dose between low voltage CT pulmonary angiography (CTPA) and conventional CTPA protocols in patients of standard body type. Methods 60 consecutive patients with low body mass index (≤25 kg/m2) and low body mass (≤80 kg) suspected having pulmonary embolism (PE) were prospectively enrolled from February 2013 to August 2014. The patients were divided into two groups. Tube voltage was set at 80 Kv for group A and 120 Kv for group B. Tube current settings were determined by testing bolus peak attenuation. Radiation dose and image quality were compared between the two groups. The relationship between image quality parameter and radiation dose measured at pulmonary artery trunk were analyzed with Pearson correlation. Results The total pulmonary arteries showed significantly higher attenuation and noise in group A than in group B (P=0.000). The total signal-to-noise ratio and total contrast-to-noise ratio did not significantly differ between groups A and B (P=0.187, P=0.309, respectively). The mean effective dose showed significantly lower in group A than in group B (1.69±0.43 mSv vs 5.63± 1.84 mSv, P=0.000). The attenuation or noise and effective dose was negatively correlated. Conclusion Using 80 Kv-CTPA can achieve stable image quality with reduced effective radiation dose compared with 120 Kv-CTPA in patients with low body mass index (≤25 kg/m2) and low body mass (≤80 kg).%目的 通过对比低管电压CT肺动脉成像(CTPA)与常规CTPA的影像质量与辐射剂量,从而评价低管电压CTPA应用于标准体型病人的临床价值.方法 前瞻性选取我院2013年2月-2014年8月标准体型(体质量指数≤25 kg/m2,体质量≤80 kg)病人60例,并随机分为2组.A、B两组管电压分别设置为80 Kv和120 Kv.管电流设置基于循环时间测试峰值.评价并对比A、B两组影像质量与辐射剂量,选取肺动脉干影像质量参数与辐射剂

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

    International Nuclear Information System (INIS)

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

  13. 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

  14. 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.

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

    International Nuclear Information System (INIS)

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

  16. 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.

  17. 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.)

  18. 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

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

    International Nuclear Information System (INIS)

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

  20. 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.)

  1. 64排螺旋CT泌尿系三维成像患者的护理%Nursing of patients undergoing 64-slice CT urography

    Institute of Scientific and Technical Information of China (English)

    高丽; 张金玲; 赵云霞; 申秀芬

    2009-01-01

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

  2. 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 ...

  3. 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 ...

  4. 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

    International Nuclear Information System (INIS)

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

  5. 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.

  6. Italian multicenter, prospective study to evaluate the negative predictive value of 16- and 64-slice MDCT imaging in patients scheduled for coronary angiography (NIMISCAD-non invasive multicenter Italian study for coronary artery disease)

    Energy Technology Data Exchange (ETDEWEB)

    Marano, Riccardo [Hospital - Catholic University, Department of Bioimaging and Radiological Sciences, Institute of Radiology, Rome (Italy); Cobelli, Francesco de; Maschio, Alessandro del [Vita-Salute Univ., Milan (Italy). Scientifi Inst.; Floriani, Irene [Mario Negri Inst., Milan (Italy); Becker, Christoph [Muenchen Univ. (Germany); Herzog, Christopher [Frankfurt Univ. (Germany); Centonze, Maurizio [Chiara Hospital, Trento (Italy); Morana, Giovanni [Foncello Hospital, Trevisio (Italy); Gualdi, Gian Franco [DEA Umberto Hospital, Rome UNiv. (Italy); Ligabue, Guido [Univ. of Modena (Italy); Pontone, Gianluca [Centro Cardiologico Monzino, Milan (Italy); Catalano, Carlo [Umberto Hospital, La Sapienza Univ., Rome (Italy); Chiappino, Dante [Pasquinucci Hospital, Massa (Italy); Midiri, Massimo [DIBIMEL, Univ. of Palermo (Italy); Simonetti, Giovanni [Tor Vergata Univ., Rome (Italy); Marchisio, Filippo [Univ. of Turin (Italy); Olivetti, Lucio [Istituti Ospitalieri of Cremona (Italy); Fattori, Rossella [Orsola University Hospital, Bologna (Italy); Bonomo, Lorenzo [Gemelli Hospital, Catholic Univ., Rome (Italy)

    2009-05-15

    This was a prospective, multicenter study designed to evaluate the utility of MDCT in the diagnosis of coronary artery disease (CAD) in patients scheduled for elective coronary angiography (CA) using different MDCT systems from different manufacturers. Twenty national sites prospectively enrolled 367 patients between July 2004 and June 2006. Computed tomography (CT) was performed using a standardized/optimized scan protocol for each type of MDCT system ({>=}16 slices) and compared with quantitative CA performed within 2 weeks of MDCT. A total of 284 patients (81%) were studied by 16-slice MDCT systems, while 66 patients (19%) by 64-slice MDCT scanners. The primary analysis was on-site/off-site evaluation of the negative predictive value (NPV) on a per-patient basis. Secondary analyses included on-site evaluation on a per-artery and per-segment basis. On-site evaluation included 327 patients (CAD prevalence 58%). NPV, positive predictive value (PPV), sensitivity, specificity, and diagnostic accuracy (DA) were 0.91 (95% CI 0.85-0.95), 0.91 (95% CI 0.86-0.95), 0.94 (95% CI 0.89-0.97), 0.88 (95% CI 0.81-0.93), and 0.91 (95% CI 0.88-0.94), respectively. Off-site analysis included 295 patients (CAD prevalence 56%). NPV, PPV, sensitivity, specificity, and DA were 0.73 (95% CI 0.65-0.79), 0.93 (95% CI 0.87-0.97), 0.73 (95% CI 0.65-0.79), 0.93 (95% CI 0.87-0.97), and 0.82 (95% CI 0.77-0.86), respectively. The results of this study demonstrate the utility of MDCT in excluding significant CAD even when conducted by centers with varying degrees of expertise and using different MDCT machines. (orig.)

  7. 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

  8. 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.

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

    OpenAIRE

    Behroozi, Hamid; Davoodi, Mohammad; Aghasi, Shahriar

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

  11. 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

  12. 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

  13. 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.

  14. 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

  15. CT Angiography of the Coronary Arteries

    Directory of Open Access Journals (Sweden)

    H.Ghanaati

    2005-08-01

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-10-15

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

  18. 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。

  19. Value of 64-slice spiral CT in detection of the extrahepatic artery of primary hepatocellular carcinoma%64层螺旋 CT对原发性肝癌肝外供血动脉的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王树庆; 左赞江; 宋高业; 姚斌; 杨德军; 谢柳平

    2015-01-01

    目的:探讨64层螺旋CT对原发性肝癌肝外供血动脉的诊断价值。方法回顾性分析经 DSA 证实的存在肝外供血动脉的41例肝癌患者的64层 CT 资料。分别统计 CT 和 DSA 能检出的肝癌肝外供血动脉数,将两者的结果进行 Kappa 一致性检验并分析。另总结有侧支性供血动脉的肝癌的 CT 表现特点。结果本资料75%(48/64)的肝癌肝外供血动脉能够通过 CT 正确检出。CT 与 DSA 相比,在对肝癌肝外供血动脉的检出上一致性好(k =0.62,P <0.05)。一些常规 CT 表现特点可对肝癌存在侧支性供血动脉作出提示性诊断。CT 指导后的 DSA 提高了对肝外供血动脉的检出率。结论64层 CT 对肝癌肝外供血动脉有良好的检出能力,认真分析术前 CT 特征对肝癌的肝动脉化疗栓塞术(TACE)治疗有重要的临床意义。%Objective To investigate the value of 64-slice spiral CT in detection of extrahepatic artery of primary hepatocellular carcinoma (PHC).Methods 64-slice spiral CT data of 41 patients with PHC with extrahepatic arteries were retrospectively ana-lyzed.The number of these extrahepatic arteries was measured on CT and DSA respectively.Cohen’s Kappa test was used to deter-mine the consistency between CT and DSA.The imaging features of PHC supplied by the lateral blood vessels were also summa-rized.Results Among 64 branches of the extrahepatic arteries,48 (75%)were detected by CT.64-slice spiral CT showed a good consistency on the diagnosis of PHC extrahepatic artery with DSA.Some CT characteristics of PHC were helpful for identification of the lateral blood vessels.The DSA under CT guidance improved the detection rate of extrahepatic artery.Conclusion 64-slice spiral CT has better ability in detection of PHC extrahepatic artery and improves the detection rate.Preoperative CT palys an important role in transcatheter arterial chemoembolization treatment of PHC.

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

    Directory of Open Access Journals (Sweden)

    A. Arjmand Shabestari

    2007-05-01

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

  1. 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

  2. 64-slice Computed Tomography Assessment of Coronary Artery Stents: a Phantom Study

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-02-15

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

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

    Institute of Scientific and Technical Information of China (English)

    王振芳; 岳学旺; 毕言刚; 李飞; 张仕状

    2014-01-01

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

  4. 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

  5. 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

  6. 肺不典型腺瘤样增生64层容积 CT 表现与鉴别诊断%Pulmonary atypical adenomatous hyperplasia:64-slice volume CT findings and differential diagnosis

    Institute of Scientific and Technical Information of China (English)

    孙贞超; 李家德

    2014-01-01

    Objective To investigate the 64-slice volume CT findings and differential diagnosis of the pulmo-nary atypical adenomatous hyperplasia ( AAH) .Methods The data of 64-slice volume CT image of 12 cases of patho-logically confirmed pulmonary AAH was made retrospectively .The CT data were compared with those of the 76 cases of localized ground-glass opacity(GGO) in terms of the lesion location ,size,shape,edge signs,internal structure and relationship to adjacent structures .Results Pure ground-glass density nodules were commonly seen in AAH group , pure ground-glass density and mixed-density nodules were seen in benign group , and mixed-density nodules account for the majority in malignant group .There were statistical differences between AAH group and benign or mglignant GGO group in the aspects of lobulation sign,spicular sign,pleural indentation sign and vascular convergence sign (P0.05 ) .Conclusion Pure ground-glass density nodules are the main constituent seen in AAH group .The nodules′diameter were commonly less than 10mm.And no lobulation sign,spicular sign,pleural indentation sign or vascular convergence sign can be seen in the AAH group .It can do help in differential diagnosis analyzing the CT value of the solid component .However,only the histopathology result is the real and the last diagnosis .%目的:探讨肺不典型腺瘤样增生( AAH)的64排容积CT表现及其鉴别诊断。方法回顾性分析经手术病理确诊的AAH 12例64排容积CT影像资料,与同期确诊的76例局限性磨玻璃密度结节( GGO)患者的CT资料对比,对病灶的部位、大小、形态、边缘征象、内部结构和邻近结构关系进行评价。结果 AAH以纯GGO多见,GGO良性组纯磨玻璃密度结节和混合密度结节均可见,GGO恶性组以混合密度结节为主,分叶征、毛刺征、胸膜凹陷征及血管集束征AAH与良、恶性GGO间比较差异均有统计学意义( P<0.05),空泡征、细支气管充气

  7. 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.

  8. 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

  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. 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.

  11. 大前庭导水管综合征的64层螺旋CT诊断探讨%Discussion on 64-Slice Spiral CT Diagnosis of Large Vestibular Aqueduct Syndrome

    Institute of Scientific and Technical Information of China (English)

    车宏伟; 许茂盛; 刘俊

    2013-01-01

    目的:探讨64层螺旋CT在诊断大前庭导水管综合征的应用,以提高诊断正确率.方法:44例大前庭导水管综合征患者均行颞骨轴位薄层扫描,必要时行冠状位及斜矢状位重建.并对患者64层螺旋CT影像学表现进行分析.结果:在CT图像上44例患者,86耳(左42耳、右44耳),均不同程度显示前庭或总脚层面岩骨后缘骨质缺损影,部分骨质缺损影与前庭或总脚直接相通,前庭导水管外口和中间段宽度超过1.5 mm.结论:CT颞骨轴位薄层高分辨扫描对大前庭导水管综合征患者明确诊断具有重要临床价值,是其首选、常规的检查方法.%Objective:To discuss application of 64 slice spiral CT diagnosis of large vestibular aqueduct syndrome in order to improve diagnostic accuracy. Methods:44 patients with large vestibular aqueduct syndrome were all carried out temporal bone axial thin slice scan, coronal and oblique sagittal reconstruction if needed. And 64 slice spiral CT imaging findings of patients with large vestibular aqueduct syndrome were analyzed. Results:In CT images of 44 patients,86 ears (left ear of 42,right ear of 44) have varying degrees of showed vestibular or total foot dimensions of petrous bone posterior marginal osseous defect, bone defect and vestibular or total foot connected directly,the external aperture of vestibular aqueduct and the intermediate segment width greater than 1.5mm. Conclusion:There is an important clinical value of CT axial thin layer high resolution of temporal bone scanning to clarify a diagnosis of large vestibular aqueduct syndrome, which is the preferred, regular inspection method.

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

    International Nuclear Information System (INIS)

    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

  13. 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

  14. 64排螺旋CT低剂量筛查肾上腺肿瘤的实验研究%Screening Adrenal Tumors with 64-Slice Spiral CT in Low Dose:an Experimental Study

    Institute of Scientific and Technical Information of China (English)

    亓波; 王小红

    2011-01-01

    Objective The purpose of this study was to probe into the optimal scan param eters in low dose when sereening adrenal tumors with 64-slice spiral CT, in order to make itm ore popular in clinical application .Materials and .Methods Wehad selected 30 adrenal tumors patients ( 15 male and 15 fem ale ;between 28 and 67 years old ;mean age 38 years old ) maken a definite diagnosis in general hospital of Jilin Chemical lndustry from June 2009 to June 2010 .All of the selected adrenal tumors patients were confirmed by surgical pathology .Control group; 10 healthy volunteers.Both cases and controls were scanned on a 64-slice spiral CT under auto tube current modulation mode with com blnations of serval param eters ;noise index (NI):8/12/15/18/21/24/27/30/33;tube voltage (TV) :140 kV/120 kV/100 kV/80 kV ;rotation time (RT): 0.4 s/0.5 s.The datum were reconstructed per 0.625m m and then transferred to the ADW 4.3 workstation .Using adrenal imaging special softwate to reconstruct adrenal im aging .An radiologist who has more than 10 years work experience had scored the com prised imaging recorded doze length product (DLP) .The relations between DLP and NI/TV/RT and the relations between IQS and NI/DLP/TV/RT were analyzed through partial correlation .Results Coefficient ofpartial correlation between DLP and NI was- 0.613 (P<0.01) ;Coefficient of partial correlation between DLP and TV was 0 .198 (P>0 .05) ;Coefficient of partial correlation between DLP and RT was -0.054 (P>0.05) .Conclusion The optimal param eters of 64-slice spialCT cobnography was a com bination of 120 kV (TV) ,12 (NI) ,0.5s(RT ) under the auto tube current modulation mode .The dose of screening adrenal tum ors with w ith 64-slice spiral CT using the scan com binated patam eters was about 18.6% of fixed tube current TV ,NI and RT can be used as low dose scan param eters when screening adrenal tumors with 64-slice spiral CT.%目的 探索适用于64层螺旋CT肾上腺成像筛查肾上腺肿瘤的低

  15. 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.

  16. 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

  17. 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

  18. Value of 64-slice spiral CT with postprocessing techniques for evaluation of complications after liver transplantation%64层螺旋CT结合后处理技术对肝移植术后并发症的评估

    Institute of Scientific and Technical Information of China (English)

    丁莺; 严福华; 徐鹏举; 陈刚; 缪熙音; 曾良斌

    2011-01-01

    目的:探讨64层螺旋CT结合后处理技术在肝移植术后评估的应用价值.方法:选取50例(男40例、女10例)肝移植术后患者,行64层螺旋CT平扫、四期增强扫描及CTA检查,由两位放射科医师对图像进行评估,内容包括肝实质、血管、胆道情况及有无转移.将结果与彩超及临床随访行对照分析.结果:CT检查示:肝动脉并发症3例、门脉并发症6例、下腔静脉并发症4例、肝脏灌注不良17例、胆道并发症9例、肝脏复发8例、肺部转移5例,术后出现胸腔积液患者15例、肺部感染或肺不张者11例、腹腔积液者20例.彩超示:肝动脉显示不清、肝内动脉流速偏低者3例、门脉管腔内出现涡流者6例、胆道扩张者9例、右侧膈下或移植肝周积液者20例.结论:64层螺旋CT结合多种后处理技术,能准确客观反映肝实质、血管情况,早期发现术后并发症,提高手术成功率.%Objective : To discuss the values of 64-slice spiral CT with post-processing techniques in evaluation of post liver transplantation. Methods: Fifty patients ( 40 males,l0 females) who had received liver transplantation underwent plain scan,multiphasic contrast-enhanced scan and CTA examination. Two radiologists experienced in abdominal radiology assessed the images , including liver parenchyma , vessel, biliary complication and having or no metastasis. Findings on CT imaging were compared with those on color Doppler ultrasonography and clinical follow-up. Results : Among all the patients who received 64-slice spiral CT examination , the main findings includcd : one case with proper hepatic artery thrombosis .one case with hepatic artery stenosis,one case with proper hepatic artery pseudoaneurysm, six cases with portal vein stenosis, four cases with inferior vena cava stenosis,seventeen cases with abnormal perfusion of liver, nine cases with biliary complications , eight cases with malignant tumors recurring, five cases with pulmonary

  19. 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

  20. 64层螺旋CT对胰腺实性假乳头状瘤的诊断价值%The value of the 64-slice CT for solid-pseudopapillary tumor of pancreas

    Institute of Scientific and Technical Information of China (English)

    龙威

    2012-01-01

    目的:探讨64层螺旋CT对胰腺实性假乳头状瘤(SPTP)的诊断价值,提高对该病的认识.方法:回顾性分析9例经病理证实的SPTP的CT平扫、3期增强扫描及MPR或MIP表现.结果:9例均为女性、单发,边界清楚.5例位于胰头部,2例位于胰体部,2例位于胰尾部.7例呈类圆形,2例呈分叶状.9例均表现为囊实性肿块,1例伴有钙化.3期增强扫描,肿瘤实性成分及包膜呈渐进性强化,囊性部分无强化.结论:64层螺旋CT能准确地反映SPTP影像学特点,具有重要的诊断价值.%Objective: To study the value of the 64-slice CT for Solid-pseudopapillary tumor of pancreas (SPTP)and improve the diagnosis of SPTP. Methods:CT scan, three-phase enhanced scanning performance and MPR or MIP post-processing technology of 9 cases of SPTP proved by pathology were reviewed. Results :9 cases were women ,single tumor and had clear boundaries. 5 cases were in the head or neck of pancreas ,2 cases were in the body of pancreas ,2 cases were in the tail of pancreas ,7 cases were round or oval in shape ,2 cases showed signs of lobulation. 9 cases showed cystic and solid ,1 case had calcified tissues. In three-phase enhanceed scanning , the solid ingredients and envelope were enhanced by filling progressively except cystic part. Conclusion:the 64-slice CT can reflect the SPTP imaging characteristics and it has important diagnostic value.

  1. 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.

  2. 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

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

    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.

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

    Institute of Scientific and Technical Information of China (English)

    王强

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    黄冰; 杨玲; 桂绍高

    2014-01-01

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

  6. 64排容积CT后处理技术对输尿管梗阻的诊断%64-slice volume CT post-processing techniques for the diagnosis of ureteral obstruction

    Institute of Scientific and Technical Information of China (English)

    万书友; 侯明杰; 杜灵艳

    2014-01-01

    Objective To investigate the diagnostic value of post-processing technique for ureteral obstruction. Methods All cases were confirmed by surgery or clinical data. 64-slice volume CT (VCT) was performed in 90 cases with ureteral obstruction. The volume data of all patients were reconstructed with 3D reconstruction techniques in-cluding multiple planar reformation (MPR), and volume rendering technique (VR), and curved planar reformation (CPR). Results Among the 90 cases,there were 78 cases of ureteral calculus, 4 ureteral and bladder carcinomas, 2 congenital malformations,and 1 inflammatory stenosis. Conclusion 64-slice VCT and post-processing technique have unique advantage for the etiology and level diagnosis of ureteral obstruction ,which have important significance for clinical treatment programs.%目的:探讨64排螺旋CT后处理技术对输尿管梗阻的诊断价值。方法选取我院2010年6至2013年6月间90例经临床确诊输尿管梗阻病例,所有病例均行64排容积CT扫描并进行多平面重建(multipla-nar reformatting,MPR)、容积重建(volume rendering technique,VR)、曲面重建(curved planar reformation,CPR)等处理。结果90例输尿管梗阻中78例由于输尿管结石所致,邻近器官压迫5例,输尿管癌或膀胱癌4例,先天畸形2例,输尿管炎1例。结论64排容积CT平扫及多种后处理技术对输尿管梗阻病因及定位诊断具有很高的临床应用价值,对临床治疗方案的选择具有重要指导意义。

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

    Institute of Scientific and Technical Information of China (English)

    蔡胜艳; 孙妍; 胡嘉航

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    朱刚明; 谭琦碹; 钟胜; 李兆勇; 付东

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王秋霞; 陈亮; 黄文华; 胡道予

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

  11. 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.

