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Sample records for 64-slice mdct study

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

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

    2010-06-15

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

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

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

    2010-06-15

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

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

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    Jun Sung Moon

    2013-02-01

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

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

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

    2009-03-15

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

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

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    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.

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

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

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    郭小超; 邱建星; 蒋学祥; 王霄英

    2013-01-01

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

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

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

    2012-05-15

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

  9. 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.

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

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

    2015-01-01

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

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

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    Coche, E

    2007-01-01

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

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

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

    2007-07-01

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

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

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

    2009-02-01

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

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

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

    2007-03-15

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

  15. 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

  16. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  18. 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

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

    Institute of Scientific and Technical Information of China (English)

    李欣; 孙吉林; 戴国华; 付英杰; 李志远; 柳溪

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  1. 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

  2. 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.

  3. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-05-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Comparison between MDCT and Grayscale IVUS in a Quantitative Analysis of Coronary Lumen in Segments with or without Atherosclerotic Plaques

    Energy Technology Data Exchange (ETDEWEB)

    Falcão, João L. A. A.; Falcão, Breno A. A. [Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, SP (Brazil); Gurudevan, Swaminatha V. [Cedars-Sinai Heart Institute, Los Angeles, California, USA (United States); Campos, Carlos M.; Silva, Expedito R.; Kalil-Filho, Roberto; Rochitte, Carlos E.; Shiozaki, Afonso A.; Coelho-Filho, Otavio R.; Lemos, Pedro A. [Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, SP (Brazil)

    2015-04-15

    The diagnostic accuracy of 64-slice MDCT in comparison with IVUS has been poorly described and is mainly restricted to reports analyzing segments with documented atherosclerotic plaques. We compared 64-slice multidetector computed tomography (MDCT) with gray scale intravascular ultrasound (IVUS) for the evaluation of coronary lumen dimensions in the context of a comprehensive analysis, including segments with absent or mild disease. The 64-slice MDCT was performed within 72 h before the IVUS imaging, which was obtained for at least one coronary, regardless of the presence of luminal stenosis at angiography. A total of 21 patients were included, with 70 imaged vessels (total length 114.6 ± 38.3 mm per patient). A coronary plaque was diagnosed in segments with plaque burden > 40%. At patient, vessel, and segment levels, average lumen area, minimal lumen area, and minimal lumen diameter were highly correlated between IVUS and 64-slice MDCT (p < 0.01). However, 64-slice MDCT tended to underestimate the lumen size with a relatively wide dispersion of the differences. The comparison between 64-slice MDCT and IVUS lumen measurements was not substantially affected by the presence or absence of an underlying plaque. In addition, 64-slice MDCT showed good global accuracy for the detection of IVUS parameters associated with flow-limiting lesions. In a comprehensive, multi-territory, and whole-artery analysis, the assessment of coronary lumen by 64-slice MDCT compared with coronary IVUS showed a good overall diagnostic ability, regardless of the presence or absence of underlying atherosclerotic plaques.

  7. Role of multidetector computed tomography (MDCT in patients with ovarian masses

    Directory of Open Access Journals (Sweden)

    Mubarak F, Alam MS

    2011-04-01

    Full Text Available Fatima Mubarak, Muhammad Shahbaz Alam, Waseem Akhtar, Saima Hafeez, Noureen NizamuddinRadiology Department, Aga Khan University Hospital, Karachi, PakistanObjective: To evaluate the diagnostic accuracy of multidetector 64-slice computed tomography (MDCT in the diagnosis and differentiation of benign and malignant ovarian masses using histopathology and surgical findings as the gold standard.Material and methods: This study was conducted in Aga Khan University Hospital, Karachi, Pakistan. Data was reviewed retrospectively from 1 November 2008 to 12 December 2009. One hundred patients found to have ovarian masses on CT scan were included in the study. CT scan was performed in all these patients after administration of oral and IV contrast. Ovarian masses were classified as benign and malignant on scan findings. Imaging findings were compared with histopathologic results and surgical findings. Sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV, and diagnostic accuracy of MDCT were calculated.Results: MDCT was found to have 97% sensitivity, 91% specificity, and an accuracy of 96% in the differentiation of benign and malignant ovarian masses, while PPV and NPV were 97% and 91%, respectively.Conclusion: MDCT imaging offers a safe, accurate and noninvasive modality to differentiate between benign and malignant ovarian masses.Keywords: ovarian masses, surgery, MDCT

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

    Directory of Open Access Journals (Sweden)

    Afshin Akbarzadeh

    2009-06-01

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

  9. 64-slice coronary computed tomography angiography using low tube voltage of 80 kV in subjects with normal body mass indices: comparative study using 120 kV

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

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

  12. 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.

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

  14. Sixty-four MDCT achieves higher contrast in pancreas with optimization of scan time delay

    Science.gov (United States)

    Stuber, Tina; Brambs, Hans-Jürgen; Freund, Wolfgang; Juchems, Markus S

    2012-01-01

    AIM: To compare different multidetector computed tomography (MDCT) protocols to optimize pancreatic contrast enhancement. METHODS: Forty consecutive patients underwent contrast-enhanced biphasic MDCT (arterial and portal-venous phase) using a 64-slice MDCT. In 20 patients, the scan protocol was adapted from a previously used 40-channel MDCT scanner with arterial phase scanning initiated 11.1 s after a threshold of 150 HU was reached in the descending aorta, using automatic bolus tracking (Protocol 1). The 11.1-s delay was changed to 15 s in the other 20 patients to reflect the shorter scanning times on the 64-channel MDCT compared to the previous 40-channel system (Protocol 2). HU values were measured in the head and tail of the pancreas in the arterial and portal-venous phase. RESULTS: Using an 11.1-s delay, 74.2 HU (head) were measured on average in the arterial phase and 111.2 HU (head) were measured using a 15-s delay (P < 0.0001). For the pancreatic tail, the average attenuation level was 76.73 HU (11.1 s) and 99.89 HU (15 s) respectively (P = 0.0002). HU values were also significantly higher in the portal-venous phase [pancreatic head: 70.5 HU (11.1 s) vs 84.0 HU (15 s) (P = 0.0014); pancreatic tail: 67.45 HU (11.1 s) and 77.18 HU (15 s) using Protocol 2 (P = 0.0071)]. CONCLUSION: Sixty-four MDCT may yield a higher contrast in pancreatic study with (appropriate) optimization of scan delay time. PMID:22900134

  15. 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.

  16. 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.

  17. MDCT of the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Aschoff, A.J. [Dept. for Diagnostic Radiology, Univ. Hospitals of Ulm (Germany)

    2006-01-10

    Multi-detector row computed tomography (MDCT) enables fast and thin acquisition of the abdominal anatomy. This allows multi-pass multi-planar studies that can be obtained during defined circulatory phases. When bolus timing is adequate, arterial phases with high contrast levels provide 'free lunch' CT angiographies eliminating the need for diagnostic angiographies in most cases. In addition to established clinical indications for abdominal CT such as preoperative MDCT of the liver or pancreas, MDCT of the abdomen is especially gaining ground in the work up for acute abdominal pain and abdominal trauma and is opening new indications for MDCT of the gastrointestinal tract. Indications for gastrointestinal MDCT include tumors, bleeding and ischemia of the small and large bowel as well as diverticulitis. The question of whether to use positive or negative contrast material for bowel distention for MDCT of the gastrointestinal tract is still a controversial issue. In selected cases, modifying the protocol to perform a 'CT enteroclysis' might improve sensitivity and specificity in depicting small bowel tumors or inflammatory changes such as in Crohn's disease. The most common gastrointestinal mesenchymal tumor is the gastrointestinal stromal tumor (GIST). MDCT may show hypervascular submucosal masses. Acute gastrointestinal (GI) bleeding is common with patients presenting with melena, hematemesis or hematochezia. In addition to the established initial work-up MDCT is beginning to establish itself for this indication. It may be especially helpful in the work up of obscure bleeding. Another relatively rare but important cause for acute abdominal pain is mesenteric ischemia. It may be caused by many conditions and may mimic various intestinal diseases. Bowel ischemia severity ranges from transient superficial changes of the intestinal mucosa to life-threatening transmural bowel wall necrosis. CT can demonstrate changes in ischemic bowel segments

  18. 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.

  19. 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

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-11-15

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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Hong-sheng WANG

    2013-02-01

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

  8. 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.

  9. MR-Imaging of teeth and periodontal apparatus: an experimental study comparing high-resolution MRI with MDCT and CBCT

    Energy Technology Data Exchange (ETDEWEB)

    Gaudino, Chiara; Csernus, Reka; Pham, Mirko; Bendszus, Martin; Rohde, Stefan [University Hospital Heidelberg, Department of Neuroradiology, Heidelberg (Germany); Cosgarea, Raluca; Kim, Ti-Sun [University Hospital Heidelberg, Department of Periodontology, Heidelberg (Germany); Heiland, Sabine [University Hospital Heidelberg, Section of Experimental Radiology, Heidelberg (Germany); Beomonte Zobel, Bruno [University Campus Bio-Medico of Rome, Department of Radiology, Interdisciplinary Center for Biomedical Research, Rome (Italy)

    2011-12-15

    The aim of this study was (1) to assess the ability of magnetic resonance imaging (MRI) to visualize dental and periodontal structures and (2) to compare findings with multidetector computed tomography (MDCT) and cone beam CT (CBCT). Four porcine mandibles were examined with (1) 3T-MRI, (2) MDCT and (3) CBCT. Two observers independently reviewed MR, MDCT and CBCT images and assessed image quality of different dental and periodontal structures. To assess quantitatively the accuracy of the different imaging technique, both observers measured burr holes, previously drilled in the mandibles. Dental structures, e.g. teeth roots, pulpa chamber and dentin, were imaged accurately with all imaging sources. Periodontal space and cortical/trabecular bone were better visualized by MRI (p < 0.001). MRI could excellently display the lamina dura, not detectable with MDCT and only inconstant visible with CBCT (p < 0.001). Burr hole measurements were highly precise with all imaging techniques. This experimental study shows the diagnostic feasibility of MRI in visualization of teeth and periodontal anatomy. Detection of periodontal structures was significantly better with MRI than with MDCT or CBCT. Prospective trials have to evaluate further the potential benefit of MRI in a clinical setting. (orig.)

  10. MDCT findings after elbow dislocation: a retrospective study of 140 patients

    Energy Technology Data Exchange (ETDEWEB)

    Sormaala, Markus J. [Helsinki University Central Hospital, Medical Imaging Center, Helsinki (Finland); Turku University Hospital, Medical Imaging Center, Turku (Finland); Helsinki University Central Hospital, Toeoeloe Trauma Center, Helsinki (Finland); Sormaala, Annastiina; Koskinen, Seppo K. [Helsinki University Central Hospital, Medical Imaging Center, Helsinki (Finland); Helsinki University Central Hospital, Toeoeloe Trauma Center, Helsinki (Finland); Mattila, Ville M. [Tampere University Hospital, Department of Orthopedic Surgery and Trauma, Tampere (Finland); Karolinska Hospital, Department of Orthopedic Surgery, Stockholm (Sweden)

    2014-04-15

    To assess the number and anatomical location of fractures associated with elbow dislocation, to study the correlation between the direction of dislocation and the trauma energy, and to assess radiographs' diagnostic performance characteristics for fractures using MDCT as a reference standard. A retrospective study was performed at a level 1 trauma center, finding a total of 140 patients who had sustained an elbow dislocation and who had undergone a subsequent MDCT examination. The CT and radiographs of the patient were reviewed by two musculoskeletal radiologists. CT images were analyzed for the site and size of the fracture fragments. In addition, the primary direction of the dislocation, patients' age, and gender were recorded. Trauma energy was also assessed. One hundred and thirty-four out of 140 patients (96 %) had a fracture that was seen on the correlative CT examination. The most common anatomical fracture locations were the coronoid process of the ulna 84 out of 140 (60 %), the radial head 75 out of 140 (54 %), and the humeral capitellum 57 out of 140 (41 %). Multiple fractures were seen in 71 out of 134 (53 %) patients with fractures. The left elbow was more commonly dislocated than the right one. The overall sensitivity of the radiographs was 62 % and the specificity 96 %. Small fractures and impaction fractures are almost invariably present in elbow dislocations, and half of the patients have more than one fracture. Radiographs have a sensitivity of only 62 %. MDCT is an invaluable method for determining the extent of bony injury and revealing occult fractures. (orig.)

  11. 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.)

  12. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-15

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

  14. 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.

  15. 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.

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

    Institute of Scientific and Technical Information of China (English)

    戴贵东; 肖正远; 兰永树; 粱卡丽

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    赵胜祥; 张琴; 陈朝晖

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-11-15

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

  19. Assessment of microembolization associated with revascularization in acute myocardial infarction: MDCT cardiac perfusion and function study.

    Science.gov (United States)

    Saeed, Maythem; Hetts, Steven W; Do, Loi; Wilson, Mark W

    2013-12-01

    To use multi-detector computed tomography (MDCT) for assessing the effects of coronary microemboli on pre-existing acute myocardial infarct (AMI) and to compare this pathology to LAD microembolization and occlusion/reperfusion. An angioplasty balloon catheter was placed in the LAD coronary artery of pigs under X-ray guidance. Four animals served as controls without intervention (group A) and an additional 24 animals (8/group) were subjected to microembolization (group B), occlusion/reperfusion (group C) or combination of the two insults (group D). MDCT was used to assess perfusion, LV function and viability. At postmortem, the LV sections were stained with hematoxylin/eosin and triphenyltetrazolium chloride (TTC). Dynamic perfusion and helical cine MDCT demonstrated decline in regional LV perfusion and function, respectively, after all interventions. MDCT showed significant differences in ejection fraction between groups: A = 57.5 ± 4.7%, B = 40.3 ± 0.5% P 0.7). Microscopic examination confirmed the presence of patchy and contiguous necrosis, MVO, edema and calcium deposits. Dynamic and helical cine MDCT imaging can grade LV dysfunction and perfusion deficit, respectively. DE-MDCT demonstrated a large and persistent MVO zone after microembolization of pre-existing AMI. Furthermore, it has the potential to visualize patchy microinfarct, detect perfusion deficits and dysfunction at the border zone after microembolization of pre-existing AMI.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-03-15

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

  1. 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

  2. Adult exposures from MDCT including multiphase studies: first Italian nationwide survey

    Energy Technology Data Exchange (ETDEWEB)

    Palorini, Federica; Origgi, Daniela [Fisica Sanitaria Istituto Europeo di Oncologia, Milan (Italy); Granata, Claudio [UOC di Radiologia Istituto Giannina Gaslini, Genoa (Italy); Matranga, Domenica [Universita degli Studi di Palermo, Dipartimento di Scienze per la Promozione della Salute e Materno-infantile ' ' G. D' Alessandro' ' , Palermo (Italy); Salerno, Sergio [Policlinico Universita di Palermo, Dipartimento di Scienze Radiologiche, Palermo (Italy)

    2014-02-15

    To evaluate the radiation dose in routine multidetector computed tomography (MDCT) examinations in Italian population. This was a retrospective multicentre study included 5,668 patients from 65 radiology departments who had undergone common CT protocols: head, chest, abdomen, chest-abdomen-pelvis (CAP), spine and cardiac. Data included patient characteristics, CT parameters, volumetric CT dose index (CTDI{sub vol}) and dose length product (DLP) for each CT acquisition phase. Descriptive statistics were calculated, and a multi-regression analysis was used to outline the main factors affecting exposure. The 75th percentiles of CTDI{sub vol} (mGy) and DLP (mGy cm) for whole head were 69 mGy and 1,312 mGy cm, respectively; for chest, 15 mGy and 569 mGy cm; spine, 42 mGy and 888 mGy cm; cardiac, 7 mGy and 131 mGy cm for calcium score, and 61 mGy and 1,208 mGy cm for angiographic CT studies. High variability was present in the DLP of abdomen and CAP protocols, where multiphase examinations dominated (71 % and 73 % respectively): for abdomen, 18 mGy, with 555 and 920 mGy cm in abdomen and abdomen-pelvis acquisitions respectively; for CAP, 17 mGy, with 508, 850 and 1,200 mGy cm in abdomen, abdomen-pelvis and CAP acquisitions respectively. The results of this survey could help in the definition of updated diagnostic reference levels (DRL). (orig.)

  3. The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Yong-Chan; Kim, Jae Yoon [Chung-Ang University College of Medicine, Department of Orthopaedic Surgery, Seoul (Korea, Republic of); Choi, Jung-Ah; Lee, Guen Young; Kang, Heung Sik [Seoul National University Bundang Hospital, Departments of Radiology, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam (Korea, Republic of); Lee, Young-Kyun; Koo, Kyung-Hoi [Seoul National University Bundang Hospital, Orthopaedic Surgery, Seoul National University College of Medicine, Seongnam (Korea, Republic of)

    2013-05-15

    The purpose of this study was first, to determine the sensitivity, specificity, and accuracy of MDCT arthrography (CTA) for the diagnosis of acetabular labral tear and sulcus; second, to correlate tear types using the Lage classification system on CTA compared with the arthroscopic classification; and third, to correlate CTA localization with arthroscopic localization. Direct CTA was performed using 16- or 64-slice MDCT in 126 hips (124 patients) who had chronic groin pain and positive impingement test. Images were reviewed and evaluated by two experienced musculoskeletal radiologists preoperatively. CTA findings were compared with arthroscopic findings in 58 hips (56 patients) under consensus by two orthopedic surgeons. Forty-one of the 58 hips were diagnosed as labral tears on CT arthrography. Forty-three of the 58 hips were shown to have a labral tear on arthroscopy. Sensitivity, specificity, and accuracy for detecting labral tear and sulcus by CTA were 90.7%, 86.7%, and 89.7%, and 93.8%, 97.6% and 96.6% respectively for observer 1, and 90.7% and 80.0%, 87.9% and 87.5%, 95.2%, and 93.1 % respectively for observer 2. Thirty-five out of 41 hips (85%) that were diagnosed with labral tear on CTA correlated substantially with arthroscopic Lage classification (kappa coefficient = 0.65). CTA and arthroscopic findings showed similar distribution patterns of the tears with most lesions located in antero- and postero-superior areas (p = 0.013). Direct CT arthrography using MDCT may be a useful diagnostic technique in the detection of acetabular labral tear. (orig.)

  4. Comparative study of image quality and radiation dose between prospective and retrospective ECG gating technique in coronary artery imaging with 64-slice spiral CT%64排螺旋CT冠状动脉成像的前瞻性与回顾性心电门控技术的图像质量及辐射剂量的比较研究

    Institute of Scientific and Technical Information of China (English)

    刘建新; 刘剑; 窦砚彬; 王继琛; 孙洪跃

    2009-01-01

    目的 研究前瞻性心电门控触发(prospective ECG-triggering)与回顾性心电门控(retrosp-ective ECG gating)两种技术方法行冠状动脉CTA检查时,对冠状动脉图像质量及辐射剂量的比较.方法 33名疑似冠状动脉疾病的患者分两组进行对比研究.前瞻组16例为前瞻性心电门控成像,心率小于65次/min;回顾组17例为回顾性心电门控成像,心率小于75次/min.记录两组的辐射剂量并统计分析,同时进行图像质量评价.结果 两组图像质量比较,差异无统计学意义(P0.05).前瞻性心电门控冠状动脉CTA的平均DLP 234.4 mGy·cm,占回顾性心电门控冠状动脉CTA的平均DLP 974.4 mGy·cm的24.1%.前瞻性心电门控冠状动脉CTA的患者的平均有效剂量为3.2 mSy,回顾心电门控冠状动脉CTA患者的为13.6 mSv,降低76.47%.结论 64排螺旋CT在前瞻性心电门控冠状动脉CTA与回顾性心电门控冠状动脉CTA比较可以获得相似的图像质量,可大幅降低患者的有效剂量对于不能接受高辐射剂量且心率较低的受检人群具有重要的临床价值.%Objective To compare the image quality and radiation dose between prospective ECG-trigering and retrospective ECG gating technique in coronary artery imaging. Methods 33 patients suspected coronary artery disease were included in this study and divided into experimental group (prospective ECG-triggering coronary artery imaging, heart rate < 65 bpm, 16 patients)and control group (retrospective ECG gating coronary artery imaging, heart rate < 75 bpm, 17 patients). Radiation dose was recorded for statistical analysis. At the same time, image quality was evaluated. Results There were no significant differences in image quality 3.2 msy. Effective dose reduced 76.47 %. Conclusions Prospective ECG gating coronary artery imaging can obtain the similar image quality compared with prospective ECG gating coronary artery imaging but the effective dose reduced 76.47 %. Prospective ECG

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

    Directory of Open Access Journals (Sweden)

    Leaila Karimi-Afshar

    2009-06-01

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

  6. Determining gastric cancer resectability by dynamic MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Zilai; Zhang, Huan; Du, Lianjun; Ding, Bei; Song, Qi; Ling, Huawei; Huang, Baisong; Chen, Kemin [Jiaotong University, Department of Radiology, Shanghai (China); Yan, Chao [Jiaotong University, Department of Surgery, Shanghai (China)

    2010-03-15

    Multi-detector row CT (MDCT) has been widely used to detect primary lesions and to evaluate TNM staging. In this study we evaluated the accuracy of dynamic MDCT in the preoperative determination of the resectability of gastric cancer. MDCT was used to image 350 cases of gastric cancer diagnosed by biopsy before surgery. MDCT findings regarding TNM staging and resectability were correlated with surgical and pathological findings. The accuracy of MDCT for staging gastric cancer was high, especially for tumour stage T1 (94.3%), lymph node stage N2 (87.3%), and for predicting distant metastases (>96.6%). When resectability was considered to be the outcome, the total accuracy of MDCT was 87.4%, sensitivity was 89.7% and specificity was 76.7%. Results showed high sensitivity for identifying peritoneal seeding (90.0%) and for predicting liver metastasis (80.0%). Dynamic enhanced MDCT is useful for TNM staging of gastric cancers and for predicting tumour respectability preoperatively. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-08-15

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

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

    Directory of Open Access Journals (Sweden)

    "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

  9. Influence of radiation dose and reconstruction algorithm in MDCT assessment of airway wall thickness: A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Cardona, Daniel [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Nagle, Scott K. [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792 (United States); Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792 (United States); Li, Ke; Chen, Guang-Hong, E-mail: gchen7@wisc.edu [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792 (United States); Robinson, Terry E. [Department of Pediatrics, Stanford School of Medicine, 770 Welch Road, Palo Alto, California 94304 (United States)

    2015-10-15

    Purpose: Wall thickness (WT) is an airway feature of great interest for the assessment of morphological changes in the lung parenchyma. Multidetector computed tomography (MDCT) has recently been used to evaluate airway WT, but the potential risk of radiation-induced carcinogenesis—particularly in younger patients—might limit a wider use of this imaging method in clinical practice. The recent commercial implementation of the statistical model-based iterative reconstruction (MBIR) algorithm, instead of the conventional filtered back projection (FBP) algorithm, has enabled considerable radiation dose reduction in many other clinical applications of MDCT. The purpose of this work was to study the impact of radiation dose and MBIR in the MDCT assessment of airway WT. Methods: An airway phantom was scanned using a clinical MDCT system (Discovery CT750 HD, GE Healthcare) at 4 kV levels and 5 mAs levels. Both FBP and a commercial implementation of MBIR (Veo{sup TM}, GE Healthcare) were used to reconstruct CT images of the airways. For each kV–mAs combination and each reconstruction algorithm, the contrast-to-noise ratio (CNR) of the airways was measured, and the WT of each airway was measured and compared with the nominal value; the relative bias and the angular standard deviation in the measured WT were calculated. For each airway and reconstruction algorithm, the overall performance of WT quantification across all of the 20 kV–mAs combinations was quantified by the sum of squares (SSQs) of the difference between the measured and nominal WT values. Finally, the particular kV–mAs combination and reconstruction algorithm that minimized radiation dose while still achieving a reference WT quantification accuracy level was chosen as the optimal acquisition and reconstruction settings. Results: The wall thicknesses of seven airways of different sizes were analyzed in the study. Compared with FBP, MBIR improved the CNR of the airways, particularly at low radiation dose

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

    Science.gov (United States)

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

    2016-10-01

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

  11. Lateralized odontoid in plain film radiography. Sign of fractures? A comparison study with MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Keller, S.; Bieck, K.; Karul, M.; Schoennagel, B.; Adam, G.; Habermann, C.; Yamamura, J. [University Hospital Hamburg Eppendorf (Germany). Dept. of Diagnostic and Interventional Radiology

    2015-09-15

    To evaluate X-ray standards for the detection of odontoid fractures. Summary of background data: Cervical spine fractures are a common finding in emergency medicine, accounting for 1 - 3 % of injuries. Involvement of the C1 / C2 complex is found in 25 % of cases, affecting the odontoid peg in 55 - 80 %. Regarding the consequences of missed fractures, radiographic techniques built the groundwork for further treatment procedures. As standardized X-ray measurements have not been established, the incidence of unrecognized cervical spine fracture is expected to be up to 20 %. The establishment of X-ray-based guidelines is also limited by the presumed low specificity and sensitivity of distance measurements caused by rotational distortion which leads to a rising popularity of CT. 79 (age 60 ± 26 yrs) patients with lateralization of the odontoid process on conventional plain film radiography (anteroposterior, lateral, and open mouth odontoid process view projection) were examined. The distance between the odontoid process and lateral mass of C1, angles of vertical odontoid line and basis of C2 were measured in the ap view. In the lateral view, dorsal alignment and atlantodental distance were assessed. MDCT examinations were used as a reference. Discriminatory power test was applied to assess significance. 8/79 (10.1 %) odontoid process fractures were found. Diagnosis was achieved on conventional radiographs in 6 patients. Neither distance and angle measurements between odontoid and C1 nor the dorsal alignment of the vertebral bodies differed significantly between healthy and affected patients. Decentralization of the odontoid process is not necessarily an indirect sign for its fracture. In patients with suspected injury of the odontoid process, an MDCT scan might be the method of choice to rule out a fracture.

  12. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  14. Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Deux, Jean-Francois [University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, Creteil (France); University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, CNRS EAC 4396, Centre de Recherches Chirurgicales, Henri Mondor Hospital, Creteil (France); Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); Mihalache, Cristian-Ionut; Legou, Francois; Luciani, Alain; Kobeiter, Hicham; Rahmouni, Alain [University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, Creteil (France); Damy, Thibaud [Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiology Department, Henri Mondor Hospital, Creteil (France); Mayer, Julie [University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, Creteil (France); Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); Rappeneau, Stephane [Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); Plante-Bordeneuve, Violaine [Reseau Amylose Mondorien, Henri Mondor Hospital, Creteil (France); University Paris Est Creteil, Assistance Publique-Hopitaux de Paris, Department of Neurophysiology of Neurology, Henri Mondor Hospital, Creteil (France)

    2015-08-15

    To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT). Thirteen patients with CA and 11 control patients were examined with first-pass and delayed CT acquisition. A qualitative and quantitative analysis of images was performed. Myocardial attenuation, myocardial signal-to-noise ratio (SNR{sub myoc}), blood pool SNR (SNR{sub blood}), contrast-to-noise ratio between blood pool and myocardium (CNR{sub blood-myoc}) and relative attenuation index (RAI) defined as variation of myocardial attenuation between delayed and first-pass acquisitions were calculated. Two false negative cases (15 %) and three false positive cases (27 %) were detected on qualitative analysis. SNR{sub myoc} of patients with CA was significantly (p < 0.05) lower on first-pass (4.08 ± 1.9) and higher on delayed acquisition (7.10 ± 2.7) than control patients (6.1 ± 2.2 and 5.03 ± 1.8, respectively). Myocardial attenuation was higher in CA (121 ± 39 HU) than control patients (81 ± 17 HU) on delayed acquisition. CNR{sub blood-myoc} was significantly (p < 0.05) lower in CA (1.51 ± 0.7) than control patients (2.85 ± 1.2) on delayed acquisition. The RAI was significantly (p < 0.05) higher in CA (0.12 ± 0.25) than in control patients (-0.56 ± 0.21). Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA. (orig.)

  15. MDCT: cardiology indications

    Energy Technology Data Exchange (ETDEWEB)

    Kopp, A.F.; Kuettner, A.; Trabold, T.; Heuschmid, M.; Claussen, C.D. [Dept. of Diagnostic Radiology, Eberhard Karls Univ. Tuebingen, Tuebingen (Germany); Schroeder, S. [Div. of Cardiology, Dept. of Internal Medicine, Eberhard Karls Univ. Tuebingen, Tuebingen (Germany)

    2003-12-01

    In the past 2 years mechanical multidetector-row CT (MDCT) systems with simultaneous acquisition of four slices and half-second scanner rotation have become widely available. Data acquisition with these scanners allows for considerably faster coverage of the heart volume compared with single-slice scanning. This increased scan speed can be used for retrospective gating together with 1-mm collimated slice widths and allows coverage of the entire cardiac volume in one breath hold. Initial results from studies in correlation with intracoronary ultrasound suggest that MDTC technology not only offers the possibility to visualize intracoronary stenoses non-invasively but also to differentiate plaque morphology. This is especially the case with the next generation of 16-row multidetector CT. An increased number of simultaneously acquired slices and sub-millimeter collimation for cardiac applications allows true isotropic scanning with high temporal resolution. Contrastenhanced MDTC is a promising non-invasive technique for the detection, visualization, and characterization of stenotic artery disease. It could act as a gate keeper prior to cardiac catherization and finally replace conventional diagnostic modalities. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-15

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

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

    Science.gov (United States)

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

    2009-07-01

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

  18. Detection of metastatic bone lesions in breast cancer patients: Fused {sup 18}F-Fluoride-PET/MDCT has higher accuracy than MDCT. Preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Piccardo, Arnoldo, E-mail: arnoldo.piccardo@galliera.it [Department of Nuclear Medicine, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Altrinetti, Vania, E-mail: vania.altrinetti@galliera.it [Department of Nuclear Medicine, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Bacigalupo, Lorenzo, E-mail: lorenzo.bacigalupo@galliera.it [Department of Radiolog, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Puntoni, Matteo, E-mail: matteo.puntoni@galliera.it [Department of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Biscaldi, Ennio, E-mail: ennio.biscaldi@galliera.it [Department of Radiolog, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Gozza, Alberto, E-mail: alberto.gozza@galliera.it [Department of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Cabria, Manlio, E-mail: manlio.cabria@galliera.it [Department of Nuclear Medicine, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Iacozzi, Massimiliano, E-mail: massimiliano.iacozzi@galliera.it [Department of Nuclear Medicine, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Pasa, Ambra, E-mail: ambra.pasa@galliera.it [Department of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); Morbelli, Silvia, E-mail: silviadaniela.morbelli@hsanmartino.it [Unit of Nuclear Medicine, San Martino Hospital, Largo Rosanna Benzi 10,16132 Genoa (Italy); Villavecchia, Giampiero, E-mail: giampiero.villavecchia@galliera.it [Department of Nuclear Medicine, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy); DeCensi, Andrea, E-mail: andrea.decensi@galliera.it [Department of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa (Italy)

    2012-10-15

    Purpose: So far, no studies comparing {sup 18}F-Fluoride-PET/CT and MDCT for the detection of bone metastases are available. We compared the accuracy of {sup 18}F-Fluoride-PET/CT (MDCT: 3.75 mm thickness-image-reconstruction), whole-body Multi-Detector-CT (MDCT: 1.25 mm thickness-image-reconstruction) and {sup 18}F-Fluoride-PET/MDCT (MDCT: 1.25 mm thickness-image-reconstruction) in identifying bone metastases in breast cancer patients. Methods: We studied 39 breast cancer patients for bone metastases. Imaging was performed on an integrated PET/MDCT-system; CT images were reconstructed at 3.75 mm and 1.25 mm thickness. Two nuclear medicine physicians and one radiologist interpreted blindly {sup 18}F-Fluoride-PET/CT, {sup 18}F-Fluoride-PET/MDCT and MDCT. MDCT at 12 months served as the standard of reference. Results: Overall, 662 bone lesions were detected in our analysis. Of these, 542 were malignant and 120 were benign according to the standard of reference. {sup 18}F-Fluoride-PET/CT detected 491 bone metastases, 114 (23%) of which displayed no clear morphological changes on MDCT, whereas MDCT detected 416 bone metastases, 39 (9.3%) of which showed no {sup 18}F-Fluoride-PET uptake. Overall sensitivity and specificity were: 91% and 91%, respectively, for {sup 18}F-Fluoride-PET/CT, and 77% and 93% for MDCT. The integrated assessment of {sup 18}F-Fluoride-PET/MDCT yielded sensitivity and specificity values of 98% and 93%, respectively. Conclusions: {sup 18}F-Fluoride-PET/MDCT has higher diagnostic accuracy than {sup 18}F-Fluoride-PET/CT and MDCT for the evaluation of bone metastases in breast cancer.

  19. 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.

  20. 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

  1. MDCT features of cardiothoracic sources of stroke.

    Science.gov (United States)

    Hoey, E T D; Mansoubi, H; Gopalan, D; Tasker, A D; Screaton, N J

    2009-05-01

    Multidetector computed tomography (MDCT) is widely used in the assessment of cardiothoracic disease and provides high-resolution images of the heart, great vessels, and lungs. A range of cardiothoracic conditions can precipitate stroke, including intracardiac thrombus, right-to-left shunts, and diseases of the thoracic aorta. Many of these conditions may be identified on non-electrocardiogram (ECG)-gated studies, but the advent of high temporal resolution ECG-gated MDCT provides superior anatomical delineation. Radiologists should be familiar with the pathogenesis and CT features of cardiothoracic conditions that can precipitate stroke as their early identification to enables appropriate management and prognostic decisions.

  2. MDCT features of cardiothoracic sources of stroke

    Energy Technology Data Exchange (ETDEWEB)

    Hoey, E.T.D.; Mansoubi, H. [Department of Radiology, Papworth Hospital, Cambridge (United Kingdom); Gopalan, D. [Department of Radiology, Papworth Hospital, Cambridge (United Kingdom)], E-mail: deepa.gopalan2@papworth.nhs.uk; Tasker, A.D.; Screaton, N.J. [Department of Radiology, Papworth Hospital, Cambridge (United Kingdom)

    2009-05-15

    Multidetector computed tomography (MDCT) is widely used in the assessment of cardiothoracic disease and provides high-resolution images of the heart, great vessels, and lungs. A range of cardiothoracic conditions can precipitate stroke, including intracardiac thrombus, right-to-left shunts, and diseases of the thoracic aorta. Many of these conditions may be identified on non-electrocardiogram (ECG)-gated studies, but the advent of high temporal resolution ECG-gated MDCT provides superior anatomical delineation. Radiologists should be familiar with the pathogenesis and CT features of cardiothoracic conditions that can precipitate stroke as their early identification to enables appropriate management and prognostic decisions.

  3. 64排容积CT扫描在严重多发伤快速评估中的应用%Clinical application of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma

    Institute of Scientific and Technical Information of China (English)

    熊坤林; 龚水根; 李然; 曹红元; 张伟国

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-15

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

  5. 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.

  6. 64排螺旋CT对先天性主动脉缩窄诊断的临床应用价值%Clinical Application of 64-slice Spiral CT Angiography in Diagnosing the Congenital Coarctation of Aorta

    Institute of Scientific and Technical Information of China (English)

    王小红; 亓波

    2011-01-01

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

  7. A Numerical Study of Water Loss Rate Distributions in MDCT-Based Human Airway Models.

    Science.gov (United States)

    Wu, Dan; Miyawaki, Shinjiro; Tawhai, Merryn H; Hoffman, Eric A; Lin, Ching-Long

    2015-11-01

    Both three-dimensional (3D) and one-dimensional (1D) computational fluid dynamics methods are applied to study regional water loss in three multi-detector row computed-tomography-based human airway models at the minute ventilations of 6, 15 and 30 L/min. The overall water losses predicted by both 3D and 1D models in the entire respiratory tract agree with available experimental measurements. However, 3D and 1D models reveal different regional water loss rate distributions due to the 3D secondary flows formed at bifurcations. The secondary flows cause local skewed temperature and humidity distributions on inspiration acting to elevate the local water loss rate; and the secondary flow at the carina tends to distribute more cold air to the lower lobes. As a result, the 3D model predicts that the water loss rate first increases with increasing airway generation, and then decreases as the air approaches saturation, while the 1D model predicts a monotonic decrease of water loss rate with increasing airway generation. Moreover, the 3D (or 1D) model predicts relatively higher water loss rates in lower (or upper) lobes. The regional water loss rate can be related to the non-dimensional wall shear stress (τ (*)) by the non-dimensional mass transfer coefficient (h 0 (*) ) as [Formula: see text].

  8. A numerical study of heat and water vapor transfer in MDCT-based human airway models.

    Science.gov (United States)

    Wu, Dan; Tawhai, Merryn H; Hoffman, Eric A; Lin, Ching-Long

    2014-10-01

    A three-dimensional (3D) thermo-fluid model is developed to study regional distributions of temperature and water vapor in three multi-detector row computed-tomography-based human airways with minute ventilations of 6, 15 and 30 L/min. A one-dimensional (1D) model is also solved to provide necessary initial and boundary conditions for the 3D model. Both 3D and 1D predicted temperature distributions agree well with available in vivo measurement data. On inspiration, the 3D cold high-speed air stream is split at the bifurcation to form secondary flows, with its cold regions biased toward the inner wall. The cold air flowing along the wall is warmed up more rapidly than the air in the lumen center. The repeated splitting pattern of air streams caused by bifurcations acts as an effective mechanism for rapid heat and mass transfer in 3D. This provides a key difference from the 1D model, where heating relies largely on diffusion in the radial direction, thus significantly affecting gradient-dependent variables, such as energy flux and water loss rate. We then propose the correlations for respective heat and mass transfer in the airways of up to 6 generations: [Formula: see text] and [Formula: see text], where Nu is the Nusselt number, Sh is the Sherwood number, Re is the branch Reynolds number, D a is the airway equivalent diameter, and [Formula: see text] is the tracheal equivalent diameter.

  9. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

    To test the effects of heart rate, body mass index (BMI) and noise level on interscan and interobserver variability of coronary artery calcium (CAC) scoring on a prospective electrocardiogram (ECG)-triggered 64-slice CT. One hundred and ten patients (76 patients with CAC) were scanned twice on prospective ECG-triggered scans. The scan parameters included 120 kV, 82 mAs, a 2.5 mm thickness, and an acquisition center at 45% of the RR interval. The interscan and interobserver variability on the CAC scores (Agatston, volume, and mass) was calculated. The factors affecting the variability were determined by plotting it against heart rate, BMI, and noise level (defined as the standard deviation: SD). The estimated effective dose was 1.5 {+-} 0.2 mSv. The mean heart rate was 63 {+-} 12 bpm (range, 44-101 bpm). The patient BMIs were 24.5 {+-} 4.5 kg/m{sup 2} (range, 15.5-42.3 kg/m2). The mean and median interscan variabilities were 11% and 6%, respectively by volume, and 11% and 6%, respectively, by mass. Moreover, the mean and median of the algorithms were lower than the Agatston algorithm (16% and 9%, respectively). The mean and median interobserver variability was 10% and 4%, respectively (average of algorithms). The mean noise levels were 15 {+-} 4 Hounsfield unit (HU) (range, 8-25 HU). The interscan and interobserver variability was not correlated with heart rate, BMI, or noise level. The interscan and interobserver variability of CAC on a prospective ECG-triggered 64-slice CT with high image quality and 45% of RR acquisition is not significantly affected by heart rate, BMI, or noise level. The volume or mass algorithms show reduced interscan variability compared to the Agatston scoring (p < 0.05)

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

    Directory of Open Access Journals (Sweden)

    Dietrich Jehle

    2012-02-01

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

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

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

    2011-08-15

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

  13. 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

  14. Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: Intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Furlan, Alessandro, E-mail: furlana@upmc.edu [Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 (United States); Marin, Daniele [Department of Radiology, Duke University Medical Center, Durham, NC 27710 (United States); Department of Radiological Sciences, University of Rome-La Sapienza, Rome, 00161 (Italy); Cabassa, Paolo [Department of Radiology, Brescia University, Brescia (Italy); Taibbi, Adele [Department of Radiology, University of Palermo, Palermo, 90127 (Italy); Brunelli, Elena [Department of Radiology, Brescia University, Brescia (Italy); Agnello, Francesco; Lagalla, Roberto; Brancatelli, Giuseppe [Department of Radiology, University of Palermo, Palermo, 90127 (Italy)

    2012-09-15

    Objective: To evaluate agreement between contrast-enhanced ultrasound (CEUS), multi-detector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for the assessment of typical and atypical enhancement patterns of small hepatocellular carcinoma (HCC); and to compare diagnostic sensitivity of 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines. Materials and methods: Between January 2008 and December 2009, we included cirrhotic patients with newly diagnosed 10–20 mm HCC imaged at two contrast-enhanced imaging techniques among CEUS, MDCT, and MRI. Dynamic studies were reviewed by two radiologists to assess enhancement pattern. Percentage of cases with concordant findings and Cohen coefficient (k) were calculated. McNemar's test was used to compare sensitivity between 2005 and 2010 AASLD guidelines. Results: There were 91 patients (69 M; 22 F; mean age, 68 years) with 96 HCCs, studied with a combination of CEUS and MDCT (n = 59), CEUS and MRI (n = 26), or MDCT and MRI (n = 11). Intermodality agreement for assessment of tumor enhancement pattern was 67% (k = 0.294, P = 0.001). Typical enhancement pattern was detected coincidentally at two imaging modalities in 50 (52%) HCCs. Sensitivity for the diagnosis of HCC increased significantly using the 2010 AASLD (81/96 (84%) vs. 50/96 (52%), P < 0.001). Conclusions: Agreement between two imaging modalities for the detection of typical tumor enhancement pattern was reached in 52% of cases. The 2010 AASLD guidelines significantly increased the sensitivity for the diagnosis of HCC.

  15. 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

  16. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

  18. Safety and efficacy of a drug regimen to control heart rate during 64-slice ECG-gated coronary CTA in children

    Energy Technology Data Exchange (ETDEWEB)

    Rigsby, Cynthia K.; Nicholas, Angela C. [Children' s Memorial Hospital, Department of Medical Imaging, 2300 Children' s Plaza, Box 9, Chicago, IL (United States); deFreitas, R.A. [Children' s Memorial Hospital, Department of Pediatrics, Chicago, IL (United States); Leidecker, Christianne [Siemens Medical Solutions, Malvern, PA (United States); Johanek, Andrew J. [Children' s Memorial Hospital, Department of Medical Imaging, 2300 Children' s Plaza, Box 9, Chicago, IL (United States); Provena St. Joseph Medical Center, Department of Radiology, Joliet, IL (United States); Anley, Peter [Children' s Memorial Hospital, Pharmacy Department, Chicago (United States); Wang, Deli [Children' s Memorial Hospital, Biostatistical Research Department, Chicago, IL (United States); Uejima, Tetsu [Children' s Memorial Hospital, Department of Anesthesiology, Chicago, IL (United States)

    2010-12-15

    The adult practice for ECG-gated single-source 64-slice coronary CTA (CCTA) includes administering beta-blockers to reduce heart rate. There are limited data on this process in children. To evaluate the safety and efficacy of a drug regimen to decrease heart rate before performing CCTA in children. IV remifentanil and esmolol infusion were chosen to decrease heart rate in 41 children (mean age 6.5 years) while they were under general anesthesia (GA) for CCTA. Drug doses, changes in heart rate and procedural complications were recorded. CCTA image quality was graded on a scale of 1 to 5. The relationships between image quality and heart rate and image quality and age were evaluated. Patient effective radiation doses were calculated. Heart rates were lowered utilizing esmolol (4 children), remifentanil (2 children) or both (35 children); 26 children received nitroglycerin for coronary vasodilation. The mean decrease in heart rate was 26%. There were no major complications. The average image-quality score was 4.4. Higher heart rates were associated with worse image quality (r = 0.67, P < 0.0001). Older age was associated with better image quality (r = 0.66, P < 0.0001). Effective radiation doses were 0.7 to 7.0 mSv. Heart rate reduction for pediatric CCTA can be safely and effectively achieved while yielding high-quality images. (orig.)

  19. MDCT in blunt intestinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy)]. E-mail: stefromano@libero.it; Scaglione, Mariano [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Tortora, Giovanni [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Martino, Antonio [Trauma Center, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Di Pietto, Francesco [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Romano, Luigia [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Grassi, Roberto [Department ' Magrassi-Lanzara' , Section of Radiology, Second University of Naples, 80138 Naples (Italy)

    2006-09-15

    Injuries to the small and large intestine from blunt trauma represent a defined clinical entity, often not easy to correctly diagnose in emergency but extremely important for the therapeutic assessment of patients. This article summarizes the MDCT spectrum of findings in intestinal blunt lesions, from functional disorders to hemorrhage and perforation.

  20. 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

  1. 64-Slice CT Angiography in Diagnosis of Congenital Heart Disease in Children%64排CTA在小儿先天性心脏病的应用

    Institute of Scientific and Technical Information of China (English)

    时胜利; 陈志平; 冯东曚

    2013-01-01

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

  2. MDCT findings in sports and recreational accidents

    Energy Technology Data Exchange (ETDEWEB)

    Bensch, Frank V; Koivikko, Mika P; Koskinen, Seppo K (Dept. of Radiology, Toeoeloe Hospital, Helsinki (Finland)), email: frank.bensch@hus.fi

    2011-12-15

    Background. Sports and recreational accidents involving critical areas of the body occur commonly in the general population. Reports on their demographics and recommendations for screening procedures are, however, few. Purpose. To assess injuries of the craniofacial area, spine, and torso resulting from sports and recreational accidents with multidetector computed tomography (MDCT) as primary imaging method in a Level I trauma center. Material and Methods. All emergency room CT requests over a time span of 105 months were reviewed retrospectively for trauma mechanism and injury. Patients were identified using an electronic picture archiving and communications system (PACS), and MDCT studies interpreted by two radiologists independently. Results. Of a total of 5898 patients, 492 patients (301 boys/men, 191 girls/women, age range 2-76 years, mean 33.5 years, median 29.5 years) with sports or recreational accidents emerged. A total of 102 traumatic findings were diagnosed, thereof 72 (71%) serious. The three most commonly encountered serious injuries were intracranial injury, fractures of facial bones, and vertebral injuries. The three most common injury mechanisms were bicycling, horseback riding, and team ball sports. Patients from recreational activities were on average significantly younger (29.2 years) than those from sports accidents (36.9 years; P < 0.001). Only age groups <21 years and 41-50 years differed in injury severity from the other age groups (P = 0.004 and P = 0.063, respectively). Of all trauma mechanisms, only bicycling had a significantly increased risk of injury (P < 0.001). Conclusion. Injuries in sports and recreational accidents presented with an overall incidence of 21%, of which 71% are serious. The most common mechanisms of injury were bicycling, horseback riding, and team ball sports. The largest incidence of serious injury involved bicycling. Because of the high probability of a serious injury and the high energies that are often involved

  3. Coronary lesion complexity assessed by SYNTAX score in 256-slice dual-source MDCT angiography

    Science.gov (United States)

    Yüceler, Zeyneb; Kantarcı, Mecit; Tanboğa, İbrahim Halil; Sade, Recep; Kızrak, Yeşim; Pirimoğlu, Berhan; Bayraktutan, Ümmügülsüm; Oğul, Hayri; Aksakal, Enbiya

    2016-01-01

    PURPOSE The SYNTAX Score (SS) has an important role in grading the complexity of coronary artery disease (CAD) in patients undergoing revascularization. Noninvasive determination of SS prior to invasive coronary angiography (ICA) might optimize patient management. We aimed to evaluate the agreement between ICA and multidetector computed tomography (MDCT) while testing the diagnostic effectiveness of SS-MDCT. METHODS Our study included 108 consecutive patients who underwent both MDCT angiography with a 256-slice dual-source MDCT system and ICA within 14±3 days. SS was calculated for both ICA and MDCT coronary angiography. Spearman’s rank correlation coefficient was used to evaluate the association of SS-MDCT with SS-ICA, and Bland-Altman analysis was performed. RESULTS The degree of agreement between SS-ICA and SS-MDCT was moderate. The mean SS-MDCT was 14.5, whereas the mean SS-ICA was 15.9. After dividing SS into three groups (high [≥33], intermediate [23–32], and low [≤22] subgroups), agreement analysis was repeated. There was a significant correlation between SS-MDCT and SS-ICA in the low SS group (r=0.63, P = 0.043) but no significant correlation in the high SS group (r=0.036, P = 0.677). The inter-test agreement analysis showed at least moderate agreement, whereas thrombotic lesions and the type of bifurcation lesion showed fair agreement. CONCLUSION The calculation of SS-MDCT by adapting SS-ICA parameters achieved nearly the same degree of precision as SS-ICA and was better than SS-ICA, especially in the low SS group. PMID:27328718

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

    Institute of Scientific and Technical Information of China (English)

    王振栋; 马淑华; 黎叶芳; 袁珠

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    谢强; Eugene Williams; Charlie Shaughnessy; 唐向阳

    2005-01-01

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

  6. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D

    2013-08-01

    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  7. Pulmonary 64-MDCT angiography with 50 mL of iodinated contrast material in an unselected patient population: a feasible protocol*

    Science.gov (United States)

    Trad, Henrique Simão; Boasquevisque, Gustavo Santos; Giacometti, Tiago Rangon; Trad, Catherine Yang; Zoghbi Neto, Orlando Salomão; Trad, Clovis Simão

    2016-01-01

    Objective To propose a protocol for pulmonary angiography using 64-slice multidetector computed tomography (64-MDCT) with 50 mL of iodinated contrast material, in an unselected patient population, as well as to evaluate vascular enhancement and image quality. Materials and Methods We evaluated 29 patients (22-86 years of age). The body mass index ranged from 19.0 kg/m2 to 41.8 kg/m2. Patients underwent pulmonary CT angiography in a 64-MDCT scanner, receiving 50 mL of iodinated contrast material via venous access at a rate of 4.5 mL/s. Bolus tracking was applied in the superior vena cava. Two experienced radiologists assessed image quality and vascular enhancement. Results The mean density was 382 Hounsfield units (HU) for the pulmonary trunk; 379 and 377 HU for the right and left main pulmonary arteries, respectively; and 346 and 364 HU for the right and left inferior pulmonary arteries, respectively. In all patients, subsegmental arteries were analyzed. There were streak artifacts from contrast material in the superior vena cava in all patients. However, those artifacts did not impair the image analysis. Conclusion Our findings suggest that pulmonary angiography using 64-MDCT with 50 mL of iodinated contrast can produce high quality images in unselected patient populations. PMID:27141128

  8. Pulmonary 64-MDCT angiography with 50 mL of iodinated contrast material in an unselected patient population: a feasible protocol

    Energy Technology Data Exchange (ETDEWEB)

    Trad, Henrique Simao; Boasquevisque, Gustavo Santos; Giacometti, Tiago Rangon; Trad, Catherine Yang; Zoghbi Neto, Orlando Salomao; Trad, Clovis Simao, E-mail: hsimtrad@gmail.com [Central de Diagnostico Ribeirao Preto (CEDIRP), Ribeirao Preto, SP (Brazil)

    2016-03-15

    Objective: To propose a protocol for pulmonary angiography using 64-slice multidetector computed tomography (64-MDCT) with 50 mL of iodinated contrast material, in an unselected patient population, as well as to evaluate vascular enhancement and image quality. Materials and methods: We evaluated 29 patients (22-86 years of age). The body mass index ranged from 19.0 kg/m{sup 2} to 41.8 kg/m{sup 2}. Patients underwent pulmonary CT angiography in a 64-MDCT scanner, receiving 50 mL of iodinated contrast material via venous access at a rate of 4.5 mL/s. Bolus tracking was applied in the superior vena cava. Two experienced radiologists assessed image quality and vascular enhancement. Results: The mean density was 382 Hounsfield units (HU) for the pulmonary trunk; 379 and 377 HU for the right and left main pulmonary arteries, respectively; and 346 and 364 HU for the right and left inferior pulmonary arteries, respectively. In all patients, subsegmental arteries were analyzed. There were streak artifacts from contrast material in the superior vena cava in all patients. However, those artifacts did not impair the image analysis. Conclusion: Our findings suggest that pulmonary angiography using 64-MDCT with 50 mL of iodinated contrast can produce high quality images in unselected patient populations. (author)

  9. Quantitative right and left ventricular functional analysis during gated whole-chest MDCT: A feasibility study comparing automatic segmentation to semi-manual contouring

    Energy Technology Data Exchange (ETDEWEB)

    Coche, Emmanuel, E-mail: Emmanuel.coche@uclouvain.b [Department of Medical Imaging, Universite Catholique de Louvain, Cliniques Universitaires St-Luc (UCL), Avenue Hippocrate, 10, 1200 Brussels (Belgium); Walker, Matthew J. [Philips Healthcare, CT Clinical Science, Cleveland, OH (United States); Zech, Francis [Department of Internal Medicine, Universite Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels (Belgium); Crombrugghe, Rodolphe de [Department of Medical Imaging, Universite Catholique de Louvain, Cliniques Universitaires St-Luc (UCL), Avenue Hippocrate, 10, 1200 Brussels (Belgium); Vlassenbroek, Alain [Philips Healthcare, Brussels (Belgium)

    2010-06-15

    Purpose: To evaluate the feasibility of an automatic, whole-heart segmentation algorithm for measuring global heart function from gated, whole-chest MDCT images. Material and methods: 15 patients with suspicion of PE underwent whole-chest contrast-enhanced MDCT with retrospective ECG synchronization. Two observers computed right and left ventricular functional indices using a semi-manual and an automatic whole-heart segmentation algorithm. The two techniques were compared using Bland-Altman analysis and paired Student's t-test. Measurement reproducibility was calculated using intraclass correlation coefficient. Results: Ventricular analysis with automatic segmentation was successful in 13/15 (86%) and in 15/15 (100%) patients for the right ventricle and left ventricle, respectively. Reproducibility of measurements for both ventricles was perfect (ICC: 1.00) and very good for automatic and semi-manual measurements, respectively. Ventricular volumes and functional indices except right ventricular ejection fraction obtained from the automatic method were significantly higher for the RV compared to the semi-manual methods. Conclusions: The automatic, whole-heart segmentation algorithm enabled highly reproducible global heart function to be rapidly obtained in patients undergoing gated whole-chest MDCT for assessment of acute chest pain with suspicion of pulmonary embolism.

  10. 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.

  11. 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。

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

    Institute of Scientific and Technical Information of China (English)

    沈永菊; 冷永新; 唐翠松; 汤光宇

    2012-01-01

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

  13. Cardiac Computed Tomography (Multidetector CT, or MDCT)

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Cardiac Computed Tomography (Multidetector CT, or MDCT) Updated:Sep 19, ... The ECG is also needed to help the computer that is connected to the CT scanner create ...

  14. 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

  15. 64排螺旋CT多种后处理技术在肋骨骨折诊断中的应用%Application of Various Post Processing Techniques of 64 Slice Spiral CT in the Diagnosis of Rib Fractures

    Institute of Scientific and Technical Information of China (English)

    潘兴朋

    2016-01-01

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

  16. How accurate is unenhanced multidetector-row CT (MDCT) for localization of renal calculi?

    Energy Technology Data Exchange (ETDEWEB)

    Goetschi, Stefan, E-mail: goetschi@gmx.net [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Umbehr, Martin, E-mail: martin.umbehr@triemli.ch [Urology Clinic, Department of Surgery, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Ullrich, Stephan, E-mail: stephan.ullrich@triemli.ch [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Glenck, Michael, E-mail: michael.glenck@triemli.ch [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Suter, Stefan, E-mail: stefan.suter@triemli.ch [Urology Clinic, Department of Surgery, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland); Weishaupt, Dominik, E-mail: dominik.weishaupt@triemli.ch [Institute of Radiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zuerich (Switzerland)

    2012-11-15

    Purpose: To investigate the correlation between unenhanced MDCT and intraoperative findings with regard to the exact anatomical location of renal calculi. Design, setting, and participants: Fifty-nine patients who underwent unenhanced MDCT for suspected urinary stone disease, and who underwent subsequent flexible ureterorenoscopy (URS) as treatment of nephrolithiasis were included in this retrospective study. All MDCT data sets were independently reviewed by three observers with different degrees of experience in reading CT. Each observer was asked to indicate presence and exact anatomical location of any calcification within pyelocaliceal system, renal papilla or renal cortex. Results were compared to intraoperative findings which have been defined as standard of reference. Calculi not described at surgery, but present on MDCT data were counted as renal cortex calcifications. Results: Overall 166 calculi in 59 kidneys have been detected on MDCT, 100 (60.2%) were located in the pyelocaliceal system and 66 (39.8%) in the renal parenchyma. Of the 100 pyelocaliceal calculi, 84 (84%) were correctly located on CT data sets by observer 1, 62 (62%) by observer 2, and 71 (71%) by observer 3. Sensitivity/specificity was 90-94% and 50-100% if only pyelocaliceal calculi measuring >4 mm in size were considered. For pyelocaliceal calculi {<=}4 mm in size diagnostic performance of MDCT was inferior. Conclusion: Compared to flexible URS, unenhanced MDCT is accurate for distinction between pyelocaliceal calculi and renal parenchyma calcifications if renal calculi are >4 mm in size. For smaller renal calculi, unenhanced MDCT is less accurate and distinction between a pyelocaliceal calculus and renal parenchyma calcification is difficult.

  17. Trabecular bone structure analysis of the spine using clinical MDCT: can it predict vertebral bone strength?

    Science.gov (United States)

    Baum, Thomas; Gräbeldinger, Martin; Räth, Christoph; Garcia, Eduardo Grande; Burgkart, Rainer; Patsch, Janina M; Rummeny, Ernst J; Link, Thomas M; Bauer, Jan S

    2014-01-01

    Recent technical improvements have made it possible to determine trabecular bone structure parameters of the spine using clinical multi-detector computed tomography (MDCT). Therefore, the purpose of this study was to analyze trabecular bone structure parameters obtained from clinical MDCT in relation to high resolution peripheral quantitative computed tomography (HR-pQCT) as a standard of reference and to investigate whether clinical MDCT can predict vertebral bone strength. Fourteen functional spinal segment units between T7 and L3 were harvested from 14 formalin-fixed human cadavers (11 women and 3 men; age 84 ± 10 years). All functional spinal segment units were examined using HR-pQCT (isotropic voxel size of 41 μm(3)) and a clinical whole-body MDCT (interpolated voxel size of 146 × 146 × 300 μm(3)). Trabecular bone structure analyses (histomorphometric and texture measures) were performed in the HR-pQCT as well as MDCT images. Vertebral failure load (FL) of the functional spinal segment units was determined in an uniaxial biomechanical test. The HR-pQCT and MDCT derived trabecular bone structure parameters showed correlations ranging from r = 0.60 to r = 0.90 (p parameters and FL amounted up to r = 0.86 (p parameters obtained with HR-pQCT and MDCT were not significantly different (p > 0.05). In this cadaver model, the spatial resolution of clinically available whole-body MDCT scanners was suitable for trabecular bone structure analysis of the spine and to predict vertebral bone strength.

  18. In-vivo assessment of femoral bone strength using Finite Element Analysis (FEA based on routine MDCT imaging: a preliminary study on patients with vertebral fractures.

    Directory of Open Access Journals (Sweden)

    Hans Liebl

    Full Text Available To experimentally validate a non-linear finite element analysis (FEA modeling approach assessing in-vitro fracture risk at the proximal femur and to transfer the method to standard in-vivo multi-detector computed tomography (MDCT data of the hip aiming to predict additional hip fracture risk in subjects with and without osteoporosis associated vertebral fractures using bone mineral density (BMD measurements as gold standard.One fresh-frozen human femur specimen was mechanically tested and fractured simulating stance and clinically relevant fall loading configurations to the hip. After experimental in-vitro validation, the FEA simulation protocol was transferred to standard contrast-enhanced in-vivo MDCT images to calculate individual hip fracture risk each for 4 subjects with and without a history of osteoporotic vertebral fractures matched by age and gender. In addition, FEA based risk factor calculations were compared to manual femoral BMD measurements of all subjects.In-vitro simulations showed good correlation with the experimentally measured strains both in stance (R2 = 0.963 and fall configuration (R2 = 0.976. The simulated maximum stress overestimated the experimental failure load (4743 N by 14.7% (5440 N while the simulated maximum strain overestimated by 4.7% (4968 N. The simulated failed elements coincided precisely with the experimentally determined fracture locations. BMD measurements in subjects with a history of osteoporotic vertebral fractures did not differ significantly from subjects without fragility fractures (femoral head: p = 0.989; femoral neck: p = 0.366, but showed higher FEA based risk factors for additional incident hip fractures (p = 0.028.FEA simulations were successfully validated by elastic and destructive in-vitro experiments. In the subsequent in-vivo analyses, MDCT based FEA based risk factor differences for additional hip fractures were not mirrored by according BMD measurements. Our data suggests, that MDCT

  19. A study on variation types in celiac axis and superior mesenteric artery using 3D volume rendering of MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Keun; Jang, Seong Joo [Dept. of Radiological physics Graduate School of Dongshin University, Naju (Korea, Republic of); Jang, Young Ill [Dept. of Radiological Technology of Kwangyang Health College, Kwangyang (Korea, Republic of)

    2013-06-15

    The aim of this study was to evaluate the variation which based on Celiac axis and SMA using by CT volume rendering images. 613 patients underwent abdominal CTA, there were 552 patients (99.05%, TypeⅠ, Ⅱ ) with normal anatomical form and 61 (9.95%, Type Ⅲ-Ⅻ) with variation. TypeⅠ was 339(55.31%), Type Ⅱ was 213 (34.74%), Type Ⅲ was 18 (2.93%), Type Ⅳ was 12 patients (1.95%), Type Ⅴ was 11 patient (1.79%), Type Ⅵ was 9 patients (1.46%), Type Ⅶ was 6 patients (0.97%), Type Ⅷ was 1 patient (0.16%), Type Ⅸ was 1 patient (0.16%), Type Ⅹ was 1 patient (0.16%), Type Ⅺ was 1 patient (0.16%), and Type Ⅻ was 1 patient (0.16%) into totally new types of variation. In conclusion, we could found 9 new types of variation by classifying based on celiac axis and superior mesenteric artery. These results were considered to be an important opportunity for a new vessel map.

  20. 64排螺旋CT重建技术在急性阑尾炎诊断中的应用价值%application of 64-Slice Spiral CT Reconstruction Technique in diagnosis of acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    任春慧; 冯华; 梁爽; 曲世巍

    2013-01-01

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

  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. Fulminant hepatic failure in children: Etiology, histopathology and MDCT findings

    Energy Technology Data Exchange (ETDEWEB)

    Cakir, Banu [Baskent University Faculty of Medicine Department of Radiology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: banutopcu@yahoo.com; Kirbas, Ismail [Baskent University Faculty of Medicine Department of Radiology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: drismailk@yahoo.com; Demirhan, Beyhan [Baskent University Faculty of Medicine Department of Pathology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: beyhand@baskent-ank.edu.tr; Tarhan, Nefise Cagla [Baskent University Faculty of Medicine Department of Radiology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: caglat@gmail.com; Bozkurt, Alper [Baskent University Faculty of Medicine Department of Radiology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: abozkurt78@hotmail.com; Ozcay, Figen [Baskent University Faculty of Medicine Department of Pediatric Gastroenterology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: fozcay@baskent.edu.tr; Coskun, Mehmet [Baskent University Faculty of Medicine Department of Radiology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: mcoskun@baskent-ank.edu.tr

    2009-11-15

    Introduction: The purpose of this study is to determine the etiologies, histopathology and MDCT findings of children with fulminant hepatic failure admitted to our institution. Materials and methods: Between June 2004 and November 2006, 15 children with fulminant hepatic failure who underwent MDCT were included retrospectively in this study. Twelve patients had liver biopsies. The patients were divided into three groups as hyperacute (Group I), acute (Group II) and subacute (Group III) depending on onset of hepatic encephalopathy. Results: Hepatitis A in 4 patients, non-A, non-E hepatitis in 4; mushroom poisoning in 3; fulminant Wilson's disease in 2; autoimmune hepatitis in 1; and both hepatitis B and toxic hepatitis (with leflunomide treatment) in 1 patient were detected. MDCT of all three groups revealed diffuse reduction in hepatic attenuation in 11 patients; ascites in 9; periportal edema in 6; edema of gallbladder wall in 6; splenomegaly in 6; heterogeneous hepatic parenchyma in 6; hepatomegaly in 3; irregular contours of liver in 2; multiple micronodules in 1 and necrotic areas and regeneration in liver parenchyma in 2 patients. Histopathologic evaluation of liver biopsies showed massive hepatic necrosis, inflammatory cell infiltration and ductular proliferation in 8 patients, periportal edema in 6, edema of gallbladder wall in 5, regenerating nodules and fibrous septa consistent with cirrhotic pattern in 2, and regenerating nodules and necrotic areas in 2 patients. Conclusion: The most common MDCT findings in fulminant hepatic failure were diffuse reduction in hepatic attenuation and ascites. Massive hepatic necrosis was the most common histopathologic finding.

  3. MDCT arthrography of the wrist: Diagnostic accuracy and indications

    Energy Technology Data Exchange (ETDEWEB)

    De Filippo, Massimo [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci, 14, 43100 Parma (Italy)], E-mail: massimo.defilippo@unipr.it; Pogliacomi, Francesco [Orthopaedics, Traumatology and Functional Rehabilitation Unit, Department of Surgical Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Bertellini, Annalisa [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci, 14, 43100 Parma (Italy); Araoz, Philip A. [Department of Radiology, Division of Biostatistics, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (United States); Averna, Raffaele; Sverzellati, Nicola; Ingegnoli, Anna [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci, 14, 43100 Parma (Italy); Corradi, Maurizio; Costantino, Cosimo [Orthopaedics, Traumatology and Functional Rehabilitation Unit, Department of Surgical Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Zompatori, Maurizio [Department of Radiological and Histopathological Sciences, Policlinic S.Orsola-Malpighi, University of Bologna, Via Massarenti 9, 40138 Bologna (Italy)

    2010-04-15

    Purpose: To evaluate the diagnostic accuracy and indications of arthrography with Multidetector Computed Tomography (arthro-MDCT) of the wrist in patients with absolute or relative contraindications to magnetic resonance imaging (MRI) studies and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. Materials and methods: After intra-articular injection of iodixanol and volumetric acquisition, 43 wrists in patients of both genders (18 females, 25 males, age range 32-60 years) were examined with a 16-detector-row CT scanner. Fifteen patients had prior wrist surgery. The patients had arthralgia, degenerative and traumatic arthropathies as well as limited range of motion, but no radiologically detected fractures. All examinations were interpreted by two experienced musculoskeletal radiologists. The findings were compared with arthroscopic findings carried out within 28 days of the CT study. Results: In non-operated and operated wrists the comparison between arthro-MDCT and arthroscopy showed sensitivity, specificity and accuracy ranging between 92% and 94% for triangular fibrocartilage complex (TFCC), between 80% and 100% for intrinsic ligaments located within the proximal carpal compartment, and between 94% and 100% for articular cartilage. Inter-observer agreement between two radiologists, in the evaluation of all types of lesions, was almost perfect (k = 0.96) and statistically significant (p < 0.05). Conclusions: Arthro-MDCT of the wrist provides an accurate diagnosis to identify chondral, fibrocartilaginous and intra-articular ligament lesions in patients who cannot be evaluated by MRI, and in post-surgical patients.

  4. Ultra-low dose abdominal MDCT: Using a knowledge-based Iterative Model Reconstruction technique for substantial dose reduction in a prospective clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Khawaja, Ranish Deedar Ali, E-mail: rkhawaja@mgh.harvard.edu [MGH Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Singh, Sarabjeet; Blake, Michael; Harisinghani, Mukesh; Choy, Gary; Karosmangulu, Ali; Padole, Atul; Do, Synho [MGH Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Brown, Kevin; Thompson, Richard; Morton, Thomas; Raihani, Nilgoun [CT Research and Advanced Development, Philips Healthcare, Cleveland, OH (United States); Koehler, Thomas [Philips Technologie GmbH, Innovative Technologies, Hamburg (Germany); Kalra, Mannudeep K. [MGH Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2015-01-15

    Highlights: • Limited abdominal CT indications can be performed at a size specific dose estimate of (SSDE) 1.5 mGy (∼0.9 mSv) in smaller patients (BMI less than or equal to 25 kg/m{sup 2}) using a knowledge based Iterative Model Reconstruction (IMR) technique. • Evaluation of liver tumors and pathologies is unacceptable at this reduced dose with IMR technique especially in patients with a BMI greater than 25 kg/m{sup 2}. • IMR body soft tissue and routine settings perform substantially better than IMR sharp plus setting in reduced dose CT images. • At SSDE of 1.5 mGy, objective image noise in reduced dose IMR images is 8–56% less than compared to standard dose FBP images, with lowest image noise in IMR body-soft tissue images. - Abstract: Purpose: To assess lesion detection and image quality parameters of a knowledge-based Iterative Model Reconstruction (IMR) in reduced dose (RD) abdominal CT examinations. Materials and methods: This IRB-approved prospective study included 82 abdominal CT examinations performed for 41 consecutive patients (mean age, 62 ± 12 years; F:M 28:13) who underwent a RD CT (SSDE, 1.5 mGy ± 0.4 [∼0.9 mSv] at 120 kV with 17–20 mAs/slice) immediately after their standard dose (SD) CT exam (10 mGy ± 3 [∼6 mSv] at 120 kV with automatic exposure control) on 256 MDCT (iCT, Philips Healthcare). SD data were reconstructed using filtered back projection (FBP). RD data were reconstructed with FBP and IMR. Four radiologists used a five-point scale (1 = image quality better than SD CT to 5 = image quality unacceptable) to assess both subjective image quality and artifacts. Lesions were first detected on RD FBP images. RD IMR and RD FBP images were then compared side-by-side to SD-FBP images in an independent, randomized and blinded fashion. Friedman's test and intraclass correlation coefficient were used for data analysis. Objective measurements included image noise and attenuation as well as noise spectral density (NSD) curves

  5. 64层螺旋CT血管成像在自发性蛛网膜下腔出血中的应用价值%Application value of 64 slice spiral CT angiography in spontaneous subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    白光宇

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  7. The diagnostic role of MDCT enterography in small bowel lesions

    OpenAIRE

    Hasan I. Megally; Hosam eldin Mohamed Elmalah; Gehan S. Seifeldein; Nisreen Adel Abbas; Hussien Ahmed Elamin

    2015-01-01

    Purpose: To evaluate the role of MDCT enterography in the diagnosis of small bowel diseases. Patient and methods: Thirty nine patients suspected to have small bowel diseases were examined with 64 MDCT enterography. Result: MDCT enterography easily diagnosed small intestinal diseases which confirmed with histopathological results, operative data and follow up. Conclusions: MDCT can be used as a front-line imaging and one stop imaging modality for the detection of small bowel diseases....

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

    Institute of Scientific and Technical Information of China (English)

    付传明; 徐官珍; 陈伦刚; 徐霖; 龚晓虹; 邹建华; 陈杰

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    齐晨晖; 范红燕; 史琼玉

    2012-01-01

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

  10. Detection of cutaneous invasion by malignant head and neck tumors with MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Nemec, Stefan Franz [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)], E-mail: stefan.nemec@meduniwien.ac.at; Linecker, Alexander [Department of Craniomaxillofacial and Oral Surgery, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Czerny, Christian; Imhof, Herwig; Krestan, Christian Robert [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2008-11-15

    Objective: Cutaneous invasion by direct infiltration and metastasis, in malignant head and neck tumors, has a distinct impact on therapeutic options, especially surgical procedures, curative intent, and overall prognosis. Therefore, the purpose of this study was to determine the diagnostic accuracy of MDCT in detecting cutaneous invasion by malignant head and neck tumors. Materials and methods: Nineteen patients with malignant head and neck tumors and clinical suspicion of cutaneous invasion routinely underwent contrast-enhanced 16-row MDCT (Philips MDCT MX 8000) of the region of interest in the axial plane before surgical intervention. The following parameters were used: 16 mm x 0.75 mm detector collimation; 3 mm reconstructed slice thickness; 1.5 mm increment; 0.75 s rotation speed; 120 kV, 200 mAs; and 100 ml non-ionic contrast agent, i.v., with a flow of 2.0 ml/s and a scan delay of 50 s. The studies were reconstructed with a soft tissue algorithm (W400, L100 HU), and coronal and sagittal planes were also reconstructed. The axial images were retrospectively reviewed in consensus by two radiologists for the evidence of cutaneous invasion blinded to the histological results. The MDCT results were correlated with histology that was obtained by punch biopsy or surgery. Results: MDCT correctly revealed 11 of 11 cases with cutaneous invasion, and correctly excluded 4 of 8 cases without cutaneous invasion. The diagnostic accuracy of MDCT in detecting cutaneous invasion showed a sensitivity of 100%, a specificity of 50%, and an overall accuracy of 79%. Conclusion: MDCT reconstructed with a soft tissue algorithm has a good sensitivity and moderate overall accuracy in detecting cutaneous invasion by malignant head and neck tumors.

  11. 64层螺旋CT在消化道穿孔的诊断价值%The Value of 64 Slice Spiral CT in the Diagnosis of Digestive Tract Perforation

    Institute of Scientific and Technical Information of China (English)

    孙晓霞; 郭强强; 兰国宾; 路凯; 李宝栋; 郭福庆

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘兆芹; 钱学江

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  15. Reducing radiation dose to selected organs by selecting the tube start angle in MDCT helical scans: A Monte Carlo based study

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Di; Zankl, Maria; DeMarco, John J.; Cagnon, Chris H.; Angel, Erin; Turner, Adam C.; McNitt-Gray, Michael F. [David Geffen School of Medicine at UCLA, Los Angeles, California 90024 (United States); German Research Center for Environmental Health (GmbH), Institute of Radiation Protection, Helmholtz Zentrum Muenchen, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); David Geffen School of Medicine at UCLA, Los Angeles, California 90024 (United States)

    2009-12-15

    Purpose: Previous work has demonstrated that there are significant dose variations with a sinusoidal pattern on the peripheral of a CTDI 32 cm phantom or on the surface of an anthropomorphic phantom when helical CT scanning is performed, resulting in the creation of ''hot'' spots or ''cold'' spots. The purpose of this work was to perform preliminary investigations into the feasibility of exploiting these variations to reduce dose to selected radiosensitive organs solely by varying the tube start angle in CT scans. Methods: Radiation dose to several radiosensitive organs (including breasts, thyroid, uterus, gonads, and eye lenses) resulting from MDCT scans were estimated using Monte Carlo simulation methods on voxelized patient models, including GSF's Baby, Child, and Irene. Dose to fetus was also estimated using four pregnant female models based on CT images of the pregnant patients. Whole-body scans were simulated using 120 kVp, 300 mAs, both 28.8 and 40 mm nominal collimations, and pitch values of 1.5, 1.0, and 0.75 under a wide range of start angles (0 deg. - 340 deg. in 20 deg. increments). The relationship between tube start angle and organ dose was examined for each organ, and the potential dose reduction was calculated. Results: Some organs exhibit a strong dose variation, depending on the tube start angle. For small peripheral organs (e.g., the eye lenses of the Baby phantom at pitch 1.5 with 40 mm collimation), the minimum dose can be 41% lower than the maximum dose, depending on the tube start angle. In general, larger dose reductions occur for smaller peripheral organs in smaller patients when wider collimation is used. Pitch 1.5 and pitch 0.75 have different mechanisms of dose reduction. For pitch 1.5 scans, the dose is usually lowest when the tube start angle is such that the x-ray tube is posterior to the patient when it passes the longitudinal location of the organ. For pitch 0.75 scans, the dose is lowest

  16. Diagnostic value of color Doppler ultrasonography and MDCT angiography in complications of hemodialysis fistulas and grafts

    Energy Technology Data Exchange (ETDEWEB)

    Cansu, Aysegul, E-mail: drcansu@gmail.com [Department of Radiology, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey); Soyturk, Mehmet; Ozturk, Mehmet Halil; Kul, Sibel [Department of Radiology, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey); Pulathan, Zerrin [Department of Cardiovascular Surgery, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey); Dinc, Hasan [Department of Radiology, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey)

    2013-09-15

    Purpose: The purpose of the study was to compare the diagnostic value of color Doppler ultrasonography (CDUS) and multidetector computed tomography (MDCT) angiography against that of digital subtraction angiography (DSA) or surgery in the evaluation of failing hemodialysis arteriovenous fistulas (AVFs). Materials and methods: CDUS and MDCT angiography were performed with 41 patients (24 men, 17 women; mean age 55.8) with dysfunctional hemodialysis fistulas. The presence of stenosis, thrombosis, aneurysm, pseudoaneurysm and seroma were recorded. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) and accuracy of CDUS and MDCT angiography were calculated both individually and in combination for the detection of vascular segments with significant stenosis, thrombosis, aneurysms, pseudoaneurysms, perivascular complications and stenosis subgroups. Results: Sixty-four segmental lesions were diagnosed by DSA or surgery. Sensitivity, specificity, PPV, NPV and accuracy of CDUS for all vascular tree lesions were 85.9%, 99.2%, 96.4%, 96.7% and 94.5%, respectively. For MDCT angiography the figures were 96.8%, 99.6%, 98.4%, 99.2% and 98.5%, respectively. When both tests were used in combination, sensitivity, specificity, PPV, NPV and accuracy for all vascular tree lesions rose to 100%. Conclusion: Combined use of MDCT and CDUS for diagnosis of AVF dysfunctions is of equivalent value to surgery or DSA, a gold standard technique.

  17. The value of MDCT in diagnosis of hyaline-vascular Castleman's disease

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Xiaoli [Department of Radiology, Beijing Shijitan Hospital affiliated to Capital University of Medical Sciences, Yangfangdian Tieyiyuan, Road No. 10, Haidian District, Beijing, 100038 China (China); Liu, Cheng [CT Department, Shandong Medical Imaging Research Institute (China); Wang, Rengui, E-mail: 490150302@qq.com [Department of Radiology, Beijing Shijitan Hospital affiliated to Capital University of Medical Sciences, Yangfangdian Tieyiyuan, Road No. 10, Haidian District, Beijing, 100038 China (China); Zhu, Xuejun [Dermatology Department, Beijing University First Hospital (China); Gao, Li [Department of Radiology, Beijing University First Hospital (China); Chen, Jiuhong [Healthcare, Siemens Ltd. (China)

    2012-09-15

    Purpose: Castleman's disease (CD) is an uncommon entity characterized by a massive growth of lymphoid tissue. There are two types: the hyaline-vascular (HV) type and the plasma cell (PC) type. The purpose of this study was to evaluate the clinical value of multiple detector computed tomography (MDCT) in the diagnosis and planning of treatment for hyaline-vascular CD. Materials and methods: Fifty-two cases of confirmed hyaline-vascular CD were retrospectively reviewed. Unenhanced and contrast-enhanced MDCT scans had been performed in all patients, followed by surgery and pathological analysis of the lesion. Original MDCT transverse and reconstructed images were used for image interpretation. Features of the lesion and its adjacent structures were identified. Results: The lesion was present in the thorax of 24 patients and the abdomen in 28. Obvious features of hyaline-vascular CD (especially feeding vessels and draining veins) and its adjacent structures were demonstrated on 52 patients. Conclusion: On MDCT imaging, original MDCT transverse and reconstructed images provide an excellent tool for diagnosis of hyaline-vascular CD and have high value in the determination of a treatment plan.

  18. Multiphasic MDCT in small bowel volvulus

    Energy Technology Data Exchange (ETDEWEB)

    Feng Shiting, E-mail: fst1977@163.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Chan Tao, E-mail: taochan@hku.hk [Department of Diagnostic Radiology, University of Hong Kong, Room 406, Block K, Queen Mary Hospital (Hong Kong); Sun Canhui, E-mail: canhuisun@sina.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Li Ziping, E-mail: liziping163@tom.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Guo Huanyi, E-mail: guohuanyi@163.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Yang Guangqi, E-mail: shwy03@126.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Peng Zhenpeng, E-mail: ppzhen@21cn.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Meng Quanfei, E-mail: mzycoco@gmail.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China)

    2010-11-15

    Objective: Evaluate the use of MDCT with 3D CT angiography (CTA) and CT portal venography (CTPV) reconstruction for the diagnosis of small bowel volvulus (SBV). Methods: Multiphasic MDCT findings in nine patients (seven males and two females, age range 2-70) with surgically proven SBV were retrospectively reviewed. Non-contrast and double phase contrast enhanced MDCT including 3D CTA and CTPV reconstruction were performed in all the patients. Two experienced abdominal radiologists evaluated the images and defined the location, direction and degree of SBV. Results: On axial MDCT images, all cases show segmental or global dilatation of small intestine. Other findings include circumferential bowel wall thickening in eight cases, halo appearance and hyperemia in seven cases, whirl sign in six cases, beak-like appearance in six cases, closed loops in six cases and ascites in one case. CTA/CTPV showed abnormal courses involving main trunks of superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in seven cases, with or without distortion of their tributaries. Normal course of SMA but abnormal course of SMV was seen in the other two cases. Of all the nine cases, whirl sign was seen in six cases and barber's pole sign in five cases. Dilated SMV was observed in eight cases and abrupt termination of SMA was found in one case. Compared with surgical findings, the location, direction and degree of SBV were correctly estimated in all cases based on CTA/CTPV. Conclusion: Multiphasic MDCT with CTA/CTPV reconstruction can play an important role in the diagnosis of SBV. The location, direction and degree of SBV can all be defined preoperatively using this method.

  19. 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

  20. 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

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

    王富山

    2014-01-01

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

  4. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  6. 64层螺旋CT三维重建活体肝静脉的研究及临床意义%3D-reconstruction of hepatic vein by 64-Slice Spiral Computed Tomography and its significance

    Institute of Scientific and Technical Information of China (English)

    杨新文; 王剑华; 周庭永; 吕发金; 洪永华

    2009-01-01

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

  7. Value of 64-slices spiral computed tomography in the diagnosis of cavernous transformation of portal vein%64层螺旋CT对门静脉海绵样变性的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李金平; 赵德利; 王彦民; 李大庆; 李艳英; 姜慧杰

    2011-01-01

    目的 探讨64层螺旋CT在门静脉海绵样变性(CTPV)诊断中的价值.方法 对CT检查发现的CTPV患者22例,采用MPR、MIP、VR等图像后处理技术显示异常的门静脉及侧支血管情况.结果 22例CTPV 在CT平扫上显示门静脉结构不清,肝门区可见多发的结节状、条状软组织影.增强扫描显示6例动脉期肝实质灌注异常;门静脉期11例患者门静脉主干和(或)左右分支增粗,内可见充盈缺损,4例门静脉显示不清;2例门静脉主干和(或)左右分支在正常范围内;4例门静脉主干变细;1例门静脉主干受侵致管腔狭窄.胆管周围静脉丛(86.36%)、胆囊静脉(77.27%)及食管胃底静脉(77.27%)呈点状、细网状、簇状扩张.结论 64层螺旋CT能准确显示CTPV的部位、范围,立体地显示各曲张血管的走行及曲张程度,是检查CTPV的有效手段.%Objective To investigate the value of 64-slice spiral computed tomography in the diagnosis of cavemous transformation of portal vein (CTPV). Methods A 64-slices spiral CT scanner was used to perform plain and three-phase contrast enhanced abdominal scanning in 22 patients with CTPV. Image post-processing techniques,including MPR,MIP and VR,were applied to depict the abnormal portal vein and its collateral vessels.Results The portal vein was not clearly seen on plain in 22 cases,while multiple soft tissue nodules and strips were found in the porta hepatis region. On dynamic enhanced scans,abnormal hepatic perfusion during arterial phase in 6 cases was demonstrated. On portal vein phase images the main trunk of portal vein and/or its left and right branches were dilated with filling defects in 11 cases. Inconspicuous portal veins were demonstrated. The main trunk of portal vein looked thin in 4 cases. The main trunk of portal vein was lumen stenosis as a result of tumor-infiltrating in 1 case. Pericholedochal venous plexus (86.36%) , cystic vein (77.27%)and esophageal gastric veins (77.27

  8. 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.

  9. 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。

  10. Robust extraction of the aorta and pulmonary artery from 3D MDCT image data

    Science.gov (United States)

    Taeprasartsit, Pinyo; Higgins, William E.

    2010-03-01

    Accurate definition of the aorta and pulmonary artery from three-dimensional (3D) multi-detector CT (MDCT) images is important for pulmonary applications. This work presents robust methods for defining the aorta and pulmonary artery in the central chest. The methods work on both contrast enhanced and no-contrast 3D MDCT image data. The automatic methods use a common approach employing model fitting and selection and adaptive refinement. During the occasional event that more precise vascular extraction is desired or the method fails, we also have an alternate semi-automatic fail-safe method. The semi-automatic method extracts the vasculature by extending the medial axes into a user-guided direction. A ground-truth study over a series of 40 human 3D MDCT images demonstrates the efficacy, accuracy, robustness, and efficiency of the methods.

  11. Segmentation of the central-chest lymph nodes in 3D MDCT images.

    Science.gov (United States)

    Lu, Kongkuo; Higgins, William E

    2011-09-01

    Central-chest lymph nodes play a vital role in lung-cancer staging. The definition of lymph nodes from three-dimensional (3D) multidetector computed-tomography (MDCT) images, however, remains an open problem. We propose two methods for computer-based segmentation of the central-chest lymph nodes from a 3D MDCT scan: the single-section live wire and the single-click live wire. For the single-section live wire, the user first applies the standard live wire to a single two-dimensional (2D) section after which automated analysis completes the segmentation process. The single-click live wire is similar but is almost completely automatic. Ground-truth studies involving human 3D MDCT scans demonstrate the robustness, efficiency, and intra-observer and inter-observer reproducibility of the methods.

  12. Myocardial bridging as evaluated by 16 row MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Canyigit, Murat [Hacettepe University, Faculty of Medicine, Department of Radiology, Sihhiye, 06100 Ankara (Turkey)], E-mail: mcanyigit@yahoo.com; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Dagoglu, Merve Gulbiz; Akata, Deniz [Hacettepe University, Faculty of Medicine, Department of Radiology, Sihhiye, 06100 Ankara (Turkey); Aytemir, Kudret; Oto, Ali [Hacettepe University, Faculty of Medicine, Department of Cardiology, Sihhiye, 06100 Ankara (Turkey); Balkanci, Ferhun; Akpinar, Erhan; Besim, Aytekin [Hacettepe University, Faculty of Medicine, Department of Radiology, Sihhiye, 06100 Ankara (Turkey)

    2009-01-15

    Purpose: The purpose of this study is to find out the prevalence, appearance and clinical symptoms of myocardial bridging (MB) by MDCT coronary angiography (CTA). Materials and methods: A total of 280 (50 females) consecutive patients followed with coronary artery disease or postoperative stent and bypass control, underwent CTA performed by 16-MDCT scanner between January 2006 and April 2006. Short axis multiplanar reformatted images were evaluated. MBs were classified as complete and incomplete bridges with respect to continuity of the myocardium over the tunneled segment of left anterior descending artery (LAD) in interventricular groove and the cut-off value is 1.3 mm. Patients diagnosed with MB on CTA who had prior catheter angiography studies were re-evaluated for the presence of MB. Results: One hundred and twenty MBs [98 (81.6%) on LAD, 2 (1.6%) on diagonal branch, 11 (9.1%) on obtuse marginal, 4 (3.3%) on right coronary artery, 5 (4.1%) on ramus intermedius artery] were detected in 108 (38.5%) patients. Eighty-five (70.8%) of bridged segments in 79 (28.2%) patients were complete and the rest [35 (29.2%) in 34 (12.1%) patients] were incomplete. In 12 patients two MBs (either on different arteries or on the same artery) were detected. The length of bridged segments in patients with complete and incomplete MBs varied between 4-50.9 mm (mean 18 mm) and 4-37.3 mm (mean 13.6 mm), respectively, and the depth of myocardium over the artery ranged between 1-6.4 mm (mean 2.3 mm) and 1-1.2 mm (mean 1 mm), respectively. Thirty (27.7%) out of 108 patients, in whom MB was detected on CTA, were found to have correlative catheter angiography studies, retrospectively and MB was detected only in 4 (13.3%) out of 30 patients. Conclusion: MDCT coronary angiography is a non-invasive, efficient method in the diagnosis of MB avoiding the procedural risks that catheter angiography carries. MDCT coronary angiography allows direct visualization of the bridge itself and may thus give

  13. 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

  14. 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

  15. 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

  16. Ectopic Varices in Colonic Stoma: MDCT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jae Woong; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min; Kim, Jin Yong [Guro Hospital of Korea University, Seoul (Korea, Republic of)

    2006-12-15

    We describe the 2D reformatted and 3D volume rendered images by MDCT in a patient with an episode of acute bleeding from the colonic stoma. This case indicates that the 2D reformatted and 3D volume rendered images are useful to detect this rare complication of portal hypertension, and they help to tailor adequate treatment for the patients with bleeding from stomal varices. Ectopic varices are an uncommon cause of gastrointestinal hemorrhage, but they account for up to 5% of all variceal bleedings (1). Bleeding from stomal varices has been reported in up to 20% of the patients suffering with chronic liver failure with permanent stoma (2). However, the diagnosis of stomal varices is difficult because bleeding from stoma may also be associated with lower gastrointestinal bleeding. To the best of our knowledge, the 2D reformatted and 3D volume rendered images by MDCT for visualization of ectopic stomal varices have not been previously reported in the medical literature.

  17. Baseline MDCT findings after prosthetic heart valve implantation provide important complementary information to echocardiography for follow-up purposes

    Energy Technology Data Exchange (ETDEWEB)

    Sucha, Dominika; Mali, Willem P.T.M.; Habets, Jesse [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Chamuleau, Steven A.J. [University Medical Center Utrecht, Department of Cardiology, Utrecht (Netherlands); Symersky, Petr [VU Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Meijs, Matthijs F.L. [Thoraxcentrum Twente, Medisch Spectrum Twente, Department of Cardiology, Enschede (Netherlands); Brink, Renee B.A. van den [Academic Medical Center, Department of Cardiology, Amsterdam (Netherlands); Mol, Bas A.J.M. de [Academic Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Herwerden, Lex A. van [University Medical Center Utrecht, Department of Cardiothoracic Surgery, Utrecht (Netherlands); Budde, Ricardo P.J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands)

    2016-04-15

    Recent studies have proposed additional multidetector-row CT (MDCT) for prosthetic heart valve (PHV) dysfunction. References to discriminate physiological from pathological conditions early after implantation are lacking. We present baseline MDCT findings of PHVs 6 weeks post implantation. Patients were prospectively enrolled and TTE was performed according to clinical guidelines. 256-MDCT images were systematically assessed for leaflet excursions, image quality, valve-related artefacts, and pathological and additional findings. Forty-six patients were included comprising 33 mechanical and 16 biological PHVs. Overall, MDCT image quality was good and relevant regions remained reliably assessable despite mild-moderate PHV-artefacts. MDCT detected three unexpected valve-related pathology cases: (1) prominent subprosthetic tissue, (2) pseudoaneurysm and (3) extensive pseudoaneurysms and valve dehiscence. The latter patient required valve surgery to be redone. TTE only showed trace periprosthetic regurgitation, and no abnormalities in the other cases. Additional findings were: tilted aortic PHV position (n = 3), pericardial haematoma (n = 3) and pericardial effusion (n = 3). Periaortic induration was present in 33/40 (83 %) aortic valve patients. MDCT allowed evaluation of relevant PHV regions in all valves, revealed baseline postsurgical findings and, despite normal TTE findings, detected three cases of unexpected, clinically relevant pathology. (orig.)