  12. 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

  13. 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

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

    Institute of Scientific and Technical Information of China (English)

    胡敏霞; 赵心明; 宋俊峰; 周纯武; 赵红枫

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

  16. 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

  17. 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

    International Nuclear Information System (INIS)

    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

  18. Application of three-dimensional reconstruction based on 64-slice spiral CT scanning in the diagnosis and preoperative evaluation of neonatal type (Ⅲ) congenital esophageal atresia%64排CT三维重建在新生儿(Ⅲ)型食道闭锁诊断和术前评估中的应用价值

    Institute of Scientific and Technical Information of China (English)

    李春; 陈启雄; 余加林; 张先红

    2014-01-01

    目的:研究64排CT三维重建在新生儿型食道闭锁诊断和术前评估中的应用价值。方法回顾性分析56例先天性食道闭锁患儿的64排CT影像学资料,并与食道造影及手术结果进行对照研究。结果56例患儿均行食道造影及64排CT三维重建,其中35例食道闭锁型患儿接受手术治疗。64排CT食道重建及食道造影在先天性食道闭锁的诊断符合率相近,并能准确显示瘘口位置。35例患儿64排CT三维重建与手术所见食管两盲端距离吻合。结论64排CT三维重建在显示和评价型闭锁食管两盲端距离和瘘口位置是可靠的,可为新生儿型食道闭锁术前估计与制定合适的手术方案提供更加可靠的影像学依据。%Objective To study the clinical value of 3-dimensional (3D) reconstruction based on 64-slice spiral CT scanning data in diagnosis and preoperative evaluation of neonatal type  congenital esophageal atresia (CEA). Methods The 64-slice spiral CT data of 56 cases with CEA were analyzed retrospectively and correlated to the findings of esophagography and surgery.Results 56 cases were examined by 64-slice spiral CT and esophagography, and 35 cases of type  CEA undergo operation therapy.The rate of coincidence of diagnostic between 64-slice spiral CT and esophagography was getting very close, and 64-slice spiral CT can clearly reveal the orifice of fistula. Among 35 cases,the distance between the two esophageal extremes of 64-slice spiral CT scanning were coincided with operative findings.Conclusions 64 slice spiral CT 3-D reconstruction is a reliable technique for showing and assessing the distance between the two esophageal pouches,and position of fistula in CEA,and can afford the reliable evidence in the preoperative assessment of neonatal type  CEA and accurate establishment of surgical plan.

  19. The Diagnostic Value of Warthin Tumor in Parotid Gland at 64-slice Spiral CT%64层螺旋CT对腮腺Warthin瘤的诊断价值

    Institute of Scientific and Technical Information of China (English)

    朱刚明; 谭琦瑄; 李扬彬; 刘晓; 李兆勇

    2011-01-01

    目的 研究分析腮腺Warthin瘤的多层螺旋CT影像表现,探讨64层螺旋CT对腮腺Warthin瘤的诊断价值及合理扫描方案.资料与方法 回顾性分析15例经手术及组织学病理证实的腮腺Warthin瘤的CT平扫及两期增强表现.结果 15例腮腺Warthin瘤患者中7例单侧发病,8例双侧发病,总共26个病灶;位于腮腺浅叶后下部22个,其他部位4个;20个病灶呈结节状,径线范围为0.8~4cm;其中23个边界清楚,12个密度均匀,14个病灶内见囊变区,3个病灶内可见钙化.两期增强扫描中动脉期各病灶呈中度至明显强化,静脉期21例病灶密度降低,5例与动脉期相近,病灶内囊变区两期增强均未见强化.结论 64层螺旋CT对于腮腺Warthin瘤的诊断具有很强的实用性,合理的扫描方案能提高该疾病的诊断准确率.%Purpose To analyze multi-slice spiral CT images of parotid Warthin tumor, and investigate its diagnostic value and make a reasonable scan protocol. Materials and Methods The plain and two-phase enhanced CT characteristics of 15 cases of Warthin tumor confirmed by surgery and histological pathology were retrospectively analyzed. Results There were total 26 lesions in 15 cases, 7 cases with lesions in unilateral side and 8 cases in bilateral sides. 22 lesions located in the superficial lobe, 4 lesions in other parts. 20 lesions were nodular, the diameters were in the range between 0.8 ~ 4cm. 23 lesions were clear boundary, 12 lesions were homogeneous. Cystic areas were found in 14 lesions and calcification in 3 lesions. All lesions showed significantly enhancement in the arterial phase. The density of 21 lesions were decreased in vein phase, 5 lesions had similar density to that in the arterial phase. Cystic areas were not enhanced in both phases. Conclusion 64-slice spiral CT is useful in the diagnosis and differential diagnosis of Warthin tumor. Making a reasonable scan protocol can improve accuracy of the diagnosis and differential

  20. Coronary CT angiography and MR angiography of Kawasaki disease

    International Nuclear Information System (INIS)

    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.)

  1. 64排螺旋CT三维重建技术在颌骨埋伏阻生牙定位中的应用价值%Application Value of Three-dimensional Reconstruction Technique of 64-slice Spiral CT in Diagnosis of Impacted Teeth within Jaw Bone

    Institute of Scientific and Technical Information of China (English)

    谢友扬; 潘功茂; 施君; 孟庆乐; 夏云宝

    2012-01-01

    目的:探讨64排螺旋CT三维重建技术对颔骨内埋伏阻生牙的定位及临床应用价值.方法:对33例临床疑似埋伏阻生牙患者行64排螺旋CT容积扫描,利用GEAW4.4工作站对数据进行多平面重组(MPR)、容积再现技术(VRT)重组图像.结果:33例阻生牙患者中,切牙8颗,侧切牙5颗,尖牙11颗,第三磨牙5颗,多生牙9颗.结论:64排螺旋CT三维重建能准确显示颔骨内埋伏阻生牙及多生牙的数量、位置、形态及萌出方向,为临床提供可靠的指导信息.%Objective To discuss the value of three-diniensiona)(3D) reconstruction technique of 64-slice spiral CT in the diagnosis of impacted teeth within the jaw bone, Methods Thirty-three suspected eases of impacted teeth were examined by 64-slice CT volume scan. The acquired data were processed by multi-planar reconstruction(MPR), volume rendering technique(VRT) using GEAW4.4 workstation. Results Impacted teeth consisted of 8 centra! incisors, 5 lateral incisors, 11 canine teeth, 5 cranters and 9 accessory teeth were detected from all the 33 patients. Conclusion The 3D reconstruction technique of 64-slice spiral CT could display the details of impacted teeth, including the shape, location and eruption orientation. It can provide valuable information for diagnosis.[Chinese Medical Equipment Journal.2012,33(5):76-77

  2. 64排螺旋CT血管造影诊断颅内动脉瘤%DIAGNOSIS OF INTRACRANIAL ANEURYSM WITH 64-SLICE SPIRAL CT ANGIOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    钱惠农; 王有刚; 朱蕴杰; 姜峰

    2009-01-01

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

  3. 64排螺旋CT血管成像诊断永存三叉动脉%Diagnosis of persistent trigeminal artery with 64-slice spiral CT angiography

    Institute of Scientific and Technical Information of China (English)

    袁飞; 刘银社; 赵军; 谷鹏; 顾欣; 冯凯琳

    2010-01-01

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

  4. 64层螺旋CT评价膝关节创伤后的隐匿病变及软组织损伤%Evaluation of the occult lesions and soft tissue injury after knee injury by 64-slice spiral CT

    Institute of Scientific and Technical Information of China (English)

    钟俊; 杨法宝; 赵学航; 张丽; 李勤祥

    2012-01-01

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

  5. 64层螺旋CT冠状动脉成像筛查中老年人冠状动脉粥样硬化的价值%Value of 64-slice spiral CT coronary artery imaging to screening examination of coronary atherosclerosis in middle-aged and senile patients

    Institute of Scientific and Technical Information of China (English)

    徐元昌; 周维彬; 唐娟; 邓娟

    2015-01-01

    Objective To analyze the incidence rate of coronary atherosclerosis (CA) in middle-aged and senile people and the relation between high-risk factors and CA by means of 64-slice spiral CT coronary artery imaging .Methods Total 2738 middle-aged and senile people without history of coronary heart disease ( CHD) were provided with 64-slice spiral CT coronary artery imaging examination, and the results were analyzed statistically .Results Among the 2738 people, 2512 vessels with CA in 735 patients were found;the incidence rate became higher with the increase of age and it was also higher in the patients smoking and drinking for a long time and those with hypertension and high blood fat .Conclusion 64-slice spiral CT coronary artery imaging has important value to early diagnosis and treatment of CA in middle-aged and senile people .%目的:通过64层螺旋CT冠状动脉成像检查,分析冠状动脉粥样硬化在中老年人群的发病率及高危因子与冠状动脉粥样硬化的相关性。方法对2738例无冠心病病史的中老年人进行64层螺旋CT冠状动脉成像检查,对检查结果进行统计学分析。结果2738例中,共发现冠状动脉粥样硬化735例2512支血管;随着年龄增加发病率增高,长期吸烟、嗜酒、高血压、高血脂者冠状动脉粥样硬化发病率高。结论对中老年人群开展64层螺旋CT冠状动脉成像检查,对冠状动脉粥样硬化的早诊断、早治疗有着重要的价值。

  6. 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.

  7. 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.

  8. The Application of Automatic Tracking and Manually Trigger Technology in Head and Neck 64-slice Spiral CT Angiograph%64排螺旋CT头颈联合CTA成像中自动跟踪与手动触发技术的应用

    Institute of Scientific and Technical Information of China (English)

    叶佳国; 邹才盛; 黄广仁

    2014-01-01

    Objective:To investigate the effect of image quality between automatic tracking and manually trigger technology in head and neck 64-slice spiral CT angiography.Method:100 patients underwent CT head and neck angiography were randomly divided into the group A and the group B,50 cases in each group.Group A:when the mean CT value of region of interest(ROI) determined in the top of the aortic arch reached the threshold preset value(threshold 90 HU),the computer started a scanning automatically.Group B:after contrast injection,when the contrast appeared in the top of the aortic arch, the scan was started manually.Analyzed the image quality,recorded the time from contrast injection to scan, excluding the unsuccessful and poor display of images.The mean CT value of the top of the aortic arch,the C5 segment of the carotid bifurcation,the C1 segment of the internal carotid artery and middle cerebral artery were measured.Result:The image quality of group B was better than group A,the difference was statistically significant(χ²=6.205,P=0.044). The monitoring time in group B was (13.32±1.63)s,it was significantly less than (14.24±1.73)s in group A,the difference was statistically significant(P=0.007).The average CT value of aortic arch was significantly lower than the group A(P0.05).Conclusion:The satisfactory images can easier obtain using the manually trigger technology than automatic tracking,and save time.%目的:探讨自动跟踪与手动触发技术在Philips 64排螺旋CT对头颈联合CTA成像图像质量的影响。方法:将接受头颈联合CTA检查的100例患者按照随机数字表法分为A组和B组各50例。A组于监控层面主动脉弓层感兴趣区域CT值达阈值(阈值设定为90 HU)后自动跟踪智能触发扫描。B组在对比剂开始注射后观察监控层主动脉弓层对比剂的增强程度,当观察到对比剂开始进入监控层时按下手动按钮触发扫描。统计分析两组的图像质量、记录监控时间

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

    International Nuclear Information System (INIS)

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

  10. 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

  11. 2型糖尿病患者冠状动脉粥样硬化与视网膜病变的关系%Relationship Between Retinopathy and Coronary Atherosclerosis Determined by Coronary 64-Slice Multidetector Computed Tomography Angiography in Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    魏富春; 戎健; 陈玉群; 干雪梅; 于长青; 陈静; 杨沛; 陈金华

    2013-01-01

    Aim To evaluate the relationship between diabetic retinopathy (DR) and subclinical coronary atherosclerosis (CAs) on coronary 64-slice multidetector computed tomography angiography (MDCT) in individuals with type 2 diabetes mellitus.Methods From July 2007 to December 2009,114 and 124 type 2 diabetic patients with and without CAs were enrolled.They received fundus photochromy,coronary 64-slice multidetector computed tomography angiography,physical examination,and measurement of fasting plasma glucose (FPG),glycosylated haemoglobin (HbAlc),plasma lipid profile,estimated glomerular filtration rate (eGFR) and urinary albumin excretion rate (UAER).Then the analysis of the relationship among the detection and measurement outcomes were conducted.Results Diabetic patients with CAs had a higher prevalence of DR than those without CAs (67.5% vs 33.1%,P < 0.001).After adjustment for the traditional risk factors for cardiovascular disease,CAs was independently associated with DR (OR =5.0,95% CI 2.6~ 9.8).There was significant difference in the prevalence of CAs by the number of CAs vessels among patients without DR (NDR),those with pre-proliferative retinopathy (pre-PDR) and those with proliferative retinopathy (PDR) (P <0.01).The prevalences for CAs,the prevalences of CAs ≥3 vessels involved by plaque,and proportions of vessels with significant coronary plaque and of involved vessels in all detected coronary arteries were significantly increased with the presence and severity of DR (NDR vs Pre-PDR,Pre-PDR vs PDR,P < 0.01 for each).Conclusions The severity and extent of CAs were significantly increased with the incidence and progression of DR,and much of CAs and DR could be still multifactoral with common pathway.%目的 采用64层螺旋CT血管造影(MDCT),探讨2型糖尿病患者冠状动脉粥样硬化(CAs)与糖尿病视网膜病变(DR)的关系.方法 诊断为CAs的2型糖尿病患者114例,无CAs的患者124例,受试者均进行眼底彩色照相

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    陈殿森; 陈望; 滑炎卿

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

  16. Usefulness of CT angiography for demonstrating cerebral aneurysm

    International Nuclear Information System (INIS)

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

  17. 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.

  18. 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

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

    International Nuclear Information System (INIS)

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

  20. 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

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

    International Nuclear Information System (INIS)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    周旭; 王建中; 刘骏桢

    2013-01-01

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

  3. 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

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

    Institute of Scientific and Technical Information of China (English)

    朱新勇; 方驰华; 鲍苏苏; 全显跃; 焦培峰; 钟世镇

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    薛波; 高国波; 李勇; 张立军; 李昌晓

    2013-01-01

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

  6. 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.

  7. 64 slice-coronary computed tomography sensitivity and specificity in the evaluation of coronary artery bypass graft stenosis: A meta-analysis.

    Science.gov (United States)

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

    2016-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

  9. CT Angiography in the Diagnosis of Brain Death

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  11. CT angiography versus intraarterial DSA in abdominal aortic aneurysms; CT-Angiographie versus intraarterielle DSA bei Bauchaortenaneurysmen

    Energy Technology Data Exchange (ETDEWEB)

    Rieker, O. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Dueber, C. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Schmiedt, W. [Klinik fuer Herz-, Thorax- und Gefaesschirurgie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Neufang, A. [Klinik fuer Herz-, Thorax- und Gefaesschirurgie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Pittow, M. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Schweden, F. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany)

    1996-07-01

    To evaluate if CT angiography is able to image all features necessary for the preoperative planning of abdominal aortic aneurysms (accessory renal arteries, stenoses or occlusions of renal and iliac arteries, patency of inferior mesentric artery). CT angiography and DSA were performed on 27 patients with abdominal aortic aneurysms. CT angiography was performed using a protocol that covered the abdominal aorta and the pelvic arteries with a single spiral acquisition (contrast dose: 150 ml, collimation: 5 mm, table feed: 7.5 mm/s, increment of reconstruction: 2 mm). Maximum intensity projections (MIP) and axial scans were compared with the results of intraarterial DSA. Using axial scans and subvolume MIP, CTA accurately defined 7/8 accessory renal arteries, 13/13 occlusions and 9/12 high grade stenoses of renal and pelvic arteries. High-grade stenoses of the iliac arteries were underestimated in two cases and overlooked in one case. CT angiography was superior to DSA in imaging the inferior mesenteric artery. CT angiography precisely diagnosed 33 aneurysms of the iliac, renal and coeliac arteries. CT angiography using a single administration of intravenous contrast may replace preoperative DSA in most cases of abdominal aortic aneurysm. (orig.) [Deutsch] Ziel dieser Studie war es zu pruefen, ob mit der CT-Angiographie die fuer die praeoperative Planung von Bauchaortenaneurysmen relevanten Gefaessveraenderungen darstelbar sind (Akzessorische Nierenarterien, Nierenarterienstenosen, A. mesenterica inferior, Beckenarterien). Die CT-Angiographien wurden mit einem Protokoll durchgefuehrt, das die Bauchaorta und die Beckenarterien bis zur Leiste mit einer einzigen Spiralakquisition erfasst (150 ml Kontrastmittel, Kollimation: 5 mm, Tischvorschub: 7,5 mm/s, Rekonstruktionsintervall: 2 mm). Die Befunde aus Maximum-Intensitaets-Projektionen (MIP) und den axialen Schnittbildern wurden mit den Befunden der intraarteriellen DSA bei 27 Patienten verglichen. Bei Hinzuziehung von

  12. Assessment of 82 Live Potential Renal Donors with Multi Detector Row Helical CT Angiography (MDCTA

    Directory of Open Access Journals (Sweden)

    R. Javadrashid

    2008-01-01

    Full Text Available Background/Objective: To retrospectively review the authors' experience with multi-detector row helical computed tomography (CT in assessing 82 consecu-tive alive potential renal donors."nPatients and Methods: Eighty-two potential renal donors underwent multi-detector row CT assess-ment, using a 64-slice scanner (Somatom Sensation, Siemens with 0.6-mm slice thickness followed by maximum intensity projection and volume rendering techniques post-processing algorithms. Arterial phase and venous phase examinations were performed. De-layed tomograms were acquired to visualize the col-lecting system anatomy. Two vascular radiologists prospectively interpreted the multi-detector row CT images. Forty candidates subsequently underwent donor nephrectomy. Surgical findings served as the reference standard for 40 kidneys. The imaging find-ings in all 82 candidates (164 kidneys were reviewed, although these findings were considered observa-tional data only because there was no reference stan-dard for 124 kidneys."nResults: Identification of vascular anomalies was best on direct viewing of the axial images using interactive scrolling through the images and cine-loop paging. In 164 kidneys evaluated, a single renal artery was pre-sent in 74.5% and a single renal vein in 87.5%. Mul-tiple renal arteries were more common on the right side (37.8% vs. the left side (20.7%. Early branching of the arteries was seen with equal frequency (10% on either side. Multiple renal veins were more often on the right side (20% vs. the left side (5%. CT an-giographic findings were concordant with the intra-operative findings in 100% of the cases that under-went nephrectomy. CT also revealed cortical cysts (four cases, duplex collecting system (two cases, hy-dronephrosis (one case, renal stone (one case, and liver hemangiomas (two cases. There was no signifi-cant interobserver disagreement between the vascular radiologists."nConclusion: CT angiography is highly accurate for

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

    International Nuclear Information System (INIS)

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

  14. 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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-05-01

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

  17. 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.

  18. 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

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

    International Nuclear Information System (INIS)

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

  20. 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.

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

    International Nuclear Information System (INIS)

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

  2. 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.

  3. Preoperative CT angiography reduces surgery time in perforator flap reconstruction

    NARCIS (Netherlands)

    Smit, Jeroen M.; Dimopoulou, Angeliki; Liss, Anders G.; Zeebregts, Clark J.; Kildal, Morten; Whitaker, Iain S.; Magnusson, Anders; Acosta, Rafael

    2009-01-01

    The use of perforator flaps in breast reconstructions has increased considerably in the past decade. A disadvantage of the perforator flap is difficult dissection, which results in a longer procedure. During spring 2006, we introduced CT angiography (CTA) as part of the diagnostic work-up in perfora

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-11-01

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

  5. 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

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

    International Nuclear Information System (INIS)

    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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  8. 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

  9. 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 ...

  10. 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

    OpenAIRE

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

    2011-01-01

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

  11. 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

    OpenAIRE

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

    2011-01-01

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

  12. 64层螺旋CT血管造影在蛛网膜下腔出血诊断的临床运用%Clinical application of 64-slices spiral CT angiography in diagnosing subarachnoid haemorrhage

    Institute of Scientific and Technical Information of China (English)

    苏海; 孙晓川; 朱继; 唐文渊

    2007-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杜忆兵; 闫宇涛; 王晓辉; 陆利霞

    2009-01-01

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

  14. 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.

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

    International Nuclear Information System (INIS)

    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

  16. The value of mental intervention in 64-line spiral CT for coronary angiography%心理干预在64排螺旋CT冠状动脉造影中的应用价值

    Institute of Scientific and Technical Information of China (English)

    孙倩; 胡修媚; 谢延平; 朱建凤

    2008-01-01

    Objective To evaluate the value of mental intervention in 64-slice spiral CT for coronary angiography. Methods 60 patients who suspected coronary artery stenosis were divided into two groups at random (the mental intervention group and the routine group, with 30 cases in each group). The quality of coronary imaging was assessed as excellent, good and bad according to ACC1999 by two experienced doctors. The results of the two groups were calculated by statistical analysis. Results The image quality of the mental intervention group includes: excellent 72 cases, good 15 cases, and bad 3 cases; and the image quality of the routine group includes: excellent 48 cases, good 12 cases, and bad 30 cases, respectively. The quality of imaging in the mental intervention group was obviously superior to the routine group, and there was significant difference between the two groups (P<0.05). Conclusions In 64-slice spiral CT for coronary angiography, mental intervention can raise the achievement ratio of examination and improve the image quality of coronary artery. It is the essential for the success of the 64-slice spiral CT coronary angiography.%目的 评价心理干预在64排螺旋CT冠状动脉造影中的应用价值.方法 将60例患者随机分为心理干预组和常规组各30例,采用双盲法由2名高年资医生参照冠状动脉标准分段法(ACC1999)对冠状动脉进行分段评价,以"优"、"良"、"差"三个级别评价冠状动脉图像质量,对两组评价结果 进行统计分析.结果 心理干预组图像质量优72例,良15例,差3例,常规组优48例,良12例,差30例,心理干预组图像质量明显优于常规组,两组间比较差异有统计学意义(P<0.05).结论 对患者进行必要的心理干预,可显著提高检查成功率和改善冠脉图像质量,是64排螺旋CT冠状动脉造影检查成功的重要保证.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

  18. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-15

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

  20. 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.)

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

    International Nuclear Information System (INIS)

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

  2. 320-detector row CT coronary angiography in patients with arrhythmia

    International Nuclear Information System (INIS)

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

  3. 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

  4. 3D Multislice CT Angiography in Post-Aortic Stent Grafting: A Pictorial Essay

    International Nuclear Information System (INIS)

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

  5. 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.)

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  7. 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.

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

    International Nuclear Information System (INIS)

    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.)

  9. 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.)

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

    Directory of Open Access Journals (Sweden)

    M. Noaparast

    2011-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  12. 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.

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

    International Nuclear Information System (INIS)

    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.

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

    International Nuclear Information System (INIS)

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

  15. 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

  16. 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.

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2011-11-01

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

  20. ECG gated tomographic reconstruction for 3-D rotational coronary angiography

    Science.gov (United States)

    Hu, Yining; Xie, Lizhe; Nunes, Jean Claude; Bellanger, Jean Jacques; Bedossa, Marc; Toumoulin, Christine

    2010-01-01

    A method is proposed for 3-D reconstruction of coronary from a limited number of projections in rotational angiography. A Bayesian maximum a posteriori (MAP) estimation is applied with a Poisson distributed projection to reconstruct the 3D coronary tree at a given instant of the cardiac cycle. Several regularizers are investigated L0-norm, L1 and L2 -norm in order to take into account the sparsity of the data. Evaluations are reported on simulated data obtained from a 3D dynamic sequence acquired on a 64-slice GE LightSpeed CT scan. A performance study is conducted to evaluate the quality of the reconstruction of the structures. PMID:21096844

  1. 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

  2. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  4. Pancreatic pseudoaneurysm in a child with hereditary pancreatitis: diagnosis with multidetector CT angiography

    International Nuclear Information System (INIS)

    Pseudoaneurysm formation is a serious vascular complication of pancreatitis. It most commonly affects splenic and gastroduodenal arteries. We report a rare case of superior mesenteric artery pseudoaneurysm in a child with hereditary pancreatitis. Multidetector CT angiography allowed the comprehensive assessment of the aneurysm and allowed accurate surgical planning obviating the need for catheter angiography. (orig.)

  5. Assessment of feasibility of endovascular treatment of ruptured intracranial aneurysms with 16-detector row CT angiography

    NARCIS (Netherlands)

    M. van der Jagt (Mathieu); H.Z. Flach (Zwenneke); H.L.J. Tanghe (Hervé); S.L.M. Bakker (Stef); M.G.M. Hunink (Myriam); P.J. Koudstaal (Peter Jan); A. van der Lugt (Aad)

    2008-01-01

    textabstractBackground: It is unclear whether 16-detector row CT angiography (CTA) can replace digital subtraction angiography (DSA) to assess the feasibility of endovascular treatment (EVT) in the acute phase after aneurysmal subarachnoid hemorrhage. Methods: We studied 80 consecutive patients with

  6. Generalised brain edema and brain infarct in ergotamine abuse: Visualization by CT, MR and angiography

    International Nuclear Information System (INIS)

    Abuse of ergotamine can release a generalised brain edema and brain infarctions. This can be visualized by CT, MR and angiography. The reason, however, can only be found in the patients history. (orig.)

  7. 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.)

  8. 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.

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

    International Nuclear Information System (INIS)

    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

  10. 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.

  11. CT ANGIOGRAPHY EVALUATION OF PERIPHERAL VASCULAR DISEASE AND COMPARISON WITH COLOR DOPPLER ULTRASOUND

    Directory of Open Access Journals (Sweden)

    Sathyabhuwan Singh

    2015-10-01

    Full Text Available I NTRODUCTION: Peripheral vascular disease is narrowing or occlusion of arteries and comprises of atherosclerosis, burger,s disease, Renoud,s disease and aneurysm. DSA, CT angiography and color Doppler ultrasound are the radiological modalities used for these diseases. Here we compared role of the CT angiography and Color Doppler ultrasonography in detection of peripheral vascular disease. AIMS AND OBJECTIVE: To assess the role of CT angiography in peripheral vascular disease and comparison with color Doppler ultrasound. MATERIAL AND METHOD: we examined 50 patients by CT angiography and color Doppler ultrasound who were suspected for arterial disease. We divided the disease on the ground of severity as follows: No stenosis - grade - 0, 0 - 25% stenosis - grade - 1 , 25 - 50% stenosis - grade - 2, 50 - 75 % stenosis - grade - 3 and 75 - 100% stenosis - grade - 4. We compared the two modalities in terms of diagnosis and grading of peripheral vascular disease . RESULT: We found Color Doppler ultrasound detected more number of normal vessel segment, gra de - 1 and grade - 2 stenosis. In stenosis grade - 3 and grade - 4 CT angiography and Color Doppler ultrasound are equally sensitive. CONCLUSION: Doppler sonography is better than CT angiography in the diagnosis of early onset ( Grade I & II cases, with a better a ssessment of soft plaques, segmental flow and re - canalisation in peripheral arterial disease. CDUS is the initial modality of choice in any case of peripheral arterial disease. CT angiography is more accurate in assessing grade - 3 and grade - 4 stenosis. CT a ngiography exceeds the color Doppler in detecting vascular lesions in cases of gas gangrene and thick patients.

  12. 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.

  13. Radiation Dose and Image Quality at High-Pitch CT Angiography of the Aorta : Intraindividual and Interindividual Comparisons With Conventional CT Angiography

    NARCIS (Netherlands)

    Apfaltrer, Paul; Hanna, E. Lexworth; Schoepf, U. Joseph; Spears, J. Reid; Schoenberg, Stefan O.; Fink, Christian; Vliegenthart, Rozemarijn

    2012-01-01

    OBJECTIVE. The objective of our study was to evaluate radiation dose and quantitative image quality parameters at high-pitch CT angiography (CTA) of the aorta compared with conventional CTA. MATERIALS AND METHODS. We studied the examinations of 110 patients (65 men and 45 women; mean age +/- SD, 64

  14. 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

  15. CT coronary angiography in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    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 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.)

  16. Computed tomography angiography of lower extremities in the emergency room for evaluation of patients with gunshot wounds

    Energy Technology Data Exchange (ETDEWEB)

    Adibi, Ali; Plotnik, Adam N.; Mohajer, Kiyarash; Arellano, Cesar; Ruehm, Stefan G. [University of California, Diagnostic Cardiovascular Imaging, Department of Radiological Sciences, Los Angeles, CA (United States); Krishnam, Mayil S.; Dissanayake, Sumudu [University of California, Cardiovascular and Thoracic Imaging, Department of Radiology, Irvine, CA (United States)

    2014-07-15

    To assess the role of CT angiography in the evaluation of patients with lower extremity gunshot wounds in the emergency room. Eighty patients (73 male, 7 female, mean age 26 years) underwent CT angiography for the evaluation of lower extremity gunshot injuries. Imaging was conducted on the basis of standardized protocols utilizing 16-slice and 64-slice multidetector systems and images were qualitatively graded and assessed for various forms of arterial injury. CT angiography findings indicative of arterial injury were observed in 24 patients (30 %) and a total of 43 arterial injuries were noted; the most common form was focal narrowing/spasm (n = 16, 37.2 %); the most common artery involved was the superficial femoral artery (n = 12, 50 %). In qualitative assessment of images based on a 4-point grading system, both readers considered CT angiography diagnostically excellent (grade 4) in most cases. Surgical findings were consistent with CT angiography and follow-up of patients' medical records showed no arterial injuries in patients with normal findings on initial imaging. Our findings demonstrate that CT angiography is an effective imaging modality for evaluation of lower extremity gunshot wounds and could help limit more invasive procedures such as catheter angiography to a select group of patients. (orig.)

  17. 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.)

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

    International Nuclear Information System (INIS)

    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 R2 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 (R2 = 0.58) was superior to patient characteristics and non-contrast CT alone (R2 = 0.44) and to addition of CTA alone (R2 = 0.55) or CTP alone (R2 = 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.)

  19. 肋软骨骨折的64层螺旋CT诊断价值分析%Diagnostic value analysis of 64-slice spiral computed tomography in Costal Cartilage Fractures

    Institute of Scientific and Technical Information of China (English)

    周超; 李凤英; 汪云超

    2012-01-01

    Objective To discuss the value of 64-slice spiral CT in diagnosing costal cartilage fracture so as to improve the level of imaging diagnosis. Method Three-dimensional images of 64-slice computed tomography in 28 patients with fracture in costal cartilage were analyzed,and compared with chest plain film and axial CT images. Results In 28 patients, 33 costal cartilage fractures were found with three-dimensional images of 64-slice computed tomography; 23 patients with X-ray, 9 patients with axial CT images did not show costal cartilage fracture.Conclusion Three-dimensional images of 64-slice computed tomography were better than plain film and CT axial scans in costal cartilage fracture, it may be considered as the best imaging method in detecting the costal cartilage fracture.%目的 探讨64层螺旋CT在肋软骨骨折诊断中的价值,提高诊断水平.方法 回顾性分析28例肋软骨骨折患者的64层螺旋CT三维重组图像,并与X线平片CT直接扫描横断位图像对照.结果 28例患者中64层螺旋CT三维重组图像发现肋软骨骨折33处,23例X线平片、9例CT直接横断位图像未显示.结论 64层螺旋CT对肋软骨骨折的显示优于普通X线平片及常规CT胸部横断位图像,可望成为检测肋软骨骨折的最佳影像学检查手段.

  20. 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.

  1. 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)

  2. 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.

  3. 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.)

  4. 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.

  5. 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.

  6. 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.

  7. Angiography

    International Nuclear Information System (INIS)

    The history of angiography is short, with its centennial approaching. A very brief review of milestones begins with the discovery of x-rays in 1895. Only a few months later contrast agents too toxic for human use were being injected into cadavers, severed limbs, and animals. The next major developments came in the late 1970s when percutaneous translumbar aortography and cerebral angiography were described. Contrast agents were now less toxic, and clinically useful angiography was a reality. In 1953 a technique for percutaneous vascular catheterization which formed the basis of many catheterization techniques to follow was described. In the 1970s the development of less invasive diagnostic methods such as computed tomography and diagnostic ultrasound decreased the indications for angiography, but newer interventional techniques such as embolization therapy and angioplasty have taken up the slack. Angiography remains the most important way to demonstrate vascular diseases graphically. Specific techniques such as angioplasty and digital subtraction angiography will be dealt with in other chapters. The authors hope to provide an overview of major areas of angiographic utilization. The basic techniques of arterial puncture and catheterization have been well described elsewhere

  8. Diagnostic Accuracy and Radiation Dose of CT Coronary Angiography in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vorre, Mette Medom; Abdulla, Jawdat

    2013-01-01

    Purpose:To determine by means of a systematic review and meta-analysis the diagnostic accuracy, associated radiation dose, and technical challenges of computed tomographic (CT) coronary angiography in patients with atrial fibrillation.Materials and Methods:A systematic literature search was perfo...

  9. 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

  10. 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

  11. 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.)

  12. Detection of intracranial aneurysms with multislice CT: comparison with conventional angiography

    Energy Technology Data Exchange (ETDEWEB)

    Dammert, S.; Krings, T.; Moller-Hartmann, W.; Ueffing, E.; Mull, M.; Thron, A. [Department of Neuroradiology, University Hospital of the Technical University Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany); Hans, F.J. [Department of Neurosurgery, University Hospital of the Technical University Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany); Willmes, K. [Department of Neurology, University Hospital of the Technical University Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany)

    2004-06-01

    We assessed the diagnostic accuracy of multislice CT in detection of intracranial aneurysms in patients presenting with subarachnoid or intracranial haemorrhage. Multislice CT and multiplanar digital subtraction angiography (DSA) images were obtained in 50 consecutive patients presenting with subarachnoid (SAH) and/or intracranial haemorrhage and reviewed by three neuroradiologists for the number, size and site of any aneurysms. The CT data were assessed using multiplanar reformats (MPR), maximum-intensity projections (MIP), surface-shaded display (SSD) and volume-rendering (VRT). In conventional angiography 51 aneurysms were detected in 41 patients. CT angiography (CTA) showed up to 48 aneurysms in 39 patients, depending on the observer. The overall sensitivity of multislice CT was 83.3% for small (<4 mm), 90.6% for medium-size (5-12 mm) and 100% for large (>13 mm) aneurysms. The sensitivity of multislice CTA to medium-size and large intracranial aneurysm is within the upper part of the range reported for helical single-slice CT. However, as small aneurysms may not be found, DSA remains the standard technique for investigation of SAH. (orig.)

  13. Detection of intracranial aneurysms with multislice CT: comparison with conventional angiography.

    Science.gov (United States)

    Dammert, S; Krings, T; Moller-Hartmann, W; Ueffing, E; Hans, F J; Willmes, K; Mull, M; Thron, A

    2004-06-01

    We assessed the diagnostic accuracy of multislice CT in detection of intracranial aneurysms in patients presenting with subarachnoid or intracranial haemorrhage. Multislice CT and multiplanar digital subtraction angiography (DSA) images were obtained in 50 consecutive patients presenting with subarachnoid (SAH) and/or intracranial haemorrhage and reviewed by three neuroradiologists for the number, size and site of any aneurysms. The CT data were assessed using multiplanar reformats (MPR), maximum-intensity projections (MIP), surface-shaded display (SSD) and volume-rendering (VRT). In conventional angiography 51 aneurysms were detected in 41 patients. CT angiography (CTA) showed up to 48 aneurysms in 39 patients, depending on the observer. The overall sensitivity of multislice CT was 83.3% for small ( 13 mm) aneurysms. The sensitivity of multislice CTA to medium-size and large intracranial aneurysm is within the upper part of the range reported for helical single-slice CT. However, as small aneurysms may not be found, DSA remains the standard technique for investigation of SAH. PMID:15105978

  14. 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.

  15. Whole-brain dynamic CT angiography and perfusion imaging

    International Nuclear Information System (INIS)

    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.

  16. Liver hydatid cyst ruptured into the thorax: CT angiography findings of a case

    International Nuclear Information System (INIS)

    Full text: Introduction: Intrathoracic rupture of hepatic hydatid cyst is a rare but severe condition causing a spectrum of lesions to the pleura, lung parenchyma, and bronchi. Pulmonary complications result from the proximity of hydatid cysts in the liver and the diaphragm. Objectives and tasks: In this report we aimed to present computed tomography (CT) angiography findings of a case with liver hydatid cyst ruptured into the thorax. The patient underwent CT angiography examination with suspicion of pulmonary embolism. Materials and methods: A 71-year-old female patient admitted to our emergency department with complaints of severe and persistent cough. Basal region of the right hemithorax could not get breath sounds on physical examination. Chest radiography revealed the presence of consolidation-effusion. The patient was treated with antibiotherapy for pneumonia and parapneumonic effusion. Because of the clinical symptoms and chest radiograph findings persisted the patient underwent CT angiography examination with suspicion of pulmonary embolism. Results: On CT angiography images pulmonary artery and its branches were normal. There were subtotal collapse in the right middle and lower lung lobes and complicated cystic lesion that has air densities in the basal interlobar space. Another thick walled complicated cystic lesion with multiple septations and air densities was detected in the right posterior liver lobe. The right hemidiaphragm was interrupted and the right liver lobe partially herniated into the thorax cavity. Serologic tests were positive for Echinococcus granulosus and there were prior therapy history for liver cyst hydatid. The diagnostic aspiration findings were consistent with hydatid cyst lesion. Conclusion: In patients with hepatic hydatid cyst associated with persistent and severe cough, thoracic rupture of the cyst should be considered in differential diagnosis. CT angiography is fast, non-invasive and effective method in the detection of

  17. Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility

    Science.gov (United States)

    Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

    2007-03-01

    Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

  18. Coronary calcium mass scores measured by identical 64-slice MDCT scanners are comparable : a cardiac phantom study

    NARCIS (Netherlands)

    Dijkstra, Hildebrand; Greuter, Marcel J. W.; Groen, Jaap M.; Vliegenthart-Proenca, Rozemarijn; Renema, KlaasJan W. K.; de Lange, Frank; Oudkerk, Matthijs

    2010-01-01

    To assess whether absolute mass scores are comparable or differ between identical 64-slice MDCT scanners of the same manufacturer and to compare absolute mass scores to the physical mass and between scan modes using a calcified phantom. A non-moving anthropomorphic phantom with nine calcifications o

  19. 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.

  20. Digital medical technology based on 64-slice computed tomography in hepatic surgery

    Institute of Scientific and Technical Information of China (English)

    FANG Chi-hua; HUANG Yan-peng; CHEN Mian-ling; LU Chao-min; LI Xiao-feng; QIU Wen-feng

    2010-01-01

    Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery. Methods Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.Results The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.Conclusions Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.

  1. Appearance and impact of post-operative intracranial clips and coils on whole-brain CT angiography and perfusion

    International Nuclear Information System (INIS)

    Background: To evaluate the effect of vascular clips and endovascular coils placed for intracranial aneurysms and arteriovenous malformations on whole-brain computed tomography (CT) angiography and perfusion. Methods: A 320-detector row dynamic volume CT system imaged 11 patients following surgical placement of vascular clips or endovascular coils. The extent of clip and coil subtraction by automated software was evaluated using CT digital subtraction angiography and CT perfusion. Impact on CT perfusion values by retained intracranial devices was compared to age- and gender-matched controls. Results: Clip and coil subtraction on CT angiography was graded as good in 8 and moderate in 3 cases. A residual neck and additional aneurysm were noted in 1 of 11 patients. Post-procedural axial slice level CT perfusion values decreased in reliability with increasing proximity to the metallic devices secondary to beam hardening. However, the intracranial devices did not affect axial slice level CTP values of cerebral blood volume, cerebral blood flow and mean transit time outside of the level of the device. Time to peak values was globally decreased outside of the immediate vascular intervention region. Conclusions: Advances in CT technology have provided clinically useful subtraction of intracranial clips and coils. While CT perfusion values were altered in device subtraction areas and within beam hardening artifact areas; they can provide valuable postoperative information on whole-brain hemodynamics. In selected cases, the combination of CT angiography and whole-brain CT perfusion can offer an alternative to conventional angiography that is a more invasive option.

  2. 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.

  3. CT, MR, and Angiography Findings of a Solitary Fibrous Tumor of the Larynx: a Case Report

    OpenAIRE

    Chang, Suk Ki; Yoon, Dae Young; Choi, Chul Soon; Yun, Eun Joo; Seo, Young Lan; Nam, Eun suk

    2008-01-01

    This report details the CT, MR, and angiography findings of a solitary fibrous tumor involving the larynx of a 34-year-old man. A precontrast CT scan revealed a well-defined isodense mass in the submucosal region of the supraglottic larynx. The tumor appeared as a mixed intensity lesion on the T1- and T2-weighted MR images. A T2-weighted MR image showed a central, round, and low signal intensity area within the mass. For both the CT and MR images, the mass demonstrated heterogeneous enhanceme...

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

    AIM: The purpose of this study was to compare the diagnostic accuracy of biphasic multi-detector row helical computed tomography (MDCT), digital subtraction angiography (DSA)and Lipiodol computed tomography (CT) in detection of hypervascular hepatocellular carcinoma (HCC).METHODS: Twenty-eight patients with nodular HCC underwent biphasic MDCT examination: hepatic arterial phase (HAP) 25 s and portal venous phase (PVP) 70 s after injection of the contrast medium (1.5 mL/kg). They also underwent hepatic angiography and intra-arterial infusion of iodized oil. Lipiodol CT was performed 3-4 wk after infusion. MDCT images were compared with DSA and Lipiodol CT images for detection of hepatic nodules.RESULTS: The three imaging techniques had the same sensitivity in detecting nodules >20 mm in diameter. There was no significant difference in the sensitivity among HAP-MDCT, Lipiodol CT and DSA for nodules of 10-20 mm in diameter. For the nodules <10 mm in diameter, HAP-MDCT identified 47, Lipiodol CT detected 27 (X2= 11.3, P= 0.005<0.01, HAP-MDCT vs Lipiodol CT) and DSA detected 16(X2= 9.09, P= 0.005<0.01 vs Lipiodol CT and X2= 29.03,P = 0.005<0.01 vs HAP-MDCT). However, six nodules <10 mm in diameter were detected only by Lipiodol CT.CONCLUSION: MDCT and Lipiodol CT are two complementary modalities. At present, MDCT does not obviate the need for DSA and subsequent Lipiodol CT as a preoperative examination for HCC.