  18. Comparison of measurements from digital cephalometric radiographs and 3D MDCT-synthetized cephalometric radiographs and the effect of head position

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Ja; Choi, Bo Ram; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2009-09-15

    To investigate the reproducibilities and compare the measurements in digital and MDCT-synthesized cephalometric radiograph, and to investigate the effect of head position on the measurement during imaging with MDCT. Twenty-two dry skulls (combined with mandible) were used in this study. Conventional digital cephalometric radiograph was taken in standard position, and MDCT was taken in standard position and two rotated position (10 .deg. C left rotation and 10 .deg. C right tilting). MDCT data were imported in OnDemand and lateral cephalometric radiograph were synthesized from 3D virtual models. Two types of rotated MDCT data were synthesized with default mode and with corrected mode using both ear rods. For all six images, sixteen angular and eleven linear measurements were made in V-Ceph three times. Reproducibility of measurements was assessed using repeated measures ANOVA and ICC. Linear and angular measurements were compared between digital and five MDCTsynthesized images by Student t-test. All measurements in six types of cephalometric radiograph were not statistically different under ICC examination. Measurements were not different between digital and MDCT-synthesized images (P> .05). Measurements in MDCT-synthesized image in 10 .deg. C left rotation or 10 .deg. C right tilting position showed possibility of difference from digital image in some measurements, and possibility of improvement via realignment of head position using both ear rods. MDCT-synthesized cephalometric radiograph can substitute conventional cephalometric radiograph. The error on head position during imaging with MDCT have possibility that can produce measurement errors with MDCT-synthesized image, and these position error can be corrected by realignment of the head position using both ear rods.

  19. Assessment of vascular invasion in pancreatic carcinoma by MDCT

    Directory of Open Access Journals (Sweden)

    Omar Hassanen

    2014-06-01

    Conclusion: Assessment of vascular invasion is crucial in the evaluation of resectability for pancreatic cancer. MDCT is an accurate diagnostic tool for peripancreatic vascular invasion in cancer pancreas.

  20. 64层螺旋CT腹部扫描参数优化的个体化选择%Optimization of individualized abdominal scan protocol with 64-slice CT scanner

    Institute of Scientific and Technical Information of China (English)

    胡敏霞; 赵心明; 宋俊峰; 周纯武

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈穹; 王钢; 汪茂文; 钱春锋; 姚强; 路明; 汤友英

    2011-01-01

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

  2. 64排螺旋CT仿真结肠镜在结肠癌诊断中的应用%Clinical application of 64-slice spiral CT virtual colonoscopy in diagnosis of colonic carcinoma

    Institute of Scientific and Technical Information of China (English)

    张明

    2012-01-01

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

  3. 64排CT用于创伤性颅脑损伤诊断中的价值%Value of Applying 64-slice CT to Diagnosis of Traumatic Brain Injury

    Institute of Scientific and Technical Information of China (English)

    刘光祖

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李杨; 杨峰; 余河

    2012-01-01

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

  5. 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.

  6. 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

  7. 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

  8. The usefulness of MDCT in acute intestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kum Rae; Park, Won Kyu; Kim, Jae Woon; Chang, Jay Chun; Jang, Han Won [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2006-10-15

    We wanted to evaluate the usefulness of MDCT for localizing a bleeding site and for helping make a decision on further management for acute intestinal bleeding. We conducted a retrospective review of 17 consecutive patients who presented with acute intestinal bleeding and who also underwent MDCT before angiography or surgery. The sensitivity of MDCT for detecting acute intestinal bleeding was assessed and compared with that of conventional angiography. The sensitivity of MDCT for the detection of acute intestinal bleeding was 77% (13 or 17), whereas that of angiography was 46% (6 or 13). All the bleeding points that were subsequently detected on angiography were visualized on MDCT. In three cases, the bleeding focus was detected on MDCT and not on angiography. In four cases, both MDCT and angiography did not detect the bleeding focus; for one of these cases, CT during SMA angiography was performed and this detected the active bleeding site. In patients with acute intestinal bleeding, MDCT is a useful image modality to detect the bleeding site and to help decide on further management before performing angiography or surgery. When tumorous lesions are detected, invasive angiography can be omitted.

  9. Our Incidence of Diaphragmatic Hernia Detected with MDCT in the Past Two Years

    Directory of Open Access Journals (Sweden)

    Nesrin Atcı

    2015-11-01

    Full Text Available Aim: Diaphragmatic hernia develops as a result of extension of the intraabdominal organs to the thorax from a diaphragmatic defect which may be either a congenital fusion defect or subsequently formed defect(iatrojenic or traumatic. The diagnosis of symptomatic or asymptomatic diaphragmatic hernia can be easily done with the cross-sectional imaging, multidetector computed tomography (MDCT devices our aim in this study is to investigate diaphragmatic hernia incidence diagnosed by MDCT retrospectively. Methods: An experienced radiologist retrospectively evaluated MDCT results of 1000 patients to whom thorax and abdominal computed tomography was done due to chest and abdominal discomfort or trauma during the last 2 years. Results: According to our results, out of 1000 patients, 77 (7.7% patients had different types of diaphragmatic hernia the most common herniation was hiatal hernia which was seen in 54 patients. Congenital diaphragmatic hernia (n=21 and traumatic diaphragmatic hernia (n=2 were observed also. Conclusion: Diaphragmatic hernia diagnosis could be made easily with extensive use of MDCT in which multi-planar imaging can be taken.

  10. Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast en-hanced images

    Institute of Scientific and Technical Information of China (English)

    Alomary Mahfooz-Naef; Vikash; Wang Qiu-xia; Zhang Jin-hua; Hu Dao-yu

    2015-01-01

    Objective:To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cor-tex thickness with renal cortex CT value on contrast enhanced 64-slice CT images.Methods:96 patients (50 men and 46 women;16~74 years)with normal kidney function,which was confirmed by kidney function test were enrolled in this stud-y,including bilateral kidneys of 92 cases and unilateral kidney of 4 cases (total of 188 kidneys;92 left,96 right).After intra-venous (IV)injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were per-formed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5 software.Quantitative data were presented as mean ± standard deviation,while qualitative data were presented as frequency (%).P<0.05 was considered to be statistically significant.Results:The mean renal cortex thickness was (5.19±0.81)mm in all kidneys.In the arterial phase,a statistically significant positive correla-tion between renal cortex CT values and abdominal aortic CT values was showed (r= 0.584;P<0.001).A statistically sig-nificant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated (r= 0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values (r= 0.43,P<0.001).Conclusion:It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.

  11. 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.

  12. Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Henes, Frank Oliver, E-mail: f.henes@uke.de [Department of Diagnostic and Interventional Radiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Groth, Michael [Department of Diagnostic and Interventional Neuroradiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Kramer, Harald [Department of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, 81377 Munich (Germany); Department of Radiology, University of Wisconsin – Madison, Clinical Science Center, 600 Highland Avenue, Madison, WI 53792 (United States); Schaefer, Christian [Department of Trauma-, Hand- and Reconstructive Surgery, Spine Center, Center for Surgical Sciences, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Regier, Marc; Derlin, Thorsten; Adam, Gerhard; Bannas, Peter [Department of Diagnostic and Interventional Radiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany)

    2014-01-15

    Objectives: To determine a cut-off value of Hounsfield attenuation units (HU) at multidetector computed tomography (MDCT) for valid and reliable detection of bone marrow oedema (BME) related to occult vertebral fractures. Methods: 36 patients underwent both MDCT and Magnetic Resonance Imaging (MRI) for evaluation of vertebral fractures of the thoracolumbar spine and were included in this retrospective study. Two readers independently assessed HU values at MDCT in a total of 196 vertebrae. Reliability was assessed by intraclass correlation coefficient and Bland–Altman analysis. For each patient we determined the vertebra with the lowest HU value and calculated the HU-difference to each other vertebral body. HU-differences were subjected to receiver operating characteristic (ROC) curve analysis to determine the diagnostic accuracy for detection of BME as determined by MRI, which served as the reference standard. Results of HU-measurements were compared with standard visual evaluation of MDCT. Results: HU measurements demonstrated a high interrater reliability (ICC = 0.984). ROC curve analysis (AUC = 0.978) exhibited an ideal cut-off value of 29.6 HU for detection of BME associated with vertebral fractures with an accuracy of 97.4% as compared to 93.4% accuracy of visual evaluation. Particularly, HU-measurements increased the sensitivity for detection of vertebral fractures from 78.0% to 92.7% due to the detection of 7 of 9 occult fractures that were missed by visual evaluation alone. Conclusions: Assessing bone marrow density by HU measurements using the cut-off of 29.6 HU is a valid and reliable tool for detection of BME related to occult vertebral fractures in MDCT. The introduced technique may allow more accurate treatment decisions and may make further diagnostic work-up with MRI unnecessary.

  13. Evaluation of portosystemic collaterals by MDCT-MPR imaging for management of hemorrhagic esophageal varices

    Energy Technology Data Exchange (ETDEWEB)

    Kodama, Hideaki [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Aikata, Hiroshi, E-mail: aikata@hiroshima-u.ac.jp [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Takaki, Shintaro; Azakami, Takahiro; Katamura, Yoshio; Kawaoka, Tomokazu; Hiramatsu, Akira; Waki, Koji; Imamura, Michio; Kawakami, Yoshiiku; Takahashi, Shoichi [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Toyota, Naoyuki; Ito, Katsuhide [Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Chayama, Kazuaki [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan)

    2010-11-15

    Objective: To study the correlation between changes in portosystemic collaterals, evaluated by multidetector-row computed tomography imaging using multiplanar reconstruction (MDCT-MPR), and prognosis in patients with hemorrhagic esophageal varices (EV) after endoscopic treatment. Methods: Forty-nine patients with primary hemostasis for variceal bleeding received radical endoscopic treatment: endoscopic injection sclerotherapy (EIS) or endoscopic variceal ligation (EVL). Patients were classified according to the rate of reduction in feeding vessel diameter on MDCT-MPR images, into the narrowing (n = 24) and no-change (n = 25) groups. We evaluated changes in portosystemic collaterals by MDCT-MPR before and after treatment, and determined rebleeding and survival rates. Results: The left gastric and paraesophageal (PEV) veins were recognized as portosystemic collaterals in 100 and 80%, respectively, of patients with EV on MDCT-MPR images. The rebleeding rates at 1, 2, 3, and 5 years after endoscopic treatment were 10, 15, 23, and 23%, respectively, for the narrowing group, and 17, 24, 35, and 67%, respectively, for the no-change group (P = 0.068). Among no-change group, the rebleeding rate in patients with large PEV was significantly lower than that with small PEV (P = 0.027). The rebleeding rate in patients with small PEV of the no-change group was significantly higher than that in the narrowing group (P = 0.018). There was no significant difference in rebleeding rates between the no-change group with a large PEV and narrowing group (P = 0.435). Conclusion: Changes in portosystemic collaterals evaluated by MDCT-MPR imaging correlate with rebleeding rate. Evaluation of portosystemic collaterals in this manner would provide useful information for the management of hemorrhagic EV.

  14. 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

  15. Radiological profile of anemia on unenhanced MDCT of the thorax

    Energy Technology Data Exchange (ETDEWEB)

    Kamel, Ehab M.; Rizzo, Elena; Duran, Rafael; Goncalves-Matoso, Vasco; Schnyder, Pierre [Centre Hospitalier Universitaire Vaudois (CHUV), Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Duchosal, Michel A. [Centre Hospitalier Universitaire Vaudois (CHUV), Service of Hematology, Lausanne (Switzerland); Qanadli, Salah D. [Centre Hospitalier Universitaire Vaudois (CHUV), Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); University of Lausanne-CHUV, Diagnostic and Interventional Radiology, Lausanne (Switzerland)

    2008-09-15

    Our aim was to investigate the diagnostic value of unenhanced MDCT in anemic patients. Fifty consecutive patients with proven anemia and 50 nonanemic matched group for age, sex and body mass index were evaluated. In either group, hemoglobin levels were assessed no more than 24 h from an unenhanced CT of the thorax. For each patient, the presence of a hyperattenuating aortic wall (aortic ring sign) and/or dense interventricular septum (subjective parameters) were identified by two radiologists who were blinded to the laboratory findings. Furthermore, the aortic CT attenuation values (objective parameter) were also obtained and correlated with the hemoglobin levels. The sensitivity and specificity in detecting anemia were calculated for each variable, and ROC analysis was generated for subjective and objective parameters. Subjective image analysis revealed that the aortic ring sign was more sensitive than the interventricular septum sign for anemia detection (84% vs. 72%), whereas this latter sign was more specific (100% vs. 92%). A good correlation (r=0.60) was observed between the aortic CT attenuation values and the hemoglobin levels in the whole study population. Using a threshold of {<=}35 HU for anemia diagnosis, the sensitivity and specificity of aortic CT attenuation value were 84% and 94%, respectively, with the largest area under the curve (0.89) among all diagnostic criteria. However, the best trade-off between sensitivity (80%) and specificity (100%) was obtained from combining both subjective and objective analysis. Interpreting anemia upon unnenhanced MDCT of the thorax is quite feasible. A diagnostic approach that considers both subjective and objective analysis offers the best trade-off between sensitivity and specificity. (orig.)

  16. Giant colonic diverticulum: radiographic and MDCT characteristics.

    Science.gov (United States)

    Zeina, Abdel-Rauf; Mahamid, Ahmad; Nachtigal, Alicia; Ashkenazi, Itamar; Shapira-Rootman, Mika

    2015-12-01

    Giant colonic diverticulum (GCD), defined as a diverticulum larger than 4 cm, is a rare entity that is generally a manifestation of colonic diverticular disease. Because of its rarity and its variable and non-specific presentation, the diagnosis of GCD depends mainly on imaging findings. Knowledge of the spectrum of radiographic and CT features of the GCD is important in making the correct diagnosis and potentially preventing complications. This review focuses on imaging findings characteristic of GCD as well as its complications and radiographic mimics. Teaching points • Giant colonic diverticulum is a rare complication of diverticulosis.• The most common symptom is abdominal pain presenting in approximately 70 % of patients.• Diagnosis is based on imaging findings with plain abdominal radiographs and MDCT.• Treatment consists of en bloc resection of the diverticulum and affected adjacent colon.

  17. Role of multi-detector computed tomography (MDCT in management of post percutaneous nephrolithotomy (PCNL bleeding [v1; ref status: indexed, http://f1000r.es/205

    Directory of Open Access Journals (Sweden)

    Arvind P Ganpule

    2013-11-01

    Full Text Available Objective: To evaluate the role of multidetector computerized tomography (MDCT angiography in post percutaneous nephrolithotomy (PCNL bleed and compare findings with conventional angiography (CA. Material and methods: We conducted a retrospective analysis of patients who had post PCNL bleeding and subsequently underwent a MDCT angiography followed by CA. We reviewed eight patients, who presented between January 2009 and January 2013. We performed a MDCT angiography on a 16 slice GE bright speed CT scanner. All angiographies were done by using the Digital Subtraction Angiography Suite. The angioembolisation, if required, was conducted by an interventional nephrologist, specializing in therapeutic embolisation. Results: The mean age of the patients was 42±17 years. Mean time of post PCNL bleed presentation was 10.06±7.9 days. Five patients presented with aneurysm and three presented with an AV fistula with pseudoaneurysm. The right renal unit was involved in six cases and the left in two cases. The lower polar segmental artery was involved in six cases and the upper polar artery in two cases. The CA and MDCT findings matched in all cases and the MDCT helped the clinician to assess and embolise the appropriate arterial tree. Conclusion: MDCT is rapid, reproducible and noninvasive. MDCT angiography performed in the setting of post PCNL bleeding provides an accurate assessment of the site and nature of bleeding. The MDCT angiography matched the CA findings in all patients in the present study.

  18. 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.

  19. Evaluation of morphologic characteristics of the aortic root with 64-slice spiral computed tomography%64层螺旋CT对主动脉根部形态结构的评价

    Institute of Scientific and Technical Information of China (English)

    陈华; 黄新苗; 赵仙先; 曹江; 秦永文

    2011-01-01

    目的 研究主动脉根部及临近组织结构64层螺旋CT(MSCT)成像技术、影像解剖及其临床意义.方法 60例无明显主动脉、主动脉瓣膜疾病患者行MSCT检查,采用多平面重建(MPR)、容积再现(VR)及仿真内镜(VE)等方法重建并测量相关数据.结果 测得主动脉根部直径(22.79±3.31)mm,主动脉窦间距(33.43±3.34)mm,冠脉开口处直径(30.06±2.70) mm,升主动脉内径(30.39±3.42),窦底平面至窦顶平面距离(19.18±2.21) mm.左右冠状动脉开口距主动脉根部距离分别为(15.71±3.53) mm、(15.96±3.78) mm.结论 应用MSCT增强扫描可清楚显示主动脉开口大小、冠脉开口位置、有无发育畸形及与周边结构关系,为带瓣膜支架的设计与经皮主动脉瓣膜植入手术顺利施行提供影像学依据.%Objective To explore the imaging technique for demonstrating the aortic root and its neighbouring structures with 64-slice spiral computed tomography, and to discuss the morphologic characteristics of the aortic root as well as their clinical signif'icance. Methods Multislice spiral CT scanning was performed in sixty adult patients who had no obvious ascending aorta diseases or aortic valve abnormalities. Multi-plane reconstruction (MPR) . volume rendering (VR)and virtual endoscopy (VE)were employed to demonstrate the anatomy of the aortic root, while the relevant data concerning the aorta and coronary smus were also determined. The results were analyzed. Results The mean aortic diameter at aortic root was(22.79 ± 3.3l)mm. the mean distance between coronary sinuses was (33.43 ± 3.34) mm, and the mean coronary diameter at its orifice was (30.06 ± 2.70) mm. The measurements also included the inner diameter of middle ascending aorta(30.39 ± 3.42) mm , the distance between the bottom plane and top plane of the coronary sinus(19.18 ± 2.21) mm, the distance between left coronary orifice and aortic root( 15.71 ± 3.53) mm and the distance between right coronary

  20. Robust method for extracting the pulmonary vascular trees from 3D MDCT images

    Science.gov (United States)

    Taeprasartsit, Pinyo; Higgins, William E.

    2011-03-01

    Segmentation of pulmonary blood vessels from three-dimensional (3D) multi-detector CT (MDCT) images is important for pulmonary applications. This work presents a method for extracting the vascular trees of the pulmonary arteries and veins, applicable to both contrast-enhanced and unenhanced 3D MDCT image data. The method finds 2D elliptical cross-sections and evaluates agreement of these cross-sections in consecutive slices to find likely cross-sections. It next employs morphological multiscale analysis to separate vessels from adjoining airway walls. The method then tracks the center of the likely cross-sections to connect them to the pulmonary vessels in the mediastinum and forms connected vascular trees spanning both lungs. A ground-truth study indicates that the method was able to detect on the order of 98% of the vessel branches having diameter >= 3.0 mm. The extracted vascular trees can be utilized for the guidance of safe bronchoscopic biopsy.

  1. Spontaneous Renal Artery Dissection as a Cause of Acute Renal Infarction: Clinical and MDCT Findings.

    Science.gov (United States)

    Yoon, Kibo; Song, Soon Young; Lee, Chang Hwa; Ko, Byung Hee; Lee, Seunghun; Kang, Bo Kyeong; Kim, Mi Mi

    2017-04-01

    The purpose of this study was to assess the incidence of spontaneous renal artery dissection (SRAD) as a cause of acute renal infarction, and to evaluate the clinical and multidetector computed tomography (MDCT) findings of SRAD. From November 2011 to January 2014, 35 patients who were diagnosed with acute renal infarction by MDCT were included. We analyzed the 35 MDCT data sets and medical records retrospectively, and compared clinical and imaging features of SRAD with an embolism, using Fisher's exact test and the Mann-Whitney test. The most common cause of acute renal infarction was an embolism, and SRAD was the second most common cause. SRAD patients had new-onset hypertension more frequently than embolic patients. Embolic patients were found to have increased C-reactive protein (CRP) more often than SRAD patients. Laboratory results, including tests for lactate dehydrogenase (LDH) and blood urea nitrogen (BUN), and the BUN/creatinine ratio (BCR) were significantly higher in embolic patients than SRAD patients. Bilateral renal involvement was detected in embolic patients more often than in SRAD patients. MDCT images of SRAD patients showed the stenosis of the true lumen, due to compression by a thrombosed false lumen. None of SRAD patients progressed to an estimated glomerular filtration rate renal disease during the follow-up period. SRAD is not a rare cause of acute renal infarction, and it has a benign clinical course. It should be considered in a differential diagnosis of acute renal infarction, particularly in patients with new-onset hypertension, unilateral renal involvement, and normal ranges of CRP, LDH, BUN, and BCR.

  2. Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok [Korea University Guro Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Ham, Soo-Youn [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Ki Yeol; Choo, Ji Yung [Korea University Ansan Hospital, Korea University College of Medicine, Department of Radiology, Ansan (Korea, Republic of)

    2014-12-15

    The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

  3. Spectrum of imaging findings on MDCT enterography in patients with small bowel tuberculosis.

    Science.gov (United States)

    Kalra, N; Agrawal, P; Mittal, V; Kochhar, R; Gupta, V; Nada, R; Singh, R; Khandelwal, N

    2014-03-01

    Abdominal tuberculosis (TB) is the sixth most common extrapulmonary site of involvement. The sites of involvement in abdominal tuberculosis, in descending order of frequency, are lymph nodes, genitourinary tract, peritoneal cavity, and gastrointestinal tract. The radiological armamentarium for evaluating tuberculosis of the small bowel (SBTB) includes barium studies (small bowel follow-through, SBFT), CT (multidetector CT, CT enterography, and CT enteroclysis), ultrasound (sonoenteroclysis), and magnetic resonance imaging (MRI; enterography and enteroclysis). In this review, we illustrate the abnormalities at MDCT enterography in 20 consecutive patients with SB TB and also describe extraluminal findings in these patients. MDCT enterography allows non-invasive good-quality assessment of well-distended bowel loops and the adjacent soft tissues. It displays the thickness and enhancement of the entire bowel wall in all three planes and allows examination of all bowel loops, especially the ileal loops, which are mostly superimposed. The terminal ileum and ileocaecal junction are the most common sites of small bowel involvement in intestinal TB. The most common abnormality is short-segment strictures with symmetrical concentric mural thickening and homogeneous mural enhancement. Other findings include lymphadenopathy, ascites, enteroliths, peritoneal thickening, and enhancement. In conclusion, MDCT enterography is a comprehensive technique for the evaluation of SB TB.

  4. Efficient stereological approaches for the volumetry of a normal or enlarged spleen from MDCT images

    Energy Technology Data Exchange (ETDEWEB)

    Mazonakis, Michalis; Stratakis, John; Damilakis, John [University of Crete, Department of Medical Physics, Faculty of Medicine, P.O. Box 2208, Iraklion, Crete (Greece)

    2015-06-01

    To introduce efficient stereological approaches for estimating the volume of a normal or enlarged spleen from MDCT. All study participants underwent an abdominal MDCT. The first group included 20 consecutive patients with splenomegaly and the second group consisted of 20 subjects with a normal spleen. Splenic volume estimations were performed using the stereological point counting method. Stereological assessments were optimized using the systematic slice sampling procedure. Planimetric measurements based on manual tracing of splenic boundaries on each slice were taken as reference values. Stereological analysis using five to eight systematically sampled slices provided enlarged splenic volume estimations with a mean precision of 4.9 ± 1.0 % in a mean time of 2.3 ± 0.4 min. A similar measurement duration and error was observed for normal splenic volume assessment using four to seven systematically selected slices. These stereological approaches slightly but insignificantly overestimated the volume of a normal and enlarged spleen compared to planimetry (P > 0.05) with a mean difference of -1.3 ± 4.3 % and -2.7 ± 5.2 %, respectively. The two methods were highly correlated (r ≥ 0.96). The variability of repeated stereological estimations was below 3.8 %. The proposed stereological approaches enable the rapid, reproducible, and accurate splenic volume estimation from MDCT data in patients with or without splenomegaly. (orig.)

  5. Contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Ryusuke; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Yoshida, Tamiko; Okazaki, Emi; Kumita, Shin-ichiro; Owan, Chojin [Nippon Medical School, Department of Radiology, Graduate School of Medicine, Tokyo (Japan)

    2012-10-15

    To evaluate the safety of contrast-enhanced MDCT in patients with renal impairment. We conducted a retrospective review of 938 patients with stable renal insufficiency (eGFR between 15 and 60 ml/min) who underwent contrast-enhanced MDCT. SCr levels were measured at baseline and 48-72 h after contrast medium administration. The incidence of contrast-induced nephropathy (CIN) in the total study population was assessed. As a control group, 1,164 separate patients with renal insufficiency who did not receive contrast medium for CT were also reviewed. The overall incidence of CIN in the patient population with renal insufficiency was 6.1 %; the incidence was 4.4 %, 10.5 % and 10.0 % for patients whose eGFR was 45-60, 30-45 and {<=}30 ml/min, respectively (P < 0.01). In the control group, 5.8 % of patients showed an increase in the SCr level from the baseline. The increase in the SCr level showed no significant difference between the patients who received CM and those who did not (P = 0.82) The risk of CIN from contrast-enhanced MDCT in patients with renal insufficiency appeared to be low, and there was no significant difference in the incidence of CIN in comparison with patients who did not receive CM. (orig.)

  6. MAXILLOFACIAL AND ORBITAL INJURIES EVALUATION BY THREE DIMENSIONAL MDCT

    Directory of Open Access Journals (Sweden)

    Shrishail

    2015-09-01

    Full Text Available There has been considerable increase in maxillofacial and orbital injuries due to road traffic accidents, falls and assaults. There is need for accurate detection of these maxillofacial bony fractures. MDCT is the method of choice in the evaluation of maxillofacial traumas, as it allows accurate determination of the presence, location and extent of fractures especially in cases of communited fractures, rotational deformities and multiple bone fractures also having advantage to diagnose even in patients with facial edema, lacerations and altered sensorium. PURPOSE: The objective of the study is to compare axial, coronal and 3D reformatted CT images for the study of maxillofacial and orbital fractures. MATERIALS AND METHODS: Multislice CT scan was done for 131 patients attending BTGH Gulbarga with history of maxillofacial and orbital trauma during the period of December 2012 to September 2014 using Philips Brilliance 6 slice CT scanner. RESULTS : Majority of the patients were males (85.5% belonged to age group of 21 - 30 years (42%. Most common cause of maxillofacial trauma was road traffic accident (78.6%. Fractures of nasal bones were most common followed by walls of maxillary sinuses and least common fractured bone was cribriform plate. Most common type of complex fracture was naso - ethmoido - orbital complex fracture followed by zygomaticomaxillary complex. Lateral wall of the orbit was most commonly fractured followed by medial wall and floor. DISCUSSION : Axial CT was better in diagnosing anterior maxillary wall, zygomatic arch fractures. Coronal CT was better in detecting orbital floor, O rbital roof, P terygoid plate fractures, C lassification of Le Fort fractures and orbital floor blow out fractures. 3D CT was slightly better to 2D CT in evaluating anterior maxillary wall fractures and frontal bone fractures. 2D and 3D CT were almost similar in evaluating fractures of nasal bone, zygomatic bone and zygomatic arch fractures. 3D CT was

  7. Demonstration of vascular abnormalities compressing esophagus by MDCT: Special focus on dysphagia lusoria

    Energy Technology Data Exchange (ETDEWEB)

    Alper, Fatih [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey)]. E-mail: fatihrad@yahoo.com; Akgun, Metin [Department of Chest Diseases, Medical Faculty, Atatuerk University, Erzurum (Turkey); Kantarci, Mecit [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey); Eroglu, Atilla [Department of Thoracic Surgery, Medical Faculty, Atatuerk University, Erzurum (Turkey); Ceyhan, Elvan [Department of Mathematics, College of Arts and Sciences, Koc University, Istanbul (Turkey); Onbas, Omer [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey); Duran, Cihan [Department of Radiology, Florence Nightingale Hospital, Istanbul (Turkey); Okur, Adnan [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey)

    2006-07-15

    Purpose: Dysphagia lusoria (DL) is described in the literature as difficulty in swallowing caused by vascular abnormalities. The most common cause is an aberrant right subclavian artery (SCA) which passes behind the esophagus and is also called arteria lusoria (AL). Our aim was to demonstrate the use of multidetector computed tomography (MDCT) in the diagnosis of AL, as there is no comprehensive study investigating the role of MDCT in such cases. Material and methods: A total of 38 consecutive patients, comprising of 23 females (61%) and 15 males (39%), who had extrinsic compression were included in the study. These patients are selected from the cases who were admitted due to their gastrointestinal symptoms, such as dysphagia, epigastric pain, chronic nausea, vomiting, etc. The mean age of patients was 40 {+-} 25 years (range 15-65). Following barium esophagogram and then endoscopy performed, MDCT angiography was carried out on the same or the following few days. MDCT sections were examined to determine the following: presence of vascular abnormality; the diameter and angle of that vascular structure; and the compressed area of esophagus. Radiological findings and dysphagia scores were also compared. Results: In each of 15 cases, there was a compression due to vascular abnormality which were all located between the esophagus and the spine. There was an esophageal compression in each of 12 cases, due to right aberrant SCA, in one case due to right superior aortic arch and in two cases due to both right aortic arch and left SCA with Kommerell's diverticulum. The mean diameter and the angle of AL were 16.4 mm and 48.8{sup o}, respectively, and the mean area of pressured esophagus was 194.7 mm{sup 2}. Dysphagia scores of the cases was 1 in thirteen cases and 2 in two cases. However, dysphagia scores were not correlated with these parameters. Conclusions: MDCT angiography is a useful diagnostic tool for evaluation of patients with dysphagia, especially caused by a

  8. Osteoid osteoma and osteoid osteoma-mimicking lesions: biopsy findings, distinctive MDCT features and treatment by radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Becce, Fabio [Centre Hospitalier Universitaire Vaudois, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Universite Paris Descartes, Department of Radiology B, Hopital Cochin, AP-HP, Paris (France); Theumann, Nicolas [Centre Hospitalier Universitaire Vaudois, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Rochette, Antoine; Campagna, Raphael; Drape, Jean-Luc; Feydy, Antoine [Universite Paris Descartes, Department of Radiology B, Hopital Cochin, AP-HP, Paris (France); Larousserie, Frederique [Universite Paris Descartes, Department of Anatomic Pathology, Hopital Cochin, AP-HP, Paris (France); Cherix, Stephane; Mouhsine, Elyazid [Centre Hospitalier Universitaire Vaudois, Department of Orthopaedic and Traumatologic Surgery, Lausanne (Switzerland); Guillou, Louis [University Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Anract, Philippe [Universite Paris Descartes, Department of Orthopaedic Surgery, Hopital Cochin, AP-HP, Paris (France)

    2010-10-15

    To report the biopsy findings of osteoid osteoma (OO) and OO-mimicking lesions, assess their distinctive multidetector computed tomography (MDCT) features and evaluate treatment by radiofrequency ablation (RFA). In this multicentric retrospective study, 80 patients (54 male, 26 female, mean age 24.1 years, range 5-48) with presumed (clinical and MDCT features) OO were treated by percutaneous RFA between May 2002 and June 2009. Per-procedural biopsies were always performed. The following MDCT features were assessed: skeletal distribution and location within the bone, size, central calcification, surrounding osteosclerosis and periosteal reaction. Clinical success of RFA was evaluated. Histopathological diagnoses were: 54 inconclusive biopsies, 16 OO, 10 OO-mimicking lesions (5 chronic osteomyelitis, 3 chondroblastoma, 1 eosinophilic granuloma, 1 fibrous dysplasia). OO-mimicking lesions were significantly greater in size (p = 0.001) and presented non-significant trends towards medullary location (p = 0.246), moderate surrounding osteosclerosis (p = 0.189) and less periosteal reaction (p = 0.197), compared with OO. Primary success for ablation of OO-mimicking lesions was 100% at 1 month, 85.7% at 6 and 12 months, and 66.7% at 24 months. Secondary success was 100%. Larger size, medullary location, less surrounding osteosclerosis and periosteal reaction on MDCT may help differentiate OO-mimicking lesions from OO. OO-mimicking lesions are safely and successfully treated by RFA. (orig.)

  9. Application of MPVR and TL-VR with 64-row MDCT in neonates with congenital EA and distal TEF

    Institute of Scientific and Technical Information of China (English)

    Yang Wen; Yun Peng; Ren-You Zhai; Ying-Zi Li

    2011-01-01

    AIM: To assess the application of multiple planar volume reconstruction (MPVR) and three-dimensional (3D) transparency lung volume rendering (TL-VR) with 64-row multidetector-row computed tomography (MDCT) in neonates with congenital esophageal atresia (EA) and distal tracheoesophageal fistula (TEF). METHODS: Twenty neonates (17 boys, 3 girls) with EA and distal TEF at a mean age of 4.6 d (range 1-16 d) were enrolled in this study. A helical scan of 64-row MDCT was performed at the 64 mm × 0.625 mm collimation. EA and TEF were reconstructed with MPVR and TL-VR, respectively. Initial diagnosis of EA was made by chest radiography showing the inserted catheter in the proximal blind-ended esophageal pouch. Manifestations of MDCT images were compared with the findings at surgery. RESULTS: MDCT showed the proximal and distal esophageal pouches in 20 cases. No significant difference was observed in gaps between the proximal and distal esophageal pouches detected by MPVR and TLVR. The lengths of gaps between the proximal and distal esophageal pouches detected by MPVR and TL-VR correlated well with the findings at surgery (R = 0.87, P < 0.001). The images of MPVR revealed the orifice of TEF in 13 cases, while TL-VR images showed the orifice of TEF in 4 cases. CONCLUSION: EA and distal TEF can be reconstructed using MPVR and TL-VR of 64-row MDCT, which is a noninvasive technique to demonstrate the distal esophageal pouches and inter-pouch distance in neonates with EA and distal TEF.

  10. Forensic considerations for preprocessing effects on clinical MDCT scans.

    Science.gov (United States)

    Wade, Andrew D; Conlogue, Gerald J

    2013-05-01

    Manipulation of digital photographs destined for medico-legal inquiry must be thoroughly documented and presented with explanation of any manipulations. Unlike digital photography, computed tomography (CT) data must pass through an additional step before viewing. Reconstruction of raw data involves reconstruction algorithms to preprocess the raw information into display data. Preprocessing of raw data, although it occurs at the source, alters the images and must be accounted for in the same way as postprocessing. Repeated CT scans of a gunshot wound phantom were made using the Toshiba Aquilion 64-slice multidetector CT scanner. The appearance of fragments, high-density inclusion artifacts, and soft tissue were assessed. Preprocessing with different algorithms results in substantial differences in image output. It is important to appreciate that preprocessing affects the image, that it does so differently in the presence of high-density inclusions, and that preprocessing algorithms and scanning parameters may be used to overcome the resulting artifacts.

  11. MDCT imaging of post interventional liver: a pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy)]. E-mail: stefromano@libero.it; Tortora, Giovanni [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Scaglione, Mariano [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Lassandro, Francesco [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Guidi, Guido [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Grassi, Roberto [Institute of Radiology, Department ' Magrassi-Lanzara' , Second University of Naples, Naples 80138 (Italy); Romano, Luigia [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy)

    2005-03-01

    In this pictorial essay, we consider the post operative MDCT findings after liver resection, transplantation, surgical managed major trauma and radiofrequency ablation of focal lesions. Common complications such as fluid collections, hemorrhage, biloma, vascular disease, hematoma, abscesses will be also considered.

  12. 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.

  13. 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

  14. Juxtapapillary duodenal diverticula: MDCT findings in 1010 patients and proposal for a new classification.

    Science.gov (United States)

    Wiesner, W; Beglinger, Ch; Oertli, D; Steinbrich, W

    2009-01-01

    The aim of this study is to analyze the MDCT findings of juxtapapillary duodenal diverticula (JPDD) and to propose a new radiological classification. CT-examinations of 1010 consecutive patients, all examined by 16-row MDCT of the abdomen over a time period of 20 months were retrospectively analyzed. All study patients were examined by triple phase CT (native, arterial and portal venous CT scan) of the abdomen and all recieved positive oral contrast prior to the examination. Thirty-three patients showed a juxtapapillary duodenal diverticulum, which could be seen on all CT scans, but jusually was depicted most clearly on the thin collimated arterial phase CT images. Size of diverticula range from 4 mm to 4.5 cm (mean 1.7 cm). In 17 cases the diverticulum was located ventrally to the vaterian sphincter complex, extending less or more into the pancreas at the site where the dorsal and the ventral anlage of the pancreas have fused (type I). 12 diverticula were located dorsally to the sphincter complex (type II). Three patients presented with a bilobated juxtapapillary diverticulum extending to both sides, ventrally and dorsally (type III) and one patient showed a little diverticulum ventrally to the minor papilla (type IV).Three patients presented with food impaction in the diverticulum but only one of these patients with a large IPDD showed a Lemmel-syndrome, whereas the other three patients with non-calculous extrahepatic cholostasis showed larger diverticula without food impaction. MDCT allows to identify four different types of juxtapapillary duodenal diverticula and using the proposed classification may be helpful for a more exact, anatomy based radiological description of this CT finding.

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

    Institute of Scientific and Technical Information of China (English)

    张志强; 李孟云

    2015-01-01

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

  16. Coronary fly-through or virtual angioscopy using dual-source MDCT data.

    Science.gov (United States)

    van Ooijen, Peter M A; de Jonge, Gonda; Oudkerk, Matthijs

    2007-11-01

    Coronary fly-through or virtual angioscopy (VA) has been studied ever since its invention in 2000. However, application was limited because it requires an optimal computed tomography (CT) scan and time-consuming post-processing. Recent advances in post-processing software facilitate easy construction of VA, but until now image quality was insufficient in most patients. The introduction of dual-source multidetector CT (MDCT) could enable VA in all patients. Twenty patients were scanned using a dual-source MDCT (Definition, Siemens, Forchheim, Germany) using a standard coronary artery protocol. Post-processing was performed on an Aquarius Workstation (TeraRecon, San Mateo, Calif.). Length travelled per major branch was recorded in millimetres, together with the time required in minutes. VA could be performed in every patient for each of the major coronary arteries. The mean (range) length of the automated fly-through was 80 (32-107) mm for the left anterior descending (LAD), 75 (21-116) mm for the left circumflex artery (LCx), and 109 (21-190) mm for the right coronary artery (RCA). Calcifications and stenoses were visualised, as well as most side branches. The mean time required was 3 min for LAD, 2.5 min for LCx, and 2 min for the RCA. Dual-source MDCT allows for high quality visualisation of the coronary arteries in every patient because scanning with this machine is independent of the heart rate. This is clearly shown by the successful VA in all patients. Potential clinical value of VA should be determined in the near future.

  17. Correlation of 64 row MDCT, echocardiography and cardiac catheterization angiography in assessment of pulmonary arterial anatomy in children with cyanotic congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Chandrashekhar, Guruprasadh, E-mail: cguruprasadh@gmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Sodhi, Kushaljit Singh, E-mail: sodhiks@gmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Saxena, Akshay Kumar, E-mail: fatakshay@yahoo.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Rohit, Manoj Kumar, E-mail: rohitmanoj@gmail.com [Department of Pediatric Cardiology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India)

    2012-12-15

    Objective: To study the correlation of low-dose 64-row multi-detector computed tomography (MDCT) with echocardiography and cardiac catheterization angiography (CCA) in the assessment of pulmonary arterial anatomy in children with cyanotic congenital heart disease (CCHD). Materials and methods: This prospective study included 105 children (74 males, 31 females) with CCHD, in the age group of 2 months to 20 years, who underwent 64-row MDCT examination (low-dose CT protocol), echocardiography and CCA for the assessment of pulmonary arteries, including visualization, presence of confluence, stenosis and collaterals. Statistical analysis was performed using the non-parametric statistical analysis test to evaluate the concordance or discordance between echocardiography, MDCT and CCA. Results: 64-row MDCT detected significantly more main and branch pulmonary arteries, patent pulmonary confluences, and more cases of pulmonary artery stenosis. CCA detected more major aorto-pulmonary collaterals than MDCT, whereas echocardiography failed to identify these major aorto-pulmonary collaterals. The effective CT radiation dose to patients less than 2 years of age was in the range of 0.7–2.5 mSv, where as the dose in patients more than 2 years of age ranged from that of 2.1 to 4.2 mSv, which is much less than the radiation dose reported in cardiac catheterization angiography. Conclusion: In cases where cardiac MRI cannot be performed, or is not sufficiently informative, low-dose 64-row MDCT correlates well with CCA and can provide adequate information about pulmonary arterial anatomy in children with cyanotic congenital heart disease, and can replace invasive cardiac catheterization angiography with markedly reduced radiation dosage to the patient.

  18. Vascular involvement in periampullary tumors: MDCT, EUS, and CDU.

    Science.gov (United States)

    Gusmini, S; Nicoletti, R; Martinenghi, C; Del Maschio, A

    2009-07-01

    In patients affected by periampullary tumors, surgical resection represents the only treatment with curative intent. Preoperative evaluation of vascular involvement is necessary to avoid surgical treatments unable of curative intent resection. The aim of our update article is to assess the performance of multidetector computed tomography (MDCT), endoscopic ultrasonography (EUS), and color Doppler ultrasonography (CDU) in the evaluation of vascular involvement of major peripancreatic vessels, in periampullary tumors, analyzing the current and past literature.

  19. Accuracy of Monte Carlo simulations compared to in-vivo MDCT dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Bostani, Maryam, E-mail: mbostani@mednet.ucla.edu; McMillan, Kyle; Cagnon, Chris H.; McNitt-Gray, Michael F. [Departments of Biomedical Physics and Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024 (United States); Mueller, Jonathon W. [United States Air Force, Keesler Air Force Base, Biloxi, Mississippi 39534 (United States); Cody, Dianna D. [University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030 (United States); DeMarco, John J. [Departments of Biomedical Physics and Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024 (United States)

    2015-02-15

    Purpose: The purpose of this study was to assess the accuracy of a Monte Carlo simulation-based method for estimating radiation dose from multidetector computed tomography (MDCT) by comparing simulated doses in ten patients to in-vivo dose measurements. Methods: MD Anderson Cancer Center Institutional Review Board approved the acquisition of in-vivo rectal dose measurements in a pilot study of ten patients undergoing virtual colonoscopy. The dose measurements were obtained by affixing TLD capsules to the inner lumen of rectal catheters. Voxelized patient models were generated from the MDCT images of the ten patients, and the dose to the TLD for all exposures was estimated using Monte Carlo based simulations. The Monte Carlo simulation results were compared to the in-vivo dose measurements to determine accuracy. Results: The calculated mean percent difference between TLD measurements and Monte Carlo simulations was −4.9% with standard deviation of 8.7% and a range of −22.7% to 5.7%. Conclusions: The results of this study demonstrate very good agreement between simulated and measured doses in-vivo. Taken together with previous validation efforts, this work demonstrates that the Monte Carlo simulation methods can provide accurate estimates of radiation dose in patients undergoing CT examinations.

  20. Can outer-to-outer diameter be used alone in diagnosing appendicitis on 128-slice MDCT?

    Institute of Scientific and Technical Information of China (English)

    Jamal; Yaqoob; Muhammad; Idris; Muhammad; Shahbaz; Alam; Nazia; Kashif

    2014-01-01

    AIM: To assess the frequency of visualization, position and diameter of normal appendix on 128-slice multidetector computed tomography(MDCT) in adult population.METHODS: Retrospective cross sectional study conducted at Radiology Department, Dallah Hospital, Riyadh, Saudi Arabia from March 2013 to October 2013. Non-enhanced computed tomography scans of abdomen and pelvis of 98 patients presenting with hematuria(not associated with abdominal pain, fever or colonic disease) were reviewed by two radiologists, blinded to patient history. The study group included 55 females and 43 males with overall mean age of 54.7 years(range 21 to 94 years). The coronal reformatted images were reviewed in addition to the axial images. The frequency of visualization of appendix was recorded with assessment of position, diameter and luminal contents.RESULTS: The appendix was recorded as definitely visualized in 99% of patients and mean outer-to-outer diameter of the appendix was 5.6 ± 1.3 mm(range 3.0-11.0 mm).CONCLUSION: MDCT with its multiplanar reformation display is extremely useful for visualization of normal appendix. The normal appendix is very variable in its position and diameter. In the absence of other signs, the diagnosis of acute appendix should not be made solely on outer-to-outer appendiceal diameter.

  1. Investigation of airways using MDCT for visual and quantitative assessment in COPD patients

    Directory of Open Access Journals (Sweden)

    Pierre-Yves Brillet

    2008-03-01

    Full Text Available Pierre-Yves Brillet1, Catalin I Fetita2, Amaury Saragaglia2, Anne-Laure Brun3, Catherine Beigelman-Aubry3, Françoise Prêteux2, Philippe A Grenier31Department of Radiology, Avicenne Hospital, Assistance Publique–Hôpitaux de Paris, Université Léonard de Vinci–Paris Nord, EA 2361, Bobigny, France; 2ARTEMIS Department, Institut National des Télécommunications, Université Paris V, Evry, France; 3Department of Radiology, Pitié-Salpêtrière Hospital, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, FranceAbstract: Multidetector computed tomography (MDCT acquisition during a single breath hold using thin collimation provides high resolution volumetric data set permitting multiplanar and three dimensional reconstruction of the proximal airways. In chronic obstructive pulmonary disease (COPD patients, this technique provides an accurate assessment of bronchial wall thickening, tracheobronchial deformation, outpouchings reflecting dilatation of the submucous glands, tracheobronchomalacia, and expiratory air trapping. New software developed to segment adequately the lumen and walls of the airways on MDCT scans allows quantitative assessment of the airway dimensions which has shown to be reliable in clinical practice. This technique can become important in longitudinal studies of the pathogenesis of COPD, and in the assessment of therapeutic interventions.Keywords: COPD – tracheobronchial tree, multidetector CT – airway remodeling, tracheobronchomalacia

  2. Anemia and the risk of contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Ryusuke, E-mail: rywakana@nms.ac.jp; Kumita, Shin-ichiro; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Okazaki, Emi; Kiriyama, Tomonari; Hakozaki, Kenta; Tani, Hitomi; Miki, Izumi; Takeda, Minako

    2013-10-01

    Purpose: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT. Materials and methods: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48–72 h after contrast administration. Results: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P = .027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0–20.5, P = .046). Conclusions: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT.