  5. Detection of malignant right coronary artery anomaly by multi-slice CT coronary angiography

    International Nuclear Information System (INIS)

    Coronary artery anomalies occur in 0.3-0.8% of the population and infer a high risk for sudden cardiac death in young adults. Diagnosis is usually established during coronary angiography, which is hampered by poor spatial visualization. Magnetic resonance imaging is an alternative, but it is not feasible in the presence of metal objects or claustrophobia. In this report, a 15-year-old boy experienced ventricular fibrillation and was successfully resuscitated. Cardiac catheterization was inconclusive, and pacemaker implantation prohibited the use of MR imaging. Multi-slice CT coronary angiography revealed a malignant anomalous right coronary artery. (orig.)

  6. 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.)

  7. 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

  8. 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

  9. 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

  10. 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.)

  11. Application of CT angiography of carotid atherosclerotic plaque in patients with ischemic cerebral stroke%颈动脉斑块 CT 血管成像在缺血性脑卒中患者中的应用

    Institute of Scientific and Technical Information of China (English)

    郑玉飞; 朱丽丽; 王卓群; 徐辉

    2014-01-01

    Objective To analysis 64-slice CT angiography imaging features of carotid atherosclerotic plaque and explore the relationship between different types of carotid atherosclerotic plaque and ischemic cerebral stroke. Methods The clinical data of 60 cases of ischemic cerebral stroke were retrospectively analyzed, all the cases were underwent 64-detector row CT angiography, and the distribution, character and morphological characteristics of carotid atherosclerotic plaque, and morphological characteristics and the extent of stenosis were observed with the original ax -ial image,volume rendering ( VR) and curved planar reconstruction ( CPR). Results In the 60 cases of ischemic cer-ebral stroke,58 cases with carotid atherosclerotic plaque were found. A total of 228 plaques were detected, including 43 non-calcified plaque, 125 calcified plaque and 60 mixed plaque. In 60 cases, 170 mild stenosis, 20 moderate ste-nosis, 12 severe stenosis and 1 occlusion were found, no significant stenosis were found in 20 sites. Five calcified plaques were found in intracranial segment of internal carotid artery, and CT can′t evaluate the severity of the steno-sis. There was significantly statistical difference in unstable plaque between non-lacunar infarct and lacunar infarct (P<0. 05 ). Conclusion 64-detector row CT angiography of carotid atherosclerotic plaques can accurately detect the dis -tribution, character and morphological characteristics of carotid atherosclerotic plaque and the degree of stenosis of ca -rotid artery,it is a valuable method in prevention, treatment, and prognosis judgement of ischemic cerebral stroke.%目的:通过分析颈动脉斑块64排CT血管成像特点,探讨不同类型颈动脉斑块与缺血性脑卒中的相关性。方法回顾分析60例缺血性脑卒中患者头颈部64排CT血管成像资料,轴位原始图像结合容积再现( VR)及曲面重建( CPR),观察颈动脉斑块的分布、性质及形态特征,测量

  12. Analysis about Inlfuencing Factors of Image Quality of Coronary Angiography with Multi-Slice CT%MSCT冠状动脉成像质量的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    赵坤; 邵广瑞; 王勇; 侯代伦

    2014-01-01

    目的:分析64层螺旋CT冠状动脉扫描中影响成像质量的各种因素。方法对89例怀疑冠心病或冠心病复查患者进行64层螺旋CT冠状动脉检查,回顾性分析成像质量,探讨心率及心率波动对冠脉成像质量的影响,pitch值与心率的关系,替代(override)功能的应用价值,从而优化扫描参数。结果心率及心率波动与冠脉成像质量成负相关;心率与扫描/重建方式及pitch值存在相互对应关系;心率替代功能的合理使用可以提高CT冠状动脉的成像质量。结论通过控制心率及心率波动,选择心率替代功能,采取适当的扇区扫描/重建模式可以提高图像质量和冠状动脉诊断的可靠性。%Objective To analyze the inlfuencing factors of image quality of coronary angiography with 64-slice CT.Methods Eighty-nine patients with known or suspected CAD underwent CT coronary angiography using 64 multi-slice CT. The image quality in those cases was analyzed retrospectively to evaluate the influence of heart rate, fluctuation of heart rate during the scanning. The relationship between heart rate and the value of pitch was analyzed, and the application value of the override function was discussed.Results① The patient’s heart rate and lfuctuation were negatively related to the coronary image quality.② There was corresponding relationship between the value of pitch and segment scan/reconstruction mode according to the heart rate.③ Correct use of override function could improve the image quality of coronary.Conclusion The appropriate control of heart rate and lfuctuation, the correct use of override function, and the corresponding selection of segment scan/reconstruction mode according to the heart rate could improve the image quality and reliability of coronary angiography.

  13. The Utility of 64 Channel Multidetector CT Angiography for Evaluating the Renal Vascular Anatomy and Possible Variations: a Pictorial Essay

    International Nuclear Information System (INIS)

    The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment

  14. 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.

  15. The Value of Cerebral CT Angiography with Low Tube Voltage in Detection of Intracranial Aneurysms

    OpenAIRE

    Kun Tang; Rui Li; Jie Lin; Xiangwu Zheng; Ling Wang; Weiwei Yin

    2015-01-01

    Objective. The aim of this study is to investigate the value of cerebral CT angiography (CTA) with low tube voltage in detection of intracranial aneurysms. Materials and Methods. A total of 294 consecutive patients with spontaneous subarachnoid hemorrhage (SAH) were enrolled in this study and randomly assigned into conventional voltage CTA (C-CTA) group and low voltage CTA (L-CTA) group. The objective and subjective image qualities were analyzed and compared between C-CTA and L-CTA groups. W...

  16. 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....

  17. 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

  18. 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.

  19. Effects of electrocardiogram gating on CT pulmonary angiography image quality

    International Nuclear Information System (INIS)

    Pulmonary embolism (PE) is the third most common cause of death from cardiovascular disease. Computed-tomographic pulmonary angiography (CTPA) is an accurate and safe test for diagnosing PE. The aim of this retrospective analysis was to evaluate the effects on image quality (IQ) of electrocardiogram (ECG) gating during CTPA. Fifty consecutive patients presenting for CTPA were included in the study. A single acquisition was performed, resulting in two reconstructions: one at 75% of the R–R interval and the other without ECG influence. IQ evaluation was undertaken by two radiologists, focusing on respiratory and cardiac motion, image noise, low-contrast resolution, vessel and lung clarity, contrast media opacification and artefacts. Various regions of the lungs and vasculature were evaluated, and IQ scores were statistically compared. For the ECG-tagged reconstructions, IQ was noted to be better overall with regard to vessel clarity (P<0.05) and cardiac motion (P<0.05), while lung clarity was better only in the left lower zone (P<0.05). IQ was better with regard to image noise (P<0.05) and low-contrast resolution (P<0.05) in the non-ECG-tagged reconstructions. No statistical IQ difference between the two types of reconstruction was noted with regard to respiratory motion, contrast media opacification or presence of artefacts. The two types of reconstruction provide complementary information for evaluating CTPA results.

  20. Coronary artery dissection with rupture of aortic valve commissure following type A aortic dissection: the role of 64-slice MDCT.

    Science.gov (United States)

    Das, K M; Abdou, Sayed M; El-Menyar, Ayman; Ayman, El Menyar; Khulaifi, A A; Nabti, A L

    2008-01-01

    A rare case of bilateral coronary artery dissection with rupture of aortic valve commissure following type A aortic dissection is described. 64-slice multidetector computed tomography (MDCT) was able to demonstrate both this findings along with involvement of other neck vessels. TEE demonstrated the severity and mechanisms of aortic valve damage and assisted the surgeon in valve repair. MDCT has played an invaluable role in the diagnosis of the abnormal details of such life-threatening vascular complications. PMID:18384568

  1. 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.

  2. Low-dose CT coronary angiography using iterative reconstruction with a 256-slice CT scanner

    OpenAIRE

    Carrascosa, Patricia; Rodriguez-Granillo, Gastón A; Capuñay, Carlos; Deviggiano, Alejandro

    2013-01-01

    AIM: To explore whether computer tomography coronary angiography (CTCA) using iterative reconstruction (IR) leads to significant radiation dose reduction without a significant loss in image interpretability compared to conventional filtered back projection (FBP).

  3. 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.

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

    International Nuclear Information System (INIS)

    Full text: 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.

  5. Automated coronary CT angiography plaque-lumen segmentation

    Science.gov (United States)

    Cline, Harvey E.; Krishnan, Karthik; Napel, Sandy; Rubin, Geoffrey D.; Turner, Wesley D.; Avila, Ricardo S.

    2009-02-01

    We are investigating the feasibility of a computer-aided detection (CAD) system to assist radiologists in diagnosing coronary artery disease in ECG gated cardiac multi-detector CT scans having calcified plaque. Coronary artery stenosis analysis is challenging if calcified plaque or the iodinated blood pool hides viable lumen. The research described herein provides an improved presentation to the radiologist by removing obscuring calcified plaque and blood pool. The algorithm derives a Gaussian estimate of the point spread function (PSF) of the scanner responsible for plaque blooming by fitting measured CTA image profiles. An initial estimate of the extent of calcified plaque is obtained from the image evidence using a simple threshold. The Gaussian PSF estimate is then convolved with the initial plaque estimate to obtain an estimate of the extent of the blooming artifact and this plaque blooming image is subtracted from the CT image to obtain an image largely free of obscuring plaque. In a separate step, the obscuring blood pool is suppressed using morphological operations and adaptive region growing. After processing by our algorithm, we are able to project the segmented plaque-free lumen to form synthetic angiograms free from obstruction. We can also analyze the coronary arteries with vessel tracking and centerline extraction to produce cross sectional images for measuring lumen stenosis. As an additional aid to radiologists, we also produce plots of calcified plaque and lumen cross-sectional area along selected blood vessels. The method was validated using digital phantoms and actual patient data, including in one case, a validation against the results of a catheter angiogram.

  6. 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.

  7. 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

  8. Multiple detector-row CT angiography of the renal and mesenteric vessels

    International Nuclear Information System (INIS)

    Computed tomography angiography (CTA) of the abdomen with multiple detector-row computed tomography (MD-CT) is an effective technique for minimally invasive imaging of the renal arteries and the visceral vasculature. This article reviews the clinical and technical aspects of MD-CT angiography in terms of image acquisition and reconstruction parameters, contrast medium application, and three-dimensional visualization with special attention to renal and mesenteric vascular imaging. Because of its high sensitivity to detect renal artery stenosis on the one hand, and because a normal renal CTA virtually excludes the presence of a significant renal artery stenosis on the other hand, renal CTA plays a useful role in the management of patients with suspected renovascular hypertension. Mesenteric CTA is a useful tool for visualizing normal vascular anatomy and its variants--particularly in the setting of organ transplantation. Vascular pathology, e.g. atherosclerotic disease (abdominal angina), or aneurysms of the visceral arteries are reliably assessed with CTA. Mesenteric CTA is an invaluable adjunct to abdominal CT in the setting of abdominal emergencies, because of its ability to detect the causes of acute intestinal ischemia (superior mesenteric artery embolism or thrombosis, superior mesenteric vein thrombosis). Accurate timing of the CTA acquisition and the subsequent parenchymal phase acquisition relative to the contrast medium transit time is critical to obtain excellent image quality in double-pass abdominal CT acquisitions

  9. 64-MSCT coronary angiography with prospective ECG gating at intermediate heart rate

    International Nuclear Information System (INIS)

    Objective: To evaluate robustness of coronary artery computed tomographic (CT) angiography with prospectively gated axial (PGA) CT technique at intermediate heart rate (65-75 beats per minute) using retrospectively gated helical (RGH) CT technique in 64-slice spiral CT. Methods: 63 consecutive patients with heart rates (HR) of 65 to 75 bpm, heart rate variability of below 5 bpm underwent CT angiography with RGH technique (tube voltage was 120 kV and tube current tailored to BMI). The 5% acquired data during each intermediate temporal window in the R-R interval were used to reconstruct images. The intermediate temporal window was 400 ms in the R-R interval at current mean HR, and the centre of the temporal window was 60%. All coronary artery segments were evaluated for image quality with 5-point scale. The mean image quality score and the percentage of assessable coronary artery segments were used to evaluate diagnostic value on the selected temporal window. Results: 822 coronary artery segments were depicted and were evaluated. The mean image quality score was 4.15±0.72. The percentage of assessable coronary artery segments was 97.76%. Conclusion: PCA coronary CT angiography with proper revise image acquisition phase and padding time could offer assessable image quality at intermediate HR. (authors)

  10. Pulmonary embolism: Comparison of ventilation-perfusion lung scintigraphy and helical CT angiography

    International Nuclear Information System (INIS)

    Full text: Objective: Retrospective study of the patients undergoing ventilation-perfusion pulmonary scintigraphy and helical CT angiography from March/ 2000 to July/ 2002, due to suspected pulmonary embolism (PE). Methods: Fifty-four patients were evaluated, with those unable to undergo a ventilation study or whose scintigraphy or CT studies were performed after anticoagulant therapy being excluded. The study group included 40 patients (24 male, 16 female) with an average age of 55,8 ± 18,8 years. Ninety per cent of the patients had a measurement of D-dimers levels and only 5% were submitted to angiography. Results: Both studies were concordant in 32 patients (80%), with concordant positive findings in 25 cases and concordant negative results in 7. In concordant positive cases, main risk factors included venous pathology of the lower extremities (40%) and malignant neoplasms (24%); no risk factors were found in 16% of these patients. Clinical findings included thoracic pain (16 patients), dyspnea (15 cases) and cough (7 patients). In these 25 patients PE was bilateral in 52%, right-sided in 28% and left-sided in the remaining 20%. D-dimers were elevated in 19 patients, normal in 3 and not measured in 3 cases. In concordant negative cases, D-dimers were elevated in 6 patients and not measured in one. Studies were discordant in 8 patients: in 5 of them, lung scintigraphy yielded a high-probability study but CT was negative for PE (revealing parenchymatous consolidation in 3 cases and pleural effusion in 2 patients); two patients had an intermediate-probability lung scintigram but CT was also negative (detecting a pericardial cyst around right hilum in one patient); in the remaining discordant case (a patient with chronic pulmonary hypertension), scintigraphy yielded a low-probability result but CT detected a non-occlusive clot in the right pulmonary artery. The angiographic studies performed in only 2 patients, both with concordant positive studies, confirmed the

  11. 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.

  12. 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%.

  13. 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.

  14. Automated bone removal in CT angiography : Comparison of methods based on single energy and dual energy scans

    NARCIS (Netherlands)

    van Straten, Marcel; Schaap, Michiel; Dijkshoorn, Marcel L.; Greuter, Marcel J.; van der Lugt, Aad; Krestin, Gabriel P.; Niessen, Wiro J.

    2011-01-01

    Purpose: To evaluate dual energy based methods for bone removal in computed tomography angiography (CTA) images and compare these with single energy based methods that use an additional, nonenhanced, CT scan. Methods: Four different bone removal methods were applied to CT scans of an anthropomorphic

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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.

  17. 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

  18. Diagnostic accuracy of computed tomography coronary angiography in patients with a zero calcium score

    Energy Technology Data Exchange (ETDEWEB)

    Cademartiri, Filippo [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Azienda Ospedaliero-Universitaria - Parma, Department of Radiology, Parma (Italy); Maffei, Erica; Seitun, Sara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Palumbo, Alessandro; Martini, Chiara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Tedeschi, Carlo; Rosa, Roberto de [Ospedale San Gennaro, Department of Radiology and Cardiology, Napoli (Italy); Arcadi, Teresa; Salamone, Ignazio; Blandino, Alfredo [University Hospital, Department of Radiology, Messina (Italy); Weustink, Annick C.; Mollet, Nico R.; Feyter, Pim J. de; Krestin, Gabriel P. [Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands)

    2010-01-15

    To evaluate the diagnostic accuracy of 64-slice CT coronary angiography (CT-CA) for the detection of significant coronary artery stenosis in patients with zero on the Agatston Calcium Score (CACS). We enrolled 279 consecutive patients (96 male, mean age 48{+-}12 years) with suspected coronary artery disease. Patients were symptomatic (n = 208) or asymptomatic (n=71), and underwent conventional coronary angiography (CAG). For CT-CA we administered an IV bolus of 100 ml of iodinated contrast material. CT-CA was compared to CAG using a threshold for significant stenosis of {>=}50%. The prevalence of disease demonstrated at CAG was 15% (1.4% in asymptomatic). The population at CAG showed no or non-significant disease in 85% (238/279), single vessel disease in 9% (25/279), and multi-vessel disease in 6% (16/279). Sensitivity, specificity, and positive and negative predictive values of CT-CA vs. CAG on the patient level were 100%, 95%, 76%, and 100% in the overall population and 100%, 100%, 100%, and 100% in asymptomatic patients, respectively. CT-CA proves high diagnostic performance in patients with or without symptoms and with zero CACS. The prevalence of significant disease detected by CT-CA was not negligible in asymptomatic patients. The role of CT-CA in asymptomatic patients remains uncertain. (orig.)

  19. Identification of the segmental artery feeding the anterior spinal artery. Correlation between helical CT and angiography

    International Nuclear Information System (INIS)

    We investigated whether identification of the segmental artery feeding the anterior spinal artery (ASA) is possible by single-slice helical CT. Enhanced CT and angiography were performed in 14 patients with retroperitoneal, liver, or bone tumor. A single-slice helical CT scanner with 7 mm collimation and a 1.0 helical pitch was used. Scanning was started 25 to 30 sec after an intravenous injection of 100 ml of contrast medium at a rate of 3.0 ml/sec. We predicted the segmental artery feeding the ASA in all 14 patients using enhanced CT images. In 12 of the 14 patients, the segmental artery feeding the ASA was angiographically identified. In 7 of these 12 patients, the level of the segmental artery feeding the ASA identified on segmental arteriogram was the same level as that predicted by enhanced CT. In the remaining 5 patients, the level of the segmental artery feeding the ASA identified on segmental arteriogram was one level higher or lower than the predicted spinal level. We could identify the segmental artery feeding the ASA by detailed examination and interpretation of single-slice helical CT images. (author)

  20. 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.

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

    International Nuclear Information System (INIS)

    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.)

  2. 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.)

  3. Role of coronary CT angiography in asymptomatic patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Diabetic patients with coronary artery disease are often asymptomatic, making appropriate care of such patients difficult. The purpose of this study was to investigate the prevalence of coronary lesions in asymptomatic diabetic patients. Coronary computed tomography (CT) angiography was performed in 120 consecutive diabetic patients (90 of whom were men, mean age 65, mean HbA1c 7.2%). Images from patients whose coronary artery calcium scores (CAC scores) were less than 400 were subjected to stenosis and plaque analysis. Significant stenosis was defined as coronary artery stenosis >70%. High-risk plaque was defined as plaque having both a CT density <30 Hounsfield Units (HU) and showing positive remodeling. Significant stenoses were identified in 30.5% of the patients. High-risk plaques were identified in 17.1% of the patients. Less than half of the high-risk plaques were obstructive plaques. There was a statistically significant association between significant stenosis and high-risk plaque by chi-square test (P=0.022). We found significant stenosis even in patients whose CAC score =0 at a rate of 5.0%. Using univariate logistic-regression analysis, we found that coronary risk factors associated with significant stenosis and high-risk plaque were dyslipidemia (P=0.033) and current smoking (P=0.030), respectively. We report for the first time, the prevalence of high-risk plaques in the arteries of patients with asymptomatic diabetes, as assessed by coronary CT angiography. (author)

  4. 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.

  5. Dual-energy CT angiography plus CT perfusion-diagnostic value in coronary artery disease: initial experience

    International Nuclear Information System (INIS)

    Objective: To evaluate the combination of dual-energy CT angiography (DE-CTA) and dual-energy CT perfusion (DE-CTP) in the diagnosis of coronary artery disease. Methods: Thirty-one patients with angina pectoris were examined using dual-source dual energy CT and conventional coronary angiography. For DE-CTA, we used a contrast-enhanced ECG-gated coronary scan protocol with energy levels of' two tube detector arrays at 140 and 100 kVp. Two kinds of acquired images were fused for the CT angiogram and further calculated to construct a perfusion map (Siemens DE Heart PBV). The compared the following results: DE-CTA vs. CA, DE-CTP vs. CA to assess the sensitivity and specificity, and further compared DE-CTA plus DE-CTP with CA. Results: DECT obtained diagnostic image quality in 28 patients. DE-CTA detected 41/112 arterial stenosis. Using CA as a reference, the sensitivity of DE-CTA was 81% (38/47), specificity was 95% (62/65), positive predictive value was 92% (38/41), negative predictive value was 87% (62/71), and accuracy was 89% (100/112). DE-CTP detected 46 perfusion defects in artery territories. Using CA as a reference, the sensitivity of DE-CTP was 76% (36/47), specificity was 85% (55/65), positive predictive value was 78% (36/46), negative predictive value was 83% (55/66), and accuracy was 81% (91/112). DE-CTA plus DE-CTP diagnosed 52 arteries stenosis. Using CA as a reference, combination of DE-CTA and DE-CTP gave sensitivity of 95% (45/47), specificity of 89% (58/65), NPV of 97% (58/60), and accuracy of 92% (103/112). Conclusions: DECT can provide perfusion blood volume information as well as vessel pathology in one scan. DECT can provide comprehensive diagnosis and improve diagnosis of CAD. (authors)

  6. Analysis of shielding calculation methods for 16- and 64-slice computed tomography facilities

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, C; Cenizo, E; Bodineau, C; Mateo, B; Ortega, E M, E-mail: c_morenosaiz@yahoo.e [Servicio de RadiofIsica Hospitalaria, Hospital Regional Universitario Carlos Haya, Malaga (Spain)

    2010-09-15

    The new multislice computed tomography (CT) machines require some new methods of shielding calculation, which need to be analysed. NCRP Report No. 147 proposes three shielding calculation methods based on the following dosimetric parameters: weighted CT dose index for the peripheral axis (CTDI{sub w,per}), dose-length product (DLP) and isodose maps. A survey of these three methods has been carried out. For this analysis, we have used measured values of the dosimetric quantities involved and also those provided by the manufacturer, making a comparison between the results obtained. The barrier thicknesses when setting up two different multislice CT instruments, a Philips Brilliance 16 or a Philips Brilliance 64, in the same room, are also compared. Shielding calculation from isodose maps provides more reliable results than the other two methods, since it is the only method that takes the actual scattered radiation distribution into account. It is concluded therefore that the most suitable method for calculating the barrier thicknesses of the CT facility is the one based on isodose maps. This study also shows that for different multislice CT machines the barrier thicknesses do not necessarily become bigger as the number of slices increases, because of the great dependence on technique used in CT protocols for different anatomical regions.