  3. 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

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

    Institute of Scientific and Technical Information of China (English)

    贺敬红; 李健丁; 乔英; 张瑞平

    2016-01-01

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

  5. Automated 3D Analysis of Pre-Procedural MDCT to Predict Annulus Plane Angulation and C-Arm Positioning Benefit on Procedural Outcome in Patients Referred for TAVR

    NARCIS (Netherlands)

    Samim, Mariam; Stella, Pieter R.; Agostoni, Pierfrancesco; Kluin, Jolanda; Ramjankhan, Faiez; Budde, Ricardo P. J.; Sieswerda, Gertjan; Algeri, Emanuela; van Belle, Camille; Elkalioubie, Ahmed; Juthier, Francis; Belkacemi, Anouar; Bertrand, Michel E.; Doevendans, Pieter A.; Van Belle, Eric

    2013-01-01

    OBJECTIVES The aim of this study was to determine whether pre-procedural analysis of multidetector row computed tomography (MDCT) scans could accurately predict the "line of perpendicularity" (LP) of the aortic annulus and corresponding C-arm angulations required for prosthesis delivery and impact t

  6. 64排螺旋CT诊断成人门静脉海绵样变性的影像学表现及价值%Imaging Findings and Value of 64-slice Spiral CT in Diagnosis of Cavernous Transformation of Portal Vein

    Institute of Scientific and Technical Information of China (English)

    施健; 施小平; 王强; 王勤英

    2012-01-01

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

  7. Utility of 64-row MDCT in assessment of neonates with congenital EA and distal TEF

    Directory of Open Access Journals (Sweden)

    Hosam El-Deen Galal Mohamed El-Malah

    2015-12-01

    Conclusion: Preoperative MDCT scan with MPVR, 3D TL-VR of 64-row MDCT which is a noninvasive technique could provide more accurate information about the assessment of the origin of the fistula, the distal esophageal pouches and inter-pouch distance in neonates with EA and distal TEF.

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

    Institute of Scientific and Technical Information of China (English)

    姚红霞; 张国富; 张鹏; 崔二峰; 杨鹏午

    2011-01-01

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

  9. Preoperative evaluation of colorectal liver metastases: comparison between gadoxetic acid-enhanced 3.0-T MRI and contrast-enhanced MDCT with histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Scharitzer, M.; Ba-Ssalamah, A.; Ringl, H.; Koelblinger, C.; Weber, M. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Gruenberger, T. [Medical University of Vienna, Department of Surgery, Vienna (Austria); Schima, W. [Department of Radiology, KH Goettlicher Heiland, KH der Barmherzigen Schwestern and St Josef-Krankenhaus, Vienna (Austria)

    2013-08-15

    The aim of this prospective study was to compare the diagnostic performance of 64-row MDCT and gadoxetic-acid-enhanced MRI at 3.0 T in patients with colorectal liver metastases in correlation with histopathological findings. Lesions detected at MDCT and MRI were interpreted by three blinded readers and compared with histopathological workup as the term of reference. Two subgroups of lesions were additionally evaluated: (1) metastases smaller than 10 mm and (2) lesions in patients with and without steatosis of the liver, assessed histopathologically. Surgery and histopathological workup revealed 81 colorectal liver metastases in 35 patients and diffuse metastatic involvement in 3 patients. In a lesion-by-lesion analysis, significant sensitivity differences could only be found for reader 1 (P = 0.035) and reader 3 (P = 0.003). For segment-based evaluation, MRI was more sensitive only for reader 3 (P = 0.012). The number of false-positive results ranged from 3 to 12 for MDCT and 8 to 11 for MRI evaluation. In the group of small lesions, the sensitivity differed significantly between both methods (P = 0.003). In patients with hepatic steatosis, MRI showed a trend toward better performance than MDCT, but without statistical performance. The 3.0-T MRI with liver-specific contrast agents is the preferred investigation in the preoperative setting, especially for the assessment of small colorectal liver metastases. (orig.)

  10. High-pitch computed tomography of the lung in pediatric patients. An intraindividual comparison of image quality and radiation dose to conventional 64-MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Tsiflikas, I.; Thomas, C.; Ketelsen, D.; Claussen, C.D.; Schaefer, J.F. [University Hospital of Tuebingen (Germany). Diagnostic and Interventional Radiology; Seitz, G.; Warmann, S. [University Hospital of Tuebingen (Germany). Pediatric Surgery

    2014-06-15

    Purpose: The aim of this study was to investigate frequencies of typical artifacts in low-dose pediatric lung examinations using high-pitch computed tomography (HPCT) compared to MDCT, and to estimate the effective radiation dose (E{sub eff}). Materials and Methods: Institutional review board approval for this retrospective study was obtained. 35 patients (17 boys, 18 girls; mean age 112 ± 69 months) were included and underwent MDCT and follow-up scan by HPCT or vice versa (mean follow-up time 87 days), using the same tube voltage and current. The total artifact score (0-8) was defined as the sum of artifacts arising from movement, breathing or pulsation of the heart or pulmonary vessels (0 - no; 1 - moderate; 2 - severe artifacts). E{sub eff} was estimated according to the European Guidelines on Quality Criteria for Multislice Computed Tomography. The Mann-Whitney U test was used to analyze differences between the patient groups. The Spearman's rank correlation coefficient was used for correlation of ordinal variables. Results: The scan time was significantly lower for HPCT compared to MDCT (0.72 ± 0.13 s vs. 3.65 ± 0.81s; p < 0.0001). In 28 of 35 (80 %) HPCT examinations no artifacts were visible, whereas in MDCT artifacts occurred in all examinations. The frequency of pulsation artifacts and breathing artifacts was higher in MDCT compared to HPCT (100% vs. 17% and 31% vs. 6%). The total artifact score significantly correlated with the patient's age in MDCT (r=-0.42; p=0.01), but not in HPCT (r=-0.32; p=0.07). The estimated E{sub eff} was significantly lower in HPCT than in MDCT (1.29±0.31 vs. 1.47±0.37 mSv; p < 0.0001). Conclusion: Our study indicates that the use of HPCT has advantages for pediatric lung imaging with a reduction of breathing and pulsation artifacts. Moreover, the estimated E{sub eff} was lower. In addition, examinations can be performed without sedation or breath-hold without losing image quality. (orig.)

  11. MDCT Diagnosis of Isolated Colonic Hernia Through the Esophageal Hiatus

    Directory of Open Access Journals (Sweden)

    Naime Altınkaya

    2011-03-01

    Full Text Available Colonic herniation through the esophageal hiatus is an unusual condition. Isolated trans-hiatal herniation of the transverse colon is very rare and only five cases have been reported. All these reported patients were symptomatic, and had dysphagia, epigastralgia, vomiting, dyspnea, cough, or palpitations. Hiatal hernia is an important clinical problem. Because of the severe complications of hiatal hernia, including bleeding, strangulation, and perforation, early diagnosis and treatment are important. A 75-year-old man who had prostate carcinoma was evaluated with multidetector computed tomography (MDCT. In this case, CT findings and clinical emphasis of the incidentally discovered isolated transverse colonic hiatal herniation was reviewed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-04-15

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

  13. Elective vs non-elective radial artery grafts: comparing midterm results through 64-Slice computed tomography Enxertos de artéria radial eletivos vs emergência: comparando resultados em seguimento a médio prazo

    Directory of Open Access Journals (Sweden)

    Roberto Rocha-e-Silva

    2007-01-01

    Full Text Available BACKGROUND: Left internal thoracic artery to left anterior descending artery (LITA-LADA grafting has become a fundamental part of the coronary artery bypass graft procedure (CABG. This grafting in turn has led to an increased use of other arterial conduits, of which the radial artery (RA is most popular. Whether RA grafting can be used in the emergency patient is controversial. METHODS: 47 patients with critical stenosis (>70% in all target vessels underwent CABG with LITA and RA grafts from 1996 to 2003. Patients were divided into elective (23 patients and non-elective groups (24 patients with LITA and RA grafts per patient being similar in both groups. Of these 47 patients, 5 died from non-cardiac complications and 12 were unavailable. Thus, 30 patients (71% of survivors were studied by multidetector computed tomography. A total of 36 LITA and 64 RA grafts were studied. RESULTS: The RA patency rate for elective and non-elective grafts were 82% (31/38 and 85% (22/26, respectively (p=0.75. The RA had a similar patency rate for all target vessels ranging from 73% to 100%. Only one patient had a redo CABG and 29 (97% are free from angina or re-intervention. LITA-LADA had a 92% (11/12 and 100% (10/10 patency rate for elective and non-elective groups, respectively (p=0.37. The sequential LITA-diagonal-LADA in the elective group had a 50% (03/06 patency rate, which was significantly lower than the 100% (08/08 patency rate of the non-elective group (p=0.02. CONCLUSION: Radial Artery grafts can be used in both elective and non-elective patients with excellent results.INTRODUÇÃO: A anastomose da artéria torácica interna esquerda com a artéria descendente anterior (ATIE-DA se tornou parte fundamental da cirurgia de revascularização do miocárdio (RM. Esta técnica levou ao aumento de utilização de outros enxertos arteriais, entre os quais, a artéria radial (AR é muito usasa. Na literatura há controvérsia se a AR pode ser usada em pacientes

  14. 正常成年人MDCT门静脉测量的区域性研究%Regional Studies of MDCT Measurement of the Portal Vein in the Normal Adult

    Institute of Scientific and Technical Information of China (English)

    李帮雪; 郭顺林; 曾苗苗; 苏李娜

    2016-01-01

    Objective To measure the diameters of the portal vein and abdominal aorta of the normal adult in Gansu Province by Multi-detector Row Spiral CT, and determine the normal CT scale of portal vein and abdominal aorta of adult.Methods Retrospective analysis 300 normal cases that were performed enhanced abdomen CT in the First Hospital of Lanzhou University from February 2014 to April 2015. They were equally assigned to 3 groups according to their age (A group:18—39years,B group:40-59 years,C group:be equal or greater than 60 years;50 females and 50 males in each group). Measurements were done on 3D reconstruction image with precise landmarks, and these data were statistically analyzed by SPSS22.0.Results There were significant differences in the diameters of the left portal vein between group A and group C(P<0.05), and the diameters of the main portal vein were significantly diffrent between group A and group C, group B and group C(P<0.05), and the diameters of abdominal aorta and R3 differed significantly among each group(P<0.01). The diameters of left portal vein,right portal vein,main portal vein, and abdominal aorta differed significantly among the genders(P<0.05).Conclusion The diameters of main portal vein and abdominal aorta differed significantly among the age and genders. Imaging standard is provided for Gansu Province adult in early diagnosis of liver or portal vein disease.%目的:利用多排螺旋CT(MDCT)测量甘肃地区健康成人门静脉及腹主动脉直径,建立正常成年人门静脉及腹主动脉直径的数值标准。方法回顾性分析2014年2月至2015年4月在兰州大学第一医院行上腹部CT增强检查的正常成年人300例,按年龄分组:18-39岁(A组),40-59岁(B组),≥60岁(C组);各组均包括男50例,女50例。扫描图像经工作站3D重建后进行测量,所得结果利用SPSS22.0统计分析。结果 LPV在A组与C组间有明显差异(P<0.05),MPV在A组与C组、B

  15. [Radiation dose reduction using a non-linear image filter in MDCT].

    Science.gov (United States)

    Nakashima, Junya; Takahashi, Toshiyuki; Takahashi, Yoshimasa; Imai, Yasuhiro; Ishihara, Yotaro; Kato, Kyoichi; Nakazawa, Yasuo

    2010-05-20

    The development of MDCT enabled various high-quality 3D imaging and optimized scan timing with contrast injection in a multi-phase dynamic study. Since radiation dose tends to increase to yield such high-quality images, we have to make an effort to reduce radiation dose. A non-linear image filter (Neuro 3D filter: N3D filter) has been developed in order to improve image noise. The purpose of this study was to evaluate the physical performance and effectiveness of this non-linear image filter using phantoms, and show how we can reduce radiation dose in clinical use of this filter. This N3D filter reduced radiation dose by about 50%, with minimum deterioration of spatial reduction in phantom and clinical studies. This filter shows great potential for clinical application.

  16. Mixed-radix Algorithm for the Computation of Forward and Inverse MDCT.

    Science.gov (United States)

    Wu, Jiasong; Shu, Huazhong; Senhadji, Lotfi; Luo, Limin

    2008-08-12

    The modified discrete cosine transform (MDCT) and inverse MDCT (IMDCT) are two of the most computational intensive operations in MPEG audio coding standards. A new mixed-radix algorithm for efficient computing the MDCT/IMDCT is presented. The proposed mixed-radix MDCT algorithm is composed of two recursive algorithms. The first algorithm, called the radix-2 decimation in frequency (DIF) algorithm, is obtained by decomposing an N-point MDCT into two MDCTs with the length N/2. The second algorithm, called the radix-3 decimation in time (DIT) algorithm, is obtained by decomposing an N-point MDCT into three MDCTs with the length N/3. Since the proposed MDCT algorithm is also expressed in the form of a simple sparse matrix factorization, the corresponding IMDCT algorithm can be easily derived by simply transposing the matrix factorization. Comparison of the proposed algorithm with some existing ones shows that our proposed algorithm is more suitable for parallel implementation and especially suitable for the layer III of MPEG-1 and MPEG-2 audio encoding and decoding. Moreover, the proposed algorithm can be easily extended to the multidimensional case by using the vector-radix method.

  17. Acute colonic diverticulitis: an update on clinical classification and management with MDCT correlation.

    Science.gov (United States)

    Barat, Maxime; Dohan, Anthony; Pautrat, Karine; Boudiaf, Mourad; Dautry, Raphael; Guerrache, Youcef; Pocard, Marc; Hoeffel, Christine; Eveno, Clarisse; Soyer, Philippe

    2016-09-01

    Currently, the most commonly used classification of acute colonic diverticulitis (ACD) is the modified Hinchey classification, which corresponds to a slightly more complex classification by comparison with the original description. This modified classification allows to categorize patients with ACD into four major categories (I, II, III, IV) and two additional subcategories (Ia and Ib), depending on the severity of the disease. Several studies have clearly demonstrated the impact of this classification for determining the best therapeutic approach and predicting perioperative complications for patients who need surgery. This review provides an update on the classification of ACD along with a special emphasis on the corresponding MDCT features of the different categories and subcategories. This modified Hinchey classification should be known by emergency physicians, radiologists, and surgeons in order to improve patient care and management because each category has a specific therapeutic approach.

  18. A Rare Presentation of an Entrapment in a Liver Transplant Candidate Depicted by MDCT Angiography

    Science.gov (United States)

    Kantarci, Mecit; Aydin, Unal; Doganay, Selim; Aydinli, Bulent; Yuce, Ihsan; Polat, Kamil Yalcin

    2010-01-01

    Hypertrophic caudate lobe veins can mimic a normal venous configuration. In cases of multiple vascular collaterals, Doppler evaluations must be conducted, and the flow direction of these veins as well as the IVC should be evaluated. If the flow in the IVC is reversed, Budd-Chiari syndrome should be suspected; moreover, at the supra diaphragmatic level, which may be considered a blind spot, particularly for radiologists, a web should be searched for in the area where the IVC opens into the right atrium. In this study, we present the unique findings of multidetector computed tomography (MDCT) angiography for a liver transplant candidate with Budd-Chiari syndrome caused by a web in the proximal IVC. PMID:25610132

  19. 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

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

    Institute of Scientific and Technical Information of China (English)

    邓海平; 曹军; 李建胜

    2011-01-01

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

  1. The evaluation of the cardiac and small airway changes in pectus excavatum of children with 64-slice computed tomography%64层螺旋CT对儿童漏斗胸的心脏及小气道改变的评价

    Institute of Scientific and Technical Information of China (English)

    赵磊磊; 何玲; 陈欣; 陈建蓉; 刘代松

    2012-01-01

    Objective:Through the retrospective research of cardiac rotation and small airway changes in pectus excavatum, we investigate the effect of the degree of sternal depression on them and the value of the 64-slice CT. Methods: 64-slice CT and three-dimensional reconstruction features of pectus excavatum proved clinically 183 cases between 2009 and 2011 were retrospectively reviewed. Measured the Haller index,cardiac rotation angle on axial CT images of the chest,researched the small airway changes on MPR lung-window. Haller index was used as standard to classify the cases to three grades,analysed differences between the three grades on cardiac angle,small airway changes,and investigated the effect of the degree of sternal depression on them. Results:183 cases were classified into three grades: mid-grade: 54 cases(2. 86 + 0. 31) , middle-grade: 22cases(3. 36 + 0. 10) ,high-grade: 107case(4. 61 ± 1. 27). The three grades were significant different(P<0. 05). The cardiac rotation angle of the three grades were 55. 52° ± 8. 76°,57. 38° ± 5. 03°,65. 93° ± 7. 67°,there were significant difference among them (P<0. 05). 60 cases had small airway changes,the morbidity of the three grades were 22. 22%(12/54) ,22. 73%(5/22) ,40. 19%(43/107), there were significant difference among the three grades(P<0. 05). 53 cases among them had lobus pulrnonis sinister small airway changes. Conclusion:The 64-slice CT is a better tool for revealing chest deformity,cardiac rotation and small airway changes of pectus excavatum. As the degree of chest deformity increase, the cardiac rotation angle, morbidities of small airway changes increases,the three exist positive correclation.%目的:通过CT观察儿童漏斗胸心脏形态及小气道改变,探讨胸廓畸形程度对心脏形态、小气道改变的影响及64层螺旋CT的价值.方法:搜集2009~2011年临床确诊漏斗胸并行胸部64层螺旋CT三维重建检查的患儿183例,测量胸廓的Haller指数、心脏旋转

  2. 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

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

    Institute of Scientific and Technical Information of China (English)

    杨琳; 张兆琪; 范占明; 徐超; 赵蕾; 晏子旭; 姜红

    2010-01-01

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

  4. 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

  5. Empirical description of bronchial and nonbronchial arteries with MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Yu Hong, E-mail: yuhong.2002@hotmail.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Liu Shiyuan, E-mail: cjr.liushiyuan@vip.163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Li Huimin, E-mail: yuhongphd@163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Xiao Xiangsheng, E-mail: cjr.xxsh@vip.163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Dong Weihua, E-mail: dongweihua2000@163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China)

    2010-08-15

    Purpose: We aimed to retrospectively evaluate bronchial and nonbronchial systemic arteries using multi-detector row helical computed tomographic (MDCT) angiography in patients with pulmonary disorders. Materials and Methods: Thirty-nine patients (24 men, 15 women; mean age, 63.4 years; range, 20-82 years) with congenital and acquired pulmonary disorders of the bronchial and nonbronchial systemic arteries underwent multi-detector row helical computed tomographic angiography of the thorax using a 16-detector row scanner. Each of these patients had experienced an episode of hemoptysis. Computed tomographic angiogram data, which included maximum intensity projections, multiplanar reconstruction, and three-dimensional volume-rendered images, were used to retrospectively analyse the characteristics of the bronchial and nonbronchial systemic arteries. Results: We identified a total of 128 bronchial arteries (76 on the right side and 52 on the left) in 39 patients. We detected 42 nonbronchial systemic artery branches, including 19 internal mammary artery branches, 8 subclavian artery branches, 8 inferior phrenic artery branches, 5 intercostal artery branches, 1 thyrocervical trunk branch, and 1 celiac trunk branch. Thirty-five dilated and tortuous nonbronchial systemic arteries entered into the lung parenchyma and extended down to the lesions. Every case, except the one case of sequestration, was associated with pleural thickening where the vascular structures passed through the extrapleural fat. Conclusions: The variations in both the bronchial artery anatomy and the location and type of the nonbronchial arteries were great. Nonbronchial arteries may be a significant source of hemoptysis. MDCT angiography can be used to detect detailed anatomical information about the origins and courses of bronchial and nonbronchial systemic arteries and their pathophysiologic features.

  6. Multidetector computed tomography (MDCT angiography of thoracic aortic coarctation in pediatric patients: Pre-operative evaluation

    Directory of Open Access Journals (Sweden)

    Mohamad Zakaryia Al-Azzazy

    2014-03-01

    Conclusion: We concluded that MDCT angiography with multiplanar and three dimensional techniques can be considered the modality of choice for pre-operative assessment of coarctation of the thoracic aorta in pediatric patients.

  7. MDCT assessment of HCC patient after radiofrequency ablation among Egyptian population: Preliminary experience

    Directory of Open Access Journals (Sweden)

    Nadia F. El Ameen

    2014-06-01

    Conclusion: RF ablation is an internationally approved treatment for HCC. MDCT should be the corner stone method for follow to achieve better results and improve the survival rate via early detection and immediate interference with any new or recurrent lesions.

  8. MDCT of acute subaxial cervical spine trauma: a mechanism-based approach

    OpenAIRE

    Raniga, Sameer B.; Menon, Venugopal; Al Muzahmi, Khamis S.; Butt, Sajid

    2014-01-01

    Injuries to the spinal column are common and road traffic accidents are the commonest cause. Subaxial cervical spine (C3–C7) trauma encompasses a wide spectrum of osseous and ligamentous injuries, in addition to being frequently associated with neurological injury. Multidetector computed tomography (MDCT) is routinely performed to evaluate acute cervical spine trauma, very often as first-line imaging. MDCT provides an insight into the injury morphology, which in turn reflects the mechanics of...

  9. Abdominal Wall Hernias: Various Imaging Features Correlated with the Anatomy of Abdominal Wall at MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Shin Young; Shin, Hyeong Cheol; Kim, Sang Won; Kim, Il Young; Kim, Young Tong [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2009-07-15

    Abdominal wall hernias are a common condition. However, they may develop acute complications and require surgical correction in most cases. Hence, the correct radiological examination is requisite for an accurate diagnosis. A multi-detector row CT (MDCT) provides an accurate identification of the anatomy of the abdominal wall, precise hernia type, and helps in the detection of early signs of complication. We report various imaging features of abdominal wall hernias via a MDCT.

  10. National Survey of Radiation Dose and Image Quality in Adult CT Head Scans in Taiwan.

    Directory of Open Access Journals (Sweden)

    Chung-Jung Lin

    Full Text Available The purpose of the present study was to evaluate the influence of different variables on radiation dose and image quality based on a national database.Taiwan's Ministry of Health and Welfare requested all radiology departments to complete a questionnaire for each of their CT scanners. Information gathered included all scanning parameters for CT head scans. For the present analysis, CT machines were divided into three subgroups: single slice CT (Group A; multi-detector CT (MDCT with 2-64 slices (Group B; and MDCT with more than 64 slices (Group C. Correlations between computed tomography dose index (CTDI and signal-to-noise ratio (SNR with cumulated tube rotation number (CTW(n and cumulated tube rotation time (CTW(s, and sub group analyses of CTDI and SNR across the three groups were performed.CTDI values demonstrated a weak correlation (r = 0.33 with CTW(n in Group A. SNR values demonstrated a weak negative correlation (r = -0.46 with CTW(n in Group C. MDCT with higher slice numbers used more tube potential resulting in higher effective doses. There were both significantly lower CTDI and SNR values in helical mode than in axial mode in Group B, but not Group C.CTW(n and CTW(s did not influence radiation output. Helical mode is more often used in MDCT and results in both lower CTDI and SNR compared to axial mode in MDCT with less than 64 slices.

  11. Suspected pulmonary embolism and deep venous thrombosis: A comprehensive MDCT diagnosis in the acute clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Salvolini, Luca [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)], E-mail: lucasalvolini@alice.it; Scaglione, Mariano [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Giuseppetti, Gian Marco; Giovagnoni, Andrea [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)

    2008-03-15

    Both pulmonary arterial and peripheral venous sides of venous thromboembolism (VTE) can now be efficiently and safely investigated by multi-detector CT (MDCT) at the same time by a combined CT angiography/CT venography protocol. In the emergency setting, the use of such a single test for patients suspected of suffering from VTE on a clinical grounds may considerably shorten and simplify diagnostic algorithms. The selection of patients to be submitted to MDCT must follow well-established clinical prediction rules in order to avoid generalized referral to CT on a generic clinical suspicion basis and excessive population exposure to increased ionizing radiation dose, especially in young patients. Clinical and anatomical wide-panoramic capabilities of MDCT allow identification of underlying disease that may explain patients' symptoms in a large number of cases in which VTE is not manifest. The analysis of MDCT additional findings on cardiopulmonary status and total thrombus burden can lead to better prognostic stratification of patients and influence therapeutic options. Some controversial points such as optimal examination parameters, clinical significance of subsegmentary emboli, CT pitfalls and/or possible falsely positive diagnoses, and outcome of untreated patients in which VTE has been excluded by MDCT without additional testing, must of course be taken into careful consideration before the definite role of comprehensive MDCT VTE 'one-stop-shop' diagnosis in everyday clinical practice can be ascertained.

  12. Fractal Dimension Analysis of MDCT Images for Quantifying the Morphological Changes of the Pulmonary Artery Tree in Patients with Pulmonary Hypertension

    OpenAIRE

    2011-01-01

    Objective The aim of this study was to use fractal dimension (FD) analysis on multidetector CT (MDCT) images for quantifying the morphological changes of the pulmonary artery tree in patients with pulmonary hypertension (PH). Materials and Methods Fourteen patients with PH and 17 patients without PH as controls were studied. All of the patients underwent contrast-enhanced helical CT and transthoracic echocardiography. The pulmonary artery trees were generated using post-processing software, a...

  13. Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation

    OpenAIRE

    Chanplakorn, Pongsthorn; Kraiwattanapong, Chaiwat; Aroonjarattham, Kitti; Leelapattana, Pittavat; Keorochana, Gun; Jaovisidha, Suphaneewan; Wajanavisit, Wiwat

    2014-01-01

    Background Cervical pedicle screw (CPS) insertion is a technically demanding procedure. The quantitative understanding of cervical pedicle morphology, especially the narrowest part of cervical pedicle or isthmus, would minimize the risk of catastrophic damage to surrounding neurovascular structures and improve surgical outcome. The aim of this study was to investigate morphology and quantify cortical thickness of the cervical isthmus by using Multi-detector Computerized Tomography (MD-CT) sca...

  14. The impacts of open-mouth breathing on upper airway space in obstructive sleep apnea: 3-D MDCT analysis.

    Science.gov (United States)

    Kim, Eun Joong; Choi, Ji Ho; Kim, Kang Woo; Kim, Tae Hoon; Lee, Sang Hag; Lee, Heung Man; Shin, Chol; Lee, Ki Yeol; Lee, Seung Hoon

    2011-04-01

    Open-mouth breathing during sleep is a risk factor for obstructive sleep apnea (OSA) and is associated with increased disease severity and upper airway collapsibility. The aim of this study was to investigate the effect of open-mouth breathing on the upper airway space in patients with OSA using three-dimensional multi-detector computed tomography (3-D MDCT). The study design included a case-control study with planned data collection. The study was performed at a tertiary medical center. 3-D MDCT analysis was conducted on 52 patients with OSA under two experimental conditions: mouth closed and mouth open. Under these conditions, we measured the minimal cross-sectional area of the retropalatal and retroglossal regions (mXSA-RP, mXSA-RG), as well as the upper airway length (UAL), defined as the vertical dimension from hard palate to hyoid. We also computed the volume of the upper airway space by 3-D reconstruction of both conditions. When the mouth was open, mXSA-RP and mXSA-RG significantly decreased and the UAL significantly increased, irrespective of the severity of OSA. However, between the closed- and open-mouth states, there was no significant change in upper airway volume at any severity of OSA. Results suggest that the more elongated and narrow upper airway during open-mouth breathing may aggravate the collapsibility of the upper airway and, thus, negatively affect OSA severity.

  15. Visualization of subtle temporal bone structures. Comparison of cone beam CT and MDCT; Darstellung subtiler Schlaefenbeinstrukturen. In-vivo-Vergleich digitale Volumentomographie vs. Multidetektor-CT

    Energy Technology Data Exchange (ETDEWEB)

    Pein, M.K.; Plontke, S.K. [Universitaetsklinikum Halle (Saale), Universitaetsklinik und Poliklinik fuer HNO-Heilkunde, Kopf- und Halschirurgie, Halle (Saale) (Germany); Brandt, S.; Koesling, S. [Universitaetsklinikum Halle (Saale), Universitaetsklinik und Poliklinik fuer Diagnostische Radiologie, Halle (Saale) (Germany)

    2014-03-15

    The purpose of this study was to compare the visualization of subtle, non-pathological temporal bone structures on cone beam computed tomography (CBCT) and multi-detector computed tomography (MDCT) in vivo. Temporal bone studies of images from 38 patients archived in the picture archiving and communication system (PACS) were analyzed (slice thickness MDCT 0.6 mm and CBCT 0.125 mm) of which 23 were imaged by MDCT and 15 by CBCT using optimized standard protocols. Inclusion criteria were normal radiological findings, absence of previous surgery and anatomical variants. Images were evaluated blind by three trained observers. Using a five-point scale the visualization of ten subtle structures of the temporal bone was analyzed. Subtle middle ear structures showed a tendency to be more easily distinguishable by CBCT with significantly better visualization of the tendon of the stapedius muscle and the crura of the stapes on CBCT (p = 0.003 and p = 0.033, respectively). In contrast, inner ear components, such as the osseus spiral lamina and the modiolus tended to be better detectable on MDCT, showing significant differences for the osseous spiral lamina (p = 0.001). The interrater reliability was 0.73 (Cohen's kappa coefficient) and intraobserver reliability was 0.89. The use of CBCT and MDCT allows equivalent and excellent imaging results if optimized protocols are chosen. With both imaging techniques subtle temporal bone structures could be visualized with a similar degree of definition. In vivo differences do not seem to be as large as suggested in several previous studies. (orig.) [German] Vergleich der Identifizierbarkeit subtiler Schlaefenbeinstrukturen in der digitalen Volumentomographie (DVT) und Multidetektor-CT (MDCT) in vivo. Analysiert wurden 38 im PACS (Picture Archiving and Communication System) duennschichtig gespeicherte Schlaefenbeinuntersuchungen (23 MDCTs, Schichtdicke 0,6 mm sowie 15 DVTs, Schichtdicke 0,125 mm). Einschlusskriterium war eine

  16. Preoperative detection of colorectal liver metastases in fatty liver: MDCT or MRI?

    Energy Technology Data Exchange (ETDEWEB)

    Kulemann, Vanessa, E-mail: vanessa.kulemann@meduniwien.ac.at [Department of Radiology, Medical University of Vienna (Austria); Schima, Wolfgang [KH Goettlicher Heiland, Vienna (Austria); Tamandl, Dietmar; Kaczirek, Klaus; Gruenberger, Thomas [Department of Surgery, Medical University of Vienna (Austria); Wrba, Friedrich [Department of Pathology, Medical University of Vienna (Austria); Weber, Michael; Ba-Ssalamah, Ahmed [Department of Radiology, Medical University of Vienna (Austria)

    2011-08-15

    Objective: To compare the diagnostic value of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the preoperative detection of colorectal liver metastases in diffuse fatty infiltration of the liver, associated with neoadjuvant chemotherapy. Materials and methods: Twenty preoperative tri-phasic MDCT (4-64-row, Siemens) and dynamic contrast-enhanced MRI (1.5 T or 3.0 T, Siemens) examinations of patients with colorectal cancer and liver metastases in diffuse steatosis were retrospectively evaluated. All patients underwent surgical resection for liver metastases (time interval 1-60 days). The amount of fatty infiltration of the liver was determined histopathologically by semi-quantitative percent-wise estimation and ranged from 25 to 75%. Results: Overall, 51 metastases were found by histopathology of the resected liver segments/lobes. The size of the metastases ranged from 0.4 to 13 cm, with 18 (35%) being up to 1 cm in diameter. In the overall rating, MDCT detected 33/51 lesions (65%), and MRI 45/51 (88%). For lesions up to 1 cm, MDCT detected only 2/18 (11%) and MRI 12/18 (66%). One false positive lesion was detected by MDCT. Statistical analysis showed that MRI is markedly superior to MDCT, with a statistically significant difference (p < .001), particularly for the detection of small lesions ({<=}1 cm; p < .004). There was no significant difference between the two modalities in the detection of lesions > 1 cm. Conclusion: For the detection of colorectal liver metastases after neoadjuvant chemotherapy and consecutive diffuse fatty infiltration of the liver, MRI is superior to MDCT, especially for the detection of small lesions.

  17. 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

  18. 64-slice spiral CTA in evaluation on the changes of hepatic vessels and the portosystemic collateral circulation in liver cirrhosis%64排螺旋CT血管造影评价肝硬化血管改变及侧支循环

    Institute of Scientific and Technical Information of China (English)

    李妙玲; 赵婷婷; 袁会军; 孙兴旺; 强永乾

    2011-01-01

    Objective To investigate the changes of hepatic vessels and the portosystemic collateral circulation in patients with liver cirrhosis with 64-slices spiral CTA. Methods Tri-phase enhanced CT scan of whole hepatic region were performed in 168 patients with liver cirrhosis (liver cirrhosis group) and 120 patients without liver cirrhosis (control group). All images were post processed with MIP and VR, and were compared between the two groups. Results The difference between the two groups were statistically significant (P<0. 01) in showing hepatic artery, portal vein and hepatic vein of different grades, except in showing 1 st grade of portal vein and hepatic vein (P=0. 51, 0. 08). In liver cirrhosis group, dilated trunk of hepatic artery and portal vein were observed in 85 patients, narrowing and tortuosity of vessels were observed in 98 patients, carcinoma thrombus formation and spongy degeneration in portal vein were detected in 9 and 8 patients, respectively, while continuous enhancement of hepatic artery and portal vein were noticed in 55 and 57 patients, respectively. In the control group, dilated trunk of hepatic artery and portal vein were observed in 3 patients, narrowing and tortuosity of vessels were observed in 2 patients, continuous enhancement of hepatic artery and portal vein were noticed in 4 and 3 patients, respectively. Totally 258 portosystemic collateral circulations were found in liver cirrhosis group, including 196 esophagogastric varices (196/258, 75. 97%), whereas only 2 retroperitoneal shunts were found in control group. Conclusion 64- slices spiral CT tri-phase angiography is a safe, convenient and reliable method to display the changes of hepatic vessels and the form of portosystemic collateral circulation, especially esophagogastric varices in patients with liver cirrhosis.%目的 探讨MSCTA评价肝硬化肝脏血管的异常改变及侧支循环形成的价值.方法 对168例肝硬化患者(肝硬化组)及120例无肝硬化的患者(

  19. Consideration of Adverse Reaction to MDCT Contrast Media

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Won Seok; Shin, Seong Gyu [Dept. of Radiology, Dong A University Medical Center, Busan (Korea, Republic of)

    2012-03-15

    In this experiment, we investigated 82 patients who suffered adverse reactions due to contrast medium. We selected the subjects out of 21,178 people who had an intravenous injection of contrast medium to undergo MDCT examination at one university hospital in Busan in 2007. As a result, the largest groups of the patients were as follows. 52.4% of the patients were male when classify by gender; 28.0% of the patients were 50's by age; 45% of the patients got when it was spring(April and March); 75.6% of the patients had a side effects when the speed of injection is 2.5 mL/sec; 58.5% of the patients were suffered when the volume of injected contrast medium is over 130 mL. Urticaria was the main symptom of side effect as 26.8%. And the main treatment for the effect was alleviating the symptoms before making patients to return home. Thus, practical preventive measures are needed as follows: use the OCS system to observe warning signs at risky patients, secure warming spaces for patients to cope with season changing, prepare enough emergency kits for the patients in danger, and establish CPR call systems, explain the risk of contrast medium and get agree about using contrast medium.

  20. Contrast enhanced chest-MDCT in oncologic patients. Prospective evaluation of the prevalence of incidental pulmonary embolism and added value of thin reconstructions

    Energy Technology Data Exchange (ETDEWEB)

    Tresoldi, Silvia; Flor, Nicola [Azienda Ospedaliera San Paolo, Dipartimento di Radiologia Diagnostica ed Interventistica, Milano (Italy); Luciani, Andrea [Azienda Ospedaliera San Paolo, Oncologia, Dipartimento di Medicina, Milano (Italy); Lombardi, Maria Antonietta; Colombo, Bernardo [Universita degli Studi di Milano, Scuola di Specializzazione in Radiodiagnostica, Facolta di Medicina e Chirurgia, Milano (Italy); Cornalba, Gianpaolo [Azienda Ospedaliera San Paolo, Dipartimento di Radiologia Diagnostica ed Interventistica, Milano (Italy); Universita degli Studi di Milano, Dipartimento di Scienze della Salute, Milano (Italy)

    2015-11-15

    To prospectively assess prevalence/characteristics of clinically unsuspected pulmonary embolism (PE) in cancer patients undergoing follow-up chest MDCT and investigate MDCT protocol. We evaluated 1013 oncologic patients. MDCT images at 5 and 1.25 mm thickness were independently evaluated. Pulmonary artery opacification degree was assessed. Presence, level, and site of PE were reported. Type of malignancy and metastases were reported for PE-positive patients. After excluding 1.4 % (14/1013) of examinations due to inadequate vessel opacification, 999 patients (572 male; mean age:68 ± 12 years; range:26-93 years) entered the study. Prevalence of PE was 5 %. There was significant improvement in the sensitivity for both readers in the evaluation of 1.25 mm compared to 5 mm images (46-50 % to 82-92 %). 30 % (15/51) PE were not described by the radiologist in the prospectively issued report; 53 % (27/51) of PE were segmental, 72.5 % (37/51) unilateral. The right lower lobe was the most involved (59 %). 27 % patients had colon cancer, 18 % lung cancer. Among PE-positive patients (25 male; mean age 70 ± 10 years; range:44-87 years), 25 % (13/51) had lung cancer, 15 % (8/51) colon cancer. Thin reconstructions are essential for PE diagnosis, regardless of reader experience. Regarding oncologic patients, incidental PE diagnosis influences anticoagulation therapy. (orig.)

  1. Determination of the chemical composition of human renal stones with MDCT: influence of the surrounding media

    Science.gov (United States)

    Grosjean, Romain; Sauer, Benoît; Guerra, Rui; Kermarrec, Isabelle; Ponvianne, Yannick; Winninger, Daniel; Daudon, Michel; Blum, Alain; Felblinger, Jacques; Hubert, Jacques

    2007-03-01

    The selection of the optimal treatment method for urinary stones diseases depends on the chemical composition of the stone and its corresponding fragility. MDCT has become the most used modality to determine rapidly and accurately the presence of stones when evaluating urinary lithiasis treatment. That is why several studies have tempted to determine the chemical composition of the stones based on the stone X-ray attenuation in-vitro and invivo. However, in-vitro studies did not reproduce the normal abdominal wall and fat, making uncertain the standardization of the obtained values. The aim of this study is to obtain X-ray attenuation values (in Hounsfield Units) of the six more frequent types of human renal stones (n=217) and to analyze the influence of the surrounding media on these values. The stones were first placed in a jelly, which X-ray attenuation is similar to that of the human kidney (30 HU at 120 kV). They were then stuck on a grid, scanned in a water tank and finally scanned in the air. Significant differences in CT-attenuation values were obtained with the three different surrounding media (jelly, water, air). Furthermore there was an influence of the surrounding media and consequently discrepancies in determination of the chemical composition of the renal stones. Consequently, CT-attenuation values found in in-vitro studies cannot really be considered as a reference for the determination of the chemical composition except if the used phantom is an anthropomorphic one.

  2. Virtual multislice computed tomography cystoscopy for evaluation of urinary bladder lesions; Virtuelle MDCT-Zystoskopie bei der Detektion von Blasenlaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Heinz-Peer, G.; Happel, B.; Memarsadeghi, M.; Mang, T. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik

    2005-10-01

    The introduction of multislice computed tomography (MDCT) with the possibility of acquiring isotropic datasets has been an ideal prerequisite for development of virtual MDCT cystoscopy. Remarkable technical progress regarding post-processing of high-resolution 3D datasets as well as a considerable reduction of the time required for post-processing made it possible to introduce virtual MDCT cystoscopy into the clinical routine. 3D post-processing that often required 7-8 h when virtual endoscopy techniques were first developed can now be performed in less than 5 min after transfer of data to the 3D workstation. With the limitations and contraindications of conventional cystoscopy in mind, virtual MDCT cystoscopy may be seen as a valuable alternative to conventional cystoscopy for evaluation of hematuria. (orig.) [German] Mit der Einfuehrung der Multidetektorcomputertomographie (MDCT) und der damit verbundenen Moeglichkeit, isotrope Datensaetze zu akquirieren, ergaben sich ideale Voraussetzungen zur Entwicklung der virtuellen MDCT-Zystoskopie. Beachtliche technische Fortschritte bei der Nachbearbeitung der hochaufloesenden 3D-Datensaetze sowie eine deutliche Reduktion der Nachbearbeitungszeit haben den Einsatz der virtuellen MDCT-Zystoskopie in der klinischen Routine ermoeglicht. Waren zu Beginn der Entwicklung virtueller Endoskopietechniken 3D-Nachbearbeitungszeiten von 7-8 h keine Seltenheit, kann diese heute nach dem Datentransfer auf die Workstation in weniger als 5 min erfolgen. Unter Betrachtung der Limitationen und Kontraindikationen der konventionellen Zystoskopie kann die virtuelle MDCT-Zystoskopie als wertvolle Alternative bei der Haematurieabklaerung gesehen werden. (orig.)

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

    Institute of Scientific and Technical Information of China (English)

    耿欣; 肖世骞; 曹毅; 李健; 周鑫

    2015-01-01

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

  4. 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

  5. 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.

  6. Clinical investigation of coronary artery calcification detected by 64-slice spiral computed tomography in diagnosis of coronary heart disease%64层螺旋CT量化冠状动脉钙化在冠心病中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    苏瑞瑛; 肖文良; 申艳霞; 田帅

    2006-01-01

    目的 探讨64层螺旋CT(64-slice spiral computed tomography,64SCT)量化冠状动脉钙化(coronary artery calcification,CAC)对诊断冠心病(coronary heart disease,CHD)的价值.方法 对56例临床诊断及可疑冠心病患者,进行64SCT冠脉成像及其钙化的量化分析,并同期进行选择性经皮冠状动脉造影(coronary angiography,CAG)检查,CAG采用经典插管法,冠状动脉钙化积分(coronary artery calcification score,CACS)采用Agatston方法完成,64SCT结果与CAG结果做双盲对照研究;根据CAG结果将患者分为冠心病组34例(冠状动脉至少有1支血管狭窄≥50%)和非冠心病组22例;进一步将224支血管按狭窄程度分为A组(狭窄<50%)、B组(狭窄50%~75%)和C组(狭窄>75%),记录其CACS分别进行统计分析;按照年龄分为<60岁组和≥60岁组,分别分析CAC率和CACS与年龄的关系.结果 64SCT冠状动脉三维成像对冠状动脉钙化显示清晰,对冠状动脉各分支显示良好,冠心病组的CACS与非冠心病组比较,差异有统计学意义(P<0.01),且A组与B、C组比较CACS差异有统计学意义(P<0.01),但B组、C组两组之间CACS差异无统计学意义(P>0.05);随着年龄的增长,CAC率和CACS逐渐增高,<60岁组与≥60岁组CAC率和CACS比较差异有统计学意义(P<0.01);<60岁组冠心病患者CAC率和CACS明显高于非冠心病组(P<0.05),≥60岁组冠心病患者CAC率与非冠心病组比较差异无统计学意义(P>0.05),但CACS差异有统计学意义(P<0.01).结论 应用64SCT量化冠状动脉钙化,可以对可疑冠心病患者提供早期诊断依据,CACS与相应血管管腔狭窄的对照分析显示,CACS与冠状动脉狭窄程度之间有一定关系;年龄对CAC有影响.

  7. US and MDCT findings in a caudal blind ending bifid ureter with calculi

    Directory of Open Access Journals (Sweden)

    Caglar Uzun

    2011-09-01

    Full Text Available Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US and mainly with multidetector computerized tomography (MDCT imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula.

  8. US and MDCT findings in a caudal blind ending bifid ureter with calculi

    Directory of Open Access Journals (Sweden)

    Evren Ustuner

    2011-11-01

    Full Text Available Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US and mainly with multidetector computerized tomography (MDCT imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula.

  9. Pancreatic tuberculosis: MDCT features and differential diagnosis%胰腺结核九例的MDCT特征和误诊分析

    Institute of Scientific and Technical Information of China (English)

    梁宗辉; 窦娅芳; 唐颖; 汤伟军; 冯晓源

    2011-01-01

    Objective To study the multi-detector spiral CT (MDCT) features of pancreatic tuberculosis to improve the awareness and correct diagnosis. Methods Imaging features of MDCT were retrospectively reviewed on 9 cases with pancreatic tuberculosis that were diagnosed from 2003 to 2009, among them two patients underwent MDCT angiography, the features were compared with those of operative and pathological findings. Results One case of pancreatic cancer, 2 cases of cystadenocarcinoma and 1 case of pseudocyst, 2 cases of pancreatic cancer with retroperitoneal lymph node metastasis, 2 cases of lymphoma were diagnosed by MDCT, and all the lesions were diagnosed as pancreatic tuberculosis pathologically, and the misdiagnosis rate was 100%. Pancreatic tuberculosis often presented as pancreatic head mass, sometimes pancreatic body and tail were involved. MDCT showed isopycnic or low density solid-cyst mass, occasionally calcification was present, with slightly or moderate ring-like enhancement after contrast injection. There was no enlargement of the pancreatic duct. The retroperitoneal and adjacent lymph nodes were always enlarged with ring-like enhancement. Sometimes there was evidence of tuberculosis of other abdominal organs. Conclusions Ring-like enhanced lesions with ring-like enhanced lymph nodes without enlargement of pancreatic duct are characteristic MDCT features of pancreatic tuberculosis.%目的 分析胰腺结核(pancreatic tuberculoses,PT)的多层螺旋CT(MDCT)征象,以期提高对该病的认识和诊断正确率.方法 收集2003年至2009年行MDCT检查并最终确诊为PT的9例患者,其中2例行MDCT血管成像.分析PT的MDCT特征性表现,并与手术及病理结果进行比较.结果 MDCT诊断为胰腺癌1例、囊腺癌1例、囊腺瘤2例、假性囊肿1例、胰腺癌伴后腹膜淋巴结转移2例、淋巴瘤2例.通过病理证实,9例均为PT,误诊率达100%.PT常表现为胰头肿块,亦可累及体尾部或整个胰腺.MDCT呈现等或略

  10. MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Marano, Riccardo; Savino, Giancarlo; Merlino, Biagio; Pirro, Federica; Rutigliano, Claudia; Santangelo, Carolina; Minoiu, Aurelian Costin; Natale, Luigi; Bonomo, Lorenzo [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Radiological Sciences - Institute of Radiology, Rome (Italy); Pitocco, Dario [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Internal Medicine, Rome (Italy); Di Stasio, Enrico [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Clinical Biochemistry, Rome (Italy); Trani, Carlo [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Cardiovascular Medicine - Institute of Cardiology, Rome (Italy)

    2016-03-15

    To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87 %. These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. (orig.)