  7. 64层螺旋CTA显示胚胎型大脑后动脉伴发Willis环多血管段变异的价值%Fetal origin of the posterior cerebral artery: variation of multi-segments of the circle of Willis demonstrated with 64-slice spiral CT angiography

    Institute of Scientific and Technical Information of China (English)

    叶莹莹; 张伟国; 陈蓉; 陈金华; 李雪

    2007-01-01

    目的 探讨64层螺旋CT血管成像(CTA) 显示胚胎型大脑后动脉(FTP)伴发Willis环多血管段变异的价值.方法 对比分析201例64层螺旋CTA诊断为FTP及201例诊断为非FTP(对照组)的影像学资料,观察Willis环的形态学改变.结果 FTP组与对照组相比,FTP患者更易伴发大脑前动脉A1段、大脑后动脉P1段和椎动脉(VA)变异,且单侧FTP更易发生同侧A1段和P1段变细、发育不良或缺如(P0.05).结论 FTP患者常伴发Willis环多血管段变异,64层螺旋CTA能够全面地评价脑血管的解剖与变异,有助于指导脑血管病的诊断与治疗.

  8. 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.

  9. Clinical application of 64-slices spiral CT angiography in diagnosing subarachnoid hemorrhage and Nursing care%64层螺旋CT血管造影在蛛网膜下腔出血诊断的临床运用及护理

    Institute of Scientific and Technical Information of China (English)

    黎兴华

    2007-01-01

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

  10. CT Angiography of the Aorta: Prospective Evaluation of Individualized Low-Volume Contrast Media Protocols.

    Science.gov (United States)

    Higashigaito, Kai; Schmid, Tabea; Puippe, Gilbert; Morsbach, Fabian; Lachat, Mario; Seifert, Burkhardt; Pfammatter, Thomas; Alkadhi, Hatem; Husarik, Daniela B

    2016-09-01

    Purpose To prospectively develop individualized low-volume contrast media (CM) protocols adapted to tube voltage in patients undergoing computed tomographic (CT) angiography of the aorta. Materials and Methods The study was approved by the institutional review board and local ethics committee. All patients provided written informed consent. CT angiography was performed by using automated attenuation-based tube voltage selection (ATVS) (range, 70-150 kVp; 10-kVp increments). Iodine attenuation curves from an ex vivo experiment in a phantom were used to design CM protocols for CT angiography of the thoracoabdominal aorta in 129 consecutive patients (hereafter, cohort A). Further modified CM protocols based on results in cohort A were designed with the aim of homogeneous vascular attenuation of 300-350 HU across tube voltages and were applied to another 61 consecutive patients (cohort B). Three independent blinded radiologists assessed subjective image quality, and one reader determined objective image quality. The Kruskal-Wallis test was performed to test for differences in subjective image quality, and linear regression was performed to test for differences in objective image quality between the automatically selected tube voltages. Results Experiments revealed tube voltage-dependent iodine attenuation curves, which were used to determine the CM protocols in cohort A; these ranged from 68 mL at 110 kVp to 45 mL at 80 kVp. In both cohorts, ATVS selected 80 kVp in 62 patients, 90 kVp in 84, 100 kVp in 33, and 110 kVp in 11. In cohort A, image quality that was satisfactory or better was attained in 126 (98%) of 129 patients who had no significant differences in subjective image quality between tube voltages (P = .106) but who did have significant differences in attenuation and contrast-to-noise ratio (CNR) (P < .001 for both). In cohort B, the further-modified CM protocol (from 33 mL at 80 kVp to 68 mL at 110 kVp) yielded image quality that was satisfactory or better

  11. 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

  12. Low radiation dose imaging of myocardial perfusion and coronary angiography with a hybrid PET/CT scanner

    OpenAIRE

    Kajander, S; Ukkonen, H; Sipilä, H.; Teräs, M.; Knuuti, J

    2009-01-01

    Objectives: To test the image quality and feasibility of a sequential low radiation dose protocol for hybrid cardiac PET/CT angiography (CTA). Background: Multidetector computed tomography (MDCT) is a non-invasive method for coronary angiography. The negative predictive value of MDCT is high but perfusion imaging has a role in detecting functional significance of coronary lesions. This has encouraged combining these techniques. However, radiation dose is of concern. We report our first experi...

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

    OpenAIRE

    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 all patients presenting with a subarachnoid haemorrhage CTA was performed primarily. If CTA demonstrated an aneurysm, coiling or clipping was undertaken. IA-DSA was limited to patients with negativ...

  14. Comparing culprit lesions in ST-segment elevation and non-ST-segment elevation acute coronary syndrome with 64-slice multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Huang, W.-C. [School of Medicine, National Yang-Ming University, Taipei, Taiwan (China); Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: w.c.huang@yahoo.com.tw; Liu, C.-P. [School of Medicine, National Yang-Ming University, Taipei, Taiwan (China); Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: cpliu@isca.vghks.gov.tw; Wu, M.-T. [School of Medicine, National Yang-Ming University, Taipei, Taiwan (China); Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: wu.mingting@gmail.com; Mar, G.-Y. [Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: gymar@isca.vghks.gov.tw; Lin, S.-K. [Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: skyii89@yahoo.com.tw; Hsiao, S.-H. [Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: a841120@ms3.hinet.net; Lin, S.-L. [School of Medicine, National Yang-Ming University, Taipei, Taiwan (China); Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: sllin@isca.vghks.gov.tw; Chiou, K.-R. [School of Medicine, National Yang-Ming University, Taipei, Taiwan (China); Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan (China)], E-mail: krchiou@isca.vghks.gov.tw

    2010-01-15

    Background: Classifying acute coronary syndrome (ACS) as ST elevation ACS (STE-ACS) or non-ST elevation ACS (NSTE-ACS) is critical for clinical prognosis and therapeutic decision-making. Assessing the differences in composition and configuration of culprit lesions between STE-ACS and NSTE-ACS can clarify their pathophysiologic differences. Objective: This study focused on evaluating the ability of 64-slice multidetector computed tomography (MDCT) to investigate these differences in culprit lesions in patients with STE-ACS and NSTE-ACS. Methods: Of 161 ACS cases admitted, 120 who fit study criteria underwent MDCT and conventional coronary angiography. The following MDCT data were analyzed: calcium volume, Agatston calcium scores, plaque area, plaque burden, remodeling index, and plaque density. Results: The MDCT angiography had a good correlation with conventional coronary angiography regarding the stenotic severity of culprit lesions (r = 0.86, p < 0.001). The STE-ACS culprit lesions (n = 54) had significantly higher luminal area stenosis (78.6 {+-} 21.2% vs. 66.7 {+-} 23.9%, p = 0.006), larger plaque burden (0.91 {+-} 0.10 vs. 0.84 {+-} 0.12, p = 0.007) and remodeling index (1.28 {+-} 0.34 vs. 1.16 {+-} 0.22, p = 0.021) than those with NSTE-ACS (n = 66). The percentage of expanding remodeling index (remodeling index >1.05) was significantly higher in the STE-ACS group (81.5% vs. 63.6%, p = 0.031). The patients with STE-ACS had significantly lower MDCT density of culprit lesions than patients with NSTE-ACS (25.8 {+-} 13.9 HU vs. 43.5 {+-} 19.1 HU, p < 0.001). Conclusions: Sixty-four-slice MDCT can accurately evaluate the stenotic severity and composition of culprit lesions in selected patients with either STE-ACS or NSTE-ACS. Culprit lesions in NSTE-ACS patients had significantly lower luminal area stenosis, plaque burden, remodeling index and higher MDCT density, which possibly reflect differences in the composition of vulnerable culprit plaques and thrombi.

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

    Directory of Open Access Journals (Sweden)

    Cristian T. Badea

    2013-01-01

    Full Text Available 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.

  16. 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...

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

    International Nuclear Information System (INIS)

    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)

  18. 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)

  19. 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.

  20. 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.

  1. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  3. 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.

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

    International Nuclear Information System (INIS)

    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

  5. 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.

  6. 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.)

  7. The ascending aortic image quality and the whole aortic radiation dose of high-pitch dual-source CT angiography

    OpenAIRE

    Liu, Ying; Xu, Jian; Jian LI; Ren, Jing; LIU, HONGTAO; Xu, Junqing; Wei, Mengqi; Hao, Yuewen; Zheng, Minwen

    2013-01-01

    Background Aortic dissection is a lift-threatening medical emergency associated with high rates of morbidity and mortality. The incidence rate of aortic dissection is estimated at 5 to 30 per 1 million people per year. The prompt and correct diagnosis of aortic dissection is critical. This study was to compare the ascending aortic image quality and the whole aortic radiation dose of high-pitch dual-source CT angiography and conventional dual-source CT angiography. Methods A total of 110 conse...

  8. CT Angiography May Be a More Useful Modality Than Digital Subtractional Angiography in the Diagnosis of Patients with Subarachnoid Hemorrhage Due to Cerebral Aneurysms

    OpenAIRE

    Masih Saboori; Ali Reza Hekmatnia; Navid Omidifar; Amirhossein Ghazavi; Farzaneh Hekmatnia

    2011-01-01

    Background/Objective: The preoperative diagnostic"nvalidity of two radiological modalities (computed"ntomographic angiography and digital subtractional"nangiography) in the diagnosis of brain aneurysms were"ncompared."nPatients and Methods: During 2 years of study,"nreferred patients with signs of SAH to the emergency"nward underwent routine CT scan and after SAH was"nfirmly diagnosed, CTA and DSA methods were done"nand patients with correct indica...

  9. 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.

  10. Stenoser i koronararterierne påvist med 64-slice-computertomografi

    DEFF Research Database (Denmark)

    Rasmussen, Klaus; Tilsted, Hans Henrik; Aarøe, Jens;

    2010-01-01

    Sv) was measured with both methods. RESULTS: In 17 patients (8.8%), the CT-angiogram was not assessable. In 177 patients (91.2%) with assessable CT-angiogram, the sensitivity of CTCA was 97%, the specificity 63%, the predictive value of a positive test 58%, and the predictive value of a negative test 97...... suggesting angina who had been referred for CA according to usual criteria. We excluded patients with known ischaemic heart disease and patients with an unstable heart rhythm. CTCA was analysed without knowledge of CA and vice versa. Stenoses > 50% were considered significant. The effective radiation (m......%. In the 174 patients in whom CTCA was performed using retrospective technique, the effective radiation was 14.0 ± 2.3, versus 4.9 ± 2.6 at CA (p radiation was 5.4 ± 1.2 versus 5.9 ± 3.6 at CA (non...

  11. 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.

  12. 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.)

  13. A retrospective comparison of smart prep and test bolus multi-detector CT pulmonary angiography protocols

    International Nuclear Information System (INIS)

    Optimal arterial opacification is crucial in imaging the pulmonary arteries using computed tomography (CT). This poses the challenge of precisely timing data acquisition to coincide with the transit of the contrast bolus through the pulmonary vasculature. The aim of this quality assurance exercise was to investigate if a change in CT pulmonary angiography (CTPA) scanning protocol resulted in improved opacification of the pulmonary arteries. Comparison was made between the smart prep protocol (SPP) and the test bolus protocol (TBP) for opacification in the pulmonary trunk. A total of 160 CTPA examinations (80 using each protocol) performed between January 2010 and February 2011 were assessed retrospectively. CT attenuation coefficients were measured in Hounsfield Units (HU) using regions of interest at the level of the pulmonary trunk. The average pixel value, standard deviation (SD), maximum, and minimum were recorded. For each of these variables a mean value was then calculated and compared for these two CTPA protocols. Minimum opacification of 200 HU was achieved in 98% of the TBP sample but only 90% of the SPP sample. The average CT attenuation over the pulmonary trunk for the SPP was 329 (SD = ±21) HU, whereas for the TBP it was 396 (SD = ±22) HU (P = 0.0017). The TBP also recorded higher maximum (P = 0.0024) and minimum (P = 0.0039) levels of opacification. This study has found that a TBP resulted in significantly better opacification of the pulmonary trunk than the SPP

  14. A retrospective comparison of smart prep and test bolus multi-detector CT pulmonary angiography protocols

    Energy Technology Data Exchange (ETDEWEB)

    Suckling, Tara [Medical Imaging Department, Tamworth Rural Referral Hospital, Tamworth, New South Wales (Australia); Smith, Tony [University Department of Rural Health, The University of Newcastle, Tamworth, New South Wales (Australia); Reed, Warren [Discipline of Medical Radiation Sciences, The University of Sydney, Lidcombe (Australia); Medical Imaging Department, Tamworth Rural Referral Hospital, Tamworth, New South Wales (Australia)

    2013-06-15

    Optimal arterial opacification is crucial in imaging the pulmonary arteries using computed tomography (CT). This poses the challenge of precisely timing data acquisition to coincide with the transit of the contrast bolus through the pulmonary vasculature. The aim of this quality assurance exercise was to investigate if a change in CT pulmonary angiography (CTPA) scanning protocol resulted in improved opacification of the pulmonary arteries. Comparison was made between the smart prep protocol (SPP) and the test bolus protocol (TBP) for opacification in the pulmonary trunk. A total of 160 CTPA examinations (80 using each protocol) performed between January 2010 and February 2011 were assessed retrospectively. CT attenuation coefficients were measured in Hounsfield Units (HU) using regions of interest at the level of the pulmonary trunk. The average pixel value, standard deviation (SD), maximum, and minimum were recorded. For each of these variables a mean value was then calculated and compared for these two CTPA protocols. Minimum opacification of 200 HU was achieved in 98% of the TBP sample but only 90% of the SPP sample. The average CT attenuation over the pulmonary trunk for the SPP was 329 (SD = ±21) HU, whereas for the TBP it was 396 (SD = ±22) HU (P = 0.0017). The TBP also recorded higher maximum (P = 0.0024) and minimum (P = 0.0039) levels of opacification. This study has found that a TBP resulted in significantly better opacification of the pulmonary trunk than the SPP.

  15. 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.

  16. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  19. 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

  20. Celiaco-Mesenterial Arterial Aberrations in Patients Undergoing Extended Pancreatic Resections: Correlation of CT Angiography with Findings at Surgery

    Directory of Open Access Journals (Sweden)

    Viacheslav I Egorov

    2010-07-01

    Full Text Available Context It is important to recognize arterial variants in the preoperative planning of extended pancreatic resections. The absence of surgical confirmation of radiological data is a limitation of the majority of angiographic or CT-angiographic studies of celiac and mesenteric arterial anatomy. Objective The purpose of this study was to test the accuracy of CT angiography in delineating the arterial architecture by comparing the resultant 3D images with findings at surgery and determining the frequency of different celiac and mesenteric arterial anatomy variants. Methods Abdominal CT angiographies of 350 patients were performed on a 64- and 256- MDCT scanner prior to major pancreatic or hepatobiliary surgery. Variants of celiac and mesenteric arterial anatomy were documented as 3D reconstructions. Radiological data were compared to operative photographs during extended pancreaticoduodenectomies and extended distal pancreatectomies in 59 cases. Results Only 197 patients (56.3% had the classic arterial anatomy identified at CT angiography. The most common variants were a replaced or accessory right hepatic artery originating from the superior mesenteric artery (62 cases, 17.7% and a replaced or accessory left hepatic artery (43 cases, 12.3% originating from the left gastric artery. According to a comparison with operative photographs, CT angiography demonstrated 100% accuracy in identifying celiac and mesenteric arterial anatomy variants, stenoses, obstructions and aneurysms of the celiac and mesenteric branches, including those which were hemodynamically significant and which influence the choice and sequence of operative procedures. Conclusion The celiac and mesenteric arterial anatomy variants are fairly common and are of great significance in planning extended pancreatic resections. Radiological findings were fully corroborated by operative data, which means that CT angiography is a reliable tool for identifying celiac and mesenteric arterial

  1. Radiation Dose and Image Quality from Coronary Angiography in 320-Detecor Row CT

    International Nuclear Information System (INIS)

    Introduction: Coronary Computed Tomography Angiography examinations are increasing rapidly. New Computed Tomography has been developed to improve image quality with the patient dose reduction. The purpose of this study is to evaluate radiation dose and image quality of Coronary Computed Tomography Angiography in patients using 320-detector row CT. Methods: Forty-one patients referred for cardiac CT examinations at King Chulalongkorn Memorial Hospital were included in this study. All coronary computed tomographic angiography (CCTA) examinations were performed on the 320-detector row CT, Toshiba Aquilion One. Scanning protocol was investigated on dose estimates and image quality. Patients were scanned base on heart rate (HR) by HR75 bpm use retrospective with dose modulation. Scanning parameters, kVp, mAs, HR, BMI, CTDIvol(mGy) and DLP(mGy.cm), were recorded to study the factors affecting the image quality and patient dose. And mA and kVp setting depend on BMI of the patient. Effective dose is calculated from DLP using specific conversion factor. The image quality was evaluated in 4 vessels by two radiologists. Noise assessment was also studied quantitatively. Results: The patient effective dose in prospective gating 70-80% was 3.6 ± 0.9 mSv, prospective gating 30-80% (1R-R) was 6.3 ± 1.9 mSv, and 30-80% (2R-R) was 10.8 ± 1.8 mSv and in retrospective with tube current modulation was 12.1± 7.7 mSv. Image noise was highest in PGT 70-80% 1R-R and decreased in RGT with tube current modulation, PGT 30-80% 1R-R and lowest in PGT 30-80% 2 R-R. And overall qualitative image quality was mostly good to excellent score. Discussion: The heart rate, heart rate variability and disease of the patient are affecting in the radiation dose and image quality so the suitable acquisition protocol used could be necessary. the effective dose and the image noise for the image quality. (author)

  2. 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

  3. 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

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

    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 [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.

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

    International Nuclear Information System (INIS)

    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

  6. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  8. CT angiography for the pre- and postoperative evaluation of the thoracic aorta; CT-Angiografie zur prae- und postoperativen Evaluation in der thorakalen Aortenchirurgie

    Energy Technology Data Exchange (ETDEWEB)

    Pache, Gregor; Euringer, W.; Langer, M.; Blanke, P. [Universitaetsklinikum Freiburg (Germany). Radiology; Siepe, M. [Universitaetsklinikum Freiburg (Germany). Cardiovascular Surgery

    2011-04-15

    CT angiography is the imaging modality of choice for the pre- and postsurgical evaluation of patients with pathologies of the thoracic aorta. The purpose of this review is to familiarize the reader with the technical principle, recent technical developments and requirements for specific examination protocols and image interpretation, and to highlight common pathologies and findings. (orig.)

  9. Carotid stenosis degree in CT angiography: assessment based on luminal area versus luminal diameter measurements

    International Nuclear Information System (INIS)

    The aim of this study was to investigate CT angiography (CTA) luminal area measurements in the assessment of carotid artery stenosis compared with the current clinically used criteria based on lumen diameter measurements. Seventy-two vessels in 36 patients were evaluated by CTA and digital subtraction angiography (DSA). Two observers measured area and diameter stenosis degrees using automated 3D CTA analysis software. The ratio of the largest/smallest luminal diameter at the level of maximal stenosis (L/S ratio) was used to describe lumen morphology. Diagnostic agreement between CTA and DSA was calculated. For the assessment of area stenosis, interobserver and intraobserver correlation coefficients were 0.898 and 0.906 (p<0.001). The correlation coefficient between the diameter stenosis and area stenosis was lower in stenoses with extremely noncircular lumen (L/S ratio ≥1.5) (r=0.797, p<0.001) compared with stenoses with circular lumen (LS ratio <1.2) (r=0.978, p<0.001). Only satisfactory agreement (κ 0.54-0.77, p<0.001) was obtained between area stenosis on CTA and diameter stenosis on DSA. Assessment of stenosis degree with area measurements on 3D CTA proved to be reproducible. Area stenosis provides a less-severe estimate of the degree of carotid stenosis but might theoretically express the real hemodynamic significance of the lesion better than diameter stenosis, especially in stenoses with noncircular lumen. (orig.)

  10. 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.)

  11. 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.