  11. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    朱新勇; 方驰华; 焦培峰; 全显跃; 唐海亮; 鲍苏苏; 钟世镇

    2008-01-01

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

  14. Chronic mitral regurgitation detected on cardiac MDCT: differentiation between functional and valvular aetiologies.

    LENUS (Irish Health Repository)

    Killeen, Ronan P

    2012-02-01

    OBJECTIVE: To determine whether cardiac computed tomography (MDCT) can differentiate between functional and valvular aetiologies of chronic mitral regurgitation (MR) compared with echocardiography (TTE). METHODS: Twenty-seven patients with functional or valvular MR diagnosed by TTE and 19 controls prospectively underwent cardiac MDCT. The morphological appearance of the mitral valve (MV) leaflets, MV geometry, MV leaflet angle, left ventricular (LV) sphericity and global\\/regional wall motion were analysed. The coronary arteries were evaluated for obstructive atherosclerosis. RESULTS: All control and MR cases were correctly identified by MDCT. Significant differences were detected between valvular and control groups for anterior leaflet length (30 +\\/- 7 mm vs. 22 +\\/- 4 mm, P < 0.02) and thickness (3.0 +\\/- 1 mm vs. 2.2 +\\/- 1 mm, P < 0.01). High-grade coronary stenosis was detected in all patients with functional MR compared with no controls (P < 0.001). Significant differences in those with\\/without MV prolapse were detected in MV tent area (-1.0 +\\/- 0.6 mm vs. 1.3 +\\/- 0.9 mm, P < 0.0001) and MV tent height (-0.7 +\\/- 0.3 mm vs. 0.8 +\\/- 0.8 mm, P < 0.0001). Posterior leaflet angle was significantly greater for functional MR (37.9 +\\/- 19.1 degrees vs. 22.9 +\\/- 14 degrees , P < 0.018) and less for valvular MR (0.6 +\\/- 35.5 degrees vs. 22.9 +\\/- 14 degrees, P < 0.017). Sensitivity, specificity, and positive and negative predictive values of MDCT were 100%, 95%, 96% and 100%. CONCLUSION: Cardiac MDCT allows the differentiation between functional and valvular causes of MR.

  15. Automatic detection of osteoporotic vertebral fractures in routine thoracic and abdominal MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Baum, Thomas; Dobritz, Martin; Rummeny, Ernst J.; Noel, Peter B. [Technische Universitaet Muenchen, Institut fuer Radiologie, Klinikum rechts der Isar, Muenchen (Germany); Bauer, Jan S. [Technische Universitaet Muenchen, Abteilung fuer Neuroradiologie, Klinikum rechts der Isar, Muenchen (Germany); Klinder, Tobias; Lorenz, Cristian [Philips Research Laboratories, Hamburg (Germany)

    2014-04-15

    To develop a prototype algorithm for automatic spine segmentation in MDCT images and use it to automatically detect osteoporotic vertebral fractures. Cross-sectional routine thoracic and abdominal MDCT images of 71 patients including 8 males and 9 females with 25 osteoporotic vertebral fractures and longitudinal MDCT images of 9 patients with 18 incidental fractures in the follow-up MDCT were retrospectively selected. The spine segmentation algorithm localised and identified the vertebrae T5-L5. Each vertebra was automatically segmented by using corresponding vertebra surface shape models that were adapted to the original images. Anterior, middle, and posterior height of each vertebra was automatically determined; the anterior-posterior ratio (APR) and middle-posterior ratio (MPR) were computed. As the gold standard, radiologists graded vertebral fractures from T5 to L5 according to the Genant classification in consensus. Using ROC analysis to differentiate vertebrae without versus with prevalent fracture, AUC values of 0.84 and 0.83 were obtained for APR and MPR, respectively (p < 0.001). Longitudinal changes in APR and MPR were significantly different between vertebrae without versus with incidental fracture (ΔAPR: -8.5 % ± 8.6 % versus -1.6 % ± 4.2 %, p = 0.002; ΔMPR: -11.4 % ± 7.7 % versus -1.2 % ± 1.6 %, p < 0.001). This prototype algorithm may support radiologists in reporting currently underdiagnosed osteoporotic vertebral fractures so that appropriate therapy can be initiated. circle This spine segmentation algorithm automatically localised, identified, and segmented the vertebrae in MDCT images. (orig.)

  16. Effects of computing parameters and measurement locations on the estimation of 3D NPS in non-stationary MDCT images.

    Science.gov (United States)

    Miéville, Frédéric A; Bolard, Gregory; Bulling, Shelley; Gudinchet, François; Bochud, François O; Verdun, François R

    2013-11-01

    The goal of this study was to investigate the impact of computing parameters and the location of volumes of interest (VOI) on the calculation of 3D noise power spectrum (NPS) in order to determine an optimal set of computing parameters and propose a robust method for evaluating the noise properties of imaging systems. Noise stationarity in noise volumes acquired with a water phantom on a 128-MDCT and a 320-MDCT scanner were analyzed in the spatial domain in order to define locally stationary VOIs. The influence of the computing parameters in the 3D NPS measurement: the sampling distances bx,y,z and the VOI lengths Lx,y,z, the number of VOIs NVOI and the structured noise were investigated to minimize measurement errors. The effect of the VOI locations on the NPS was also investigated. Results showed that the noise (standard deviation) varies more in the r-direction (phantom radius) than z-direction plane. A 25 × 25 × 40 mm(3) VOI associated with DFOV = 200 mm (Lx,y,z = 64, bx,y = 0.391 mm with 512 × 512 matrix) and a first-order detrending method to reduce structured noise led to an accurate NPS estimation. NPS estimated from off centered small VOIs had a directional dependency contrary to NPS obtained from large VOIs located in the center of the volume or from small VOIs located on a concentric circle. This showed that the VOI size and location play a major role in the determination of NPS when images are not stationary. This study emphasizes the need for consistent measurement methods to assess and compare image quality in CT.

  17. Optimal dose of contrast medium for depiction of hypervascular HCC on dynamic MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Fujigai, Tetsuya, E-mail: tetuyafu2000@yahoo.co.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Kumano, Seishi, E-mail: kumano@radiol.med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Okada, Masahiro, E-mail: mokada@radiol.med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Hyodo, Tomoko, E-mail: Hyoudo@radiol.med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Imaoka, Izumi, E-mail: iizumi@med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Yagyu, Yukinobu, E-mail: y-yagyu@med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Ashikaga, Ryuichiro, E-mail: ryuman@med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Ishii, Kazunari, E-mail: ishii@med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan); Murakami, Takamichi, E-mail: murakami@med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511 (Japan)

    2012-11-15

    Purpose: The purpose of this study is to prospectively investigate the optimal dose of contrast medium for the depiction of hypervascular hepatocellular carcinoma (HCC) during the hepatic arterial phase (HAP), portal venous phase (PVP) and delayed phase (DP) of dynamic MDCT. Materials and methods: The study included 128 patients, out of these patients, 36 patients were found to have 56 hypervascular HCCs. Sixty-three patients were assigned to receive a dose of 525 mgI/kg with protocol A, and 62 received a dose of 630 mgI/kg with protocol B. Measurements of the attenuation values of the abdominal aorta, portal vein, hepatic vein, hepatic parenchyma and HCC during the HAP, PVP and DP were taken. Tumor-liver contrast (TLC) was calculated from the attenuation value of the hepatic parenchyma and HCC. Results: The aortic attenuation value with protocol B (351, 166, and 132 HU) was significantly higher than that with protocol A (313, 153, and 120 HU) during all the phases, (P < 0.01 for all phases). The hepatic enhancement from unenhanced baseline with protocol B (25.2, 63.6, 50.6 HU) was significantly higher than that with protocol A (20.2, 55.1 and 43.0 HU) during all the phases, (P < 0.01 for all phases). The TLC with protocol B (37.4, -11.8 and -13.6 HU) was significantly higher than that with protocol A (28.0, -9.8 and -12.1 HU) during HAP (P = 0.042). Conclusion: The administration of 630 mgI/kg of body weight depicts hypervascular HCC more clearly during HAP and shows sufficient hepatic enhancement of 50 HU during DP.

  18. A Robust Audio Watermarking Technique Operates in MDCT Domain based on Perceptual Measures

    Directory of Open Access Journals (Sweden)

    Maha Bellaaj

    2016-06-01

    Full Text Available the review presents a digital audio watermarking technique operating in the frequency domain with two variants. This technique uses the Modified Discrete Cosine Transform (MDCT to move to the frequency domain. To ensure more inaudibility, we exploited the proprieties of the psychoacoustic model 1 (PMH1 of MPEG1 encoder layer I in the first variant and those of psychoacoustic model 2 (PMH2 of MPEG1 encoder Layer III in the second alternative to search the places for insertion of the watermark. In both variants of the technique, the bits of the mark will be duplicated to increase the capacity of insertion then inserted into the least significant bit (LSB. For more reliability in the detection phase, we use an error correction code (Hamming on the mark. Next, to analyze the performance of the proposed technique, we perform two comparative studies. In the first, we compare the proposed digital audio watermarking technique with her two variants and those achieved by Luigi Rosa and Rolf Brigola, ‘which we download the M-files of each’. The technique developed by Luigi Rosa operates in the frequency domain but using the Discrete Cosine Transform (DCT as transformation and that proposed by Rolf Brigola uses the Fast Fourier Transform (FFT. We studied the robustness of each technique against different types of attacks such as compression / decompression MP3, stirmark audio attack and we evaluated the inaudibility by using an objective approach by calculating the SNR and the ODG notes given by PEAQ. The robustness of this technique is shown against different types of attacks. In the second, we prove the contribution of the proposed technique by comparing the payload data, imperceptibility and robustness against attack MP3 with others existing techniques in the literature.

  19. Ectopia cordis with tetralogy of Fallot in an infant with pentalogy of Cantrell: high-pitch MDCT exam.

    Science.gov (United States)

    Santiago-Herrera, Rogerio; Ramirez-Carmona, Rocio; Criales-Vera, Sergio; Calderon-Colmenero, Juan; Kimura-Hayama, Eric

    2011-07-01

    We report the MDCT findings of a 17-month-old girl with Cantrell's pentalogy, a rare congenital disease characterized by several defects in the ventral thoracoabdominal wall including ectopia cordis, and, in this patient, associated with tetralogy of Fallot. This case provides an example of the utility of a wide volume in coverage and high-pitch MDCT scan in the evaluation of complex cardiovascular anatomy in infants with congenital heart disease without the need of an ECG-gating acquisition.

  20. Development of a voxel-matching technique for substantial reduction of subtraction artifacts in temporal subtraction images obtained from thoracic MDCT.

    Science.gov (United States)

    Itai, Yoshinori; Kim, Hyoungseop; Ishikawa, Seiji; Katsuragawa, Shigehiko; Doi, Kunio

    2010-02-01

    A temporal subtraction image, which is obtained by subtraction of a previous image from a current one, can be used for enhancing interval changes (such as formation of new lesions and changes in existing abnormalities) on medical images by removing most of the normal structures. However, subtraction artifacts are commonly included in temporal subtraction images obtained from thoracic computed tomography and thus tend to reduce its effectiveness in the detection of pulmonary nodules. In this study, we developed a new method for substantially removing the artifacts on temporal subtraction images of lungs obtained from multiple-detector computed tomography (MDCT) by using a voxel-matching technique. Our new method was examined on 20 clinical cases with MDCT images. With this technique, the voxel value in a warped (or nonwarped) previous image is replaced by a voxel value within a kernel, such as a small cube centered at a given location, which would be closest (identical or nearly equal) to the voxel value in the corresponding location in the current image. With the voxel-matching technique, the correspondence not only between the structures but also between the voxel values in the current and the previous images is determined. To evaluate the usefulness of the voxel-matching technique for removal of subtraction artifacts, the magnitude of artifacts remaining in the temporal subtraction images was examined by use of the full width at half maximum and the sum of a histogram of voxel values, which may indicate the average contrast and the total amount, respectively, of subtraction artifacts. With our new method, subtraction artifacts due to normal structures such as blood vessels were substantially removed on temporal subtraction images. This computerized method can enhance lung nodules on chest MDCT images without disturbing misregistration artifacts.

  1. Evaluation of multiple trauma victims with 16-row multidetector CT (MDCT): a time analysis; Anwendung der 16-Zeilen-Mehrdetektor-CT in der Initialdiagnostik beim Polytrauma: Eine Zeitanalyse

    Energy Technology Data Exchange (ETDEWEB)

    Heyer, C.M.; Nicolas, V. [Bochum Univ. (Germany). Inst. fuer Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin; Rduch, G.J. [Bochum Univ. (Germany). Klinik fuer Chirurgie; Wick, M.; Muhr, G. [Bochum Univ. (Germany). Medizinische Klinik III, Pneumologie, Allergologie und Schlafmedizin; Bauer, T.T. [Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Univ. Bochum (Germany)

    2005-12-15

    Purpose: Description and time analysis of a 16-row MDCT protocol in the evaluation of multiple trauma patients considering transport, time of scanning, patient positioning, image reconstruction, and image interpretation. Materials and methods: Between May and December 2004, 60 multiple trauma patients underwent 16-row MDCT (Sensation, Siemens, Erlangen, Germany). The protocol included serial scanning of the head, spiral scanning of the cervical spine and contrast-enhanced spiral scanning of the thorax/abdomen with multiplanar reformations (MPR) of the thoracic/lumbar spine and the pelvis. All time intervals including transport, patient positioning, scanning, duration of MPR, total time in the examination room, and time to first and final image interpretation were prospectively evaluated. Furthermore, patient characteristics, trauma profiles, and mortality rates were recorded. Results: 46 male and 14 female patients (mean age 43.6 years) were enrolled in the study. Time analysis of 16-row MDCT revealed the following results (mean time standard deviation): Emergency room treatment and transport 19.2{+-}6.7 min, patient positioning 16.5{+-}6.5 min, scan duration 8.0{+-}3.3 min, total time in examination room 24.5{+-}7.2 min, image reconstruction including MPR 32.0{+-}16.4 min, and time of first (16.4{+-}4.7 min) and final image interpretation (82.5{+-}30.4 min). Trauma profiles revealed thoracic injuries in 35/60 patients (58.3%), head injuries in 23/60 patients (38.3%), abdominal injuries in 15/60 patients (25.0%), injuries of the cervical (9/60 patients, 15.0%), thoracic (12/60 patients, 20.0%), and lumbar spine (19/60 patients, 31.7%), pelvic injuries in 13/60 patients (21.7%), and injuries of extremities in 39/60 patients (65.0%). The mortality rate was 21.7%. (orig.)

  2. Time-effectiveness, observer-dependence, and accuracy of measurements of left ventricular ejection fraction using 4-channel MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, T.; Willmann, J.K.; Desbiolles, L.M.; Marincek, B.; Wildermuth, S. [Dept. of Radiology, Kantonsspital, Chur (Switzerland); Alkadhi, H. [Dept. Medical Radiology, Inst. of Diagnostic Radiology, Univ. Hospital, Zurich (Switzerland); Roffi, M. [Dept. of Cardiology, Univ. Hospital, Zurich (Switzerland)

    2004-04-01

    Purpose: To evaluate the time-effectiveness, inter-observer variance, and accuracy of left ventricular ejection fraction (EF) measurements using retrospectively ECG-gated four-channel multi-detector row CT (MDCT) angiography in comparison with biplane cine-ventriculography. Materials and Methods: Twenty consecutive patients underwent retrospectively ECG-gated MDCT angiography and conventional coronary angiography with biplane ventriculography. Raw MDCT data were reconstructed at 0%-90% of the cardiac cycle in increments of 10%. Ten geometrically identical multiplanar reformations parallel to the short axis of the heart were reconstructed in each patient. Three blinded readers segmented the left ventricle in the end-systolic and end-diastolic phase using standardized window settings in order to determine the EF. The EF was measured with biplane cine-ventriculography by two blinded readers and was compared with MDCT. The time needed for post-processing was recorded and the inter-observer agreement for both imaging techniques was assessed. Results: Mean post-processing time was 63{+-}3 min per patient for MDCT and 5.5{+-}1.2 min for ventriculography. MDCT and ventriculography showed a good correlation (r=0.83, p<0.0001) for measurement of the EF. Mean errors of EF measurements for the three MDCT readers compared with the mean of the ventriculography were -6.3{+-}6.6%, -4.7{+-}7.1% and -4.6{+-}5.7%, respectively. The mean differences between the three readers assessing MDCT were -1.6{+-}3.2% (reader 1 versus 2, r=0.96), -1.6{+-}5.6% (1 versus 3, r=0.95) and -0.011{+-}2.9% (2 versus 3, r=0.97, p<0.0001). The mean differences between the two readers assessing ventriculography was 0.32{+-}5.1% (r=0.88, p<0.0001). (orig.) [German] Ziel: Beurteilung der Nachverarbeitungszeit, Messgenauigkeit und Untersucherabhaengigkeit bei der Bestimmung der linksventrikulaeren Ejektionsfraktion (EF) mit der retrospektiv EKG-synchronisierten Multidetektor-CT-(MDCT-)Angiographie im

  3. Type-IV DCT, DST, and MDCT algorithms with reduced numbers of arithmetic operations

    CERN Document Server

    Shao, Xuancheng

    2007-01-01

    We present algorithms for the type-IV discrete cosine transform (DCT-IV) and discrete sine transform (DST-IV), as well as for the modified discrete cosine transform (MDCT) and its inverse, that achieve a lower count of real multiplications and additions than previously published algorithms, without sacrificing numerical accuracy. Asymptotically, the operation count is reduced from ~2NlogN to ~(17/9)NlogN for a power-of-two transform size N. These results are derived by considering the DCT to be a special case of a DFT of length 8N, with certain symmetries, and then pruning redundant operations from a recent improved fast Fourier transform algorithm (based on a recursive rescaling of the conjugate-pair split radix algorithm). The improved algorithms for DST-IV and MDCT follow immediately from the improved count for the DCT-IV.

  4. Gastrointestinal tract perforation: evaluation of MDCT according to perforation site and elapsed time

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won [Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of); Park, Seong Jin [Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of)

    2014-06-15

    To evaluate mutidetector computed tomography (MDCT) for the prediction of perforation site according to each gastrointestinal (GI) tract site and elapsed time. One hundred and sixty-eight patients who underwent MDCT before laparotomy for GI tract perforation were enrolled and allocated to an early or late lapse group based on an elapsed time of 7 h. Two reviewers independently evaluated the perforation site and assessed the following CT findings: free air location, mottled extraluminal air bubbles, focal bowel wall discontinuity, segmental bowel wall thickening, perivisceral fat stranding and localised fluid collection. The overall diagnostic accuracy was 91.07 % and 91.67 % for reviewers 1 and 2, respectively, with excellent agreement (kappa 0.86). Accuracies (98.97 % and 97.94 %) and agreements (kappa 0.894) for stomach and duodenum perforation were higher than for other perforation sites. Strong predictors of perforation at each site were: focal bowel wall discontinuity for stomach, duodenal bulb and left colon, mottled extraluminal air bubbles for retroperitoneal duodenum and right colon, and segmental bowel wall thickening for small bowel. The diagnostic accuracy was not different between the early- and late-lapse groups. MDCT can accurately predict upper GI tract perforation with high reliability. Elapsed time did not affect the accuracy of perforation site prediction. (orig.)

  5. Superwideband Bandwidth Extension Using Normalized MDCT Coefficients for Scalable Speech and Audio Coding

    Directory of Open Access Journals (Sweden)

    Young Han Lee

    2013-01-01

    Full Text Available A bandwidth extension (BWE algorithm from wideband to superwideband (SWB is proposed for a scalable speech/audio codec that uses modified discrete cosine transform (MDCT coefficients as spectral parameters. The superwideband is first split into several subbands that are represented as gain parameters and normalized MDCT coefficients in the proposed BWE algorithm. We then estimate normalized MDCT coefficients of the wideband to be fetched for the superwideband and quantize the fetch indices. After that, we quantize gain parameters by using relative ratios between adjacent subbands. The proposed BWE algorithm is embedded into a standard superwideband codec, the SWB extension of G.729.1 Annex E, and its bitrate and quality are compared with those of the BWE algorithm already employed in the standard superwideband codec. It is shown from the comparison that the proposed BWE algorithm relatively reduces the bitrate by around 19% with better quality, compared to the BWE algorithm in the SWB extension of G.729.1 Annex E.

  6. Monte Carlo simulations in multi-detector CT (MDCT) for two PET/CT scanner models using MASH and FASH adult phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Belinato, W., E-mail: wbfisica@gmail.com [Bahia Federal Institute of Education, Science and Technology – IFBA, Vitória da Conquista, 45.100-000 (Brazil); Department of Physics, Federal University of Sergipe – UFS, São Cristóvão, 49.100-000 (Brazil); Santos, W.S. [Department of Physics, Federal University of Sergipe – UFS, São Cristóvão, 49.100-000 (Brazil); Paschoal, C.M.M., E-mail: cinthiam.paschoal@gmail.com [Department of Civil Engineering, Vale do Acarau State University – UVA, Sobral 62.040-730 (Brazil); Souza, D.N. [Department of Physics, Federal University of Sergipe – UFS, São Cristóvão, 49.100-000 (Brazil)

    2015-06-01

    The combination of positron emission tomography (PET) and computed tomography (CT) has been extensively used in oncology for diagnosis and staging of tumors, radiotherapy planning and follow-up of patients with cancer, as well as in cardiology and neurology. This study determines by the Monte Carlo method the internal organ dose deposition for computational phantoms created by multidetector CT (MDCT) beams of two PET/CT devices operating with different parameters. The different MDCT beam parameters were largely related to the total filtration that provides a beam energetic change inside the gantry. This parameter was determined experimentally with the Accu-Gold Radcal measurement system. The experimental values of the total filtration were included in the simulations of two MCNPX code scenarios. The absorbed organ doses obtained in MASH and FASH phantoms indicate that bowtie filter geometry and the energy of the X-ray beam have significant influence on the results, although this influence can be compensated by adjusting other variables such as the tube current–time product (mAs) and pitch during PET/CT procedures.

  7. Quantitative assessment of bone marrow attenuation values at MDCT: An objective tool for the detection of bone bruise related to occult sacral insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Henes, F.O.; Groth, M.; Bley, T.A.; Regier, M.; Ittrich, H.; Adam, G.; Bannas, P. [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Nuechtern, J.V. [University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany); Treszl, A. [University Medical Center Hamburg-Eppendorf, Center for Experimental Medicine, Department of Medical Biometry and Epidemiology, Hamburg (Germany)

    2012-10-15

    To prove the feasibility of using Hounsfield attenuation values at MDCT to detect bone bruises related to sacral insufficiency fractures. Twenty-two patients with acute sacrum trauma and no fracture findings at MDCT were included in our prospective study. Two observers independently reviewed CTs regarding visual signs of bone bruises in 132 defined regions of the sacral alae. Interobserver agreement was tested by {kappa} statistics. Subsequently, HU values were obtained in the same regions, and attenuation differences between the two sides were calculated. Validity and reliability were assessed by intraclass correlation coefficient and Bland-Altman analysis. HU differences were subjected to ROC curve analysis to determine sensitivity, specificity, PPV and NPV. MRI served as standard reference. MRI revealed 19 regions with bone bruises and associated sacral insufficiency fractures. HU measurements demonstrated good validity and reliability (r = 0.989). ROC curve analysis exhibited an ideal cutoff value of 35.7 HU density difference between affected and non-affected regions. Visual evaluation revealed moderate agreement ({kappa} = 0.48); diagnostic accuracy was inferior to objective evaluation. Assessment of differences in bone marrow density by HU measurements is an objective and reliable tool for detection of bone bruises associated with occult sacral insufficiency fractures. (orig.)

  8. Multidetector computed tomography-guided treatment strategy in patients with non-ST elevation acute coronary syndromes: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Dorgelo, J.; Willems, T.P.; Ooijen, P.M.A. van; Oudkerk, M. [University Hospital Groningen, Department of Radiology, Groningen (Netherlands); Geluk, C.A.; Zijlstra, F. [University Hospital Groningen, Department of Cardiology, Groningen (Netherlands)

    2005-04-01

    Patients with non-ST elevation acute coronary syndrome (ACS) and evidence of myocardial ischaemia are scheduled for coronary angiography (CAG). In most patients CAG remains a single diagnostic procedure only. A prospective study was performed to evaluate whether 16-slice multidetector CT (MDCT) could predict treatment of the patients and to determine how many CAGs could have been prevented by MDCT scanning prior to CAG. Twenty-two patients with ACS were scanned prior to CAG. Based on MDCT data, a fictive treatment was proposed and compared to CAG-based treatment. Excellent accuracy was observed to detect significant stenoses using MDCT (sensitivity 94%, specificity 96%). In 45%, no PCI was performed during CAG, because of the absence of significant coronary artery disease (27%) or severe coronary artery disease, demanding CABG (18%). MDCT predicted correct treatment in 86%. By using MDCT data, 32% of the CAGs could have been prevented. (orig.)

  9. Detection of biliary and vascular anatomy in living liver donors: Value of gadobenate dimeglumine enhanced MR and MDCT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Artioli, Diana, E-mail: diansadiana@gmail.com [Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162 Milano (Italy); Tagliabue, Marianna; Aseni, Paolo; Sironi, Sandro; Vanzulli, Angelo [Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162 Milano (Italy)

    2010-11-15

    Objective: To evaluate the performance of magnetic resonance (MR) and multidetector computed tomography (MDCT) in the assessment of living donor's vascular and biliary anatomy, having surgical findings as reference standard. Methods: Thirty-two living liver donors underwent MR cholangiography (1.5-T; standard cholangiography pulse sequences and delayed acquisitions after administration of biliary contrast agent) for biliary anatomy evaluation. MDCT (16-row multidetector scanner, multiphase protocol, 3 mm slice thickness) was also performed in all cases for the assessment of vascular anatomy before transplantation. Hepatic veins (<4 mm in diameter) were not considered. MR and MDCT images interpretation was performed by two reviewers by consensus, based on source axial images, multiplanar reformats, and three-dimensional (3D) postprocessing images. Surgical intraoperative findings were used as standard of reference. Results: At surgery, 17 biliary anomalies, 3 portal anomalies, 32 venous and 8 arterial variants were found in the 32 patients. MR correctly identified 15/17 biliary anomalies, with a sensitivity of 88% and a specificity of 93%. MDCT correctly identified 8/8 arterial, 3/3 portal and 29/32 venous variants, with a sensitivity of 100% and 91%, respectively, and a specificity of 100%. Conclusions: MR and MDCT proved to be efficient in evaluating living liver donor's biliary and vascular anatomy.

  10. MDCT after balloon kyphoplasty: analysis of vertebral body architecture one year after treatment of osteoporotic fractures; MDCT nach Ballonkyphoplastie: Analyse der Wirbelkoerperarchitektur 1 Jahr nach Behandlung osteoporotischer Sinterungsfrakturen

    Energy Technology Data Exchange (ETDEWEB)

    Roehrl, B.; Dueber, C. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinik Mainz (Germany); Sadick, M. [Inst. fuer Radiologie, Universitaetsklinikum Mannheim (Germany); Brocker, K.; Voggenreiter, G.; Obertacke, U. [Zentrum fuer Orthopaedie und Traumatologie, Universitaetsklinikum Mannheim (Germany); Brade, J. [Inst. fuer Medizinische Statistik und Biometrie, Universitaetsklinikum Mannheim (Germany)

    2006-08-15

    Purpose: to evaluate the value of MDCT in the monitoring of vertebral body architecture after balloon kyphoplasty and observe morphological changes of the vertebral body. Material and methods: during a period of 26 months, 66 osteoporotic fractures of the vertebral bodies were treated with percutanous balloon kyphoplasty. The height of the vertebral body, width of spinal space, sagittal indices, kyphosis und COBB angle, and cement leakage were evaluated by computed tomography before and after treatment and in a long-term follow up. Statistical analysis was performed by calculating quantitative constant parameters of descriptive key data. In addition, parametric and distribution-free procedures were performed for all questions. Results: after kyphoplasty, the treated vertebral bodies showed a significant gain in the height of the leading edge (0.15 cm; p < 0.0001) and in the central part of the vertebral body (0.17 cm; p < 0.0001). The height of the trailing edge did not change significantly. A corresponding gain in the sagittal index was found. The index remained stable during follow-up. Treated vertebral bodies as well as untreated references showed a comparable loss of height over the period of one year. The shape of the vertebral bodies remained stable. In comparison to these findings, treated vertebral bodies showed a reduced loss of height. A significant change in kyphosis und the COBB angle was noted. In total, pallacos leakage was detected in 71% of cases. Conclusion: MDCT is an accurate method for evaluating vertebral body architecture after treatment with balloon kyphoplasty. (orig.)

  11. Clinical significance of pneumatosis intestinalis - correlation of MDCT-findings with treatment and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Treyaud, Marc-Olivier; Duran, Rafael; Knebel, Jean-Francois; Meuli, Reto A.; Schmidt, Sabine [Lausanne University Hospital, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Zins, Marc [Fondation Hopital St Joseph, Department of Radiology, Paris (France)

    2017-01-15

    To evaluate the clinical significance of pneumatosis intestinalis (PI) including the influence on treatment and outcome. Two radiologists jointly reviewed MDCT-examinations of 149 consecutive emergency patients (53 women, mean age 64, range 21-95) with PI of the stomach (n = 4), small (n = 68) and/or large bowel (n = 96). PI extension, distribution and possibly associated porto-mesenteric venous gas (PMVG) were correlated with other MDCT-findings, risk factors, clinical management, laboratory, histopathology, final diagnosis and outcome. The most frequent cause of PI was intestinal ischemia (n = 80,53.7 %), followed by infection (n = 18,12.1 %), obstructive (n = 12,8.1 %) and non-obstructive (n = 10,6.7 %) bowel dilatation, unknown aetiologies (n = 8,5.4 %), drugs (n = 8,5.4 %), inflammation (n = 7,4.7 %), and others (n = 6,4 %). Neither PI distribution nor extension significantly correlated with underlying ischemia. Overall mortality was 41.6 % (n = 62), mostly related to intestinal ischemia (p = 0.003). Associated PMVG significantly correlated with underlying ischemia (p = 0.009), as did the anatomical distribution of PMVG (p = 0.015). Decreased mural contrast-enhancement was the only other MDCT-feature significantly associated with ischemia (p p < 0.001). Elevated white blood count significantly correlated with ischemia (p = 0.03). In emergency patients, ischemia remains the most common aetiology of PI, showing the highest mortality. PI with associated PMVG is an alerting sign. PI together with decreased mural contrast-enhancement indicates underlying ischemia. (orig.)

  12. Renal cell carcinoma metastases to the pancreas - Value of arterial phase imaging at MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Corwin, Michael T. [Univ. of California, Davis Medical Center, Dept. of Radiology, Sacramento (United States)], e-mail: Michael.corwin@ucdmc.ucdavis.edu; Lamba, Ramit; McGahan, John P. [Univ. of California, Davis Medical Center, Dept. of Radiology, Sacramento (United States); Wilson, Machelle [Univ. of California, Davis, Dept. of Public Health Sciences (United States)

    2013-04-15

    Background: The pancreas is an increasingly recognized site of renal cell carcinoma metastases. It is important to determine the optimal MDCT protocol to best detect RCC metastases to the pancreas. Purpose: To compare the rate of detection of renal cell carcinoma metastases to the pancreas between arterial and portal venous phase MDCT. Material and Methods: A retrospective review of CTs of the abdomen yielded six patients with metastatic RCC to the pancreas. Five of six patients had pathologically proven clear cell RCC. Two blinded reviewers independently reported the number of pancreatic lesions seen in arterial and venous phases. Each lesion was graded as definite or possible. The number of lesions was determined by consensus review of both phases. Attenuation values were obtained for metastatic lesions and adjacent normal pancreas in both phases. Results: There were a total of 24 metastatic lesions to the pancreas. Reviewer 1 identified 20/24 (83.3%) lesions on the arterial phase images and 13/24 (54.2%) lesions on the venous phase. Seventeen of 20 (85.0%) arterial lesions were deemed definite and 9/13 (69.2%) venous lesions were definite. Reviewer 2 identified 19/24 (79.2%) lesions on the arterial phase and 14/24 (58.3%) on the venous phase. Seventeen of 19 (89.5%) arterial lesions were definite and 7/14 (50%) venous lesions were definite. Mean attenuation differential between lesion and pancreas was 114 HU and 39 HU for arterial and venous phases, respectively (P<0.0001). Conclusion: Detection of RCC metastases to the pancreas at MDCT is improved using arterial phase imaging compared to portal venous phase imaging.

  13. A New Fast Algorithm of MDCT%一种新的MDCT快速算法

    Institute of Scientific and Technical Information of China (English)

    徐盛; 胡剑凌; 陈健

    2000-01-01

    The modified discrete cosine transform (MDCT) is a part of the time domain aliasing cancellation (TDAC), and it becomes a key technique in high quality audio coding. In MPEG4, both MPEG-2 AAC and TwinVQ treat MDCT as an important filterbank tool. In some practical applications, such as digital audio station (DAS) and Studio, the computation speed of the coder is crucial. Therefore, we present a DCT-based fast algorithm of MDCT, while the former ones are FFT-based. All the operations of the proposed algorithm are real value operations, while those of FFT-based algorithm are complex value operations. Due to its unique half-butter-fly core and symmetry, fewer operations and less memory are needed in the new algorithm than those in References. The proposed algorithm is suitable for float-point implementation. The results show that faster computation speed is achieved using the new algorithm. This new algorithm can be introduced not only in high quality audio coding, but also in speech coding and other signal processing applications with similar filterbank tools.%改进型的离散余弦变换(Modified discrete cosine transform)作为良好的时频分析工具在音频编码中广泛应用。本文提出了一种基于快速DCT变换的MDCT快速算法,与其他文献的算法相比,其运算量明显减少。

  14. 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.

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

    Institute of Scientific and Technical Information of China (English)

    胡迪; 彭芸

    2013-01-01

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

  16. 64 Slice Spiral CT and Mammography for the Diagnosis of Comparative Study of Breast Carcinoma in Imaging%64排螺旋CT与钼靶摄影在影像诊断乳腺癌中的对比研究

    Institute of Scientific and Technical Information of China (English)

    赵宝贵

    2014-01-01

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

  17. MDCT of the abdominal aorta: basics, technical improvements, and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, C.; Fraioli, F.; Danti, M.; Napoli, A.; Votta, V.; Lanciotti, K.; Bertoletti, L.; Passariello, R. [Dept. of Radiological Sciences, Univ. of Rome ' ' La Sapienza' ' (Italy)

    2003-11-01

    The recent introduction into clinical practice of multidetector-row spiral CT (MDCT) [1] with simultaneous acquisition of multiple channels has had a substantial effect on CT angiography allowing the acquisition of large volumes at high resolution, with excellent visualization of small branches also, including distal collaterals of the celiac trunk and superior and inferior mesenteric arteries (Fig. 1 a, b). Other advantages of multidetector-row over single-slice spiral CT include better separation of different vascular phases of enhancement, more efficient use of contrast material administered intravenously, and comparable, if not better, image quality. For example, the entire abdomen can now be (a) routinely imaged in its entirety with thin sections in a single short breath-hold, (b) repeatedly scanned during early arterial, late arterial, and venous phases, and (c) examined with high-quality multiplanar reconstructions, which are easily generated immediately. In this article we focus on and review the major aspects, advantages, and clinical applications of MDCT in the evaluation of the abdominal aorta. (orig.)

  18. Central venous device-related thrombosis as imaged with MDCT in oncologic patients: prevalence and findings

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, Orlando; Castelguidone, Elisabetta de Lutio di; Granata, Vincenza; D' Errico, Adolfo Gallipoli (Dept. of Radiology, National Cancer Institute ' Fondazione G Pascale' (Italy)), email: orlandcat@tin.it; Sandomenico, Claudia (Dept. of Esophago-gastro-bilio-pancreatic Oncology, National Cancer Institute ' Fondazione G Pascale' (Italy)); Petrillo, Mario (Dept. of Radiology, Second Univ. of Naples (Italy)); Aprea, Pasquale (Dept. of Critical Illness and Anaesthesiology, National Cancer Institute ' Fondazione G Pascale' , Naples, (Italy))

    2011-02-15

    Background: Venous thrombosis is a common occurrence in cancer patients, developing spontaneously or in combination with indwelling central venous devices (CVD). Purpose: To analyze the multidetector CT (MDCT) prevalence, appearance, and significance of catheter related thoracic venous thrombosis in oncologic patients and to determine the percentage of thrombi identified in the original reports. Material and Methods: Five hundred consecutive patients were considered. Inclusion criteria were: presence of a CVD; availability of a contrast-enhanced MDCT; and cancer history. Exclusion criteria were: direct tumor compression/infiltration of the veins; poor image quality; device tip not in the scanned volume; and missing clinical data. Seventeen (3.5%) out of the final 481 patients had a diagnosis of venous thrombosis. Results: Factors showing the highest correlation with thrombosis included peripherally-inserted CVD, right brachiocephalic vein tip location, patient performance status 3, metastatic stage disease, ongoing chemotherapy, and longstanding CVD. The highest prevalence was in patients with lymphoma, lung carcinoma, melanoma, and gynecologic malignancies. Eleven out of 17 cases had not been identified in the original report. Conclusion: CVD-related thrombosis is not uncommon in cancer patients and can also be observed in outpatients with a good performance status and a non-metastatic disease. Thrombi can be very tiny. Radiologists should be aware of the possibility to identify (or overlook) small thrombi

  19. Acute right lower quadrant pain beyond acute appendicitis: MDCT in evaluation of benign and malignant gastrointestinal causes

    Directory of Open Access Journals (Sweden)

    Reem Hassan Bassiouny

    2014-09-01

    Conclusion: Using a systematic pattern approach MDCT has proved to be an extremely useful noninvasive method for evaluation of patients with acute RLQP, allowing diagnosis and management of not only the most common conditions such as appendicitis but also less common conditions.

  20. MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know?

    Directory of Open Access Journals (Sweden)

    Nitin P Ghonge

    2014-01-01

    Full Text Available As Laparoscopic Donor Nephrectomy (LDN offers several advantages for the donor such as lesser post-operative pain, fewer cosmetic concerns and faster recovery time, there is growing global trend towards LDN as compared to open nephrectomy. Comprehensive pre-LDN donor evaluation includes assessment of renal morphology including pelvi-calyceal and vascular system. Apart from donor selection, evaluation of the regional anatomy allows precise surgical planning. Due to limited visualization during laparoscopic renal harvesting, detailed pre-transplant evaluation of regional anatomy, including the renal venous anatomy is of utmost importance. MDCT is the modality of choice for pre-LDN evaluation of potential renal donors. Apart from appropriate scan protocol and post-processing methods, detailed understanding of surgical techniques is essential for the Radiologist for accurate image interpretation during pre-LDN MDCT evaluation of potential renal donors. This review article describes MDCT evaluation of potential living renal donor, prior to LDN with emphasis on scan protocol, post-processing methods and image interpretation. The article laid special emphasis on surgical perspectives of pre-LDN MDCT evaluation and addresses important points which transplant surgeons want to know.

  1. Hepatic Arterial Configuration in Relation to the Segmental Anatomy of the Liver; Observations on MDCT and DSA Relevant to Radioembolization Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hoven, Andor F. van den, E-mail: a.f.vandenhoven@umcutrecht.nl; Leeuwen, Maarten S. van, E-mail: m.s.vanleeuwen@umcutrecht.nl; Lam, Marnix G. E. H., E-mail: m.lam@umcutrecht.nl; Bosch, Maurice A. A. J. van den, E-mail: mbosch@umcutrecht.nl [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine (Netherlands)

    2015-02-15

    PurposeCurrent anatomical classifications do not include all variants relevant for radioembolization (RE). The purpose of this study was to assess the individual hepatic arterial configuration and segmental vascularization pattern and to develop an individualized RE treatment strategy based on an extended classification.MethodsThe hepatic vascular anatomy was assessed on MDCT and DSA in patients who received a workup for RE between February 2009 and November 2012. Reconstructed MDCT studies were assessed to determine the hepatic arterial configuration (origin of every hepatic arterial branch, branching pattern and anatomical course) and the hepatic segmental vascularization territory of all branches. Aberrant hepatic arteries were defined as hepatic arterial branches that did not originate from the celiac axis/CHA/PHA. Early branching patterns were defined as hepatic arterial branches originating from the celiac axis/CHA.ResultsThe hepatic arterial configuration and segmental vascularization pattern could be assessed in 110 of 133 patients. In 59 patients (54 %), no aberrant hepatic arteries or early branching was observed. Fourteen patients without aberrant hepatic arteries (13 %) had an early branching pattern. In the 37 patients (34 %) with aberrant hepatic arteries, five also had an early branching pattern. Sixteen different hepatic arterial segmental vascularization patterns were identified and described, differing by the presence of aberrant hepatic arteries, their respective vascular territory, and origin of the artery vascularizing segment four.ConclusionsThe hepatic arterial configuration and segmental vascularization pattern show marked individual variability beyond well-known classifications of anatomical variants. We developed an individualized RE treatment strategy based on an extended anatomical classification.

  2. Data compression in wireless sensors network using MDCT and embedded harmonic coding.

    Science.gov (United States)

    Alsalaet, Jaafar K; Ali, Abduladhem A

    2015-05-01

    One of the major applications of wireless sensors networks (WSNs) is vibration measurement for the purpose of structural health monitoring and machinery fault diagnosis. WSNs have many advantages over the wired networks such as low cost and reduced setup time. However, the useful bandwidth is limited, as compared to wired networks, resulting in relatively low sampling. One solution to this problem is data compression which, in addition to enhancing sampling rate, saves valuable power of the wireless nodes. In this work, a data compression scheme, based on Modified Discrete Cosine Transform (MDCT) followed by Embedded Harmonic Components Coding (EHCC) is proposed to compress vibration signals. The EHCC is applied to exploit harmonic redundancy present is most vibration signals resulting in improved compression ratio. This scheme is made suitable for the tiny hardware of wireless nodes and it is proved to be fast and effective. The efficiency of the proposed scheme is investigated by conducting several experimental tests.

  3. Application of 64MDCT multislice perfusion imaging in colorectal carcinoma%64排螺旋CT多层灌注成像对结直肠癌的临床应用

    Institute of Scientific and Technical Information of China (English)

    冯仕庭; 孙灿辉; 彭振鹏; 郭欢仪; 李子平; 孟悛非

    2010-01-01

    目的 研究结直肠癌(CRC)的64排螺旋CT(64MDCT)灌注成像时间-密度曲线(TDC)及诸参数与肿瘤分期、浆膜浸润、淋巴结及远处转移和CEA等的关系.方法 对33例CRC患者进行64MDCT多层灌注成像检查.绘制所选层面靶动脉、靶静脉及肿瘤感兴趣区(ROI)的TDC.CT灌注的参数包括:血流量(BF)、血容量(BY)、平均通过时间(MTT)和表面通透性(PS).肿瘤按TNM分期,TDC根据形态进行分型.对CT灌注参数与TNM分期、浆膜浸润、淋巴结及远处转移和CEA等诸因素的相关性进行统计学分析.结果 CRC的TDC分为5种类型,TNM分期中各期的TDC可表现为5型中的一种或多种.CRC的灌注参数在各期中的差异无统计学意义,BV、MTT与浆膜浸润有关(t=-2.63和-2.24,P=0.0137和0.0331),BV与肿瘤大小存在正相关(r=0.41,P=0.02),BF、MTT与肿瘤分期、浆膜浸润、淋巴结转移、远处转移和CEA等均无关(P>0.05).结论 MDCT多层灌注成像可反映CRC的血流灌注状况,可能为临床治疗方案提供客观依据.%Objective To study the correlation of time-density curves (TDC), parameters revealed by 64-multidetector-row CT(64MDCT) perfusion imaging with clinicopathological factors(staging, serosal invasion, lymph node metastasis, distant metastasis and CEA) in colorectal carcinoma (CRC).Methods 64 MDCT perfusion imaging was performed in 33 patients with pathologically verified CRC.TDC was created from the region of interest (ROI) drawn over the tumor, target artery and vein by 64MDCT with perfusion functional software. The parameters of individual perfusion maps included blood flow (BF), blood volume(BV), mean transit time (MTT) and permeability-surface area product (PS).Tumors were staged according to TMN classification. TDC was classified according to their shapes. The correlation between CT perfusion parameters and clinicopathological factors was studied. Results TDC of 64MDCT perfusion imaging could be classified into five types. TDC

  4. Bone mineral density measurements of the proximal femur from routine contrast-enhanced MDCT data sets correlate with dual-energy X-ray absorptiometry

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, M. [Medical University of Vienna, Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Vienna (Austria); Bauer, J.S.; Dobritz, M.; Woertler, K.; Rummeny, E.J.; Baum, T. [Technische Universitaet Muenchen, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Beer, A.J. [Technische Universitaet Muenchen, Department of Nuclear Medicine, Munich (Germany); Wolf, P. [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Munich (Germany)

    2013-02-15

    To evaluate the utility of femoral bone mineral density (BMD) measurements in routine contrast-enhanced multi-detector computed tomography (ceMDCT) using dual-energy X-ray absorptiometry (DXA) as the reference standard. Forty-one patients (33 women, 8 men) underwent DXA measurement of the proximal femur. Subsequently, transverse sections of routine ceMDCT of these patients were used to measure BMD of the femoral head and femoral neck. The MDCT-to-DXA conversion equations for BMD and T-score were calculated using linear regression analysis. The conversion equations were applied to the MDCT data sets of 382 patients (120 women, 262 men) of whom 74 had osteoporotic fractures. A correlation coefficient of r = 0.84 (P < 0.05) was calculated for BMD{sub MDCT} values of the femoral head and DXA T-scores of the total proximal femur using the conversion equation T-score = 0.021 x BMD{sub MDCT} - 5.90. The correlation coefficient for the femoral neck was r = 0.79 (P < 0.05) with the conversion equation T-score = 0.016 x BMD{sub MDCT} - 4.28. Accordingly, converted T-scores for the femoral neck in patients with versus those without osteoporotic fractures were significantly different (female, -1.83 versus -1.47; male, -1.86 versus -1.47; P < 0.05). BMD measurements of the proximal femur were computed in routine contrast-enhanced MDCT and converted to DXA T-scores, which adequately differentiated patients with and without osteoporotic fractures. (orig.)