  12. Diagnostic imaging of acute aortic dissection; Evaluation of thrombosed type aortic dissection by CT and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ohya, Tohru; Kumazaki, Tatsuo (Nippon Medical School, Tokyo (Japan))

    1991-01-01

    One hundred and nineteen patients with aortic dissection who underwent diagnostic imaging were reviewed and angiographic findings as well as those of CT were analysed. Thirty eight cases (43.1%) had non-contrast opacified false lumen, the type of which we call 'thrombosed type aortic dissection'. A comparative study of the thrombosed type with the patent type of false lumens was made particularly from the stand point of the characteristic diagnostic imagings (CT and angiography). At the same time, the pitfalls of these imagings in thrombosed type aortic dissection were studied. At the onset the average age of thrombosed type was 62.3 years old, while that of the patent type was 57.3. A statistical significance between the two groups was p<0.05. Thrombosed type in all cases was caused by atherosclerosis, whereas patent type was caused by the Marfan's syndrome in 11 cases. Other clinical findings, such as initial symptoms and blood pressure revealed no significant differences between the two groups. Pre-contrast CT in acute thrombosed type aortic dissection showed 'hyperdense crescent sign' in 89.4%. However, in 3 cases with thrombosed type in which the pre-contrast CT showed 'hyperdense crescent sign' contrast-enhanced CT detected no clear evidence of aortic dissection in the same site. This was due to obscurity induced by contrast medium. Angiographic findings of thrombosed type were classified into 3 groups: normal type, stenosed true lumen type and ulcer-like projection type. The incidence of normal type was estimated to be 48.4%, whereas stenosed true lumen type was 24.2% and ulcer-like projection was 27.7%. The present study concluded that thrombosed type is not rare in acute aortic dissection and contrast-enhanced CT as well as pre-contrast CT, is of great value in diagnosing thrombosed type. 'Hyperdense crescent sign' in pre-contrast CT is characteristic of intramural hematoma. (author).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    International Nuclear Information System (INIS)

    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.)

  15. 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.

  16. Contrast agent comparison for three-dimensional micro-CT angiography: A cadaveric study.

    Science.gov (United States)

    Kingston, Mitchell J; Perriman, Diana M; Neeman, Teresa; Smith, Paul N; Webb, Alexandra L

    2016-07-01

    Barium sulfate and lead oxide contrast media are frequently used for cadaver-based angiography studies. These contrast media have not previously been compared to determine which is optimal for the visualisation and measurement of blood vessels. In this study, the lower limb vessels of 16 embalmed Wistar rats, and four sets of cannulae of known diameter, were injected with one of three different contrast agents (barium sulfate and resin, barium sulfate and gelatin, and lead oxide combined with milk powder). All were then scanned using micro-computed tomography (CT) angiography and 3-D reconstructions generated. The number of branching generations of the rat lower limb vessels were counted and compared between the contrast agents using ANOVA. The diameter of the contrast-filled cannulae, were measured and used to calculate the accuracy of the measurements by comparing the bias and variance of the estimates. Intra- and inter-observer reliability were calculated using intra-class correlation coefficients. There was no significant difference (mean difference [MD] 0.05; MD 95% confidence interval [CI] -0.83 to 0.93) between the number of branching generations for barium sulfate-resin and lead oxide-milk powder. Barium sulfate-resin demonstrated less bias and less variance of the estimates (MD 0.03; standard deviation [SD] 1.96 mm) compared to lead oxide-milk powder (MD 0.11; SD 1.96 mm) for measurements of contrast-filled cannulae scanned at high resolution. Barium sulfate-resin proved to be more accurate than lead oxide-milk powder for high resolution micro-CT scans and is preferred due to its non-toxicity. This technique could be applied to any embalmed specimen model. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27075920

  17. Multi-slice spiral CT angiography: clinical application and the evaluation

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical application of multi-slice spiral CT angiography (MSCTA) in diagnosis of vascular diseases. Methods: Imaging materials of multi-slice spiral CT angiography of 73 cases were retrospectively analyzed, including 27 cases of intracranial vascular CTA, 8 of carotid CTA, 10 of pulmonary artery CTA, 6 of coronary artery CTA, 11 of aortic CTA, and 11 of low extremity artery CTA. After the raw data was reconstructed by overlapping slice-chickness, the axial images were uploaded to workstation for post data processing, and were then evaluated and reconstructed using 3D software including maximum intensity projection (MIP), shaded surface display (SSD), and volume rendering technique (VRT). Results: The blood vessels were successfully demonstrated in 71 cases out of 73. Abnormality was found in 63 cases out of 71. The intracranial CTA showed aneurysm in 7 cases, arteriovenous malformation in 5, carotid-cavernous fistula in 2, cerebral vascular occlusion in 2, astrocytoma in 2, and meningioma in 3. The carotid CTA revealed carotid stenosis in 4 cases, vertebral artery stenosis in 2 and a post-bracket implantation subclavian artery. In pulmonary artery CTA, pulmonary artery embolism and 5 cases of pulmonary artery involved with lung cancer were seen in 3 cases. In coronary artery CTA, coronary artery stenosis were shown in 3 cases. The aortic CTA demonstrated aortic dissection in 4, aortic stenosis calcification in 5, aortic aneurysm in 2, liver cancer in 2, renal artery stenosis in 2, and Budd-Chiari syndrome in 2. CTA of low extremity artery revealed external iliac artery occlusion in 2 and femoral artery stenosis in 5. Conclusion: By combining axial images with various reconstructed with adjacent organs can also be evaluated. MSCTA is of convenience, reliability, safety and noninvasive. (authors)

  18. Evaluation of patients radiation dose from computed tomography during lower peripheral angiography procedure

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate patient radiation doses in lower peripheral angiography CT examinations in Sudan. Survey was conducted in four major hospitals which almost carry out lower peripheral angiography procedures in Sudan at the time of study. All hospitals were equipped with 64 slices multi detectors CT from Toshiba (Japan). The total number of patients was 74. Information on patient's genders and ages, exposure technique factors and radiation dose were collected. The procedures performed in multi phases, up to five phases covering part of the abdomen region, which can make patients exposure reasonably high. CTDI values in the different phases ranged between (13-30) mGy. The total DLP in the four hospitals were 6888.75, 5065.05, 6608.88 and 5754.9 mGy.cm. This study provided first survey for patient dose during lower peripheral angiography procedures in Sudan. Taking into account that the CT machines were similar: the variation between patient's DLP and CTDI values in the different hospitals indicated the need of optimization of radiation protection. Staff training and awareness on factors affecting patient dose are essential.(Author)

  19. Assessment of right ventricular function for patients with rheumatic mitral stenosis by 64-slice multi-detector row computed tomography: comparison with magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-chun; YANG Zhi-gang; GUO Yin-kun; ZHANG Rui-ming; WANG Jian; ZHOU Dai-quan; CHENG Lin; CHEN Lin

    2012-01-01

    Background Right ventricular (RV) dysfunction ensues due to rheumatic mitral stenosis (RMS).The evaluation of RV function is clinically important for the diagnosis,treatment,and follow-up for patients with different degrees of RMS.Thepurpose of this study was to determine whether the 64-slice multi-detector row computed tomography (64-slice MDCT)can assess the RV function in RMS with high accuracy and reproducibility when compared to MR imaging (MRI).Methods Right ventricular end-diastolic and end-systolic volumes (RV-EDV and RV-ESV),stroke volume (RV-SV),ejection fraction (RV-EF),cardiac output (RV-CO),and wall mass (RV-Mass) were measured with dedicated cardiac analysis software on 64-slice MDCT and compared with values measured with MRI in 43 consecutive patients with RMS.Agreement between MRI and 64-MDCT results were compared with Bland and Altman analysis and linear regression analysis.Repeated measurements were performed to determine intraobserver and interobserver variability.Results No significant differences were revealed in calculated RV function parameters between the two methods.RV-EDV,RV-ESV,RV-SV,RV-EF,RV-CO,and RV-Mass by 64-slice MDCT were similar to those by MRI (P>0.05).There were good correlations (r=0.98,0.97,0.96,0.96,0.95 and 0.77,respectively) and close agreement (bias=-0.2 ml,-1.0ml,0.8 ml,0.5%,26.1 ml,and 0.5 g,respectively,P>0.05).The variability in 64-slice MDCT measurements was similar to that in MRI values.Conclusion ECG-gated 64-slice MDCT could assess the RV function in RMS with high accuracy and reproducibility when compared to MRI.

  20. 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

  1. 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

  2. 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. PMID:23746119

  3. 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.

  4. Correlation of Color Doppler with Multidetector CT Angiography Findings in Carotid Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Živorad N. Savic

    2010-01-01

    Full Text Available The aim of this paper was to examine the correlation between the Color Doppler ultrasound (CD-US and multidetector CT angiography (MDCTA diagnostic methods, and to define the degree and extent of stenosis in patients with internal carotid artery stenosis. This was a cross-sectional study with a consecutive series of patients. All US examinations were always carried out by the same physician-angiologist, while all CT examinations were always carried out by the same physician-radiologist. Both worked independently from each other. The stenosis area was measured at the narrowest point by NASCET criteria for US/CT. Peak systolic velocity (PSV over 210 cm/sec and end diastolic velocity (EDV over 110 cm/sec criteria were applied for stenoses with lumen narrowed over 70%, while PSV under 130 cm/sec and EDV under 100 cm/sec criteria were applied for those with lumen narrowed under 70%. A total of 124 carotid arteries were observed; namely, 89 narrowed and 68 surgically treated. All patients were reviewed by US and then by MDCTA; patients with 70–99% stenosis underwent surgery. The correlation coefficient between stenosis degree measured by US and MDCTA was 0.922; p 0.05. The US and CT matching level for stenoses from 70 to 99% was very high (κ = 0.778, p < 0.01. In conclusion, there is a highly significant statistical correlation among both diagnostic methods when measuring stenosis degree and extent. US is more dependent on the physician, while MDCTA is more objective and independent from the physician. We think it would be appropriate to undertake an MDCTA exam for those patients who are candidates for carotid endarterectomy.

  5. 3D multislice CT angiography for the assessment of relevant stenoses in patients with peripheral artery occlusive disease

    International Nuclear Information System (INIS)

    Method/Materials: For this study we examined 31 patients with peripheral artery occlusive disease. All patients received a multislice helical CT angiography and arterial digital subtraction angiography. Multislice CT angiography was performed with a Somatom Plus 4 Volume Zoom (Siemens, Erlangen, Germany). After test bolus injection of 20 ml Ultravist 370 (Schering AG, Berlin) additional 150 ml were applied with a flow rate of 3 ml/sec and a scan delay between 20-35 sec depending on individual blood circulation time. Collimation was 4x2.5 mm with a pitch of 6. Reconstructed slice thickness was 3 mm. 3D reconstructions of arteries of pelvic and lower extremity arteries were performed in volume rendering technique on a 3D Virtuoso workstation (Siemens, Erlangen). Results: For the assessment of therapeutically relevant stenoses (over 50% reduction of luminal diameter) multislice CT achieved the following results compared to conventional angiography for the diagnosis of stenosis: sensitivity of 86%, specifity of 86% and an accuracy of 72%. (orig.)

  6. Clinical utility of coronary CT angiography with low-dose chest CT in the evaluation of patients with atypical chest pain: a preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Soo Jin [Kimhae Bokum Hospital, Kimhae (Korea, Republic of); Choo, Ki Seok; Kim, Chang Won [Pusan National University Hospital, Busan (Korea, Republic of)] (and others)

    2008-04-15

    To determine the clinical utility of coronary CT angiography (CCTA) with low-dose chest CT in the evaluation of patients with atypical chest pain. Ninety-six patients (mean age 60.2 years; age range, 41-68 years; 70 males) were referred for CCTA with low-dose chest CT (16-slice MDCT, Siemens) for an evaluation of atypical chest pain. When significant stenoses (lumen diameter reduction > 50%) were detected on CCTA, invasive coronary angiography (CA) was performed as the standard of reference. In all patients, medical chart review or telephone contact with patients was used to evaluate the contribution of CCTA with low-dose chest CT to the final clinical diagnosis, at least 6 months after performing CCTA. Among 96 patients, seven patients (7%) had significant stenoses as detected on CCTA, whereas two patients (2%) had significant stenoses and five patients had insignificant stenoses or no stenosis, as detected on conventional catheter angiography. In 18 (19%) of the 89 patients without significant stenosis detected on CCTA, this protocol provided additional information that suggested or confirmed an alternate clinical diagnosis. In patients with atypical chest pain, CCTA with low-dose chest CT could help to exclude ischemic heart disease and could provide important ancillary information for the final diagnosis.

  7. The Value of Cerebral CT Angiography with Low Tube Voltage in Detection of Intracranial Aneurysms

    Directory of Open Access Journals (Sweden)

    Kun Tang

    2015-01-01

    Full Text Available Objective. The aim of this study is to investigate the value of cerebral CT angiography (CTA with low tube voltage in detection of intracranial aneurysms. Materials and Methods. A total of 294 consecutive patients with spontaneous subarachnoid hemorrhage (SAH were enrolled in this study and randomly assigned into conventional voltage CTA (C-CTA group and low voltage CTA (L-CTA group. The objective and subjective image qualities were analyzed and compared between C-CTA and L-CTA groups. With the results of 3D-DSA as “gold standard,” the sensitivity, specificity, and accuracy of C-CTA and L-CTA in diagnosis of aneurysms were calculated and compared with each other. Results. Compared with group C-CTA, the CT dose index volume (CTDIvol of group L-CTA reduced by 35.65%. There were no significant differences between C-CTA and L-CTA groups regarding objective and subjective image qualities. The sensitivity, specificity, and accuracy of L-CTA in diagnosis of aneurysms were 95.16%, 99.72%, and 99.42%, respectively. There were no significant differences in sensitivity, specificity, and accuracy between the C-CTA and L-CTA groups. Conclusion. The value of cerebral CTA with 100 kV low tube voltage in detection of intracranial aneurysms is significant, and it should be recommended as a routine scan method.

  8. Coronary CT angiography: automatic cardiac-phase selection for image reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Ruzsics, Balazs; Brothers, Robin L.; Costello, Philip [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Gebregziabher, Mulugeta [Medical University of South Carolina, Department of Biostatistics, Bioinformatics, and Epidemiology, Charleston, SC (United States); Lee, Heon [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Seoul Medical Center, Department of Radiology, Seoul (Korea); Allmendinger, Thomas; Vogt, Sebastian [Siemens Medical Solutions, Division CT, Forchheim (Germany); Schoepf, U.J. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Charleston, SC (United States)

    2009-08-15

    We evaluated an algorithm for automatic selection of the cardiac phase with the least motion for image reconstruction at coronary computed tomography (CT) angiography (CCTA). We analyzed data of 100 patients (49 female, mean age 59 years) who had undergone retrospectively ECG-gated CCTA. Two experienced observers visually identified the most suitable end-systolic and end-diastolic phases using a series of image reconstructions in 5% increments across the RR cycle. The same data were then reconstructed using an automatic phase finding algorithm based on a 4D weighting function of cardiac motion. On average, the algorithm determined the most suitable systolic reconstruction phase at 40.11{+-}6.29% RR compared with 40.07{+-}5.58% RR by the human observers (p=NS). The most suitable diastolic phase was found at 72.71{+-}7.37% RR by the automatic algorithm, compared with 76.43{+-}6.35% RR by the observers (p<0.05). No statistically significant difference was found between automatically and visually determined reconstruction phases regarding motion and stair-step artifacts in either systole or diastole (p>0.05). Thus, there appears to be no relevant difference between an automatic phase finding algorithm and visual selection by experienced observers for determining the phase with the least cardiac motion for CCTA image reconstruction. The use of automatic phase finding may therefore facilitate the performance of cardiac CT and reduce human error. (orig.)

  9. 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.)

  10. 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

  11. 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.

  12. 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.

  13. Diagnostic accuracy of dual energy CT angiography in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    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.)

  14. Evaluation of carotid artery stenosis with three-dimensional CT angiography and surgical revascularization

    International Nuclear Information System (INIS)

    The accuracy of three-dimensional CT angiography (3D-CTA) for delineating atherosclerotic carotid stenosis was examined in comparison with digital subtraction angiography (DSA) in symptomatic patients. In cases undergoing carotid endarterectomy (CEA), the clinical usefulness of 3D-CTA for surgical planning was also evaluated in the light of intraoperative findings. From July 1992 to Jun 1995, 52 patients suffering from internal carotid ischemia and/or presenting carotid bruit were evaluated to detect carotid bifurcation stenosis by 3D-CTA. Shaded surface reconstruction (SSR) for three-dimensional display and maximum intensity projection (MIP) were employed in multiple projection to evaluate sites of stenosis. DSA was performed in 18 out of 31 patients having atherosclerotic carotid stenosis shown by 3D-CTA. MIP reconstructions accurately delineated sites of stenosis close to DSA and allowed precise depiction of ulcerated plaque and intramural calcification. The percentage of carotid stenosis was determined by comparing the narrowest point to the internal carotid artery (ICA) beyond the bulb on both 3D-CTA and DSA. Assessment of carotid stenosis was highly correlated between 3D-CTA and DSA (r=0.987, p< 0.0001). In this series, 9 carotid arteries in 8 patients underwent CEA for severe stenosis. 3 patients with ICA occlusion and 1 patient with elongated severe stenosis underwent STA-MCA anastomosis. Using MIP reconstructions and two-dimensional original images it was found that ICA occlusion was apparently distinguished from high grade ICA stenosis. SSR provided valuable informations during CEA for atherosclerotic plaque regarding anatomical relationship with the internal jugular vein and bony structures. This advanced means of 3D-CTA can be adequate as a screening method to detect carotid stenosis in symptomatic patients and useful for surgical planning of CEA and post-operative follow-up examination. (author)

  15. The influence of heart rate, slice thickness, and calcification density on calcium scores using 64-slice multidetector computed tomography - A systematic phantom study

    NARCIS (Netherlands)

    Groen, Jaap M.; Greuter, Marcel J.; Schmidt, Bernhard; Suess, Christoph; Vliegenthart, Rozemarijn; Oudkerk, Matthis

    2007-01-01

    Objective: The purpose of this study was to investigate the influence of heart rate, slice thickness, and calcification density on absolute value and variability of calcium score using 64-slice multidetector computed tomography (MDCT). Methods and Materials: Three artificial arteries containing each

  16. CT Angiography May Be a More Useful Modality Than Digital Subtractional Angiography in the Diagnosis of Patients with Subarachnoid Hemorrhage Due to Cerebral Aneurysms

    Directory of Open Access Journals (Sweden)

    Masih Saboori

    2011-05-01

    Full Text Available Background/Objective: The preoperative diagnostic"nvalidity of two radiological modalities (computed"ntomographic angiography and digital subtractional"nangiography in the diagnosis of brain aneurysms were"ncompared."nPatients and Methods: During 2 years of study,"nreferred patients with signs of SAH to the emergency"nward underwent routine CT scan and after SAH was"nfirmly diagnosed, CTA and DSA methods were done"nand patients with correct indications were operated."nAfter surgery and detecting the existence of aneurysms"nand their location, the data were recorded in a"nchecklist. Sensitivity, specificity, positive and negative"npredictive values were calculated and compared in"nboth methods."nResults: The mean age of the 30 patients were"n49.5±9.13 years. 57.9 % of the subjects were female"nand the others were male. On CTA reports 100% true"npositive, 0% false positive, 85% true negative, and 15%"nfalse negative were calculated. DSA reports were true"npositive, false positive, true negative and false negative"nin 100%, 0%, 69% and 31%, respectively. CTA showed"n89% of sensitivity, and 100% of specificity in contrast"nto 74% sensitivity and 100% specificity of DSA."nPositive predictive values of both methods were 100%,"nbut negative predictive values of CTA and DSA were"n85% and 69%, respectively."nConclusion: Based on our data, CTA is more preferable"ndiagnostic modality for the brain aneurysm's site and"nanatomy in patients with subarachnoid hemorrhage"nthan DSA."nKeywords: CT Scan Angiography, Digital Subtraction"nAngiography, Cerebral Aneurysm, Subarachnoid"nHemorrhage

  17. The comparative study between multi-slice spiral CT angiography and color flow ultrasonography in hepatic and splenic trauma

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of multi-slice spiral CT angiography and color flow ultra- sonography in hepatic and splenic trauma. Methods Thirty-six cases of hepatic and splenic trauma were collected, the MSCT were analyzed and compared with that of color flow ultrasonography. Results: Seventeen cases were Hepatic trauma including nine cases of hepatic contusion, six cases of sub-envelope hematoma, two cases of both sub-envelope hematoma and hepatic contusion. Nineteen cases were splenic trauma including nine cases of splenic contusion, ten cases of sub-envelope hematoma. Conclusion: Multi-slice spiral CT angiography show hepatic and splenic trauma clearer than that of color flow ultrasonography, and can provide reliable basis for clinic diagnosis and therapy. (authors)

  18. 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.

  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. 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.

  1. 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.