  5. Late enhanced computed tomography in Hypertrophic Cardiomyopathy enables accurate left-ventricular volumetry

    Energy Technology Data Exchange (ETDEWEB)

    Langer, Christoph; Lutz, M.; Kuehl, C.; Frey, N. [Christian-Albrechts-Universitaet Kiel, Department of Cardiology, Angiology and Critical Care Medicine, University Medical Center Schleswig-Holstein (Germany); Partner Site Hamburg/Kiel/Luebeck, DZHK (German Centre for Cardiovascular Research), Kiel (Germany); Both, M.; Sattler, B.; Jansen, O; Schaefer, P. [Christian-Albrechts-Universitaet Kiel, Department of Diagnostic Radiology, University Medical Center Schleswig-Holstein (Germany); Harders, H.; Eden, M. [Christian-Albrechts-Universitaet Kiel, Department of Cardiology, Angiology and Critical Care Medicine, University Medical Center Schleswig-Holstein (Germany)

    2014-10-15

    Late enhancement (LE) multi-slice computed tomography (leMDCT) was introduced for the visualization of (intra-) myocardial fibrosis in Hypertrophic Cardiomyopathy (HCM). LE is associated with adverse cardiac events. This analysis focuses on leMDCT derived LV muscle mass (LV-MM) which may be related to LE resulting in LE proportion for potential risk stratification in HCM. N=26 HCM-patients underwent leMDCT (64-slice-CT) and cardiovascular magnetic resonance (CMR). In leMDCT iodine contrast (Iopromid, 350 mg/mL; 150mL) was injected 7 minutes before imaging. Reconstructed short cardiac axis views served for planimetry. The study group was divided into three groups of varying LV-contrast. LeMDCT was correlated with CMR. The mean age was 64.2 ± 14 years. The groups of varying contrast differed in weight and body mass index (p < 0.05). In the group with good LV-contrast assessment of LV-MM resulted in 147.4 ± 64.8 g in leMDCT vs. 147.1 ± 65.9 in CMR (p > 0.05). In the group with sufficient contrast LV-MM appeared with 172 ± 30.8 g in leMDCT vs. 165.9 ± 37.8 in CMR (p > 0.05). Overall intra-/inter-observer variability of semiautomatic assessment of LV-MM showed an accuracy of 0.9 ± 8.6 g and 0.8 ± 9.2 g in leMDCT. All leMDCT-measures correlated well with CMR (r > 0.9). LeMDCT primarily performed for LE-visualization in HCM allows for accurate LV-volumetry including LV-MM in > 90 % of the cases. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Danny Lee

    2015-09-01

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

  7. 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).

  8. Gastrointestinal tract labeling for MDCT of abdomen: Comparison of low density barium and low density barium in combination with water

    Energy Technology Data Exchange (ETDEWEB)

    Gulati, Kavita; Shah, Zarine K.; Sainani, Nisha; Uppot, Raul; Sahani, Dushyant V. [Massachusetts General Hospital and Harvard Medical School, Department of Abdominal Imaging and Intervention, Boston, MA (United States)

    2008-05-15

    The purpose of the study was to compare the quality of stomach and small bowel marking/labeling using 1,350 ml of low-density barium alone (Volumen) with 900 ml of low-density barium and 450 ml of water for 16-MDCT scans of the abdomen and pelvis and assess cost benefits with the two protocols. In this IRB approved study, 80 consecutive patients scheduled for routine CECT (contrast-enhanced CT) of the abdomen-pelvis were studied. Patients were randomized into two groups and were administered either 1,350 ml of VoLumen (two bottles at 20-min intervals, one half bottle at 50 min and the last half on the table) or 900 ml of Volumen (two bottles at 20-min intervals and 450 ml water on the table). Portal venous phase scanning (detector collimation = 0.625 mm, speed = 18.75 mm, thickness = 5 mm) was subsequently performed. Images were reconstructed in axial and coronal plane at the CT console. Two blinded readers used a pre-designed template to assess distension and wall characteristics of the stomach and small bowel on a 5-point scale. Median scores with the two protocols were compared using the Wilcoxon rank sum test. The stomach and small bowel labeling was rated fair to optimal in all patients and did not differ significantly in the two protocols. The mean scores for distension of the small bowel and stomach were comparable. Inter-observer agreement for bowel labeling was found to be excellent (k 0.81). With the use of coronal images there was increased reader confidence in tracing the small bowel with both protocols. Acceptance for two bottles of Volumen and water was greater among patients as compared to three bottles of VoLumen. Use of two bottles of Volumen and water combination cost less than three bottles of Volumen. Stomach and small bowel labeling with administration of 900 ml of Volumen followed by 450 ml of water is cost effective and compares well to 1,350 ml of Volumen alone. (orig.)

  9. Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Jang Gyu; Kim, Dong Hun; Paik, Sang Hyun [National Institute of Scientific Investigation, Seoul (Korea, Republic of)

    2010-08-15

    We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. Five cadavers were subjected to whole-body, 16- channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations

  10. Comparison between the deconvolution and maximum slope 64-MDCT perfusion analysis of the esophageal cancer: Is conversion possible?

    Energy Technology Data Exchange (ETDEWEB)

    Djuric-Stefanovic, A., E-mail: avstefan@eunet.rs [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Saranovic, Dj., E-mail: crvzve4@gmail.com [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Masulovic, D., E-mail: draganmasulovic@yahoo.com [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Ivanovic, A., E-mail: flydoc@eunet.rs [Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Pesko, P., E-mail: predragpesko@yahoo.com [Clinic of Digestive Surgery (First Surgical Clinic), Clinical Center of Serbia, Belgrade (Serbia); Faculty of Medicine, University of Belgrade, Belgrade (Serbia)

    2013-10-01

    Purpose: To estimate if CT perfusion parameter values of the esophageal cancer, which were obtained with the deconvolution-based software and maximum slope algorithm are in agreement, or at least interchangeable. Methods: 278 esophageal tumor ROIs, derived from 35 CT perfusion studies that were performed with a 64-MDCT, were analyzed. “Slice-by-slice” and average “whole-covered-tumor-volume” analysis was performed. Tumor blood flow and blood volume were manually calculated from the arterial tumor-time–density graphs, according to the maximum slope methodology (BF{sub ms} and BV{sub ms}), and compared with the corresponding perfusion values, which were automatically computed by commercial deconvolution-based software (BF{sub deconvolution} and BV{sub deconvolution}), for the same tumor ROIs. Statistical analysis was performed using Wilcoxon matched-pairs test, paired-samples t-test, Spearman and Pearson correlation coefficients, and Bland–Altman agreement plots. Results: BF{sub deconvolution} (median: 74.75 ml/min/100 g, range, 18.00–230.5) significantly exceeded the BF{sub ms} (25.39 ml/min/100 g, range, 7.13–96.41) (Z = −14.390, p < 0.001), while BV{sub deconvolution} (median: 5.70 ml/100 g, range: 2.10–15.90) descended the BV{sub ms} (9.37 ml/100 g, range: 3.44–19.40) (Z = −13.868, p < 0.001). Both pairs of perfusion measurements significantly correlated with each other: BF{sub deconvolution}, versus BF{sub ms} (r{sub S} = 0.585, p < 0.001), and BV{sub deconvolution}, versus BV{sub ms} (r{sub S} = 0.602, p < 0.001). Geometric mean BF{sub deconvolution}/BF{sub ms} ratio was 2.8 (range, 1.1–6.8), while geometric mean BV{sub deconvolution}/BV{sub ms} ratio was 0.6 (range, 0.3–1.1), within 95% limits of agreement. Conclusions: Significantly different CT perfusion values of the esophageal cancer blood flow and blood volume were obtained by deconvolution-based and maximum slope-based algorithms, although they correlated significantly with

  11. Automated diagnosis of interstitial lung diseases and emphysema in MDCT imaging

    Science.gov (United States)

    Fetita, Catalin; Chang Chien, Kuang-Che; Brillet, Pierre-Yves; Prêteux, Françoise

    2007-09-01

    Diffuse lung diseases (DLD) include a heterogeneous group of non-neoplasic disease resulting from damage to the lung parenchyma by varying patterns of inflammation. Characterization and quantification of DLD severity using MDCT, mainly in interstitial lung diseases and emphysema, is an important issue in clinical research for the evaluation of new therapies. This paper develops a 3D automated approach for detection and diagnosis of diffuse lung diseases such as fibrosis/honeycombing, ground glass and emphysema. The proposed methodology combines multi-resolution 3D morphological filtering (exploiting the sup-constrained connection cost operator) and graph-based classification for a full characterization of the parenchymal tissue. The morphological filtering performs a multi-level segmentation of the low- and medium-attenuated lung regions as well as their classification with respect to a granularity criterion (multi-resolution analysis). The original intensity range of the CT data volume is thus reduced in the segmented data to a number of levels equal to the resolution depth used (generally ten levels). The specificity of such morphological filtering is to extract tissue patterns locally contrasting with their neighborhood and of size inferior to the resolution depth, while preserving their original shape. A multi-valued hierarchical graph describing the segmentation result is built-up according to the resolution level and the adjacency of the different segmented components. The graph nodes are then enriched with the textural information carried out by their associated components. A graph analysis-reorganization based on the nodes attributes delivers the final classification of the lung parenchyma in normal and ILD/emphysematous regions. It also makes possible to discriminate between different types, or development stages, among the same class of diseases.

  12. Dynamic real-time 4D cardiac MDCT image display using GPU-accelerated volume rendering.

    Science.gov (United States)

    Zhang, Qi; Eagleson, Roy; Peters, Terry M

    2009-09-01

    Intraoperative cardiac monitoring, accurate preoperative diagnosis, and surgical planning are important components of minimally-invasive cardiac therapy. Retrospective, electrocardiographically (ECG) gated, multidetector computed tomographical (MDCT), four-dimensional (3D + time), real-time, cardiac image visualization is an important tool for the surgeon in such procedure, particularly if the dynamic volumetric image can be registered to, and fused with the actual patient anatomy. The addition of stereoscopic imaging provides a more intuitive environment by adding binocular vision and depth cues to structures within the beating heart. In this paper, we describe the design and implementation of a comprehensive stereoscopic 4D cardiac image visualization and manipulation platform, based on the opacity density radiation model, which exploits the power of modern graphics processing units (GPUs) in the rendering pipeline. In addition, we present a new algorithm to synchronize the phases of the dynamic heart to clinical ECG signals, and to calculate and compensate for latencies in the visualization pipeline. A dynamic multiresolution display is implemented to enable the interactive selection and emphasis of volume of interest (VOI) within the entire contextual cardiac volume and to enhance performance, and a novel color and opacity adjustment algorithm is designed to increase the uniformity of the rendered multiresolution image of heart. Our system provides a visualization environment superior to noninteractive software-based implementations, but with a rendering speed that is comparable to traditional, but inferior quality, volume rendering approaches based on texture mapping. This retrospective ECG-gated dynamic cardiac display system can provide real-time feedback regarding the suspected pathology, function, and structural defects, as well as anatomical information such as chamber volume and morphology.

  13. A multiscale MDCT image-based breathing lung model with time-varying regional ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Youbing, E-mail: youbing-yin@uiowa.edu [Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242 (United States); IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA 52242 (United States); Department of Radiology, The University of Iowa, Iowa City, IA 52242 (United States); Choi, Jiwoong, E-mail: jiwoong-choi@uiowa.edu [Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242 (United States); IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA 52242 (United States); Hoffman, Eric A., E-mail: eric-hoffman@uiowa.edu [Department of Radiology, The University of Iowa, Iowa City, IA 52242 (United States); Department of Biomedical Engineering, The University of Iowa, Iowa City, IA 52242 (United States); Department of Internal Medicine, The University of Iowa, Iowa City, IA 52242 (United States); Tawhai, Merryn H., E-mail: m.tawhai@auckland.ac.nz [Auckland Bioengineering Institute, The University of Auckland, Auckland (New Zealand); Lin, Ching-Long, E-mail: ching-long-lin@uiowa.edu [Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242 (United States); IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA 52242 (United States)

    2013-07-01

    A novel algorithm is presented that links local structural variables (regional ventilation and deforming central airways) to global function (total lung volume) in the lung over three imaged lung volumes, to derive a breathing lung model for computational fluid dynamics simulation. The algorithm constitutes the core of an integrative, image-based computational framework for subject-specific simulation of the breathing lung. For the first time, the algorithm is applied to three multi-detector row computed tomography (MDCT) volumetric lung images of the same individual. A key technique in linking global and local variables over multiple images is an in-house mass-preserving image registration method. Throughout breathing cycles, cubic interpolation is employed to ensure C{sub 1} continuity in constructing time-varying regional ventilation at the whole lung level, flow rate fractions exiting the terminal airways, and airway deformation. The imaged exit airway flow rate fractions are derived from regional ventilation with the aid of a three-dimensional (3D) and one-dimensional (1D) coupled airway tree that connects the airways to the alveolar tissue. An in-house parallel large-eddy simulation (LES) technique is adopted to capture turbulent-transitional-laminar flows in both normal and deep breathing conditions. The results obtained by the proposed algorithm when using three lung volume images are compared with those using only one or two volume images. The three-volume-based lung model produces physiologically-consistent time-varying pressure and ventilation distribution. The one-volume-based lung model under-predicts pressure drop and yields un-physiological lobar ventilation. The two-volume-based model can account for airway deformation and non-uniform regional ventilation to some extent, but does not capture the non-linear features of the lung.

  14. Feasibility and diagnostic accuracy of a low radiation exposure protocol for prospective ECG-triggering coronary MDCT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Pontone, G., E-mail: gianluca.pontone@ccfm.it [Centro Cardiologico Monzino, IRCCS, Milan (Italy); Andreini, D. [Centro Cardiologico Monzino, IRCCS, Milan (Italy); Bartorelli, A.L. [Centro Cardiologico Monzino, IRCCS, Milan (Italy); Department of Cardiovascular Sciences, University of Milan, Milan (Italy); Bertella, E.; Mushtaq, S.; Foti, C.; Formenti, A.; Chiappa, L.; Annoni, A.; Cortinovis, S.; Baggiano, A.; Conte, E.; Bovis, F.; Veglia, F.; Ballerini, G. [Centro Cardiologico Monzino, IRCCS, Milan (Italy); Agostoni, P.; Fiorentini, C. [Centro Cardiologico Monzino, IRCCS, Milan (Italy); Department of Cardiovascular Sciences, University of Milan, Milan (Italy); Pepi, M. [Centro Cardiologico Monzino, IRCCS, Milan (Italy)

    2012-03-15

    Aim: To compare the feasibility, accuracy, and effective radiation dose (ED) of multidetector computed tomography (MDCT) in the detection of coronary artery disease using a combined ED-saving strategy including prospective electrocardiogram (ECG) triggering with a short x-ray window and a body mass index (BMI)-adapted imaging protocol using adaptive statistical iterative reconstruction (ASIR; group 1), in comparison with a prospective ECG triggering strategy alone (group 2). Materials and methods: One hundred and seventy patients scheduled for invasive coronary angiography (ICA) were evaluated. Fourteen patients were not eligible for MDCT. The remaining 156 patients were randomized to group 1 (78 patients) and group 2 (78 patients). Eight and 11 patients in groups 1 and 2, respectively, were excluded after randomization because the patients' heart rates were >65 beats/min. MDCT images were assessed for feasibility, signal-to-noise ration (SNR), and contrast-to-noise ratio (CNR), accuracy in detection of coronary stenoses >50% versus ICA and for ED. Results: The feasibility, SNR, CNR, accuracy in a segment-based and patient-based model were similar in both groups (97 versus 95%, 14.5 {+-} 3.9 versus 14.2 {+-} 4.1, 16 {+-} 4.6 versus 16.5 {+-} 4.4, 95 versus 94% and 97 versus 99%, respectively). The ED in group 1 was 72% lower than in group 2 (2.1 {+-} 1.2 versus 7.5 {+-} 1.8 mSv, respectively; p < 0.01). Conclusions: The use of a multi-parametric ED saving protocol results in a significant reduction in ED without a negative impact on accuracy.

  15. 多层螺旋CT对肠道Crohn病的诊断价值%MDCT diagnosis of Crohn disease

    Institute of Scientific and Technical Information of China (English)

    付峰; 董海波; 张玉琴; 孙勤学; 陈振东

    2011-01-01

    Objective: To evaluate the CT features and diagnostic value of MDCT in the diagnosis of Crohn Disease,Methods: CT findings in 14 patients of Crohn disease confirmed by pathology were retrospectively analyzed. Results: Segmental thickening of the intestinal bowel wall was detected in all 14 patients. Mural thickening and stratification, resulring in the target or double halo appearance were detected in 8 patients, mural thickening without enhancement or mural stratification, and homogeneous attenuation in the thickened wall were observed in 11 patients; bowel wall thickening ranged from 5 to 11 mm. Four patients had perienteric abnormalities including fibrofatty proliferation, phlegmon, and abscess (1case), 7 patients had mesentetic lymph nodes hyperplasia. Comb like pattern was detected in three patients because mesenteric hypervascularity. Target or double halo appearance, comb like pattern suggested high Crohn disease activity. Conclusion : MDCT has the unparalleled ability to depict the abnormalities in the bowel wall, and contrast enhanced CT can distinguish active Crohn disease from quiescent Crohn disease, it can also detect more extra-intestinal lesions. MDCT should be the first imaging examination when Crohn disease is suspected.%目的:探讨多层螺旋CT(MDCT)Crohn病影像特点及诊断价值.方法:对我院经病理证实的14例肠道Crohn病患者的MDCT影像特点进行回顾性分析.结果:所有病例均有跳跃性肠壁增厚,8例表现为肠壁环形增厚,同时伴有粘膜强化和分层形成"靶征"及"双晕征";有11例表现为增厚肠壁分层消失,增强不明显,肠壁厚度多在5~11mm.4例表现为病变段肠管周围肠系膜水肿及增厚,蜂窝织炎,其中并发脓肿1例.7例表现为肠系膜淋巴结肿大.有3例表现为肠系膜血管增多增粗形成"梳征".其中"靶征"、"双晕征"及"梳征",均提示与病变活动度相关.结论:MDCT不但能准确显示Crohn病病变部位、肠外病

  16. Synchronous infection of the aorta and the testis: emphysematous epididymo-orchitis, abdominal aortic mycotic aneurysm, and testicular artery pseudoaneurysm diagnosed by use of MDCT.

    Science.gov (United States)

    Hegde, Rahul G; Balani, Ankit; Merchant, Suleman A; Joshi, Anagha R

    2014-07-01

    We report clinical details and imaging findings for a case of emphysematous epididymo-orchitis with co-existing mycotic abdominal aortic aneurysm and a testicular artery pseudoaneurysm in a diabetic 65-year-old male. We report imaging findings from ultrasonography (USG) and contrast-enhanced multidetector computed tomography (MDCT). Use of MDCT to identify, confirm, and define the extent of the disease, and its utility in understanding the pathogenesis of this rare condition are highlighted. For such lethal infections, early diagnosis and intervention can be lifesaving; imaging can be of crucial importance in this.

  17. Differentiation of a Femoral Hernia from an Inguinal Hernia on Isotropic Multidetector-Row CT (MDCT): the Benefit of Inguinal Ligament Coronal-Oblique Images

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ju Hyun; Jang, Kyung Mi; Kim, Min Jeong; Ko, Ji Young; Koh, Sung Hye; Yie, Mi Yeon; Min, Kwang Seon; Kim, In Gyu [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Choi, Dong Il; Park, Yul Ri [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-04-15

    This study was designed to evaluate the diagnostic value of the use of inguinal ligament coronal-oblique CT images in the differentiation of femoral hernias from inguinal hernias. A total of 32 patients (with 11 femoral hernias and 21 inguinal hernias) underwent CT imaging. All of the examinations were performed with a 16- multidetector row CT (MDCT) scanner with contrast enhancement, and transverse sections, coronal sections and coronal-oblique CT images were reformed along an imaginary inguinal ligament plane. Two independent observers retrospectively evaluated the CT scans. Image analysis was first performed with only transverse and coronal images. A second analysis was then performed with transverse, coronal and coronal- oblique images. The mean angle difference between coronal and coronal-oblique CT images was 8.0 degrees (range, 0-22 degrees). A radiologist correctly diagnosed the presence of a femoral hernia in nine (82%) of 11 patients and a radiology fellow correctly diagnosed the presence of a femoral hernia in seven (64%) of 11 patients in the first session. Both of the reviewers made the correct diagnosis in all patients in the second session. For inguinal hernias, both reviewers correctly diagnosed all patients during both sessions. The coronal-oblique CT images were the most valuable images for the evaluation of the relationship between hernias of the neck and inguinal ligament. Inguinal ligament coronal-oblique CT images can provide additional diagnostic value in the evaluation of groin hernias.

  18. C-arm CT for histomorphometric evaluation of lumbar spine trabecular microarchitecture: a study on anorexia nervosa patients.

    Science.gov (United States)

    Phan, C M; Khalilzadeh, O; Dinkel, J; Wang, I S; Bredella, M A; Misra, M; Miller, K K; Klibanski, A; Gupta, R

    2013-07-01

    Bone histomorphometry measurements require high spatial resolution that may not be feasible using multidetector CT (MDCT). This study evaluated the trabecular microarchitecture of lumbar spine using MDCT and C-arm CT in a series of young adult patients with anorexia nervosa (AN). 11 young females with AN underwent MDCT (anisotropic resolution with a slice thickness of ~626 μm) and C-arm CT (isotropic resolution of ~200 µm). Standard histomorphometric parameters the of L1 vertebral body, namely the apparent trabecular bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular number (TbN) and trabecular separation (TbSp), were analysed using MicroView software (GE Healthcare, Piscataway, NJ). Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Trabecular parameters derived from MDCT and C-arm CT were compared, and their association with BMD parameters was evaluated. Histomorphometric parameters derived from C-arm CT, namely TbTh, TbN and TbSp, were significantly different from the corresponding MDCT parameters. There were no significant correlations between C-arm CT-derived parameters and the corresponding MDCT-derived parameters. C-arm CT-derived parameters were significantly (pC-arm CT, was significantly associated with body mass index (r=0.636) and ideal body weight (r=0.730) (pC-arm CT more accurately captures the histomorphometric parameters of trabecular morphology than MDCT in patients with AN.

  19. Value of gadoxetic acid-enhanced and diffusion-weighted MR imaging in evaluation of hepatocellular carcinomas with atypical enhancement pattern on contrast-enhanced multiphasic MDCT in patients with chronic liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Su [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul (Korea, Republic of); Kim, Seong Hyun, E-mail: kshyun@skku.edu [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul (Korea, Republic of); Kang, Tae Wook; Song, Kyoung Doo; Choi, Dongil [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul (Korea, Republic of); Park, Cheol Keun [Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710 (Korea, Republic of)

    2015-04-15

    Highlights: •We investigated imaging findings on gadoxetic acid-enhanced MRI of HCCs without the typical enhancement pattern on multiphasic MDCT. •Most HCCs showed ancillary MR findings of typical HCC. •Considerable number of HCCs showed MR enhancement pattern of typical HCC. -- Abstract: Objective: The purpose of this study was to investigate the value of enhancement kinetics and ancillary imaging findings on gadoxetic acid-enhanced and diffusion-weighted (DW) MR imaging for diagnosing hepatocellular carcinomas (HCCs) without the typical enhancement pattern on contrast-enhanced multiphasic MDCT in patients with chronic liver disease. Materials and methods: Eighty-two surgically confirmed HCCs without the typical enhancement pattern (hypervascular in the arterial phase, followed by washout on the portal or equilibrium phases) on triple-phase MDCT were enrolled in this study. The patients were classified into four categories based on the CT density pattern of arterial and equilibrium phases (isodense–isodense, hypodense–hypodense, isodense–hypodense, and hyperdense–isodense) compared to liver parenchyma. Signal intensity of HCCs on T2-weighted images (T2WI), arterial phase, 3 min late-phase, hepatobiliary phase (HBP) and DW images with a b value of 800 s/mm{sup 2} were qualitatively evaluated, and ADC values were measured. Fisher's exact test and Chi-square test were used to compare the frequency and trend of hyperintensity on T2WI, hypointensity on HBP images, hyperintensity on DW images, and histopathologic grades between groups with different CT density patterns. Kruskal–Wallis test was used to compare the ADC value between groups. Results: Thirty and 52 HCCs were categorized as hypervascular (hyperdense–isodense) and non-hypervascular HCCs (3, isodense–isodense; 37, hypodense–hypodense; 12, isodense–hypodense), respectively. Most HCCs showed hyperintensity on T2WI (77/82, 93.9%) and DW images (81/82, 98.8%) and hypointensity on HBP

  20. Prevalence of extracardiac findings in the evaluation of ischemic heart disease by multidetector computed tomography

    Institute of Scientific and Technical Information of China (English)

    Jeong-Hwan Cho; Jong-Seon Park; Dong-Gu Shin; Young-Jo Kim; Sang-Hee Lee; Yoon-Jung Choi; Ihn-Ho Cho

    2013-01-01

    Objective Multidector computed tomography (MDCT) is now commonly used for the evaluation of coronary artery disease. Because MDCT images include many non-cardiac organs and the patient population evaluated is highly susceptible to extracardiac diseases, this study was designed to evaluate the prevalence of extracardiac findings in the MDCT evaluation of ischemic heart disease. Methods From March 2007 to March 2008, a total of six-hundred twenty patients, who underwent 64-slice MDCT evaluations for chest pain, or dyspnea, were enrolled in this study. Cardiac and non-cardiac findings were comprehensively evaluated by a radiologist. Results Enrolled patients included 306 men (49.4%), with a mean age of 66 years. Significant coronary artery stenosis was found in 41.6%of the patients. A total of 158 extracardiac findings were observed in 110 (17.7%) patients. Commonly involved extracardiac organs were lung (36.7%), hepatobiliary system (21.5%), thyroid (19.6%), kidney (10.8%), spine (9.7%) and breast (0.6%). Of those 110 patients, 50 (45.5%) patients underwent further diagnostic investigations. Malignant disease was detected in three (2.7%) patients (lung cancer, pancreatic cancer, and thyroid cancer). Conclusions Extracardiac findings are frequently present and should be a concern in the MDCT evaluation of chest pain syndrome.

  1. 音频压缩中3种整数型MDCT变换的比较%Comparison of three IntMDCT algorithms in audio compression

    Institute of Scientific and Technical Information of China (English)

    王膂; 伍家松; Senhadji Lotfi; 舒华忠

    2012-01-01

    为了快速计算整数型改进的离散余弦变换(IntMDCT),构造了基于提升变换、模变换以及无穷范数旋转变换的3种计算12点IntMDCT的算法.首先将12点MDCT转化为6点Ⅳ型离散余弦变换(DCT-Ⅳ),并将后者分解为7个Givens旋转变换的乘积;然后分别利用提升变换算法、模变换算法和无穷范数旋转变换算法实现Givens旋转变换的整数型近似计算;最后,对这3种算法在语音信号无损和有损压缩中的运行速度和计算精确度进行比较.实验结果表明,在这3种算法中,基于模变换的IntMDCT算法的运行速度最快;基于无穷范数旋转变换的IntMDCT算法的计算精度最高,并在有损音频压缩中获得的信噪比最高.%In order to improve the computation efficiency of the integer modified discrete cosine transform (IntMDCT), three algorithms based on the lifting scheme, modulo transform and infinity norm rotation transform are formulated respectively for computing the 12-point IntMDCT. First, the 12-point IntMDCT is converted into the 6-point type-]V discrete cosine transform (DCT-IV) , which is then factorized into a product of 7 Givens rotation matrices. The integer type Givens rotation matrices are approximated by lifting scheme, modulo transform and infinity norm rotation transform, respectively. Finally, the speed and accuracy of these three IntMDCT algorithms are compared in both lossless and lossy audio compression. The experimental results show that in the three algorithms , the IntMDCT algorithm based on the modulo transform has the highest computation speed. The IntMDCT algorithm based on the infinity norm rotation transform has the highest accuracy, and can achieve the highest signal to noise ratio (SNR) in lossy audio compression.

  2. Single-energy low-voltage arterial phase MDCT scanning increases conspicuity of adenocarcinoma of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Zamboni, Giulia A., E-mail: gzamboni@hotmail.com [Istituto di Radiologia, Policlinico GB Rossi, Azienda Ospedaliera Universitaria Integrata di Verona, P.le LA Scuro 10, 37134 Verona (Italy); Ambrosetti, Maria Chiara, E-mail: mchiara.ambrosetti@gmail.com [Istituto di Radiologia, Policlinico GB Rossi, Azienda Ospedaliera Universitaria Integrata di Verona, P.le LA Scuro 10, 37134 Verona (Italy); Guariglia, Stefania, E-mail: guariglia@gmail.com [U.O. di Fisica Sanitaria, Azienda Ospedaliera Universitaria Integrata di Verona, P.le Stefani 1, 37126 Verona (Italy); Cavedon, Carlo, E-mail: carlo.cavedon@ospedaleuniverona.it [U.O. di Fisica Sanitaria, Azienda Ospedaliera Universitaria Integrata di Verona, P.le Stefani 1, 37126 Verona (Italy); Pozzi Mucelli, Roberto, E-mail: roberto.pozzimucelli@univr.it [Istituto di Radiologia, Policlinico GB Rossi, Azienda Ospedaliera Universitaria Integrata di Verona, P.le LA Scuro 10, 37134 Verona (Italy)

    2014-03-15

    Purpose: To test a single-energy low-voltage CT protocol for pancreatic adenocarcinoma. Methods and materials: A total of 30 patients with pathology-proven pancreatic adenocarcinoma underwent 64-row MDCT with arterial phase at 80 kV and were compared to a similar group of 30 patients scanned with a 120 kV protocol. Scans were compared for quantitative image parameters (attenuation and standard deviation in the pancreas, tumor, aorta), CTDI and DLP using an unpaired t-test. Image noise values for each protocol (SD of the psoas) were compared using an unpaired t-test. Effective dose was calculated for each protocol. CNR (=conspicuity/SDnoise) and FOM (CNR{sup 2}/ED) were calculated. The Catphan600 phantom was used to evaluate image non-uniformity, noise, spatial resolution, and low contrast detectability. Results: Mean patient weight was 68 kg in the study group and 73 kg in the control group (p = 0.0355), while patient diameters at the celiac axis were not significantly different. Mean attenuation was significantly higher at 80 kV in the aorta (517.5 ± 116.4 vs 290.3 ± 76.4 HU) and normal pancreas (154.0 ± 39.95 vs 90.02 ± 19.01 HU) (all p < 0.0001), while no significant difference was observed for adenocarcinoma (61.43 ± 35.61 vs 47.45 ± 18.95; p = n.s.). CTDI and DLP were significantly lower at 80 kV (6.00 ± 0.90 mGy vs 10.24 ± 2.93 mGy, and 180.4 ± 35.49 mGy cm vs 383.8 ± 117 mGy cm, respectively; all p < 0.0001). Tumor conspicuity (HU{sub pancreas} − HU{sub tumor}) was significantly higher at 80 kV (94.2 ± 39.3 vs 39.5 ± 22 HU; p < 0.0001). Mean image noise was significantly higher at 80 kV (28.32 ± 10.06 vs 19.7 ± 7.1 HU; p < 0.0001). Effective dose was significantly lower at 80 kV (1.984 ± 0.39 vs 5.75 ± 1.75 mSv; p < 0.0001). The total DLP for the exam was 1024 ± 31.86 mGy cm for the 80 kV protocol and 1357 ± 62.60 mGy cm for the 120 kV protocol (p < 0.0001). Phantoms showed higher non-uniformity, slightly higher noise, slightly lower MTF

  3. Acute inflammatory bowel disease of the small intestine in adult: MDCT findings and criteria for differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy)], E-mail: stefromano@libero.it; Russo, Anna [Institute of Radiology, Second University of Naples, Naples (Italy); Daniele, Stefania; Tortora, Giovanni [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy); Maisto, Francesco [Institute of Radiology, Second University of Naples, Naples (Italy); Romano, Luigia

    2009-03-15

    Inflammatory changes of the intestine leading to acute abdomen could represent a frequent diagnostic challenge for radiologists actively involved in the emergency area. MDCT imaging findings needs to be evaluated considering the clinical history and symptoms and other abdominal findings that could be of help in differential diagnosis. Several protocols have been suggested and indicated in the imaging of patient with acute intestine. However, a CT protocol in which the precontrast scanning of the abdomen is followed by i.v. administration of contrast medium using the 45-55 s delay could be effective for an optimal visualization of the bowel wall. It is important to learn to recognize how the intestine reacts to the injury and how it 'talks', in order to become aware of the different patterns of disease manifestation related to an acute intestinal condition, for an effective diagnosis of active and acute inflammatory bowel disease.

  4. Survey of pediatric MDCT radiation dose from university hospitals in Thailand. A preliminary for national dose survey

    Energy Technology Data Exchange (ETDEWEB)

    Kritsaneepaiboon, Supika [Dept. of Radiology, Faculty of Medicine, Prince of Songkla Univ., Hat Yai (Thailand)], e-mail: supikak@yahoo.com; Trinavarat, Panruethai [Dept. of Radiology, Faculty of Medicine, Chulalongkorn Univ., Bangkok (Thailand); Visrutaratna, Pannee [Dept. of Radiology, Faculty of Medicine, Chiang Mai Univ., Chiang Mai (Thailand)

    2012-09-15

    Background: Increasing pediatric CT usage worldwide needs the optimization of CT protocol examination. Although there are previous published dose reference level (DRL) values, the local DRLs should be established to guide for clinical practice and monitor the CT radiation. Purpose: To determine the multidetector CT (MDCT) radiation dose in children in three university hospitals in Thailand in four age groups using the CT dose index (CTDI) and dose length product (DLP). Material and Methods: A retrospective review of CT dosimetry in pediatric patients (<15 years of age) who had undergone head, chest, and abdominal MDCT in three major university hospitals in Thailand was performed. Volume CTDI (CTDIvol) and DLP were recorded, categorized into four age groups: <1 year, 1- < 5 years, 5- <10 years, and 10- <15 years in each scanner. Range, mean, and third quartile values were compared with the national reference dose levels for CT in pediatric patients from the UK and Switzerland according to International Commission on Radiological Protection (ICRP) recommendation. Results: Per age group, the third quartile values for brain, chest, and abdominal CTs were, respectively, in terms of CTDIvol: 25, 30, 40, and 45 mGy; 4.5, 5.7, 10, and 15.6 mGy; 8.5, 9, 14, and 17 mGy; and in terms of DLP: 400, 570, 610, and 800 mGy cm; 80, 140, 305, and 470 mGy cm; and 190, 275, 560,765 mGy cm. Conclusion: This preliminary national dose survey for pediatric CT in Thailand found that the majority of CTDIvol and DLP values in brain, chest, and abdominal CTs were still below the diagnostic reference levels (DRLs) from the UK and Switzerland regarding to ICRP recommendation.

  5. Radiofrequency ablation of liver metastases-software-assisted evaluation of the ablation zone in MDCT: tumor-free follow-up versus local recurrent disease.

    Science.gov (United States)

    Keil, Sebastian; Bruners, Philipp; Schiffl, Katharina; Sedlmair, Martin; Mühlenbruch, Georg; Günther, Rolf W; Das, Marco; Mahnken, Andreas H

    2010-04-01

    The purpose of this study was to investigate differences in change of size and CT value between local recurrences and tumor-free areas after CT-guided radiofrequency ablation (RFA) of hepatic metastases during follow-up by means of dedicated software for automatic evaluation of hepatic lesions. Thirty-two patients with 54 liver metastases from breast or colorectal cancer underwent triphasic contrast-enhanced multidetector-row computed tomography (MDCT) to evaluate hepatic metastatic spread and localization before CT-guided RFA and for follow-up after intervention. Sixteen of these patients (65.1 + or - 10.3 years) with 30 metastases stayed tumor-free (group 1), while the other group (n = 16 with 24 metastases; 62.0 + or - 13.8 years) suffered from local recurrent disease (group 2). Applying an automated software tool (SyngoCT Oncology; Siemens Healthcare, Forchheim, Germany), size parameters (volume, RECIST, WHO) and attenuation were measured within the lesions before, 1 day after, and 28 days after RFA treatment. The natural logarithm (ln) of the quotient of the volume 1 day versus 28 days after RFA treament was computed: lnQ1//28/0(volume). Analogously, ln ratios of RECIST, WHO, and attenuation were computed and statistically evaluated by repeated-measures ANOVA. One lesion in group 2 was excluded from further evaluation due to automated missegmentation. Statistically significant differences between the two groups were observed with respect to initial volume, RECIST, and WHO (p free and local-recurrent ablation zones with respect to the corresponding size parameters. A new parameter (lnQ1//28/0(volume/RECIST/WHO/attenuation)) was introduced, which appears to be of prognostic value at early follow-up CT.

  6. Is the lung scan alive and well? Facts and controversies in defining the role of lung scintigraphy for the diagnosis of pulmonary embolism in the era of MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Reid, John H. [Borders General Hospital, Department of Radiology, Melrose, Scotland (United Kingdom); Coche, Emmanuel E. [Cliniques Universitaires St-Luc, Department of Medical Imaging, Brussels (Belgium); Inoue, Tomio [Yokohama City University Hospital, Department of Radiology, Yokohama (Japan); Kim, Edmund E. [MD Anderson Cancer Center, Nuclear Medicine Service, Houston, TX (United States); Dondi, Maurizio; Watanabe, Naoyuki [International Atomic Energy Agency, Vienna (Austria); Mariani, Giuliano [University of Pisa Medical School, Regional Centre of Nuclear Medicine, Pisa (Italy)

    2009-03-15

    The last decade has seen a changing pattern of utilization of multidetector CT (MDCT) versus lung perfusion scintigraphy in the investigation of pulmonary venous thromboembolism (VTE). In response to this the International Atomic Energy Agency (IAEA) determined that the subject required an overview. The IAEA has invited a group of five specialists in the relevant fields to review the current status and optimum role of scintigraphy, to explore some of the facts and controversies surrounding the use of both modalities and to make recommendations about the continued role of nuclear medicine for the investigation of pulmonary embolism. This paper identifies the relative merits of each technique, highlights benefits, focuses on complementary roles and seeks a nonadversarial symbiosis. The consultants reached a consensus that the continued use of scintigraphy for diagnosis of thromboembolic disease is recommended, particularly in scenarios where scintigraphy confers specific benefits and is complementary to MDCT. (orig.)

  7. Editorial to: Baseline MDCT findings after prosthetic heart valve implantation provide important complementary information to echocardiography for follow-up purposes by Sucha et al

    Energy Technology Data Exchange (ETDEWEB)

    Peeters, F.E.C.M. [Maastricht University Medical Center, Department of Cardiology, Maastricht (Netherlands); Kietselaer, B.L.J.H. [Maastricht University Medical Center, Department of Cardiology, Maastricht (Netherlands); Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands)

    2016-04-15

    Over the last years a growing number of prosthetic heart valve (PHV) implantation procedures have been performed in sequence with the aging of the population and improving surgical techniques. Currently, echocardiography is the most important tool in the follow-up and evaluation of complications associated with the PHV (pannus, thrombus, endocarditis). However, echocardiographic examination of PHV associated disease may be hampered by poor acoustic window or scatter artefacts caused by the PHV. PHV related disease such as endocarditis is related with a poor prognosis, especially when complications such as periannular abscess formation occurs. Early treatment of PHV associated disease improves prognosis. Therefore, an unmet clinical need for early detection of complications exists. In the evaluation of PHV (dys)function, multidetector-row computed tomography (MDCT) has shown to be of additive value. A necessity for MDCT to be implemented in daily practice is to be able to distinguish between normal and pathological features. (orig.)

  8. Pancreatic neuroendocrine tumour (PNET): Staging accuracy of MDCT and its diagnostic performance for the differentiation of PNET with uncommon CT findings from pancreatic adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoon; Lee, Jeong Min; Han, Joon Koo; Choi, Byung-Ihn [Seoul National University Hospital, Department of Radiology, 101 Daehangno, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul (Korea, Republic of); Eun, Hyo Won [Yonsei University College of Medicine, Department of Radiology, Severance Hospital, Seodaemun-ku, Seoul (Korea, Republic of); Kim, Young Jae [Soonchunhyang University Hospital, Department of Radiology, 657 Hannam-Dong, Youngsan-Ku, Seoul (Korea, Republic of)

    2016-05-15

    To investigate staging accuracy of multidetector CT (MDCT) for pancreatic neuroendocrine tumour (PNET) and diagnostic performance for differentiation of PNET from pancreatic adenocarcinoma. We included 109 patients with surgically proven PNET (NETG1 = 66, NETG2 = 31, NEC = 12) who underwent MDCT. Two reviewers assessed stage and presence of predefined CT findings. We analysed the relationship between CT findings and tumour grade. Using PNETs with uncommon findings, we also estimated the possibility of PNET or adenocarcinoma. Accuracy for T stage was 85-88 % and N-metastasis was 83-89 %. Common findings included well circumscribed, homogeneously enhanced, hypervascular mass, common in lower grade tumours (p < 0.05). Uncommon findings included ill-defined, heterogeneously enhanced, hypovascular mass and duct dilation, common in higher grade tumours (p < 0.05). Using 31 PNETs with uncommon findings, diagnostic performance for differentiation from adenocarcinoma was 0.760-0.806. Duct dilatation was an independent predictor for adenocarcinoma (Exp(B) = 4.569). PNETs with uncommon findings were associated with significantly worse survival versus PNET with common findings (62.7 vs. 95.7 months, p < 0.001). MDCT is useful for preoperative evaluation of PNET; it not only accurately depicts the tumour stage but also prediction of tumour grade, because uncommon findings were more common in higher grade tumours. (orig.)

  9. 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.

  10. Interobserver agreement in fusion status assessment after instrumental desis of the lower lumbar spine using 64-slice multidetector computed tomography

    DEFF Research Database (Denmark)

    Laoutliev, Borislav; Havsteen, Inger; Bech, Birthe Højlund;

    2012-01-01

    Persistent lower back pain after instrumental posterolateral desis may arise from incomplete fusion. We investigate the impact of experience on interobserver agreement in fusion estimation.......Persistent lower back pain after instrumental posterolateral desis may arise from incomplete fusion. We investigate the impact of experience on interobserver agreement in fusion estimation....

  11. Adenocarcinoma of the uncinate process of the pancreas: MDCT patterns of local invasion and clinical features at presentation

    Energy Technology Data Exchange (ETDEWEB)

    Padilla-Thornton, Amie E.; Willmann, Juergen K.; Jeffrey, R.B. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2012-05-15

    To compare the multidetector CT (MDCT) patterns of local invasion and clinical findings at presentation in patients with adenocarcinoma of the uncinate process of the pancreas to patients with adenocarcinomas in the non-uncinate head of the pancreas. We evaluated the two cohorts for common duct and pancreatic duct dilatation, mesenteric vascular encasement, root of mesentery invasion, perineural invasion and duodenal invasion. In addition, we compared the clinical findings at presentation in both groups. Common duct (P < 0.001) and pancreatic duct dilatation (P = 0.001) were significantly less common in uncinate process adenocarcinomas than in the non-uncinate head of the pancreas. Clinical findings of jaundice (P = 0.01) and pruritis (P = 0.004) were significantly more common in patients with lesions in the non-uncinate head of the pancreas. Superior mesenteric artery encasement (P = 0.02) and perineural invasion (P = 0.001) were significantly more common with uncinate process adenocarcinomas. Owing to its unique anatomic location, adenocarcinomas within the uncinate process of the pancreas have significantly different patterns of both local invasion and clinical presentation compared to patients with carcinomas in the non-uncinate head of the pancreas. (orig.)

  12. Diagnostic value of ECG-gated multidetector computed tomography in the early phase of suspected acute myocarditis. A preliminary comparative study with cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dambrin, Gregoire; Caussin, Christophe; Lancelin, Bernard; Paul, Jean F. [Centre Chirurgical Marie Lannelongue, Departments of Cardiology and Radiology, Le Plessis Robinson (France); Laissy, Jean P.; Serfaty, Jean M. [AP-HP, Hospital Bichat, Department of Radiology, Paris (France)

    2007-02-15

    The aim of the study was to determine the potential diagnostic value of contrast-enhanced echocardiogram (ECG)-gated multidetector computed tomography (MDCT) in the setting of suspected acute myocarditis compared with contrast-enhanced magnetic resonance imaging (MRI). The study group consisted of 12 consecutive patients admitted for suspected acute myocarditis less than 10 days after onset of symptoms. All patients had clinical, electrocardiographic signs, and laboratory findings consistent with the diagnosis. All patients but one (severe claustrophobia) underwent cardiac MRI using T1-weighted delayed-enhancement images after injection of gadolinium. ECG-gated MDCT was performed in all patients and included a first-pass contrast-enhanced acquisition and a delayed acquisition. MRI revealed abnormal focal or multifocal myocardial enhancement and confirmed the diagnosis in 11 patients. The first-pass MDCT acquisition showed homogenous left-ventricle contrast enhancement and absence of coronary stenosis in all patients. Delayed MDCT acquisition, performed 5 min later without reinjection of contrast medium revealed multiple areas of myocardial hyperenhancement in a focal or a multifocal pattern (six and six patients, respectively). Extent and location of hyperenhancement at MDCT correlated well with that observed at MR examination for all 11 patients evaluated by both techniques (r=0.9167, p=0.0004). These preliminary results show that ECG-gated MDCT could be a useful alternative noninvasive diagnostic test in the early phase of acute myocarditis. (orig.)

  13. MDCT in the Differentiation of Adrenal Masses: Comparison between Different Scan Delays for the Evaluation of Intralesional Washout

    Directory of Open Access Journals (Sweden)

    Giuseppe Angelelli

    2013-01-01

    Full Text Available Purpose. To evaluate the accuracy of the washout in the differential diagnosis between adenomas and nonadenomas and to compare the obtained results in delayed CT scans at 5, 10 and 15 minutes. Methods. Fifty patients with adrenal masses were prospectively evaluated. CT scans were performed by using a 320-row MDCT device, before and after injection of contrast material. In 25 cases, delayed scans were performed at 5′ and 10′ (group 1, while in the remaining 25, at 5′ and 15′ (group 2. Absolute and relative wash-out percentage values (APW and RPW were calculated. Results. Differential diagnosis between adenomas and nonadenomas was obtained in 48/50 (96% cases, with sensitivity, specificity, and accuracy values of 96%, 95%, and 96%, respectively. In group 1, APW and RPW values were, respectively, 69.8% and 67.2% at 5′ and 75.9% and 73.5% at 10′ for adenomas and 25.1% and 15.8% at 5′ and 33.5% and 20.5% at 10′ for nonadenomas. In group 2, APW and RPW values were 63% and 54.6% at 5′ and 73.8% and 65.5% at 15′ for adenomas and 22% and 12.5% at 5′ and 35.5% and 19.9% at 15′ for nonadenomas. Conclusions. The evaluation of the wash-out values in CT scans performed at 5′, 10′, and 15′ provides comparable diagnostic results. CT scans performed at 5′ are, therefore, to be preferred, since they reduce the examination time and patient discomfort.

  14. Risk of contrast-medium-induced nephropathy in high-risk patients undergoing MDCT - A pooled analysis of two randomized trials

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Henrik S. [University of Copenhagen, Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, and Department of Diagnostic Sciences, Faculty of Health Sciences, Herlev (Denmark); Morcos, Sameh K. [University of Sheffield, Department of Diagnostic Imaging, Northern General Hospital, Sheffield (United Kingdom)

    2009-04-15

    The incidence of contrast-medium-induced nephropathy (CIN) following intravenous (IV) CM administration of contrast media to renally impaired patients undergoing multidetector computed tomography (MDCT) is not well characterized. Our objective was to investigate the incidence of CIN in patients with glomerular filtration rate (GFR) <60 ml/min undergoing contrast-enhanced MDCT examinations and to compare the rates of CIN following the IV administration of low-osmolar contrast media (LOCM, iopamidol and iomeprol) and an iso-osmolar contrast medium (IOCM, iodixanol). A total of 301 adult patients with moderate-to-severe renal failure received a similar IV contrast dose (40 gI). Serum creatinine (SCr) was measured at screening, baseline and 48-72 {+-} 6 h after the MDCT examination. Primary CIN outcome was an increase in SCr {>=}0.5 mg/dl ({>=}44.2 {mu}mol/l) from baseline. The CIN rates were 2.3% in the total population, 0.6% when GFR >40 ml/min, 4.6% when GFR <40 ml/min and 7.8% in patients with GFR <30 ml/min. The incidence of CIN was significantly higher after iodixanol than after LOCM (seven patients, 4.7% following IOCM, no CIN cases following the LOCM; p = 0.007). Significant differences in favor of the LOCM were also observed in patients with GFR <40 ml/min and GFR <30 ml/min. Following the IV administration of nonionic contrast agents in patients with moderate-to-severe renal insufficiency, the risk of significant CIN seems to be low. The IOCM iodixanol caused a higher rate of CIN than the LOCM iopamidol and iomeprol, especially in high-risk patients. Differences in osmolality between these LOCM and iodixanol do not play a role in the genesis of CIN. (orig.)

  15. 成人肠套叠的MDCT诊断价值%The Diagnostic Value of MDCT for Adult Intussusception

    Institute of Scientific and Technical Information of China (English)

    曾莎莎; 徐嵩; 郭建东; 李春高; 李景雷

    2013-01-01

    目的 分析成人肠套叠的的MDCT影像特征.方法 回顾分析手术证实为成人肠套叠的CT影像资料共48例.观察内容主要包括肠套叠部位、数目、套叠类型及CT征象、套叠处肠壁是否增厚或肿块形成、肠壁是否水肿与坏死等.结果 本组48例50处肠套叠均为顺行套入,单处肠套叠46例(位于回盲部22例、回肠10例、空肠8例、升结肠4例、十二指肠空肠交界处、降结肠型及直肠各2例),多处肠套叠2例.MDCT示肠套叠3层肠壁结构及肠管内脂肪48例50处、杯口征及靶形征4 2例44处,彗星尾征32例34处,漩涡征24例26处.肠壁均匀增厚并水肿12例,其中考虑合并肠壁坏死4例;肠壁不均匀增厚或和肿块形成、不均匀强化14例;肠壁均匀增厚并轻中度均匀强化6例.套叠处见多发囊状低密度灶并囊壁均匀强化4例;套入远端圆形脂肪瘤合并肠壁坏死2例;小肠冗长2例;肠壁正常8例;其中合并肠梗阻12例,合并腹壁疝2例.结论 成人肠套叠MDCT影像表现有一定特征,三期增强扫描结合多平面重组技术,对其诊断及选择治疗方法具有重要价值.%Objective To analyze the imaging features of MDCT for adult intussusception.Methods A retrospective analysis was performed to assess the MDCT imaging appearances of 48 cases of adult intussusception confirmed by operation.Evaluative content contains the intussusceptions' site,number,type and direct CT signs,bowel wall thickening or mass formation,bowel wall edema and necrosis and so on.Results CT demonstrated all 50 intussusceptions in 48 cases were anterograde,of which single lesion in 46 cases (22cases located in ileocecal junction,10 cases in ileum,8 cases in jejunum,4 cases in ascending colon,2 case in duodenum-jejunum junction,descending colon and rectum respectively),multiple intussusceptions in 2 case.CT showed three bowel walls structure and intralumihal fat sign in all 50 intussusceptions of 48 cases

  16. 心脏瓣膜病的多层螺旋CT、MR研究进展%Research Advances of MDCT-MR in Valvular Heart Disease

    Institute of Scientific and Technical Information of China (English)

    张笑春; 杨志刚

    2008-01-01

    分析多层螺旋CT(Multi-detector computed tomography, MDCT)、MR(Magnetic resonance imaging, MRI)检查技术在心脏瓣膜病中的应用,并探讨常规CT、电影CT(Cine CT)、最大密度投影(Maximum intensity projection, MIP)、多平面重组(Multiple planar reconstruction, MPR)、容积再现(Volume rendering technique, VRT)及黑血序列、电影MRI(Cine MRI)等CT、MRI技术对心脏瓣膜病的诊断价值.

  17. Prediction of bone strength by μCT and MDCT-based finite-element-models: How much spatial resolution is needed?

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Jan S., E-mail: jsb@tum.de [Department of Radiology, Technische Universität München, Munich (Germany); Department of Radiology, University of California, San Francisco, CA (United States); Max Planck Institute for Extraterrestrial Physics, Garching (Germany); Sidorenko, Irina [Max Planck Institute for Extraterrestrial Physics, Garching (Germany); Mueller, Dirk [Department of Radiology, Universität Köln (Germany); Baum, Thomas [Department of Radiology, Technische Universität München, Munich (Germany); Department of Radiology, University of California, San Francisco, CA (United States); Max Planck Institute for Extraterrestrial Physics, Garching (Germany); Issever, Ahi Sema [Department of Radiology, University of California, San Francisco, CA (United States); Department of Radiology, Charite, Berlin (Germany); Eckstein, Felix [Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg (Austria); Rummeny, Ernst J. [Department of Radiology, Technische Universität München, Munich (Germany); Link, Thomas M. [Department of Radiology, University of California, San Francisco, CA (United States); Raeth, Christoph W. [Max Planck Institute for Extraterrestrial Physics, Garching (Germany)

    2014-01-15

    Objectives: Finite-element-models (FEM) are a promising technology to predict bone strength and fracture risk. Usually, the highest spatial resolution technically available is used, but this requires excessive computation time and memory in numerical simulations of large volumes. Thus, FEM were compared at decreasing resolutions with respect to local strain distribution and prediction of failure load to (1) validate MDCT-based FEM and to (2) optimize spatial resolution to save computation time. Materials and methods: 20 cylindrical trabecular bone specimens (diameter 12 mm, length 15–20 mm) were harvested from elderly formalin-fixed human thoracic spines. All specimens were examined by micro-CT (isotropic resolution 30 μm) and whole-body multi-row-detector computed tomography (MDCT, 250 μm × 250 μm × 500 μm). The resolution of all datasets was lowered in eight steps to ∼2000 μm × 2000 μm × 500 μm and FEM were calculated at all resolutions. Failure load was determined by biomechanical testing. Probability density functions of local micro-strains were compared in all datasets and correlations between FEM-based and biomechanically measured failure loads were determined. Results: The distribution of local micro-strains was similar for micro-CT and MDCT at comparable resolutions and showed a shift toward higher average values with decreasing resolution, corresponding to the increasing apparent trabecular thickness. Small micro-strains (ε{sub eff} < 0.005) could be calculated down to 250 μm × 250 μm × 500 μm. Biomechanically determined failure load showed significant correlations with all FEM, up to r = 0.85 and did not significantly change with lower resolution but decreased with high thresholds, due to loss of trabecular connectivity. Conclusion: When choosing connectivity-preserving thresholds, both micro-CT- and MDCT-based finite-element-models well predicted failure load and still accurately revealed the distribution of local micro-strains in

  18. Evaluation of left atrial function by multidetector computed tomography before left atrial radiofrequency-catheter ablation: Comparison of a manual and automated 3D volume segmentation method

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, Florian, E-mail: florian.wolf@meduniwien.ac.a [Department of Radiology, Medical University of Vienna, Vienna (Austria); Ourednicek, Petr [Philips Medical Systems, Prague (Czech Republic); Loewe, Christian [Department of Radiology, Medical University of Vienna, Vienna (Austria); Richter, Bernhard; Goessinger, Heinz David; Gwechenberger, Marianne [Department of Cardiology, Medical University of Vienna, Vienna (Austria); Plank, Christina; Schernthaner, Ruediger Egbert; Toepker, Michael; Lammer, Johannes [Department of Radiology, Medical University of Vienna, Vienna (Austria); Feuchtner, Gudrun M. [Department of Radiology, Innsbruck Medical University, Innsbruck (Austria); Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland)

    2010-08-15

    Introduction: The purpose of this study was to compare a manual and automated 3D volume segmentation tool for evaluation of left atrial (LA) function by 64-slice multidetector-CT (MDCT). Methods and materials: In 33 patients with paroxysmal atrial fibrillation a MDCT scan was performed before radiofrequency-catheter ablation. Atrial function (minimal volume (LAmin), maximal volume (LAmax), stroke volume (SV), ejection fraction (EF)) was evaluated by two readers using a manual and an automatic tool and measurement time was evaluated. Results: Automated LA volume segmentation failed in one patient due to low LA enhancement (103HU). Mean LAmax, LAmin, SV and EF were 127.7 ml, 93 ml, 34.7 ml, 27.1% by the automated, and 122.7 ml, 89.9 ml, 32.8 ml, 26.3% by the manual method with no significant difference (p > 0.05) and high Pearsons correlation coefficients (r = 0.94, r = 0.94, r = 0.82 and r = 0.85, p < 0.0001), respectively. The automated method was significantly faster (p < 0.001). Interobserver variability was low for both methods with Pearson's correlation coefficients between 0.98 and 0.99 (p < 0.0001). Conclusions: Evaluation of LA volume and function with 64-slice MDCT is feasible with a very low interobserver variability. The automatic method is as accurate as the manual method but significantly less time consuming permitting a routine use in clinical practice before RF-catheter ablation.

  19. 一种基于 MDCT 量化系数统计特征的A AC 音频隐写分析方法%A steganalysis method of AAC audio based on statistical features of MDCT quantized coefficients

    Institute of Scientific and Technical Information of China (English)

    王昱洁; 杨萍; 蒋薇薇

    2015-01-01

    文章提出了一种基于MDCT量化系数统计特征的AAC音频隐写分析方法。将AAC音频进行部分解码得到MDCT量化系数,在MDCT量化系数中提取广义高斯分布模型的参数、量化系数分布直方图的频域统计矩、帧内和帧间MDCT量化系数的Markov转移矩阵的部分数据作为隐写分析的特征,最后采用支持向量机进行分类。通过对不同比特率的AAC音频的实验结果表明,文中提出的AAC音频隐写分析方法对于MDCT量化系数中的直接扩频隐写方式的检测效果较好,对于比特率为128 kb/s的AAC音频,在隐写容量较低的情况下也能达到较高的检测率。%A steganalysis method of AAC audio based on statistical features of MDCT quantized coeffi‐cients is proposed .Firstly ,AAC audio is partly decoded to get MDCT quantized coefficients ,and then the parameters of generalized Gaussian distribution (GGD) model ,the statistical moments in fre‐quency domain of the distribution histogram of quantized coefficients ,and some data of the Markov transition matrix of the MDCT quantized coefficients in a frame and between frames are extracted from the MDCT quantized coefficients as the features of steganalysis .Finally ,the support vector machine is used as a classifier .The experimental results of AAC audio at different bitrates reveal that ,the pro‐posed steganalysis method of AAC audio has a good detection effect on the hiding method of the direct spread spectrum modulation on the MDCT quantized coefficients ,and for the AAC audio at 128 kb/s bitrate ,the detection accuracy is high even under the condition of low capacity of steganography .

  20. Anatomical variations in the origins of the celiac axis and the superior mesenteric artery: MDCT angiographic findings and their probable embryological mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yi; Cheng, Cheng; Wang, Lu; Li, Ran; Chen, Jin-hua; Gong, Shui-gen [Institute of Surgery Research, Daping Hospital, Third Military Medical University, Department of Radiology, Chongqing (China)

    2014-08-15

    To identify the spectrum and prevalence of anatomical variations in the origin of the celiac axis (CA), the superior mesenteric artery (SMA) and their major branches by using multidetector computed tomographic (MDCT) angiography. A retrospective evaluation was carried out on 1,500 abdominal MDCT angiography images. The aortic origins of the CA, the SMA and their major branch patterns were investigated. Normal aortic origins of CA and SMA were noted in 1,347 (89.8 %) patients. Seven types of CA and SMA origin variants were identified in 153 (10.2 %) patients. The three most common variations were hepatomesenteric trunk (67 patients, 4.47 %), celiomesenteric trunk (CMT) (51 patients, 3.4 %) and splenomesenteric trunk (18 patients, 1.2 %). An evaluation of CMT was classified as long (34 patients, 66.7 %) or short (17 patients, 33.3 %) subtypes, compared with the length of the common trunk. Further CMT classification was based on the origin of the left gastric artery: subtype I, 26 patients (53.1 %); subtype II, 5 patients (10.2 %); subtype III, 15 patients (30.6 %); subtype IV, 3 patients (6.1 %). Dislocation interruption, incomplete interruption and persistence of the longitudinal anastomosis could be the embryological mechanisms of the variant origins of the CA, the SMA and their major branches. (orig.)

  1. Injuries of the scapholunate and lunotriquetral ligaments as well as the TFCC in intra-articular distal radius fractures. Prevalence assessed with MDCT arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Klempka, A.; Wagner, M.; Fodor, S.; Schmitt, R. [Cardiovascular Center Bad Neustadt an der Saale, Department of Diagnostic and Interventional Radiology, Bad Neustadt an der Saale (Germany); Prommersberger, K.J. [Clinic for Hand Surgery, Bad Neustadt an der Saale (Germany); Uder, M. [Friedrich-Alexander-University Erlangen-Nuernberg (FAU), Department of Diagnostic Radiology, Erlangen (Germany)

    2016-03-15

    To evaluate the prevalence of injuries of the scapholunate and lunotriquetral interosseous ligaments (SLIL, LTIL) as well as the triangular fibrocartilage complex (TFCC) in intra-articular distal radius fractures (iaDRF). Two hundred and thirty-three patients with acute iaDRF underwent MDCT arthrography. The SLIL and LTIL were described as normal, partially or completely ruptured. Major injuries of the SLIL were defined as completely ruptured dorsal segments, those of the LTIL as completely ruptured palmar segments. The TFCC was judged as normal or injured. Interobserver variability was calculated. Injury findings were correlated with the types of iaDRF (AO classification). In 159 patients (68.2 %), no SLIL injuries were seen. Minor SLIL injuries were detected in 54 patients (23.2 %), major injuries in 20 patients (8.6 %). No correlation was found between the presence of SLIL lesions and the types of iaDRF. Minor LTIL injuries were seen in 23 patients (9.9 %), major injuries in only 5 patients (2.2 %). The TFCC was altered in 141 patients (60.5 %). Interobserver variability was high for MDCT arthrography in assessing SLIL and TFC lesions, and fair for LTIL lesions. In iaDRF, prevalence of major injuries of the most relevant SLIL is about 9 % as evaluated with CT arthrography. (orig.)

  2. Coronary fly-through or virtual angioscopy using dual-source MDCT data

    NARCIS (Netherlands)

    van Ooijen, Peter M. A.; de Jonge, Gonda; Oudkerk, Matthijs

    2007-01-01

    Coronary fly-through or virtual angioscopy (VA) has been studied ever since its invention in 2000. However, application was limited because it requires an optimal computed tomography (CT) scan and time-consuming post-processing. Recent advances in post-processing software facilitate easy constructio

  3. Association of left renal vein variations and pelvic varices in abdominal MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Koc, Zafer [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Baskent Universitesi Adana Hastanesi, Adana (Turkey); Ulusan, Serife; Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)

    2007-05-15

    The aim of this study was to determine whether left renal vein (LRV) variation is associated with pelvic varices and left ovarian vein (LOV) reflux. Routine abdominal multidetector-row computed tomography scans of 324 women without symptoms of pelvic congestion syndrome were analyzed. Presence and type of LRV variants (circumaortic [CLRV] or retroaortic [RLRV]) were recorded. Diameters of the LRV, ovarian veins (OVs), and parauterine veins were measured and a specific LRV diameter ratio was calculated for each patient. Presence and severity of pelvic varices and LOV reflux were noted. Pelvic varices were detected in 59 (18%) of the total of 324 women, in 7 (37%) of the 19 women with RLRVs, in 7 (29%) of the 24 women with CLRVs, and in 45 (16%) of the 281 women with normal LRVs. The frequency of pelvic varices in the women with LRV variation was significantly higher than that in the group with normal LRV anatomy (33 vs. 16%; p=0.009). The frequency of pelvic varices in the women with RLRVs was also significantly higher than that in the group with normal LRV anatomy (p=0.02). LRV diameter ratio was correlated with presence of pelvic varices and presence of LOV reflux (p=0.0001 for both). This study revealed an association between pelvic varices and LRV variations in a population of predominantly multiparous women. (orig.)

  4. Current role of MDCT in the diagnosis of coronary artery disease (2011). A clinical guideline of the Austrian Societies of Cardiology and Radiology; Aktueller Stellenwert der MSCTA in der Koronargefaessdiagnostik (2011). Klinischer Leitfaden der Oesterreichischen Gesellschaften fuer Kardiologie und Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Hergan, K. [Salzburger Landeskliniken, Paracelsus Medizinische Privatuniv. (Austria). Universitaetsinst. fuer Radiologie; Globits, S. [Landesklinikum St. Poelten (Austria). 3. Medizinische Abt./Kardiologie; Loewe, C. [Medizinische Univ. Wien (AT). Universitaetsklinik fuer Radiodiagnostik] (and others)

    2011-10-15

    The clinical guideline of the Austrian Societies for Cardiology and Radiology on the actual role of MDCT in the diagnosis of coronary artery diseases includes the following issues: CT calcium scoring; CT angiography (CTA) of the coronaries; actually recommended application of MDCR; generally inappropriate use of the technique for specific patients; radiation exposure; structural and organizational framework.

  5. AN IV CATHETER FRAGMENTS DURING MDCT SCANNING OF HUMAN ERROR: EXPERIMENTAL AND REPRODUCIBLE MICROSCOPIC MAGNIFICATION ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Kweon, Dae Cheol [Dept. of Radiologic Science, Shin Heung College, Uijeongbu (Korea, Republic of); Lee, Jong Woong [Dept. of of Radiology, Kyung Hee University Hospital at Gang-dong, Seoul (Korea, Republic of); Choi, Ji Won [Dept. of Radiological Science, Jeonju University, Jeonju (Korea, Republic of); Yang, Sung Hwan [Dept. of of Prosthetics and Orthotics, Korean National College of Rehabilitation and Welfare, Pyeongtaek (Korea, Republic of); Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health College University, Gwangju (Korea, Republic of); Chung, Won Kwan [Dept. of of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of)

    2011-12-15

    The use of intravenous catheters are occasionally complicated by intravascular fragments and swelling of the catheter fragments. We present a patient in whom an intravenous catheter fragments was retrieved from the dorsal metacarpal vein following its incidental CT examination detection. The case of demonstrates the utility of microscopy and multi-detector CT in localizing small of subtle intravenous catheter fragments as a human error. A case of IV catheter fragments in the metacarpal vein, in which reproducible and microscopy data allowed complete localization of a missing fragments and guided surgery with respect to the optimal incision site for fragments removal. These reproducible studies may help to determine the best course of action and treatment for the patient who presents with such a case.

  6. Assessment of the kidney tumor vascular supply by two-phase MDCT-angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ferda, Jiri [Department of Radiology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic)]. E-mail: ferda@fnplzen.cz; Hora, Milan [Department of Urology, Charles University Hospital Plzen, Dr. Edvarda Benese 13, CZ-306 40 Plzen (Czech Republic); Hes, Ondrej [Institute of Pathology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Ferdova, Eva [Department of Radiology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Kreuzberg, Boris [Department of Radiology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic)

    2007-05-15

    Purpose: Current kidney surgery uses less invasive laparoscopic and nephron-sparring procedures. Thus, perfect imaging of the renal vasculature is essential for surgery planning. The aim of our retrospective study was to evaluate the accuracy of 16-detector-row CT-angiography in assessing the vascular anatomy of the kidney with a tumor. Subjects and methods: Referred for computed tomography (CT) because of a suspected renal tumor, 50 consecutive patients (mean age 58.6 years; range 43-82) were enrolled into our retrospective study. All examinations were performed with 16 x 0.75 mm collimation after the intravenous application of 80 ml of a non-ionic contrast material. The imaging protocol contained two-phase scanning in the arterial and then in the venous phase. The vascular anatomy of the kidney with tumor was evaluated using volume rendered (VRT) and maximum intensity images (MIP). Findings were compared with the anatomy found during surgery. Results: Forty-seven patients underwent nephrectomy, with an advanced clinical stage (IV) found in the three remaining ones. Correct topography of the renal hilus, including a number of arteries and veins, and the anatomy of their branching, was described in 46 patients. A very small upper polar artery was overlooked in one patient. The accuracy for the only-arterial was 97.9% and only-venous anatomy was 100%. The parasitic vasculature of the tumor was discovered in 10 cases and all of them were confirmed by surgery (100% accuracy). Macroscopic intravenous spread of the tumor was discovered in two cases, but microscopic intravenous invasion was confirmed during histology of the kidney specimens in another two cases, the overall tumor staging accuracy reaching 95.7%. Conclusion: Two-phase multidetector CT is a valuable tool for assessing vascular supply of the kidney before surgery due to the tumor and can fully replace catheter-based angiography.

  7. Frequency of sternal foramen evaluated by MDCT: a minor variation of great relevance.

    Science.gov (United States)

    Babinski, Marcio A; de Lemos, Leandro; Babinski, Monique S D; Gonçalves, Marianna V T; De Paula, Rafael C; Fernandes, Rodrigo M P

    2015-04-01

    Due to inadvertent cardiac or great vessel injury, sternal foramina may pose as a great hazard during sternal puncture. They can also be misinterpreted as osteolytic lesions in cross-sectional imaging of the sternum. The distribution of these variations differs between populations, but data from Brazilians are scarcely reported. Therefore, this study aimed to verify the frequency of midline sternal foramen and double-ended xiphoid process, as developmental variations, in order to avoid fatal complications following sternal puncture of sternal acupuncture treatment. A total of 114 chest computed tomograms were evaluated. The frequency of midline sternal foramen in a complication risk bearing feature is of approximately 10.5%. The double-ended xiphoid process was present in 17.5%. We conclude that sternal acupuncture should be planned in the region of corpus-previous CT should be done to rule out this variation. Furthermore, we strongly recommend the acupuncture technique which prescribes a safe superficial-oblique approach to the sternum.

  8. Coronary artery bypass graft (CABG) patency: Assessment with high-resolution submillimeter 16-slice multidetector-row computed tomography (MDCT) versus coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Anders, Katharina [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany)]. E-mail: katharina.anders@idr.imed.uni-erlangen.de; Baum, Ulrich [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Schmid, Michael [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Ropers, Dieter [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Schmid, Axel [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Pohle, Karsten [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Daniel, Werner G. [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Bautz, Werner [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Achenbach, Stephan [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany)

    2006-03-15

    Purpose: To investigate the ability of 16-slice multidetector-row computed tomography (MDCT) to visualize coronary artery bypass graft (CABG) patency and to detect bypass stenoses. Materials and methods: Thirty-two patients with 94 grafts (20 mammary artery grafts, 74 venous grafts) were investigated by 16-slice MDCT using a scan protocol with 12 x 0.75 mm slice collimation (pitch 0.3), 420 ms rotation time and simultaneous electrocardiogram (ECG)-registration. One hundred milliliters iodinated contrast agent were injected with a delay according to the individually determined contrast agent transit time. Patients with heart rates above 60 bpm received oral beta-blockade. Cross-sectional images with a slice width of 1.0 mm (0.5 mm increment) were reconstructed using an ECG-gated half-scan reconstruction or a multisegment reconstruction algorithm depending on the heart rate. Bypass grafts were evaluated concerning patency and presence of stenoses {>=}50% diameter reduction on cross-sectional images, multiplanar reformations and maximum intensity projections by two independent observers. Results were compared to coronary bypass angiography. Results: Sixteen-slice MDCT results were compared to those of invasive coronary angiography concerning absence or presence of bypass graft occlusion or relevant stenosis {>=}50% lumen reduction. Coronary CT angiography (CTA) permitted detection of bypass occlusion with 100% sensitivity (28/28) and 98% specificity (64/65). Seventy-eight percent (observer 1) and 84% (observer 2) of all patent grafts were found to be evaluable concerning presence or absence of stenosis. In 34 of 40 (observer 1) and 38 of 43 (observer 2) bypass grafts, high-grade stenoses were correctly ruled out (specificity 85% versus 88%, sensitivity 80% and 82%). Yet, if all patients with either unevaluable grafts/graft anastomosis or relevant graft stenosis were excluded, only 8/32 patients (25%) had fully diagnostic 'negative' graft-CTA. According to

  9. Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey

    Energy Technology Data Exchange (ETDEWEB)

    Granata, Claudio [IRCCS Istituto Giannina Gaslini, Department of Radiology, Genoa (Italy); Origgi, Daniela; Palorini, Federica [Istituto Europeo di Oncologia, Department of Medical Physics, Milan (Italy); Matranga, Domenica [University of Palermo, Department of Sciences for Health Promotion and Mother and Child Care ' ' G. D' Alessandro' ' , Palermo (Italy); Salerno, Sergio [University of Palermo, Department of Medical and Forensic Biopathology and Biotechnologies, Section of Radiology, Palermo (Italy)

    2015-05-01

    Multidetector CT (MDCT) scanners have contributed to the widespread use of CT in paediatric imaging. However, concerns are raised for the associated radiation exposure. Very few surveys on radiation exposure from MDCT studies in children are available. The aim of this study was to outline the status of radiation exposure in children from MDCT practice in Italy. In this retrospective multicentre study we asked Italian radiology units with an MDCT scanner with at least 16 slices to provide dosimetric and acquisition parameters of CT examinations in three age groups (1-5, 6-10, 11-15 years) for studies of head, chest and abdomen. The dosimetric results were reported in terms of third-quartile volumetric CT dose index (CTDI{sub vol}) (mGy), size-specific dose estimate (SSDE) (mGy), dose length product (DLP) (mGy cm), and total DLP for multiphase studies. These results were compared with paediatric European and adult Italian published data. A multivariate analysis assessed the association of CTDI{sub vol} with patient characteristics and scanning modalities. We collected data from 993 MDCT examinations performed at 25 centres. For age groups 1-5 years, 6-10 years and 11-15 years, the CTDI{sub vol}, DLP and total DLP values were statistically significantly below the values observed in our analogous national survey in adults, although the difference decreased with increasing age. CTDI{sub vol} variability among centres was statistically significant (variance = 0.07; 95% confidence interval = 0.03-0.16; P < 0.001). This study reviewed practice in Italian centres performing paediatric imaging with MDCT scanners. The variability of doses among centres suggests that the use of standardised CT protocols should be encouraged. (orig.)

  10. MDCT Evaluation of Left Atrium and Pulmonary Vein in the Patients with Atrial Fibrillation: Comparison with the Non-Atrial Fibrillation Group

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Jung; Choi, Eun Jeong; Ham, Soo Yeon; Oh, Yu Whan; Kim, Young Hoon [Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Yong, Hwan Seok [Korea University Guro Hospital, Seoul (Korea, Republic of); Yang, Kyung Sook [Korea University, Seoul (Korea, Republic of)

    2011-02-15

    The anatomy of the left atrium (LA) and the pulmonary veins (PVs) is important in planning and performing successful electrophysiologic ablation (EPA) for atrial fibrillation (Afib) patients. The authors estimated the findings of LA and PVs of Afib patients by MDCT, and compared these with the findings of LA and PVs of the non- Afib group using coronary CT angiography (CCTA). From September, 2009 to February, 2010, 91 Afib patients underwent PVCT (male: female = 72:19, mean age = 55.0-years-old) before EPA. At same time, 90 patients underwent CCTA (male: female = 73:17, mean age = 59.1- years-old). Two radiologists reviewed and analyzed all axial and 3D images of LA and PVs retrospectively with consensus. The average LA volumes of the Afib group(100.49 mm3) was larger than that of the non-Afib group (78.38 mm3) (p<0.05). The average lengths of the LA right wall in the Afib group (40.25 mm) was longer than that of the non-Afib group (37.3 mm) (p<0.05). The average distances between the PV ostium and first segmental bifurcation of the Lt superior PV (LSPV) and the RSPV were shorter in the Afib group (LSPV, 19.38 mm: RSPV, 11.49 mm) than in the non-Afib group (LSPV, 23.23 mm: RSPV, 14.25 mm) (p<0.05). There were higher incidences of anomalous branches such as ostial, accessory branches, or common ostia in the Afib group versus the non-Afib group (p<0.05). In Afib group, variable parameters of LA and PVs were obtained and estimated by MDCT, and there was statistically significant difference in the parameters of LA and PVs between Afib and non-Afib groups

  11. 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

  12. Optimization of the scan protocol in the measurements of coronary artery calcium

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, L.C.G.; Lopes, R.T. [Coordenacao do Programa de Pos-graduacao em Engenharia (LIN/COPPE/UFRJ), RJ (Brazil). Lab. de Instrumentacao Nuclear; Gottlieb, I.; Carvalho, F.M. de [Clinica de Diagnostico por Imagem, Rio de Janeiro, RJ (Brazil); Kodlulovich, S., E-mail: simone@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Mecca, F.A. [Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    The aim of this study was to evaluate the influence of the tube current applied for studies of calcium score. The research was carried out in a private clinic of Rio de Janeiro, using a 64-slice MDCT scanner and an anthropomorphic cardiac CT phantom. In all images, the Agatston score, the volume and mass of the calcifications, and the noise for each current tube was determined. The average CT attenuation number obtained for all tube currents was 261.6 {+-} 3.2 HU for the CaHA density insert and -0.2 HU {+-} 2.0 for the water insert. The images obtained at lower tube currents were noisier and grainier than those obtained at higher tube currents. However no significant differences were found in the calcium measurements, which suggest a high potential of patient dose reduction, around 50%, without compromising diagnostic information. (author)

  13. 小肠活动性出血的MDCT诊断%The diagnostic performance of MDCT in active small intestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    林承露; 刘术松; 涂苍慨

    2012-01-01

    solutions drinking (as negative contrast agent) were executed before CT scanning, except for patients presenting to the emergency room. Slice thickness of 2. 0 mm reconstruction, and multi-plane reformation were performed to help searching for the abnormal intestinal wall and enteric cavity. Presence and location of bleeding and likely cause of hemorrhage identified at MDCT were compared with the surgical or endoscopic findings. Results Compared with plain scanning, intraluminal hyperatrenuating material in small bowel at arterial phase, which the shape and optical density altered at venous phase, was the direct signs of active bleeding. MDCT demonstrated active bleeding in 13 of 15 patients, and local thickening wall of intestine, which was enhanced obviously, occurred after contrast material injection in ail patients. 1 he sensitivity, specificity, positive predictive value- and negative predictive value of MDCT in fixing active bleeding were 97% , 100% . 100% . and 88% . respectively. Findings of MDCT and surgical or endoscopic results were concordant for fixing the bleeding point. Conclusion The sign of intraluminal hyperattenuating material in small bowel at arterial phase, which the shape and optical density altered at venous phase, was the characteristic signs of active bleeding. The local thickening wall of intestine which was enhanced obviously occurred after contrast material injection hinted the location of active hemorrhage. MDCT is very useful to fix the location of active bleeding, as well as the potential cause.

  14. A new Screening Tool for Detecting Early Atheroslerosis

    Institute of Scientific and Technical Information of China (English)

    Charlie W.Shaeffer; Palm Spring CA; Thach Nguyen

    2006-01-01

    @@ In a study published in the current issue of the Journal of Geriatric Cardiology, Ang and co-investigators used the highresolution 64-slice CT coronary angiography to detect coronary lesions in a group of patients with atypical angina.1 The clinical data of these patients were also used to calculate their risk according the Framingham and PROCAM scoring system.2,3 As the cohort is composed with a majority of low risk patients with atypical angina, only a small minority of the patients were classified as having medium and high risk. The results showed that MDCT uncovered 18% either significant lesions (>50% stenosis) or calcifications (>400Agatston units)in the low risk patients and 33% in the medium and high risk subgroups.

  15. Step-and-shoot prospectively ECG-gated versus retrospectively ECG-gated with tube current modulation coronary CT angiography using the 128-slice MDCT: comparison of image quality and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Dong Wook (Dept. of Family Medicine, Medial Research Institute, Pusan National Univ. Yangsan Hospital, School of Medicine, Gyeongsangnam-do, (Korea, Republic of)); Choo, Ki Seok; Baik, Seung Kug; Kim, Yong Woo; Jeon, Ung Bae (Dept. of Radiology, Medial Research Institute, Pusan National Univ. Yangsan Hospital, School of Medicine, Gyeongsangnam-do, (Korea, Republic of)), email: kschoo0618@naver.com; Kim, Jeong Soo (Dept. of Cardiology, Medial Research Institute, Pusan National Univ. Yangsan Hospital, School of Medicine, Gyeongsangnam-do (Korea, Republic of)); Lim, Soo Jin (Dept. of Cardiology, Kim Hae Joongang Hospital, Gyeongsangnam-do (Korea, Republic of))

    2011-02-15

    Background: Little is known regarding image quality and the required radiation dose for step-and-shoot and retrospective coronary computed tomography angiography (CCTA) with tube current modulation (TCM) in 128-slice multidetector CT (MDCT) coronary angiography. Purpose: To compare image quality and radiation dose in patients who underwent 128-slice MDCT by the step-and- shoot method with those in patients who underwent 128-slice MDCT with retrospective CCTA with TCM. Material and Methods: CCTA obtained with 128-slice MDCT was retrospectively evaluated in 160 patients. Two independent reviewers separately scored the subjective image quality of the coronary artery segments (1, excellent; 4, poor) for step-and-shoot (68, mean heart rate [HR]: 59.3+-6.8) and retrospective CCTA with TCM (77, mean HR: 59.1+-9.8). Interobserver variability was calculated. Effective radiation doses of both scan techniques were calculated with dose-length product. Results: There was good agreement for quality scores of coronary artery segment images between the independent reviewers (k=0.72). The number of coronary artery segments that could not be evaluated was 2.85% (27 of 947) in the step-and-shoot and 1.87% (20 of 1071) in retrospective CCTA with TCM. Image quality scores were not significantly different (P>.05). Mean patient radiation dose was 63% lower for step-and-shoot (1.94+-0.70 mSv) than for retrospective CCTA with TCM (4.51+-1.18 mSv) (P<0.0001). For patients who underwent step-and-shoot or retrospective CCTA with TCM, an average HR of 63.5 beats per minute was identified as the threshold for the prediction of non-diagnostic image quality for both protocols. There were no significant differences in the image quality of both methods between obese (body mass index [BMI>=25) and non-obese patients (BMI<25), but radiation doses were higher in the obesity group than in the non-obesity group for both methods. Conclusion: Both step-and-shoot and retrospective CCTA with TCM using 128

  16. MDCT evaluation of aortic root and aortic valve prior to TAVI. What is the optimal imaging time point in the cardiac cycle?

    Energy Technology Data Exchange (ETDEWEB)

    Jurencak, Tomas; Turek, Jakub; Nijssen, Estelle C. [Maastricht University Medical Center, Department of Radiology, P. Debyelaan 25, P.O. Box 5800, AZ, Maastricht (Netherlands); Kietselaer, Bastiaan L.J.H. [Maastricht University Medical Center, Department of Radiology, P. Debyelaan 25, P.O. Box 5800, AZ, Maastricht (Netherlands); Maastricht University Medical Center, CARIM School for Cardiovascular Diseases, Maastricht (Netherlands); Maastricht University Medical Center, Department of Cardiology, Maastricht (Netherlands); Mihl, Casper; Kok, Madeleine; Wildberger, Joachim E.; Das, Marco [Maastricht University Medical Center, Department of Radiology, P. Debyelaan 25, P.O. Box 5800, AZ, Maastricht (Netherlands); Maastricht University Medical Center, CARIM School for Cardiovascular Diseases, Maastricht (Netherlands); Ommen, Vincent G.V.A. van [Maastricht University Medical Center, Department of Cardiology, Maastricht (Netherlands); Garsse, Leen A.F.M. van [Maastricht University Medical Center, Department of Cardiothoracic Surgery, Maastricht (Netherlands)

    2015-07-15

    To determine the optimal imaging time point for transcatheter aortic valve implantation (TAVI) therapy planning by comprehensive evaluation of the aortic root. Multidetector-row CT (MDCT) examination with retrospective ECG gating was retrospectively performed in 64 consecutive patients referred for pre-TAVI assessment. Eighteen different parameters of the aortic root were evaluated at 11 different time points in the cardiac cycle. Time points at which maximal (or minimal) sizes were determined, and dimension differences to other time points were evaluated. Theoretical prosthesis sizing based on different measurements was compared. Largest dimensions were found between 10 and 20 % of the cardiac cycle for annular short diameter (10 %); mean diameter (10 %); effective diameter and circumference-derived diameter (20 %); distance from the annulus to right coronary artery ostium (10 %); aortic root at the left coronary artery level (20 %); aortic root at the widest portion of coronary sinuses (20 %); and right leaflet length (20 %). Prosthesis size selection differed depending on the chosen measurements in 25-75 % of cases. Significant changes in anatomical structures of the aortic root during the cardiac cycle are crucial for TAVI planning. Imaging in systole is mandatory to obtain maximal dimensions. (orig.)

  17. 急性胰腺炎64层螺旋CT灌注成像研究%Acute Pancreatitis: 64-slice Spiral CT Perfusion Imaging

    Institute of Scientific and Technical Information of China (English)

    姜海峰; 郭顺林; 周怀琪; 王刚; 张安; 徐风

    2009-01-01

    目的 探讨64层螺旋CT灌注成像在急性胰腺炎诊断中的作用.方法 分别对胰腺正常者30例和急性胰腺炎患者28例行Siemens 64层螺旋CT胰腺灌注检查,采用Siemens Body Perfusion软件测量所有病例的胰头部、胰体尾部的CT灌注参数:血流量(blood flow,BF)、血流容积(blood volume,BV)、灌注起始时间(time to start,TTS)、达峰时间(time to peak,TTP)、渗透性(permeability,P)、patlak血流容积(patlak blood volume,pBV)的平均值, 并进行统计学分析.结果 Siemens灌注软件计算所得时间-密度曲线(density-time curve,TDC)符合数据分析要求.统计数据结果显示急性胰腺炎组胰头部和体尾部的BF、BV、 pBV明显低于正常胰腺组,而其渗透性高于正常胰腺组, 差异均有显著的统计学意义(P0.05);急性胰腺炎组、正常胰腺组各自的胰头部与胰体尾部之间各灌注参数 无统计学意义(P>0.05).结论 64层螺旋CT灌注成像能够反映急性胰腺炎的血流灌注改变,对其临床的早期诊断有重要的指导意义.

  18. 64-slices spiral CT for detection of patent foramen ovale%64层螺旋CT对卵圆孔未闭的检测

    Institute of Scientific and Technical Information of China (English)

    毛定飚; 滑炎卿; 吴昊; 葛虓俊; 唐平; 郑向鹏; 张国桢

    2010-01-01

    @@ 近年来国外文献报道卵圆孔未闭(patent foramen ovale,PFO)的存在与反常栓塞、缺血性脑卒中、偏头痛、潜水减压病等的发生密切相关,与冠状动脉旁路移植术及各种心、肺手术后不明原因的卒中或猝死也有关系[1-2].本研究通过对186例患者进行心电门控64层CT心脏成像探讨CT检测PFO的可行性.

  19. Hemodynamic study of hepatocellular car-cinoma nodules by multi-slice spiral computed tomographic perfusion

    Institute of Scientific and Technical Information of China (English)

    马国林

    2013-01-01

    Objective To analyze the 64-slice computed tomographic(CT) perfusion parameters of hepatocellular carcinoma(HCC) nodule so as to assess the diagnostic value of hemodynamic changes of HCC nodule by this perfusion

  20. Study on motion artifacts in coronary arteries with an anthropomorphic moving heart phantom on an ECG-gated multidetector computed tomography unit

    NARCIS (Netherlands)

    Greuter, MJW; Dorgelo, J; Tukker, WGJ; Oudkerk, M

    2005-01-01

    Acquisition time plays a key role in the quality of cardiac multi-detector computed tomography (MDCT) and is directly related to the rotation time of the scanner. The purpose of this study is to examine the influence of heart rate and a multisector reconstruction algorithm on the image quality of co

  1. MDCT after-treatment to assess the hypopharyngeal carcinoma%多层螺旋CT后处理技术对下咽癌评估的价值

    Institute of Scientific and Technical Information of China (English)

    曹汉海; 丁海霞; 彭洪娟

    2011-01-01

    目的 探讨多层螺旋CT后处理技术对下咽癌诊断及周围组织侵犯的评估价值.方法 回顾性分析23例经病理证实的下咽癌CT横轴住图像及其多平面重建(MPR)和透明化容积重组技术(VRT)重建图像的病历资料,对下咽癌的浸润范围进行评估.结果 23例轴位图像下咽部均可见异常软组织影,其中8例可见喉软骨破坏,13例可见颈部淋巴结转移,MPR和透明化VRT重建显示17例梨状窝扭曲、变窄甚至消失.结论 CT轴位图像结合MPR和透明化VRT重建图像能更加准确、直观地显示下咽癌的浸润范围,更准确的评估下咽癌.%Objective To evaluate the clinical application of MDCT after-treatment technology in the evaluation of hypopharyngeal carcinoma and its invasibility. Methods Twenty-three patients with hypopharyngeal carcinoma confirmed by pathology underwent CT scans. Images of axial, multiplaner reconstruction (MPR) and transparent 3D volume rendering technique (VRT) of all patients were retrospectively analyzed. Results Of 23 cases, there was abnormal soft tissue shown in axial images, including 8 cases of visible laryngeal cartilage destruction and 13 cases of visible cervical lymph node metastases. Also, MPR and transparent VRT reconstruction demonstrated 17 cases of distorted, narrowed,or even an absent piriform sinus. Conclusion CT axial images combining MPR and transparent VRT reconstruction can accurately and directly show infiltrations of hypopharyngeal carcinoma.

  2. A model for quantitative correction of coronary calcium scores on multidetector, dual source, and electron beam computed tomography for influences of linear motion, calcification density, and temporal resolution : A cardiac phantom study

    NARCIS (Netherlands)

    Greuter, M. J. W.; Groen, J. M.; Nicolai, L. J.; Dijkstra, H.; Oudkerk, M.