  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

    2016-01-01

    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. PMID:27455500

  3. Carotid artery wall thickness: comparison between sonography and multi-detector row CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca [University of Cagliari, Department of Radiology, Policlinico Universitario, Cagliari (Italy); Sanfilippo, Roberto; Montisci, Roberto [Policlinico Universitario, Department of Vascular Surgery, Cagliari (Italy); Mallarini, Giorgio [University of Cagliari, Department of Radiology, Policlinico Universitario, Cagliari (Italy); Ospedale San Giovanni di Dio, Institute of Radiology, Cagliari (Italy)

    2010-02-15

    Prospective studies have shown that an increased thickness of the carotid wall is a significant predictor of coronary and cerebrovascular complications. Our purpose was to assess the agreement between multi-detector row computed tomography (CT) angiography (MDCTA) and colour Doppler ultrasound (CD-US) in measuring carotid artery wall thickness (CAWT) and the intima-media thickness (IMT). Altogether, 97 subjects (age range 64-84 years) were prospectively analysed using a four-detector row CT and a sonographic scanner. In total, 46 subjects had shown cerebral ischaemic symptoms. CAWT and IMT were measured in each patient using MDCTA and CD-US (by applying a digital calliper), respectively. Continuous data were described as the mean value {+-} standard deviation and were compared using the Mann-Whitney U test. A p value <0.05 was considered significant. Bland-Altman statistics was employed to measure the agreement between MDCTA and CD-US. CAWT ranged from 0.5 to 1.53 mm, with a mean value of 0.9072 mm. IMT ranged from 0.46 to 1.5 mm, with a mean value of 0.8839 mm. By analysing the Bland-Altman plot, we observed an excellent agreement between CD-US and MDCTA with a bias between methods of 0.023 {+-} 0.0424 mm. A limit of agreement from -0.06 to 0.106 was recorded. Correlation coefficient r was 0.9855 (95% confidence interval 0.9808-0.989). Mann-Whitney U test indicated a p value of 0.377. Obtained results indicated a significant agreement between MDCTA and CD-US in the measurement of CAWT and IMT. (orig.)

  4. Carotid artery wall thickness: comparison between sonography and multi-detector row CT angiography

    International Nuclear Information System (INIS)

    Prospective studies have shown that an increased thickness of the carotid wall is a significant predictor of coronary and cerebrovascular complications. Our purpose was to assess the agreement between multi-detector row computed tomography (CT) angiography (MDCTA) and colour Doppler ultrasound (CD-US) in measuring carotid artery wall thickness (CAWT) and the intima-media thickness (IMT). Altogether, 97 subjects (age range 64-84 years) were prospectively analysed using a four-detector row CT and a sonographic scanner. In total, 46 subjects had shown cerebral ischaemic symptoms. CAWT and IMT were measured in each patient using MDCTA and CD-US (by applying a digital calliper), respectively. Continuous data were described as the mean value ± standard deviation and were compared using the Mann-Whitney U test. A p value <0.05 was considered significant. Bland-Altman statistics was employed to measure the agreement between MDCTA and CD-US. CAWT ranged from 0.5 to 1.53 mm, with a mean value of 0.9072 mm. IMT ranged from 0.46 to 1.5 mm, with a mean value of 0.8839 mm. By analysing the Bland-Altman plot, we observed an excellent agreement between CD-US and MDCTA with a bias between methods of 0.023 ± 0.0424 mm. A limit of agreement from -0.06 to 0.106 was recorded. Correlation coefficient r was 0.9855 (95% confidence interval 0.9808-0.989). Mann-Whitney U test indicated a p value of 0.377. Obtained results indicated a significant agreement between MDCTA and CD-US in the measurement of CAWT and IMT. (orig.)

  5. Multidetector-CT angiography in pulmonary embolism - can image parameters predict clinical outcome?

    Energy Technology Data Exchange (ETDEWEB)

    Heyer, Christoph M.; Lemburg, Stefan P.; Nicolas, Volkmar; Roggenland, Daniela [Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum, Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Bochum (Germany); Knoop, Heiko [Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Medical Clinic III - Pneumology, Allergology, and Sleep Medicine, Bochum (Germany); Holland-Letz, Tim [Ruhr-University of Bochum, Department of Medical Informatics, Biometry and Epidemiology, Bochum (Germany)

    2011-09-15

    To assess if pulmonary CT angiography (CTA) can predict outcome in patients with pulmonary embolism (PE). Retrospective analysis of CTA studies of patients with PE and documentation of pulmonary artery (PA)/aorta ratio, right ventricular (RV)/left ventricular (LV) ratio, superior vena cava (SVC) diameter, pulmonary obstruction index (POI), ventricular septal bowing (VSB), venous contrast reflux (VCR), pulmonary infarction and pleural effusion. Furthermore, duration of total hospital stay, necessity for/duration of ICU therapy, necessity for mechanical ventilation and mortality were recorded. Comparison was performed by logistic/linear regression analysis with significance at 5%. 152 patients were investigated. Mean duration of hospital stay was 21 {+-} 24 days. 66 patients were admitted to the ICU; 20 received mechanical ventilation. Mean duration of ICU therapy was 3 {+-} 8 days. Mortality rate was 8%. Significant positive associations of POI, VCR and pulmonary infarction with necessity for ICU therapy were shown. VCR was significantly associated with necessity for mechanical ventilation and duration of ICU treatment. Pleural effusions were significantly associated with duration of total hospital stay whereas the RV/LV ratio correlated with mortality. Selected CTA findings showed significant associations with the clinical course of PE and may thus be used as predictive parameters. (orig.)

  6. Multidetector-CT angiography in pulmonary embolism - can image parameters predict clinical outcome?

    International Nuclear Information System (INIS)

    To assess if pulmonary CT angiography (CTA) can predict outcome in patients with pulmonary embolism (PE). Retrospective analysis of CTA studies of patients with PE and documentation of pulmonary artery (PA)/aorta ratio, right ventricular (RV)/left ventricular (LV) ratio, superior vena cava (SVC) diameter, pulmonary obstruction index (POI), ventricular septal bowing (VSB), venous contrast reflux (VCR), pulmonary infarction and pleural effusion. Furthermore, duration of total hospital stay, necessity for/duration of ICU therapy, necessity for mechanical ventilation and mortality were recorded. Comparison was performed by logistic/linear regression analysis with significance at 5%. 152 patients were investigated. Mean duration of hospital stay was 21 ± 24 days. 66 patients were admitted to the ICU; 20 received mechanical ventilation. Mean duration of ICU therapy was 3 ± 8 days. Mortality rate was 8%. Significant positive associations of POI, VCR and pulmonary infarction with necessity for ICU therapy were shown. VCR was significantly associated with necessity for mechanical ventilation and duration of ICU treatment. Pleural effusions were significantly associated with duration of total hospital stay whereas the RV/LV ratio correlated with mortality. Selected CTA findings showed significant associations with the clinical course of PE and may thus be used as predictive parameters. (orig.)

  7. Technical feasibility and validation of a coronary artery calcium scoring system using CT coronary angiography images

    Energy Technology Data Exchange (ETDEWEB)

    Pavitt, Christopher W. [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Harron, Katie [Institute of Child Health, UCL, Centre for Paediatric Epidemiology and Biostatistics, London (United Kingdom); Lindsay, Alistair C.; Ray, Robin [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Zielke, Sayeh; Rubens, Michael B. [Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Gordon, Daniel [Royal Marsden Hospital, Department of Physics, London (United Kingdom); Padley, Simon P. [Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Imperial College, Faculty of Medicine, London (United Kingdom); Nicol, Edward D. [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Imperial College, Faculty of Medicine, London (United Kingdom)

    2016-05-15

    We validate a novel CT coronary angiography (CCTA) coronary calcium scoring system. Calcium was quantified on CCTA images using a new patient-specific attenuation threshold: mean + 2SD of intra-coronary contrast density (HU). Using 335 patient data sets a conversion factor (CF) for predicting CACS from CCTA scores (CCTAS) was derived and validated in a separate cohort (n = 168). Bland-Altman analysis and weighted kappa for MESA centiles and Agatston risk groupings were calculated. Multivariable linear regression yielded a CF: CACS = (1.185 x CCTAS) + (0.002 x CCTAS x attenuation threshold). When applied to CCTA data sets there was excellent correlation (r = 0.95; p < 0.0001) and agreement (mean difference -10.4 [95 % limits of agreement -258.9 to 238.1]) with traditional calcium scores. Agreement was better for calcium scores below 500; however, MESA percentile agreement was better for high risk patients. Risk stratification was excellent (Agatston groups k = 0.88 and MESA centiles k = 0.91). Eliminating the dedicated CACS scan decreased patient radiation exposure by approximately one-third. CCTA calcium scores can accurately predict CACS using a simple, individualized, semiautomated approach reducing acquisition time and radiation exposure when evaluating patients for CAD. This method is not affected by the ROI location, imaging protocol, or tube voltage strengthening its clinical applicability. (orig.)

  8. Coronary stent on coronary CT angiography: Assessment with model-based iterative reconstruction technique

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Chae; Kim, Yeo Koon; Chun, Eun Ju; Choi, Sang IL [Dept. of of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2016-05-15

    To assess the performance of model-based iterative reconstruction (MBIR) technique for evaluation of coronary artery stents on coronary CT angiography (CCTA). Twenty-two patients with coronary stent implantation who underwent CCTA were retrospectively enrolled for comparison of image quality between filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR) and MBIR. In each data set, image noise was measured as the standard deviation of the measured attenuation units within circular regions of interest in the ascending aorta (AA) and left main coronary artery (LM). To objectively assess the noise and blooming artifacts in coronary stent, we additionally measured the standard deviation of the measured attenuation and intra-luminal stent diameters of total 35 stents with dedicated software. All image noise measured in the AA (all p < 0.001), LM (p < 0.001, p = 0.001) and coronary stent (all p < 0.001) were significantly lower with MBIR in comparison to those with FBP or ASIR. Intraluminal stent diameter was significantly higher with MBIR, as compared with ASIR or FBP (p < 0.001, p = 0.001). MBIR can reduce image noise and blooming artifact from the stent, leading to better in-stent assessment in patients with coronary artery stent.

  9. Optimal iodine dose for 3-dimensional multidetector-row CT angiography of the liver

    International Nuclear Information System (INIS)

    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

  10. Utilization of CT Pulmonary Angiography in Suspected Pulmonary Embolism in a Major Urban Emergency Department

    Directory of Open Access Journals (Sweden)

    Adil Shujaat

    2013-01-01

    Full Text Available Objectives. We conducted a study to answer 3 questions: (1 is CT pulmonary angiography (CTPA overutilized in suspected pulmonary embolism (PE? (2 What alternative diagnoses are provided by CTPA? (3 Can CTPA be used to evaluate right ventricular dilatation (RVD? Methods. We retrospectively reviewed the clinical information of 231 consecutive emergency department patients who underwent CTPA for suspected PE over a one-year period. Results. The mean age of our patients was 53 years, and 58.4% were women. The prevalence of PE was 20.7%. Among the 136 patients with low clinical probability of PE, a d-dimer test was done in 54.4%, and it was normal in 24.3%; none of these patients had PE. The most common alternative findings on CTPA were emphysema (7.6%, pneumonia (7%, atelectasis (5.5%, bronchiectasis (3.8%, and congestive heart failure (3.3%. The sensitivity and negative predictive value of CTPA for (RVD was 92% and 80%, respectively. Conclusions. PE could have been excluded without CTPA in ~1 out of 4 patients with low clinical probability of PE, if a formal assessment of probability and d-dimer test had been done. In patients without PE, CTPA did not provide an alternative diagnosis in 65%. In patients with PE, CTPA showed the potential to evaluate RVD.

  11. Descriptive anatomy of the dominant septal perforators using Dual Source Coronary CT Angiography.

    Science.gov (United States)

    Brinjikji, Waleed; Harris, Scott R; Froemming, Adam T; Christensen, Kevin N; Lachman, Nirusha; Araoz, Philip A

    2010-01-01

    Although clinical outcomes for septal ablation in treating left ventricular outflow tract obstructions are generally favorable, a variety of complications have been reported including a high incidence of right bundle branch block. These complications may be attributed to anatomic variability of the dominant septal perforator. We used Dual Source CT Coronary Angiography (DS-CTA) to determine the location of the termination point of the dominant septal perforator as well as the distance of the termination point from the mitral annulus in patients undergoing DS-CTA. One-hundred-fourteen DS-CTA scans were retrospectively reviewed by two observers by consensus. The left ventricle was divided into anterior wall, anterioseptum, and inferioseptum. For each segment, the myocardium was divided into three layers (1) right ventricular side, (2) mid portion, and (3) left ventricular side. The zone of termination of the dominant septal perforator was identified as well as the distance of the termination point from the mitral annulus. The dominant septal perforator terminated in the right ventricular side of the anterioseptum in 86 of the 118 visualized terminations (73%) and in the left ventricular anterior wall in 6 visualized terminations (5%). On average, the dominant septal perforator terminated 26.3 +/- 8.6 mm from the mitral annulus. In the majority of cases, the dominant septal perforator terminates in the right ventricular side of anterioseptum. In addition, there is great variability in the distribution of the termination point of the dominant septal perforator from the mitral annulus. PMID:19918876

  12. Technical feasibility and validation of a coronary artery calcium scoring system using CT coronary angiography images

    International Nuclear Information System (INIS)

    We validate a novel CT coronary angiography (CCTA) coronary calcium scoring system. Calcium was quantified on CCTA images using a new patient-specific attenuation threshold: mean + 2SD of intra-coronary contrast density (HU). Using 335 patient data sets a conversion factor (CF) for predicting CACS from CCTA scores (CCTAS) was derived and validated in a separate cohort (n = 168). Bland-Altman analysis and weighted kappa for MESA centiles and Agatston risk groupings were calculated. Multivariable linear regression yielded a CF: CACS = (1.185 x CCTAS) + (0.002 x CCTAS x attenuation threshold). When applied to CCTA data sets there was excellent correlation (r = 0.95; p < 0.0001) and agreement (mean difference -10.4 [95 % limits of agreement -258.9 to 238.1]) with traditional calcium scores. Agreement was better for calcium scores below 500; however, MESA percentile agreement was better for high risk patients. Risk stratification was excellent (Agatston groups k = 0.88 and MESA centiles k = 0.91). Eliminating the dedicated CACS scan decreased patient radiation exposure by approximately one-third. CCTA calcium scores can accurately predict CACS using a simple, individualized, semiautomated approach reducing acquisition time and radiation exposure when evaluating patients for CAD. This method is not affected by the ROI location, imaging protocol, or tube voltage strengthening its clinical applicability. (orig.)

  13. Prevalence and morphology of coronary artery ectasia with dual-source CT coronary angiography

    International Nuclear Information System (INIS)

    To assess the prevalence and morphological characteristics of coronary artery ectasia (CAE) with CT coronary angiography (CTCA) in comparison to conventional catheterangiography (CCA). Dual-source CTCA examinations from 677 consecutive patients (223 women; median age 57 years) were retrospectively evaluated by two blinded observers for the presence of CAE defined as a diameter enlargement ≥1.5 times the diameter of adjacent normal coronary segments. Vessel diameters and contrast attenuation within and proximal to ectatic segments were measured. CCA was used to compare measurements obtained from CTCA with the coronary flow velocity by using the thrombolysis in myocardial infarction (TIMI) frame count. CTCA identified CAE in 20 of 677 (3%) patients. CCA was performed in ten of these patients. CAE diameter measurements with CTCA (10.0 ± 5.4 mm) correlated significantly (r = 0.92, p < 0.001) with the CCA measurements (8.8 ± 4.9 mm), but had higher diameters (levels of agreement: -1.0 to 3.4 mm). Contrast attenuation was significantly lower in the ectatic (343 ± 63 HU) than in the proximal (394 ± 60 HU) segments (p < 0.01). The attenuation difference significantly correlated with the CAE ratio (r = 0.67, p < 0.01) and the TIMI frame count (r = 0.58, p < 0.05). The prevalence of CAE in a population examined by CTCA is around 3%. Contrast attenuation measurements with CTCA correlate well with the flow alterations assessed with CCA. (orig.)

  14. Best-Quality Vessel Identification Using Vessel Quality Measure in Multiple-Phase Coronary CT Angiography

    Science.gov (United States)

    Liu, Jordan; Chan, Heang-Ping; Zhou, Chuan; Wei, Jun; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella

    2016-01-01

    The detection of stenotic plaques strongly depends on the quality of the coronary arterial tree imaged with coronary CT angiography (cCTA). However, it is time consuming for the radiologist to select the best-quality vessels from the multiple-phase cCTA for interpretation in clinical practice. We are developing an automated method for selection of the best-quality vessels from coronary arterial trees in multiple-phase cCTA to facilitate radiologist's reading or computerized analysis. Our automated method consists of vessel segmentation, vessel registration, corresponding vessel branch matching, vessel quality measure (VQM) estimation, and automatic selection of best branches based on VQM. For every branch, the VQM was calculated as the average radial gradient. An observer preference study was conducted to visually compare the quality of the selected vessels. 167 corresponding branch pairs were evaluated by two radiologists. The agreement between the first radiologist and the automated selection was 76% with kappa of 0.49. The agreement between the second radiologist and the automated selection was also 76% with kappa of 0.45. The agreement between the two radiologists was 81% with kappa of 0.57. The observer preference study demonstrated the feasibility of the proposed automated method for the selection of the best-quality vessels from multiple cCTA phases.

  15. Impact of multidetector CT-angiography on the emergency management of severe hemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Chalumeau-Lemoine, Ludivine [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Khalil, Antoine, E-mail: antoine_khalil@yahoo.fr [Service de Radiologie, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Pathological Angiogenesis and Vessel Normalization, Center for Interdisciplinary Research in Biology, CNRS UMR 7241/INSERM U1050, Collège de France, Paris (France); Prigent, Hélène [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Carette, Marie-France [Service de Radiologie, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Université Pierre et Marie Curie, Paris VI (France); Fartoukh, Muriel [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Université Pierre et Marie Curie, Paris VI (France); Parrot, Antoine [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France)

    2013-11-01

    Background: Multidetector CT-angiography (MDCTA) is commonly used in patients with severe haemoptysis requiring admission to intensive care unit. However, the impact of MDCTA on the management of severe haemoptysis in emergency setting is poorly evaluated. Methods: We prospectively compared data provided by clinical bedside evaluation (clinical examination, chest-X-ray and fiberoptic bronchoscopy) to MDCTA data in terms of lateralization, location of the bleeding site, etiology as well as impact on the treatment choice. Results: Over a 13-month period, 87 patients (men n = 58, median age = 61 years, median haemoptysis expectorated volume = 180 mL) were included. Etiology was mainly (67%) bronchiectasis, tuberculosis sequelae and tumor. MDCTA and clinical bedside evaluation were equally effective in determining lateralization (87.4% and 93.1%, respectively, p = 0.23) and location (85% and 82.7%, respectively, p = 0.82) of the bleeding site. MDCTA was significantly more accurate than the clinical bedside strategy in determining the haemoptysis cause (86% and 70%, respectively, p = 0.007). Moreover, MDCTA suggested the involvement of systemic arteries as bleeding mechanism in 92% of cases, leading to the modification of the treatment initially considered after bedside evaluation in 21.8% of patients. Conclusion: MDCTA provides useful information for the management of patients with severe haemoptysis, especially in the treatment choice. Thus, in the absence of emergency fiberoptic bronchoscopy (FOB) requirement for airways management, MDCTA should be the first-line procedure performed in emergency clinical setting.

  16. Magnetic resonance angiography and CT angiography of persistent primitive olfactory artery: Incidence and association rate with aneurysm in Korea

    International Nuclear Information System (INIS)

    Japanese data indicates an incidence of persistent primitive olfactory artery (PPOA) of 0.14%. We studied the incidence of PPOA and associated cerebral vascular variation or anomalies in Korea. We retrospectively reviewed cranial magnetic resonance angiography (MRA) and computed tomography angiography (CTA) images of a total of 9841 patients of our institution. The diagnostic criterion of PPOA is extreme anterioinferior course of the proximal anterior cerebral artery, with a hairpin turn of the lateral projection. We found 29 cases (0.29%) with PPOA. The PPOA location was on the left in 19 cases, bilateral in 3 cases, and on the right in 7 cases. An aneurysm was found at the hairpin turn in 2 patients. There were aneurysms in other sites in 3 cases. There were hypoplasia of anterior cerebral artery in 3 cases, and fenestration of intracranial artery in 1 case. In Korean populations, the incidence of PPOA found in MRA and CTA was twice as high as that shown in the previous Japanese data. Within Korea, left side laterality is more common than right side or bilalterality. Aneurysmal dilatations at the hairpin turning point and aneurysms at other sites were found, and other vascular variations were observed in several cases

  17. Comparison of 16-row multislice CT angiography with conventional angiography for detection and evaluation of intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Donmez, Halil; Serifov, Elman; Kahriman, Guven [University of Erciyes, School of Medicine, Department of Radiology, Kayseri (Turkey); Mavili, Ertugrul, E-mail: ertmavili@yahoo.com [University of Erciyes, School of Medicine, Department of Radiology, Kayseri (Turkey); Durak, Ahmet Candan [University of Erciyes, School of Medicine, Department of Radiology, Kayseri (Turkey); Menkue, Ahmet [University of Erciyes, School of Medicine, Department of Neurosurgery, Kayseri (Turkey)

    2011-11-15

    Purpose: The aim of this study is to compare the diagnostic performance of 16-row computed tomographic angiography (MDCTA) with digital subtraction angiography (DSA) for the detection and characterization of intracranial aneurysms in patients with nontraumatic subarachnoid hemorrhages (SAH). Materials and methods: One-hundred and twelve consecutive patients with suspected intracranial aneurysm underwent both 16-row MDCTA and DSA. The MDCT angiograms were interpreted in a blinded fashion by using combination with VRI, MIP and MPR techniques. Sensitivity specificity and accuracy were calculated for the CTA and DSA. The results were compared with each other. The DSA reader's interpretation was accepted as the reference standard. Results: A total of 164 aneurysms were detected at DSA in 112 patients, no aneurysms were detected by DSA and MDCTA in 16 patients. Eight aneurysms were missed by MDCTA. The overall sensitivity, specificity, and accuracy of MDCTA on a per-aneurysm basis were 95.1%, 94.1%, and 95%, respectively. According to the size of the aneurysm less than 3 mm; sensitivity, specificity and diagnostic accuracy of MDCTA were 86.1%, 94.1%, 88.6%, respectively. Conclusion: This study suggests that MDCTA is equally as sensitive as DSA in the detection of intracranial aneurysms of greater than 3 mm, and it also reveals 100% detection rate for ruptured aneurysms.

  18. Single-centre cohort study of gender influence in coronary CT angiography in patients with a low to intermediate pretest probability of coronary heart disease

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten Schou; Isaksen, Christin; Buhl, Jørgen Selmer;

    2015-01-01

    BACKGROUND: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore investig...... of CAC. This may reflect a gender-specific difference in coping with chest discomfort, gender-specific referral bias for CCTA, and/or a gender-specific difference in the balance between coronary calcification and obstructive coronary heart disease.......BACKGROUND: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore...... investigated the relationship between gender, CAC and use of subsequent invasive coronary angiography and coronary revascularisation in a cohort of patients with chest discomfort and low to intermediate pretest probability of coronary artery disease who underwent a CCTA at our diagnostic centre. METHODS: This...

  19. Closing in on the K Edge : Coronary CT Angiography at 100, 80, and 70 kV-Initial Comparison of a Second-versus a Third-Generation Dual-Source CT System

    NARCIS (Netherlands)

    Meyer, Mathias; Haubenreisser, Holger; Schoepf, U. Joseph; Vliegenthart, Rozemarijn; Leidecker, Christianne; Allmendinger, Thomas; Lehmann, Ralf; Sudarski, Sonja; Borggrefe, Martin; Schoenberg, Stefan O.; Henzler, Thomas

    2014-01-01

    Purpose: To prospectively evaluate radiation and contrast medium requirements for performing high-pitch coronary computed tomographic (CT) angiography at 70 kV using a third-generation dual-source CT system in comparison to a second-generation dual-source CT system. Materials and Methods: All patien

  20. Quantitative myocardial perfusion PET combined with coronary anatomy derived from CT angiography. Validation of a new fusion and visualisation software

    Energy Technology Data Exchange (ETDEWEB)

    Fricke, Harald; Weise, Reiner; Burchert, Wolfgang; Fricke, Eva [Inst. of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine-Westphalia, Ruhr-Univ. Bochum, Bad Oeynhausen (Germany); Elsner, Andreas; Bolte, Matthias; Domik, Gitta [Research Group Computergraphics, Visualization and Image Processing, Univ. of Paderborn (Germany); Hoff, Joerg van den [PET Center, Inst. of Radiopharmacy, Research Center Rossendorf, Dresden (Germany)

    2009-07-01

    Aim: Dynamic perfusion PET offers a clinical relevant advantage over myocardial perfusion scintigraphy due to its ability to measure myocardial blood flow quantitatively. This leads to an improved detection of multivessel disease and the possibility to assess not only the culprit lesion but lower grade stenoses as well. For appropriate revascularization, perfusion defects must be matched to coronary lesions. It has been shown that image fusion of morphological and functional images is superior to side-by-side analysis. Still, software for quantitative perfusion PET combined with CT angiography is rare. In this paper we present a new software tool for image fusion and visualization of quantitative perfusion PET and coronary morphology derived from CT angiography. Methods: In our software, a PET uptake image is used for manual co-registration. Co-registration results are then applied to the functional data derived from compartment modelling. To evaluate the reproducibility of the manual co-registration, we calculated the deviation between a series of manual co-registrations performed on nine pairs of unregistered PET and CT datasets by five trained participants. Two dimensional transfer functions were used to highlight the coronary arteries from the CT study in the combined data sets. Results: The average Euclidian distances for three references points were between 3.7 and 4.1 mm. The maximum distance was 10.6 mm. By the use of the two dimensional transfer functions, coronary anatomy could be easily visualised either by user-interaction or automatically by use of neuronal networks. Conclusions: With this approach it is possible to combine quantitative perfusion PET with coronary anatomy derived from CT angiography. Our first experiences indicate that manual image fusion with our tool is reproducible and that visualisation of the combined datasets is achieved within short time. (orig.)

  1. The effect of low-dose β-blocker on heart rate and heart rate variability in health subjects wth a resting heart rate of less than 65 beats per minute: Effect on the quality of prospective electrocardiography-gated coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chul Hwan; Kim, Tae Hoon [Dept. of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Sang Min [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-02-15

    We assessed the effect of a low-dose β-blocker on heart rate (HR), HR variability (HRV) and image quality of prospective electrocardiography-gated coronary CT angiography (CCTA) in healthy subjects with low HR. CCTA was performed with a 64-slice CT in 75 subjects with a HR of less than 65 beats per minute (bpm). Subjects were divided into 2 groups: Group 1 (G1), 35 with a low dose β-blocker; and Group 2 (G2), 40 without pre-medication. The image quality (IQ) of the CCTA was assessed on a 4-point grading scale (1, poor; 4, excellent). Initial HR (bpm) was not different between the 2 groups. HR during CCTA was lower in G1 than G2 (50.3 ± 5.6 vs. 53.3 ± 4.8, p = 0.016). HRV was not different between the 2 groups. Per-segment analysis showed better IQ at the mid-segment of the right coronary artery (3.0 ± 0.9 vs. 2.5 ± 1.1, p = 0.039) and the first diagonal branch (3.4 ± 0.6 vs. 3.1 ± 0.7, p = 0.024), in the G1 than the G2 group, respectively. The IQ was negatively correlated with HR, but no correlation was found between HRV and IQ. The IQs in the per-vessel analysis were not different between the 2 groups. Low-dose β-blocker reduced HR and improved the IQ of CCTA in a few segments, even at a HR of less than 65 bpm. However the effect was limited.

  2. Comparison of target images obtained by MR angiography and 3D-CT angiography in the region of internal carotid-posterior communicating artery

    International Nuclear Information System (INIS)

    With the progress of diagnostic imaging equipment, allows us to obtain cerebral angiogram by Computed tomography (CT) and Magnetic resonance imaging (MRI). They are less invasive than conventional angiography and have its own modality-dependent information on the images. Therefore, to determine the indications of CT and MRI for neurovascular disease, we compared the target MIP images by MRI with target SSD images by CT and examined those characteristics in the particular region of internal carotid-posterior communicating (IC-PC) artery. MRA demonstrated blood flow non-invasively without influence of the surrounding bones posterior fossa. But it required several minutes of head fixation. Also, head movement yielded blurring of the images in a few cases. CTA gave us more stereographic informations than MRA so that we could easily differentiate the vascular lesion from normal vascular structure through the threshold processing. However, it is experienced that the dense bones surrounding the IC-PC region interfered reconstruction of vascular images. And high intravenous injection of contrast medium caused a few patients heat sensation or other side effect. Accordingly, both examinations should be used supplementarily, MRA selected for screening of the IC-PC region and the role of CTA is definition and evaluation of vascular lesion after MRA had pointed out the abnormality. (author)

  3. Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

    International Nuclear Information System (INIS)

    Aim: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms. Materials and methods: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared. Results: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p = 0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p = 0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p < 0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p = 0.22). Conclusion: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.

  4. Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, S., E-mail: syamamoto@gmail.co [David Geffen School of Medicine, Department of Radiology, University of California-Los Angeles, Los Angeles (United States); McWilliams, J.; Arellano, C.; Marfori, W.; Cheng, W.; Mcnamara, T.; Quinones-Baldrich, W.J.; Ruehm, S.G. [David Geffen School of Medicine, Department of Radiology, University of California-Los Angeles, Los Angeles (United States)

    2009-11-15

    Aim: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms. Materials and methods: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared. Results: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p = 0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p = 0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p < 0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p = 0.22). Conclusion: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.

  5. 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.

  6. Three-dimensional CT angiography study on the relations between the vertebral artery and atlantoaxial joint

    Institute of Scientific and Technical Information of China (English)

    DUAN Shao-yin; LU Shao-mao; YE Feng; LIN Qing-chi; CHEN Liao-bin

    2009-01-01

    Background The vertebral artery (VA) and atlantoaxial joint (AAJ), with complicated structures, are located in the depths of the head-neck boundary area, the regional anatomy of which cannot be shown globally and directly. This study aims to evaluate three-dimensional CT angiography (3DCTA) in displaying the AAJ, atlantoaxial segment of the vertebral artery (ASVA) and the identification of their interrelations.Methods Sixty-eight subjects without pathology of the ASVA and AAJ were selected from head-neck CTA examination. All the 3D images were formed with volume rendering (VR) together with techniques of separating, fusing, opacifying and false-coloring (SFOF). On the 3D images, the ASVA and AAJ were observed, and their interrelations were measured.Results All the 3DCTA images were of high quality and up to our requirements. They could cleady and directly show the ASVA, ascending along the AAJ. There were 5 curves in the course of the ASVA, of which 2 curves were away from the atlantoaxial joint, one in the 2nd curve of 0.0 mm-5.4 mm, the other in the 4th of 2.6 mm-9.2 mm. There was no significant difference in the measurements between left and dght (P>0.05). The curved parts of the ASVA slightly expanded, with the biggest diameter of 5.6 mm in the 4th curve. Statistical comparison shows that the left ASVA is larger than the right (P<0.05). Variations of the ASVA were found in 8 cases and of the AAJ in 12.Conclusions 3DCTA can globally and directly demonstrate the structures of the AAJ, ASVA and their interrelations. The 3D imaging data make up and enrich the research contents of regional anatomy and lay the foundation for related study and applications.

  7. Optimizing radiation dose by using advanced modelled iterative reconstruction in high-pitch coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Gordic, Sonja; Husarik, Daniela B.; Alkadhi, Hatem [University Hospital Zurich, University of Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Desbiolles, Lotus; Leschka, Sebastian [University Hospital Zurich, University of Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Kantonsspital, Divison of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Sedlmair, Martin; Schmidt, Bernhard [Siemens Healthcare, Computed Tomography Division, Forchheim (Germany); Manka, Robert [University Hospital Zurich, University of Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); University Hospital Zurich, University of Zurich, Clinic of Cardiology, Zurich (Switzerland); University and ETH Zurich, Institute for Biomedical Engineering, Zurich (Switzerland); Plass, Andre; Maisano, Francesco [University Hospital Zurich, University of Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland); Wildermuth, Simon [Kantonsspital, Divison of Radiology and Nuclear Medicine, St. Gallen (Switzerland)

    2016-02-15

    To evaluate the potential of advanced modeled iterative reconstruction (ADMIRE) for optimizing radiation dose of high-pitch coronary CT angiography (CCTA). High-pitch 192-slice dual-source CCTA was performed in 25 patients (group 1) according to standard settings (ref. 100 kVp, ref. 270 mAs/rot). Images were reconstructed with filtered back projection (FBP) and ADMIRE (strength levels 1-5). In another 25 patients (group 2), high-pitch CCTA protocol parameters were adapted according to results from group 1 (ref. 160 mAs/rot), and images were reconstructed with ADMIRE level 4. In ten patients of group 1, vessel sharpness using full width at half maximum (FWHM) analysis was determined. Image quality was assessed by two independent, blinded readers. Interobserver agreements for attenuation and noise were excellent (r = 0.88/0.85, p < 0.01). In group 1, ADMIRE level 4 images were most often selected (84 %, 21/25) as preferred data set; at this level noise reduction was 40 % compared to FBP. Vessel borders showed increasing sharpness (FWHM) at increasing ADMIRE levels (p < 0.05). Image quality in group 2 was similar to that of group 1 at ADMIRE levels 2-3. Radiation dose in group 2 (0.3 ± 0.1 mSv) was significantly lower than in group 1 (0.5 ± 0.3 mSv; p < 0.05). In a selected population, ADMIRE can be used for optimizing high-pitch CCTA to an effective dose of 0.3 mSv. (orig.)

  8. Carotid artery wall thickness and ischemic symptoms: evaluation using multi-detector-row CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Caddeo, Giancarlo; Mallarini, Giorgio [Azienda Ospedaliero Universitaria Polo di Monserrato, Department of Radiology, Cagliari (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria Polo di Monserrato, Department of Vascular Surgery, Cagliari (Italy); Pascalis, Luigi [Azienda Ospedaliero Universitaria Polo di Cagliari, Division of II Internal Medicine, Cagliari (Italy)

    2008-09-15

    The purpose of this study was to determine if carotid artery wall thickness (CAWT) studied by using multi-detector-row CT angiography (MDCTA) can be considered an effective parameter predictive of increased risk of stroke. A total of 217 patients were retrospectively studied by using MDCTA. In all patients CAWT was measured with an internal digital caliper. Continuous data were described as the mean value {+-} standard deviation (SD), and they were compared with Student's t-test. Scatter plots to determine interobserver agreement were performed, and correlation coefficient was calculated with Pearson statistics. A P value <0.05 was considered to mean statistical significance. Measurements of the distal common CAWT ranged from 0.5 to 1.6 mm. In the patient group without stroke, average CAWT was 0.82 mm (0.22 SD), whereas in patient group with stroke it was 1.096 mm (0.21 SD). CAWT in patients without stroke showed statistical difference (P<0.0001) when compared to patients with stroke. By using a threshold of 1 mm, an important statistical association between thick CAWT and stroke was found (P<0.0001). In fact, patients with {>=}1 mm CAWT had stroke with an odds ratio of 8.16 when compared with patients with <1 mm CAWT. Resulting data suggested that an increased CAWT is an indicator for risk of stroke. This parameter should be considered in addition to other well-known risk factors such as diabetes, hypertension, smoking, and dyslipidemia. (orig.)

  9. Automated quantification of epicardial adipose tissue using CT angiography: evaluation of a prototype software

    Energy Technology Data Exchange (ETDEWEB)

    Spearman, James V.; Silverman, Justin R.; Krazinski, Aleksander W.; Costello, Philip [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Meinel, Felix G.; Geyer, Lucas L. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Ludwig-Maximilians-University Hospital, Institute for Clinical Radiology, Munich (Germany); Schoepf, U.J. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Apfaltrer, Paul [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, Mannheim (Germany); Canstein, Christian [Siemens Medical Solutions USA, Inc., Malvern, PA (United States); De Cecco, Carlo Nicola [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' - Polo Pontino, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy)

    2014-02-15

    This study evaluated the performance of a novel automated software tool for epicardial fat volume (EFV) quantification compared to a standard manual technique at coronary CT angiography (cCTA). cCTA data sets of 70 patients (58.6 ± 12.9 years, 33 men) were retrospectively analysed using two different post-processing software applications. Observer 1 performed a manual single-plane pericardial border definition and EFV{sub M} segmentation (manual approach). Two observers used a software program with fully automated 3D pericardial border definition and EFV{sub A} calculation (automated approach). EFV and time required for measuring EFV (including software processing time and manual optimization time) for each method were recorded. Intraobserver and interobserver reliability was assessed on the prototype software measurements. T test, Spearman's rho, and Bland-Altman plots were used for statistical analysis. The final EFV{sub A} (with manual border optimization) was strongly correlated with the manual axial segmentation measurement (60.9 ± 33.2 mL vs. 65.8 ± 37.0 mL, rho = 0.970, P < 0.001). A mean of 3.9 ± 1.9 manual border edits were performed to optimize the automated process. The software prototype required significantly less time to perform the measurements (135.6 ± 24.6 s vs. 314.3 ± 76.3 s, P < 0.001) and showed high reliability (ICC > 0.9). Automated EFV{sub A} quantification is an accurate and time-saving method for quantification of EFV compared to established manual axial segmentation methods. (orig.)

  10. Initial study of optimal reconstruction windows in 320-detector row CT coronary angiography

    International Nuclear Information System (INIS)

    Objective: To investigate the optimal reconstruction windows for coronary angiography using 320-detector row dynamic volume CT (DVCT) and evaluate their effects on image quality, radiation dose and diagnostic accuracy. Methods: From 77 patients [mean heart rate (70±13) bpm, range: 46- 102 bmp] were scanned with retrospective ECG-gating 320-detector row DVCT. The relationship between heart rate and optimal reconstruction windows was analyzed. From 53 patients [mean heart rate (75± 11) bpm, range: 57-114 bpm] were scanned with prospective ECG-gating 320-detector row DVCT. The effects of prospective ECG-gating on image quality, radiation dose and diagnostic accuracy were evaluated. Friedman test was performed for image quality scores in random groups. Linear regression and Spearman correlation were performed to test bivariate data. Results: The proportion of systolic duration in the cardiac cycle increased significantly with higher heart rate (r=0.78, P 90 bpm, 35%-50%. Compared with retrospective ECG-gating, prospective ECC-gating which preset reconstruction windows according to the phases mentioned above, could decrease radiation dose [(6.1±3.8) vs (12.4± 7.0) mSv], without deteriorating the image quality (t=6.5, P<0.01). However, in higher heart rate, the radiation dose of prospective ECG-gating DVCT was still higher (r=0.64, P<0.01). Conclusions: DVCT can provide high image quality in a wide range of heart rate with prospective ECG gating. It is still recommended to control heart rate strictly since the radiation dose increases significantly in high heart rate. (authors)

  11. Pulmonary CT angiography protocol adapted to the hemodynamic effects of pregnancy.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2012-02-01

    OBJECTIVE: The purpose of this study was to compare the image quality of a standard pulmonary CT angiography (CTA) protocol with a pulmonary CTA protocol optimized for use in pregnant patients with suspected pulmonary embolism (PE). MATERIALS AND METHODS: Forty-five consecutive pregnant patients with suspected PE were retrospectively included in the study: 25 patients (group A) underwent standard-protocol pulmonary CTA and 20 patients (group B) were imaged using a protocol modified for pregnancy. The modified protocol used a shallow inspiration breath-hold and a high concentration, high rate of injection, and high volume of contrast material. Objective image quality and subjective image quality were evaluated by measuring pulmonary arterial enhancement, determining whether there was transient interruption of the contrast bolus by unopacified blood from the inferior vena cava (IVC), and assessing diagnostic adequacy. RESULTS: Objective and subjective image quality were significantly better for group B-that is, for the group who underwent the CTA protocol optimized for pregnancy. Mean pulmonary arterial enhancement and the percentage of studies characterized as adequate for diagnosis were higher in group B than in group A: 321 +\\/- 148 HU (SD) versus 178 +\\/- 67 HU (p = 0.0001) and 90% versus 64% (p = 0.05), respectively. Transient interruption of contrast material by unopacified blood from the IVC was observed more frequently in group A (39%) than in group B (10%) (p = 0.05). CONCLUSION: A pulmonary CTA protocol optimized for pregnancy significantly improved image quality by increasing pulmonary arterial opacification, improving diagnostic adequacy, and decreasing transient interruption of the contrast bolus by unopacified blood from the IVC.

  12. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

    Science.gov (United States)

    Ferreira, Eleci Vaz; Gazzana, Marcelo Basso; Sarmento, Muriel Bossle; Guazzelli, Pedro Arends; Hoffmeister, Mariana Costa; Guerra, Vinicius André; Seligman, Renato; Knorst, Marli Maria

    2016-01-01

    Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients. PMID:26982039

  13. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

    Directory of Open Access Journals (Sweden)

    Eleci Vaz Ferreira

    2016-02-01

    Full Text Available Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA in patients with suspected pulmonary thromboembolism (PTE who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%. Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%. Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%. Among those 75 cases, there were only 39 (20.4% in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases. Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001. Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients.

  14. Value of CT angiography in anterior circulation large vessel occlusive stroke: Imaging findings, pearls, and pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Power, Sarah, E-mail: drsarahpower@gmail.com [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); McEvoy, Sinead H., E-mail: sineadmcevoy@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Cunningham, Jane, E-mail: janecunningham0708@gmail.com [Department of Radiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Ti, Joanna P., E-mail: joannapearlyti@gmail.com [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Looby, Seamus, E-mail: seamuslooby@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); O' Hare, Alan, E-mail: alanohare@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Williams, David, E-mail: davidwilliams@rcsi.ie [Department of Geriatrics and Stroke Medicine, Royal College of Surgeons in Ireland (RCSI) and Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Brennan, Paul, E-mail: paulbrennan@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Thornton, John, E-mail: johnthornton@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland)

    2015-07-15

    Highlights: • Site of occlusion determines potential collateralization routes and impacts outcome. • Multifocality of arterial occlusion is common, seen in approximately 20% of cases. • ICA false occlusion sign can be seen in setting of ICA stenosis or carotid T occlusion. • False patency sign: hyperdense thrombus/calcified occlusive plaque misinterpreted as patent vessel. • Additional abnormalities on CTA may infer stroke mechanism or alter decision making. - Abstract: Hyperacute stroke imaging is playing an increasingly important role in determining management decisions in acute stroke patients, particularly patients with large vessel occlusive stroke who may benefit from endovascular intervention. CT angiography (CTA) is an important tool in the work-up of the acute stroke patient. It reliably detects large occlusive thrombi in proximal cerebral arteries and is a quick and highly accurate method in identifying candidates for endovascular stroke treatment. In this article we review the imaging findings on CTA in acute large vessel occlusive stroke using a pictorial case based approach. We retros