    2009-01-01

    Purpose: The objective of this study is to quantify the influence of linear motion, calcification density, and temporal resolution on coronary calcium determination using multidetector computed tomography (MDCT), dual source CT (DSCT), and electron beam tomography (EBT) and to find a quantitative me

  3. Isolated Multiple Fragmented Cricoid Fracture Associated with External Blunt Neck Trauma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Hoon; Hwang, Yoon Joon; Kim, Yong Hoon; Seo, Jung Wook; Cho, Hyeon Je; Kim, Yeon Soo [Inje University School of Medicine, Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2010-08-15

    Blunt laryngeal trauma is a relatively uncommon but possibly life-threatening injury. An isolated cricoid fracture associated with blunt trauma is rare. We report a case of an isolated multiple fragmented cricoid cartilage fracture that developed in a 20-year-old man after a blunt neck trauma that occurred during a baseball game and was diagnosed by 64-slice multidetector computed tomography (MDCT)

  4. Feasibility of automatic assessment of four-chamber cardiac function with MDCT: Initial clinical application and validation

    Energy Technology Data Exchange (ETDEWEB)

    Abadi, Sobhi [Radiology Department, Rambam Health Care Campus and Technion - Israel Institute of Technology, P.O.B. 9602, Haifa 31096 (Israel)], E-mail: s_abadi@rambam.health.gov.il; Roguin, Ariel [Cardiology Department, Rambam Health Care Campus and Technion - Israel Institute of Technology, P.O.B. 9602, Haifa 31096 (Israel); Engel, Ahuva [Radiology Department, Rambam Health Care Campus and Technion - Israel Institute of Technology, P.O.B. 9602, Haifa 31096 (Israel); Lessick, Jonathan [Cardiology Department, Rambam Health Care Campus and Technion - Israel Institute of Technology, P.O.B. 9602, Haifa 31096 (Israel)], E-mail: j_lessick@rambam.health.gov.il

    2010-04-15

    Background: The ability to perform a simultaneous analysis of ventricular and atrial volumes may provide clinically useful information for diagnosis and prognosis. We aimed to evaluate the feasibility and clinical value of a novel algorithm that performs fully automatic evaluation of the four cardiac chambers and myocardium from gated CT datasets. Methods: 50 patients were studied-Group 1: 30 consecutive unselected patients, Group 2A: 10 patients after myocardial infarction and Group 2B: 10 normal controls. Fully automatic, segmentation of the heart was performed with a model-based segmentation algorithm requiring no user input other than loading the datasets. Qualitative and quantitative evaluation of segmentation quality was performed. Left ventricular (LV) and right ventricular (RV) stroke volumes (SV) were compared. Results: Overall, segmentation succeeded in all patients although 11/500 (2.2%) cardiac chambers achieved poor segmentation grading. Correlation coefficients between automatic and manually derived volumes were excellent (r > 0.98) for all chambers. Bland-Altman analysis showed minimal bias (-1.0 ml, 0.4 ml, -1.8 ml) for the LV and RV, and right atria, respectively, with mild overestimation of LV myocardial volume (5.2 ml). Significant, yet consistent, overestimation of left atrial volume (23.6 ml) due to inclusion of proximal pulmonary veins was observed. LV and RV ejection fraction (r = 0.91 and 0.98) and SV (r = 0.98 and 0.99) also correlated closely with minimal bias (<2%). Most significantly, LV SV (91.0 {+-} 21.6 ml) correlated highly with RV SV (81.7 {+-} 18.2 ml, r = 0.86). Outliers could usually be explained by valvular regurgitation. Conclusions: Fully automatic segmentation of all cardiac chambers can be achieved with high accuracy over multiple cardiac phases, enabling reliable comprehensive evaluation of four-chamber cardiac function.

  5. Effect of mixing scanner types and reconstruction kernels on the characterization of lung parenchymal pathologies: emphysema, interstitial pulmonary fibrosis and normal non-smokers

    Science.gov (United States)

    Xu, Ye; van Beek, Edwin J.; McLennan, Geoffrey; Guo, Junfeng; Sonka, Milan; Hoffman, Eric

    2006-03-01

    In this study we utilize our texture characterization software (3-D AMFM) to characterize interstitial lung diseases (including emphysema) based on MDCT generated volumetric data using 3-dimensional texture features. We have sought to test whether the scanner and reconstruction filter (kernel) type affect the classification of lung diseases using the 3-D AMFM. We collected MDCT images in three subject groups: emphysema (n=9), interstitial pulmonary fibrosis (IPF) (n=10), and normal non-smokers (n=9). In each group, images were scanned either on a Siemens Sensation 16 or 64-slice scanner, (B50f or B30 recon. kernel) or a Philips 4-slice scanner (B recon. kernel). A total of 1516 volumes of interest (VOIs; 21x21 pixels in plane) were marked by two chest imaging experts using the Iowa Pulmonary Analysis Software Suite (PASS). We calculated 24 volumetric features. Bayesian methods were used for classification. Images from different scanners/kernels were combined in all possible combinations to test how robust the tissue classification was relative to the differences in image characteristics. We used 10-fold cross validation for testing the result. Sensitivity, specificity and accuracy were calculated. One-way Analysis of Variances (ANOVA) was used to compare the classification result between the various combinations of scanner and reconstruction kernel types. This study yielded a sensitivity of 94%, 91%, 97%, and 93% for emphysema, ground-glass, honeycombing, and normal non-smoker patterns respectively using a mixture of all three subject groups. The specificity for these characterizations was 97%, 99%, 99%, and 98%, respectively. The F test result of ANOVA shows there is no significant difference (p <0.05) between different combinations of data with respect to scanner and convolution kernel type. Since different MDCT and reconstruction kernel types did not show significant differences in regards to the classification result, this study suggests that the 3-D AMFM can

  6. Cuantificación del signo de la arteria cerebral media hiperdensa con TCMD Quantification of hyperdense middle cerebral artery sign by multidetector computed tomography (MDCT.

    Directory of Open Access Journals (Sweden)

    Francisco Meli

    2011-12-01

    Full Text Available Objetivos. Obtener una cuantificación absoluta y relativa de la densidad en el signo de la arteria cerebral media (ACM con el fin de lograr un valor objetivo para el diagnóstico temprano de isquemia cerebral aguda con TCMD. Materiales y Métodos. Se incluyeron 40 pacientes, 20 con sospecha de isquemia cerebral aguda (edad media 73,4 años y 20 pacientes controles (edad media 71,2 años, p=0,63, que se realizaron TC cerebral con un equipo de 64 filas de detectores. La cuantificación absoluta se realizó midiendo la densidad en UH en el segmento de la ACM visualmente de mayor densidad. También se midió la densidad en el mismo segmento de la ACM contralateral para calcular la diferencia entre ambas arterias (cuantificación relativa. Resultados. En pacientes casos, la densidad media de la ACM afectada (62,5 UH, IC 99%: 46,2-78,7 fue mayor que la de la ACM contralateral (39,3 UH, IC 99%: 33,3-45,3 (p=0,0004 y también fue mayor en comparación con la ACM en pacientes controles (44,7 UH, IC 99%: 37,4-52 (p=0,0045. En la cuantificación relativa, la diferencia media entre la densidad de la ACM afectada y la de ACM contralateral en los pacientes casos fue de 23,2 UH (IC 95%: 11,7-34,7, mientras que, en pacientes controles, la diferencia media entre la densidad de la ACM derecha y la ACM izquierda fue 5,2 UH (IC 95%: 2,4-8,4 (diferencia: 17,8 UH, p=0,0032, IC 95%: 6,8-28,8. Conclusión. Mostramos diferencias significativas (absolutas y relativas en la densidad de la ACM en pacientes con sospecha de isquemia cerebral aguda en comparación con sujetos normales.Purposes. To obtain absolute and relative quantification values of density in the middle cerebral artery (MCA sign, in order to obtain an objective value for an early diagnosis of acute ischemic stroke using MDCT. Material and Methods. Forty adult patients, 20 with suspected diagnosis of acute ischemic stroke (mean age: 73.4 years and 20 controls (mean age: 71.2 years, p=0.63, underwent brain

  7. Planimetric Measurement of the Regurgitant Orifice Area Using Multidetector CT for Aortic Regurgitation: a Comparison with the Use of Echocardiography

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    Jeon, Min Hee; Choe, Yeon Hyeon; Cho, Soo Jin; Park, Seung Woo; Park, Pyo Won; Oh, Jae K. [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2010-04-15

    This study compared the area of the regurgitant orifice, as measured by the use of multidetector-row CT (MDCT), with the severity of aortic regurgitation (AR) as determined by the use of echocardiography for AR. In this study, 45 AR patients underwent electrocardiography- gated 40-slice or 64-slice MDCT and transthoracic or transesophageal echocardiography. We reconstructed CT data sets during mid-systolic to enddiastolic phases in 10% steps (20% and 35-95% of the R-R interval), planimetrically measuring the abnormally opened aortic valve area during diastole on CT reformatted images and comparing the area of the aortic regurgitant orifice (ARO) so measured with the severity of AR, as determined by echocardiography. In the 14 patients found to have mild AR, the ARO area was 0.18{+-} 0.13 cm{sup 2} (range, 0.04-0.54 cm{sup 2}). In the 15 moderate AR patients, the ARO area was 0.36 {+-} 0.23 cm{sup 2} (range, 0.09-0.81 cm{sup 2}). In the 16 severe AR patients, the ARO area was 1.00 {+-} 0.51 cm{sup 2} (range, 0.23-1.84 cm{sup 2}). Receiver-operator characteristic curve analysis determined a sensitivity of 85% and a specificity of 82%, for a cutoff of 0.47 cm{sup 2}, to distinguish severe AR from less than severe AR with the use of CT (area under the curve = 0.91; 95% confidence interval, 0.84-1.00; p < 0.001). Planimetric measurement of the ARO area using MDCT is useful for the quantitative evaluation of the severity of aortic regurgitation.

  8. Added value of 80 kVp images to averaged 120 kVp images in the detection of hepatocellular carcinomas in liver transplantation candidates using dual-source dual-energy MDCT: Results of JAFROC analysis

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    Park, Ji Hoon [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Kim, Se Hyung, E-mail: shkim@radcom.snu.ac.kr [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Park, Hee Sun [Department of Radiology, Konkuk University Hospital (Korea, Republic of); Kim, Gi Hyeon [Department of Radiology, Chung-Ang University Hospital (Korea, Republic of); Lee, Jae Young; Lee, Jeong Min; Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital (Korea, Republic of); The Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of)

    2011-11-15

    Background: To assess the added value of 80 kVp images to weighted average 120 kVp images for detecting hepatocellular carcinomas (HCCs) using dual-source, dual-energy MDCT. Materials and methods: Forty-one HCCs in 42 patients who underwent liver transplantation (LT) were included. All patients underwent quadruple-phase CT using a 64-row dual-source, dual-energy MDCT with 80 kVp and 140 kVp. For 120 kVp, a linear blending ratio of 0.3 was chosen. Interval reviews for both simulated 120 kVp images without and with pure 80 kVp data were performed independently by two radiologists. They detected HCCs using a 4-point confidence scale. Tumor-to-liver contrast-to-noise ratio (CNR) was calculated and compared between the 80 kVp and simulated 120 kVp images. The additional diagnostic value of 80 kVp images was evaluated by jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis. Results: There were 41 HCCs on pathology and 37 of the 41 HCCs were depicted on CT scan. The mean CNR of the 37 HCCs in late arterial and portal-phase images was significantly better in the 80 kVp images than in 120 kVp images. The average JAFROC figure of merit, however, was not significantly improved when 80 kVp was added. Furthermore, the number of false-positives was significantly increased in reader 1 when adding 80 kVp data. Conclusion: The addition of 80 kVp CT images to simulated 120 kVp images did not significantly improve the detection of HCCs despite of the significantly better CNR of 80 kVp images.

  9. Calcium score of small coronary calcifications on multidetector computed tomography: Results from a static phantom study

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    Groen, J.M., E-mail: jaap.groen@slaz.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Kofoed, K.F., E-mail: kkofoed@dadlnet.dk [Department of Cardiology and Radiology, Rigshospitalet, University of Copenhagen (Denmark); Zacho, M., E-mail: dls332089@vip.cybercity.dk [Department of Cardiology and Radiology, Rigshospitalet, University of Copenhagen (Denmark); Vliegenthart, R., E-mail: r.vliegenthart@umcg.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Willems, T.P., E-mail: t.p.willems@umcg.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Greuter, M.J.W., E-mail: m.j.w.greuter@umcg.nl [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands)

    2013-02-15

    Introduction: Multi detector computed tomography (MDCT) underestimates the coronary calcium score as compared to electron beam tomography (EBT). Therefore clinical risk stratification based on MDCT calcium scoring may be inaccurate. The aim of this study was to assess the feasibility of a new phantom which enables establishment of a calcium scoring protocol for MDCT that yields a calcium score comparable to the EBT values and to the physical mass. Materials and methods: A phantom containing 100 small calcifications ranging from 0.5 to 2.0 mm was scanned on EBT using a standard coronary calcium protocol. In addition, the phantom was scanned on a 320-row MDCT scanner using different scanning, reconstruction and scoring parameters (tube voltage 80–135 kV, slice thickness 0.5–3.0 mm, reconstruction kernel FC11–FC15 and threshold 110–150 HU). The Agatston and mass score of both modalities was compared and the influence of the parameters was assessed. Results: On EBT the Agatston and mass scores were between 0 and 20, and 0 and 3 mg, respectively. On MDCT the Agatston and mass scores were between 0 and 20, and 0 and 4 mg, respectively. All parameters showed an influence on the calcium score. The Agatston score on MDCT differed 52% between the 80 and 135 kV, 65% between 0.5 and 3.0 mm and 48% between FC11 and FC15. More calcifications were detected with a lower tube voltage, a smaller slice thickness, a sharper kernel and a lower threshold. Based on these observations an acquisition protocol with a tube voltage of 100 kV and two reconstructions protocols were defined with a FC12 reconstruction kernel; one with a slice thickness of 3.0 mm and a one with a slice thickness of 0.5 mm. This protocol yielded an Agatston score as close to the EBT as possible, but also a mass score as close to the physical phantom value as possible, respectively. Conclusion: With the new phantom one acquisition protocol and two reconstruction protocols can be defined which produces

  10. Initial research on coronary artery calcification of the community population in Beijing with MDCT%北京社区自然人群冠状动脉钙化的多排螺旋CT初步研究

    Institute of Scientific and Technical Information of China (English)

    陈雄彪; 吕滨; 鲁锦国; 唐翔; 侯志辉; 孙明利; 李莹; 陈祚

    2010-01-01

    目的 利用64排螺旋CT(64 multi-detector computed tomography,64-MDCT)初步评价北京社区人群的冠状动脉钙化(coronary artery calcium,CAC)情况.方法 对北京地区社区人群进行抽样研究,利用64-MDCT(GE,LightSpeed VCT)对1 480例研究对象进行冠状动脉钙化扫描,应用 Agatston积分法分别计算其冠状动脉钙化积分(coronary artery calcium score,CACS),观察CAC分布特征,以性别及年龄分组比较组间的CAC差别.结果 总样本CAC阳性率为29.9%;男性组的CAC阳性率为37.6%,明显高于女性组的23.1%(P<0.01).同一性别各年龄组的CACS均呈正偏态分布,CAC阳性率和CACS均随年龄增加而显著增高(P<0.01);40~、50~岁组的CAC阳性率以及40~、50~、60~岁组的CACS存在性别间的显著性差异.1 480例研究对象有206例(13.9%)为单支钙化,237例(16.0%)为多支钙化;总样本共5 920支冠状动脉中以前降支(26.8%)及右冠状动脉(13.5%)钙化阳性率为高(P<0.01).结论 64-MDCT能够方便、快速地量化检测社区人群的CAC的发病情况,评价人群中的CAC分布特征及规律,从而初步判定人群中的冠状动脉粥样硬化病变的流行病学特征.

  11. Estimation of sex and age of 'virtual skeletons'-a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Grabherr, Silke [University Hospital of Lausanne, Institute of Forensic Medicine, Lausanne (Switzerland)]|[University of Bern, Institute of Forensic Medicine, Bern (Switzerland)]|[University Hospital of Lausanne, Service of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Cooper, Christine; Ulrich-Bochsler, Susi [University of Bern, Institute for the History of Medicine, Historical Anthropology, Bern (Switzerland); Uldin, Tanya [Service of Osteo-Archaeology, Aesch (Switzerland); Ross, Steffen; Oesterhelweg, Lars; Bolliger, Stephan; Thali, Michael J. [University of Bern, Institute of Forensic Medicine, Bern (Switzerland); Christe, Andreas [University of Bern, Institute of Forensic Medicine, Bern (Switzerland)]|[University of Bern, Institute of Diagnostic Radiology, Bern (Switzerland); Schnyder, Pierre [University Hospital of Lausanne, Service of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Mangin, Patrice [University Hospital of Lausanne, Institute of Forensic Medicine, Lausanne (Switzerland)

    2009-02-15

    This article presents a feasibility study with the objective of investigating the potential of multi-detector computed tomography (MDCT) to estimate the bone age and sex of deceased persons. To obtain virtual skeletons, the bodies of 22 deceased persons with known age at death were scanned by MDCT using a special protocol that consisted of high-resolution imaging of the skull, shoulder girdle (including the upper half of the humeri), the symphysis pubis and the upper halves of the femora. Bone and soft-tissue reconstructions were performed in two and three dimensions. The resulting data were investigated by three anthropologists with different professional experience. Sex was determined by investigating three-dimensional models of the skull and pelvis. As a basic orientation for the age estimation, the complex method according to Nemeskeri and co-workers was applied. The final estimation was effected using additional parameters like the state of dentition, degeneration of the spine, etc., which where chosen individually by the three observers according to their experience. The results of the study show that the estimation of sex and age is possible by the use of MDCT. Virtual skeletons present an ideal collection for anthropological studies, because they are obtained in a non-invasive way and can be investigated ad infinitum. (orig.)

  12. Prevalence and Distribution of Abdominal Aortic Calcium by Sex and Age-Group in a Community-based Cohort (From The Framingham Heart Study)

    OpenAIRE

    Chuang, Michael L.; Massaro, Joseph M.; Levitzky, Yamini S.; Fox, Caroline S.; Manders, Emily S.; Hoffmann, Udo; O'Donnell, Christopher J.

    2012-01-01

    Abdominal aortic calcium (AAC) is associated with incident cardiovascular disease but the age and sex-related distribution of AAC in a community-dwelling population free of standard cardiovascular disease risk factors has not been described. A total of 3285 participants (aged 50.2±9.9 years) in the Framingham Heart Study Offspring and Third Generation cohorts underwent abdominal multidetector computed tomography (MDCT) scanning during 1998-2005. The presence and amount of AAC was quantified (...

  13. Accuracy of multidetector row computed tomography for the diagnosis of acute bowel ischemia in a non-selected study population

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, Walter [University Hospital Basel, Institute of Diagnostic Radiology, Basel (Switzerland); Clinic Stephanshorn, Medical Radiology Center, St. Gallen (Switzerland); Hauser, Andreas; Steinbrich, Wolfgang [University Hospital Basel, Institute of Diagnostic Radiology, Basel (Switzerland)

    2004-12-01

    The diagnostic accuracy of multidetector row computed tomography for the prospective diagnosis of acute bowel ischemia in the daily clinical routine was analyzed. Two hundred ninety-one consecutive patients with an acute or subacute abdomen, examined by MDCT over a time period of 5 months, were included in the study. All original CT diagnoses made during the daily routine by radiological generalists were compared to the final diagnoses made by using all available medical information from endoscopies, surgical interventions, autopsies and follow-up. Finally, all CT examinations of patients with an initial CT diagnosis or a final diagnosis of bowel ischemia were reread by a radiologist specialized in abdominal imaging in order to analyze the CT findings and the reasons for initially false negative or false positive CT readings. Twenty-four patients out of 291 (8.2%) had acute bowel ischemia. The age of affected patients ranged from 50 to 94 years (mean age: 75.7 years). Eleven patients were male, and 13 female. Reasons for acute bowel ischemia were: arterio-occlusive (n=11), non-occlusive (n=5), strangulation (n=2), over-distension (n=3) and radiation (n=3). The prospective sensitivity, specificity, PPV and NPV of MDCT for the diagnosis of acute bowel ischemia in the daily routine were 79.17, 98.51, 90.48 and 98.15%. MDCT reaches a similarly high sensitivity in diagnosing acute bowel as angiography. Furthermore, it has the advantage of being helpful in most of its clinical differential diagnoses and of being less invasive with the consecutive possibility of being used earlier in the diagnostic process with all the resulting positive effects on the patients prognosis. Therefore, nowadays MDCT should probably be used as the first step imaging modality of choice in patients with suspected acute bowel ischemia. (orig.)

  14. Frecuencia y tipo de fracturas en traumatismos maxilofaciales: Evaluación con Tomografía Multislice con reconstrucciones multiplanares y tridimensionales Frequency and types of fractures in maxillofacial traumas: Assessment using MDCT with multiplanar and 3D reconstructions

    Directory of Open Access Journals (Sweden)

    Gabriela Tomich

    2011-12-01

    multiplanar imaging techniques for a proper evaluation. Objectives. To describe frequency and types of fractures in a series of patients with MFT evaluated by multi-slice computed tomography (MDCT with multiplanar and 3D reconstructions. Materials and Methods. Facial bone CTs ordered for MFT by the Emergency Department from June 2008 to December 2009 were retrospectively reviewed. The following data were obtained: age, gender, cause of trauma, presence and type of fractures. Patients were evaluated with an 8-channel MDCT. Multiplanar reconstructions were performed in all cases using high resolution bone window and soft tissue window, as well as 3D reconstructions. Results. One-hundred and thirty-seven CTs were performed for MFT: 78 (57% showed 131 fractures. Of these 78 patients, 52 (66% were males and 26 (34% were females; mean age 33 years old (range: 14-90 yrs.. Causes: 58 % were injuries from traffic accidents; 24% were injuries from fights; 13% were sport injuries; and 7% were due to miscellaneous etiologies. Type and frequency of fractures: 18.3% were orbital floor fractures, 16% were maxillary sinus fractures, 15.3% were nasal fractures, 13% were jaw fractures, 9.2% were orbital fractures, and 12.3% were fractures of the zygomatic-malar complex; two cases of Le Fort II-III fractures were also observed. Conclusions. Fractures were more common in males, in the age range from 15 to 35 years old. Most fractures, and the most complex ones, were caused by traffic accidents. The most common fracture, either isolated or associated with other fractures, was the orbital floor fracture.

  15. Significance of sagittal reformations in routine thoracic and abdominal multislice CT studies for detecting osteoporotic fractures and other spine abnormalities

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    Mueller, Dirk; Bauer, Jan S.; Zeile, Martin; Rummeny, Ernst J. [Klinikum Rechts der Isar, TU Muenchen, Department of Radiology, Muenchen (Germany); Link, Thomas M. [Musculoskeletal and Quantitative Imaging Research, UCSF, Department of Radiology, San Francisco, CA (United States)

    2008-08-15

    The purpose was to assess osteoporotic vertebral fractures and other spinal lesions in sagittal reformations obtained from routine multidetector computed tomography (MDCT) studies of the thorax and abdomen, to compare sagittal reformations with axial images in detecting these lesions and to investigate how frequently they were missed in the official radiology report. Routine abdominal or thoracoabdominal MDCT using a standard protocol was performed in 112 postmenopausal women. Axial images and sagittal reformations were analyzed separately by two radiologists in consensus and were compared in order to evaluate how often spinal lesions could be detected. In addition the official radiology reports were assessed to determine how many of those abnormalities were identified. Spine abnormalities were visualized in 101/112 postmenopausal women. In 27 patients osteoporotic vertebral deformities were found; 6 of these were shown in the axial images, but none of these were diagnosed in the official radiology report. Additional abnormalities included degenerative disc disease, osteoarthritis of the facet joints, scoliosis, hemangiomas and bone metastases. In only 9/101 patients spine abnormalities were mentioned in the radiology report. Sagittal reformations of standard MDCT images provide important additional information on spinal abnormalities; in particular, osteoporotic vertebral deformities are substantially better detected. (orig.)

  16. Feasibility and accuracy of coronary imaging in elderly patients using the 64-row multi-detector computed tomography: a correlation study with conventional coronary angiography

    Institute of Scientific and Technical Information of China (English)

    Wei Ling CHAN; Kui Hian SIM; Chee Khoon LIEW; Sze Piaw CHIN; Tiong Kiam ONG; Seyfarth Tobias; Yean Yip FONG; Choon Kiat ANG; Houng Bang LIEW; Rapaee ANNUAR

    2006-01-01

    Background Elderly patients generally have higher occurrence of coronary calcification, increased heart rate and difficulty with prolonged breath-holding. The aim of our study was to investigate the feasibility and accuracy of using 64-row multi-detector computed tomography (MDCT) in the assessment of coronary artery stenoses in elderly patients. Methods One hundred and fifty two patients with suspected or known coronary artery disease were divided into 4 groups according to their age (Group A: 40-49 years,n=34; Group B: 50-59 years, n=57; Group C: 60-69 years, n=48; Group D: 70 years and above; n=13). Coronary CT angiography (CTA) using a 64-row MDCT was performed and the findings were compared with that of conventional coronary angiography (CCA).Using axial images, multi-planar reconstructions (MPR) and maximum intensity projections (MIP), coronary segments of lumen diameter = 1.5mm were analyzed for the presence of significant stenosis (= 50% ). Results Percentages of poor image quality from coronary CTA preventing reliable correlations with CCA were 21%, 14%, 19% and 62% in Groups A to D respectively. Patients in Group D had significantly higher calcium scores compared with the other groups (P<0.001). In patients where CTA images were of acceptable quality, percentages of accurate correlations with CCA were 89.8%, 93.4%, 86.6% and 78.0% for Groups A to D respectively.There were no significant difference in serum creatinine, heart rate and contrast volume between the 4 groups. Conclusions The 64-row MDCT coronary angiography was less accurate and feasible for patients aged 70 years or above due to heavy coronary calcification and inability to perform a satisfactory breath-hold. However, a high diagnostic accuracy with the MDCT is possible in patients aged less than 70 years.

  17. Dose reduction to the pediatric and adult as a result of spectral optimization for high-contrast abdominal CT: A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Pih Hyun; Lee, Chang Lae; Kim, Dae Hong; Kim, Hee Joung [Dept. of Radiological Science and Research Institute of Health Science, Yonsei University (Korea, Republic of)

    2012-04-15

    Improvement in multi-detector row CT (MDCT) technology now allows numerous acquisitions to be easily and rapidly performed, leading to a possibly marked increase of the dose to patients. Managing patient dose is therefore a major concern in pediatric MDCT. Dose optimization consists of obtaining the lowest acceptable image quality compatible with diagnostic purposes. It is still the radiologist's responsibility to set the appropriate CT parameters (i.e., tube potential, beam collimation, tube current-time product or AEC-quality indices) to keep the dose 'as low as reasonably achievable' for diagnostic purposes. However, while radiation dose may be precisely defined by dedicated quantities such as the CT dose index (CTDI), image quality is still difficult to objectively assess. Up until now, the 'appropriate' quality ratio was mostly defined on the basis of empirical methods. The purpose of the present study was to assess and compare various physically measurable image quality indices obtained with dedicated pediatric phantoms and CT protocols in order to more clearly understand which index should preferably be used in children to manage the dose for routine abdominal MDCT protocols, and to provide guidance on dose reduction on the basis of patient dimensions.

  18. Bone Mineral Density Estimations From Routine Multidetector Computed Tomography: A Comparative Study of Contrast and Calibration Effects

    Science.gov (United States)

    Kaesmacher, Johannes; Liebl, Hans; Baum, Thomas; Kirschke, Jan Stefan

    2017-01-01

    Introduction Phantom-based (synchronous and asynchronous) and phantomless (internal tissue calibration based) assessment of bone mineral density (BMD) in routine MDCT (multidetector computed tomography) examinations potentially allows for diagnosis of osteoporosis. Although recent studies investigated the effects of contrast-medium application on phantom-calibrated BMD measurements, it remains uncertain to what extent internal tissue-calibrated BMD measurements are also susceptible to contrast-medium associated density variation. The present study is the first to systemically evaluate BMD variations related to contrast application comparing different calibration techniques. Purpose To compare predicative performance of different calibration techniques for BMD measurements obtained from triphasic contrast-enhanced MDCT. Materials and Methods Bone mineral density was measured on nonenhanced (NE), arterial (AR) and portal-venous (PV) contrast phase MDCT images of 46 patients using synchronous (SYNC) and asynchronous (ASYNC) phantom calibration as well as internal calibration (IC). Quantitative computed tomography (QCT) served as criterion standard. Density variations were analyzed for each contrast phase and calibration technique, and respective linear fitting was performed. Results Both asynchronous calibration-derived BMD values (NE-ASYNC) and values estimated using IC (NE-IC) on NE MDCT images did reasonably well in predicting QCT BMD (root-mean-square deviation, 8.0% and 7.8%, respectively). Average NE-IC BMD was 2.7% lower when compared with QCT (P = 0.017), whereas no difference could be found for NE-ASYNC (P = 0.957). All average BMD estimates derived from contrast-enhanced scans differed significantly from QCT BMD (all P 6.0 mg/mL). All regression fits revealed a consistent linear dependency (R2 range, 0.861–0.963). Overall accuracy and goodness of fit tended to decrease from AR to PV contrast phase. Highest precision and best linear fit could be reached

  19. The relationship between aortic calcification volume and obstructive coronary artery disease: comparison with coronary calcification volume

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Seok; Kim, Jeong Ho; Park, Chul Hi; Park, Seon Young; Choe, Soo Jin; Hwang, Hee Young; Kim, Hyung Sik [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2007-12-15

    We compared the diagnostic performance of aortic calcification volume with that of coronary artery calcification volume at CT in diagnosing obstructive coronary artery disease (OCAD). A total of 308 patients (M: F 141: 167) underwent coronary CT angiography using a 64-slice MDCT. We measured the calcification volume (mm{sup 3}) of coronary artery (CAC), thoracic aorta (TAC), abdominal aorta (AAC), and whole aorta (AC) at unenhanced CT. OCAD was defined as the significant stenosis ({>=} 50%) in any coronary artery at CT angiography. The diagnostic performance for OCAD was evaluated by calculating the area under the receiver operating characteristic (ROC) curve. Among the 308 patients studied, 45 patients were diagnosed with OCAD. The mean volumes of TAC, AAC, AC, and CAC were 518.8 mm{sup 3}, 551.5 mm{sup 3}, 1069.9 mm{sup 3}, 57.6 mm{sup 3} respectively. The areas under the ROC curve of TAC, AAC, AC, and CAC for OCAD were 0.766 (0.694 < 95% confidence interval < 0.838), 0.837 (0.784 < 95% confidence interval < 0.892), 0.814 (0.755 < 95% confidence interval < 0.873), 0.871 (0.812 < 95% confidence interval < 0.930), respectively. The volume of aortic calcification as well as coronary artery calcification is associated with obstructive coronary artery disease.

  20. MDCT and 3D evaluation of type 2 hypoplastic pulmonary artery sling associated with right lung agenesis, hypoplastic aortic arch, and long segment tracheal stenosis.

    Science.gov (United States)

    Lee, Edward Y

    2007-11-01

    The early diagnosis and complete anatomic evaluation of pulmonary artery sling, a congenital vascular anomaly in which left pulmonary artery arises from the right pulmonary artery, is paramount for proper patient management, because patients with this disorder frequently have other congenital anomalies resulting in high morbidity and mortality. Until recently, pulmonary artery sling in the neonate has been established with standard radiologic imaging studies such as plain radiographs, barium swallow studies, fluoroscopy-guided airway studies, and echocardiograms. However, with the development and widespread availability of multidetector computed tomography, pulmonary artery sling is increasingly evaluated with this newer technology. This case report presents a rare incidence of type 2 hypoplastic pulmonary artery sling in a neonate associated with right lung agenesis, hypoplastic aortic arch, and long segment tracheal stenosis. Multidetector computed tomography combined with 3-dimensional evaluation was particularly helpful in making a correct diagnosis of the complicated anatomic anomalies found in this case.

  1. Limiting CT radiation dose in children with craniosynostosis: phantom study using model-based iterative reconstruction

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    Kaasalainen, Touko; Lampinen, Anniina [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, POB 340, Helsinki (Finland); University of Helsinki, Department of Physics, Helsinki (Finland); Palmu, Kirsi [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, POB 340, Helsinki (Finland); School of Science, Aalto University, Department of Biomedical Engineering and Computational Science, Helsinki (Finland); Reijonen, Vappu; Kortesniemi, Mika [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, POB 340, Helsinki (Finland); Leikola, Junnu [University of Helsinki and Helsinki University Hospital, Department of Plastic Surgery, Helsinki (Finland); Kivisaari, Riku [University of Helsinki and Helsinki University Hospital, Department of Neurosurgery, Helsinki (Finland)

    2015-09-15

    Medical professionals need to exercise particular caution when developing CT scanning protocols for children who require multiple CT studies, such as those with craniosynostosis. To evaluate the utility of ultra-low-dose CT protocols with model-based iterative reconstruction techniques for craniosynostosis imaging. We scanned two pediatric anthropomorphic phantoms with a 64-slice CT scanner using different low-dose protocols for craniosynostosis. We measured organ doses in the head region with metal-oxide-semiconductor field-effect transistor (MOSFET) dosimeters. Numerical simulations served to estimate organ and effective doses. We objectively and subjectively evaluated the quality of images produced by adaptive statistical iterative reconstruction (ASiR) 30%, ASiR 50% and Veo (all by GE Healthcare, Waukesha, WI). Image noise and contrast were determined for different tissues. Mean organ dose with the newborn phantom was decreased up to 83% compared to the routine protocol when using ultra-low-dose scanning settings. Similarly, for the 5-year phantom the greatest radiation dose reduction was 88%. The numerical simulations supported the findings with MOSFET measurements. The image quality remained adequate with Veo reconstruction, even at the lowest dose level. Craniosynostosis CT with model-based iterative reconstruction could be performed with a 20-μSv effective dose, corresponding to the radiation exposure of plain skull radiography, without compromising required image quality. (orig.)

  2. 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.

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

    Institute of Scientific and Technical Information of China (English)

    徐崇明; 赵晓军

    2012-01-01

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

  4. Evaluation of coronary artery in-stent restenosis using 64-slice CT%64层螺旋CT评价冠状动脉支架内再狭窄的价值

    Institute of Scientific and Technical Information of China (English)

    刘新; 李颖; 杨立; 赵锡海; 王新疆; 赵绍宏; 张玉霄; 蔡祖龙

    2006-01-01

    目的 评介64层螺旋CT诊断冠状动脉支架内再狭窄(ISR)的临床价值.方法 采用64层螺旋CT对14例冠状动脉支架置入术后的患者(共37个支架)进行CT冠状动脉成像(CTA).在CTA上,通过肉眼观察和测量支架内CT值两种方法诊断ISR.以冠状动脉造影(ISR≥50%)为标准,计算并比较两种方法诊断ISR的准确性.结果 37个支架中,CCA检出ISR(≥50%)11个,正常(包括ISR<50%)26个.与CCA对照,CTA肉眼观察法正确诊断ISR 2个,正常18个,CT值测量法则分别正确诊断ISR 3个,正常21个.两种方法诊断ISR的敏感性、特异性、阳性预测值和阴性预测值分别为18%、69%、20%、67%和27%、81%、38%、72%.两种方法各项准确性指标之间差异均无统计学意义(P>0.05).结论 64层螺旋CT诊断ISR十分困难,但对排除ISR有一定的作用.

  5. 64排VCT诊断心脏血管肉瘤1例并文献复习%64-slice CT Diagnosis of Cardiac Angiosarcoma:A Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    潘元威; 高剑波; 周志刚; 郭华; 董军强

    2010-01-01

    @@ 原发性心脏恶性肿瘤临床上十分少见,易被误诊或延期诊断.本文结合CT引导下穿刺确诊心脏血管肉瘤1例,并复习相关文献,将心脏恶性肉瘤的影像学诊断作以下总结. 患者,男,29岁.以"咳嗽伴右侧胸痛,活动后心慌、气短、胸闷1 d"为主诉至当地医院,查心电图示:①广泛前壁T波改变.②R波V5振幅增高.心脏超声提示:心包及右心房实性占位,二尖瓣轻度脱垂.为求进一步诊治来本院,以"心脏占位"收入.

  6. Diagnosis of 64 Slice Spiral CT and MPR Techniques in Silico Tuberculosis%64排螺旋CT及MPR技术对肺尘埃沉着病合并肺结核的诊断

    Institute of Scientific and Technical Information of China (English)

    陈金俊

    2014-01-01

    目的:探讨64排螺旋CT及其MPR技术对肺尘埃沉着病合并肺结核的诊断价值。方法对50例肺尘埃沉着病患者进行胸部64排螺旋CT检查,得到胸部轴位(层厚1mm)及MPR图像,分析肺尘埃沉着病合并肺结核CT表现,对早期发现肺尘埃沉着病合并结核有重要价值。结果肺尘埃沉着病合并血行播散型肺结核1例,继发性肺结核48例,其中渗出浸润为主32例,占66%;干酪为主型6例,占12.5%;空洞为主型10例,占20.8%;肺尘埃沉着病合并结核性胸膜炎1例,占0.2%。结论64排螺旋CT及MPR技术对肺尘埃沉着病合并结核的诊断优势明显。MPR技术对胸部整体情况能多方位,直观,清晰和形象地显示,特别是晚期肺尘埃沉着病合并结核早期诊断提供较为可靠依据。%Objective  To explore the diagnostic value of 64 slice spiral CT and MPR technology combined with pulmonary tuberculosis of silicosis. Methods Chest 64 slice spiral CT examination of 50 cases of patients with silicosis, get the chest axis (thickness 1) and MPR image, analysis of silicosis complicated with tuberculosis CT manifestations of silicosis complicated with tuberculosis, early detection is of important value. Results  1 cases of silicosis complicated with hematogenous disseminated pulmonary tuberculosis,48 patients with secondary pulmonary tuberculosis, which exude inifltration in 32 cases, accounting for 66%; cheese based type in 6 cases, accounting for 12.5%; the main cavity type in 10 cases, accounting for 20.8%; 1 cases of silicosis complicated with tuberculosis pleurisy, accounted for 0.2%. Conclusion  Diagnostic advantage of conclusion 64 slice spiral CT and MPR technology on silicosis patients complicated with tuberculosis. MPR technology on the chest overall situation can be multi-dimensional, intuitive, clear and vivid display, especially to provide reliable evidences for early diagnosis of advanced silicosis patients complicated with tuberculosis.

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

    Institute of Scientific and Technical Information of China (English)

    陈星; 张唯唯; 张华

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    侯伟伟; 王云华; 蒋中标; 郑凯

    2015-01-01

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

  9. 64-slice spiral CT and image post-processing technique in diagnosis of SAPHO syndrome%64排螺旋CT及其后处理技术对SAPHO综合征的诊断

    Institute of Scientific and Technical Information of China (English)

    吕国义; 魏少奎; 杨实真; 李华中; 喻汉华

    2013-01-01

    目的 探讨64排螺旋CT及其后处理技术对SAPHO综合征的诊断.方法 观察分析5例SAPHO患者64排螺旋CT平扫及多平面重建、曲面重建、表面遮盖显示、容积再现图像.结果 5例SAPHO患者出现双侧锁骨近中段、第1肋骨近端及胸骨膨大,骨质增生硬化,胸-肋-锁关节面侵蚀、硬化、韧带骨化、关节间隙狭窄或骨性融合;3例患者胸椎、腰椎、颈椎表现为椎角骨质侵蚀硬化、椎间隙变窄、骨硬化、椎旁韧带骨化;2例患者发生单侧骶髂关节炎,骶髂关节髂骨面硬化,骶髂关节间隙变窄.结论 64排螺旋CT平扫及后处理技术可以良好地显示SAPHO患者胸肋锁骨区、脊柱及骶髂关节的骨炎、骨肥厚、滑膜炎的特征性改变,对SAPHO综合征诊断具有较高的应用价值.

  10. Low-radiation-dose dual-phase MDCT protocol with split contrast media dose and time optimization: protocol design for renal donors evaluation

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    Bazeed, Mohamed Fayez (Dept. of Diagnostic Radiology, Faculty of Medicine, Mansoura Univ. (Egypt)), email: bazeed@mans.eun.eg; Fooshang, Fawzy F (National Inst. of Urology and Nephrology (Egypt)); Ahmed, Magdy Aly (Nephrology Dept., Armed Forces Hospitals Southern Region (Saudi Arabia))

    2011-10-15

    Background A routine, multiphase, computed tomography (CT) protocol is associated with high radiation exposure to potential kidney donors. To reduce radiation exposure, several authors have suggested a reduction in the number of phases. Purpose To evaluate a low-radiation-dose, dual-phase protocol (i.e. a protocol with an unenhanced phase and combined vascular and excretory phase) for the preoperative evaluation of potential renal donors. Material and Methods Sixty-five potential renal donors were divided into two groups. The first group was scanned with a routine quadric-phase protocol (non-contrast, arterial, venous, and delayed), and the second group was scanned with a triple-phase protocol (dual phase protocol + venous phase). In the second group, we replaced CT angiography with a routine abdominal CT technique. In addition to the evaluation of renal arteries, veins, and excretory systems, the radiation dose of the suggested protocol was compared to that of the routine quadric-phase protocol. Results The suggested protocol was efficient in the evaluation of renal arteries, veins, and excretory systems in all studied potential renal donors. Renal arteries were well visualized in the combined vascular excretory phase using the routine abdominal CT technique; no significant difference was noted when these results were compared to those obtained from the CT angiography used in the quadric-phase protocol. The mean effective radiation dose of our suggested dual-phase protocol was only 34% of the dose resulting from the routine quadric-phase protocol. Conclusion Use of a low-radiation, dual-phase, CT protocol, which relied on both an unenhanced phase and a combined vascular and excretory phase, significantly reduced radiation dose. Furthermore, the proposed protocol provides adequate visualization of renal arteries and veins, and affords sufficient opacification of the urinary tract using improved acquisition triggering

  11. Coronary artery imaging using MDCT and MRA

    Institute of Scientific and Technical Information of China (English)

    Rajiv Kumar

    2006-01-01

    @@ The potential benefits provided by new imaging technologies for the diagnostic evaluation of CAD are quantified by considering the expense, time, and associated risk of possible complications of traditional invasive angiography.

  12. Can contrast-enhanced multi-detector computed tomography replace transesophageal echocardiography for the detection of thrombogenic milieu and thrombi in the left atrial appendage. A prospective study with 124 patients; Kann die kontrastmittelverstaerkte Mehrzeilen-Computertomografie die transoesophageale Echokardiografie bei der Detektion von thrombogenem Milieu und Vorhofohrthromben ersetzen? Eine prospektive Studie mit 124 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Homsi, R.; Luetkens, J.A.; Schild, H.H.; Naehle, C.P. [Bonn Univ. (Germany). Dept. of Radiology; Nath, B. [SHG-KLliniken Voelklingen (Germany). Dept. of Medicine I - Cardiology; Schwab, J.O. [Bonn Univ. (Germany). Dept. of Medicine I - Cardiology

    2016-01-15

    To assess the diagnostic value of contrast-enhanced multi-detector computed tomography (MD-CT) for identifying patients with left atrial appendage (LAA) thrombus or circulatory stasis. 124 patients with a history of atrial fibrillation and/or cerebral ischemia (83 men, mean age 58.6 ± 12.4 years) and with a clinical indication for MD-CT of the heart and for transesophageal echocardiography (TEE) were included in the study. LAA thrombus or thrombogenic milieu was visually identified in TEE and MD-CT. In addition, MD-CT was analyzed quantitatively measuring the Hounsfield units (HU) of the left atrium (LA), the LAA and the ascending aorta (AA), and calculating the HU ratios LAA/AA (HU [LAA/AA]) und LAA/LA (HU [LAA/LA]). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated. The prevalence of a thrombus or thrombogenic milieu as assessed by TEE was 21.8 %. The HU ratio was lower in patients with thrombus or thrombogenic milieu (HU [LAA/AA]: 0.590 ± 0.248 vs. 0.909 ± 0.141; p < 0.001 und HU [LAA/LA] 0.689 ± 0.366 vs. 1.082 ± 0.228; p < 0.001). For the diagnosis of thrombus or a thrombogenic milieu, visual analysis yielded a sensitivity of 81.5 %, a specificity of 96.9 %, a PPV of 87.5 % and a NPV of 95.2 %. By combining visual and quantitative analysis with one criterion being positive, the specificity decreased to 91.8 %, the sensitivity to 77.8 %, the PPV to 72.4 %, and the NPV to 94.9 %. Visual analysis of the LAA in the evaluation of thrombus or thrombogenic milieu yields a high NPV of 95.1 % and may especially be useful to rule out LAA thrombi in patients with contraindications for TEE. Additional calculation of HU ratios did not improve the diagnostic performance of MD-CT.

  13. Evaluation of intraductal papillary mucinous neoplasms of the pancreas on MDCT and MRI%胰腺导管内乳头状黏液性肿瘤的影像学表现及其在术前诊断相关性浸润性癌中的应用价值

    Institute of Scientific and Technical Information of China (English)

    王大丽; 周健; 郑双丽; 夏建余; 胡红杰

    2014-01-01

    Objective The purpose of our study was to evaluate the predictive factors of the presence of invasive carcinoma associated with intraductal papillary mucinous neoplasm (IPMN) of the pancreas on MDCT and MRI.Methods Preoperative MDCT or/and MRI of 27 consecutive patients (19 men,8 women,mean age 61.3 years) who had undergone surgical resection and had a pathological diagnosis of IPMN were retrospectively assessed.The type of ductal involvement,solid appearance of the lesion,location,tumor size of branch duct type and combined type lesions,maximum diameter of the tumor,caliber of the main pancreatic duct and the extent of the common bile duct dilatation were assessed on CT and MRI and correlated with the pathological findings of the invasive carcinoma.Two abdominal radiologists reviewed all the images,and when discrepancies of the findings were found,the consensus was reached by discussion.Results Pathological analysis revealed carcinoma in situ in two patients and invasive carcinoma in 19 patients arising from the IPMN.The type of ductal involvement (P =0.038),a solid mass (P =0.003) and the common bile duct dilatation (≥ 15 mm,P =0.004) were correlated with the presence of associated invasive carcinoma.For the finding of solid and cystic mass in predicting invasive IPMN,the sensitivity was 66.7%(8/12) and specificity was 100.0% (8/8),and for bile duct diameter ≥15 mm,the sensitivity was 47.4% (9/19) and specificity was 100.0% (8/8).However,no association was found between the location of the lesion and associated invasive carcinoma.The caliber of the main pancreatic duct of patients with associated invasive carcinoma was significantly larger than that in the cases without invasive carcinoma (8.07 ± 2.23 mm vs.4.86 ± 1.86 mm,P =0.002).When using the main pancreatic duct dilatation ≥ 4 mm as the threshold,the sensitivity and specificity in predicting invasive IPMN were 94.7% (18/19) and 37.5% (3/8),respectively.For the branch duct type and

  14. Optimizing the scan protocol in whole-brain perfusion imaging with 320-MDCT%320排容积CT全脑灌注成像扫描协议优化研究

    Institute of Scientific and Technical Information of China (English)

    曹国全; 许化致; 潘克华; 陈伟建; 郭翔

    2014-01-01

    目的 探讨320排容积CT全脑灌注成像扫描协议优化的可行性.方法 20名健康志愿者按随机数字表法分为对照组和试验组,对照组7例,选择标准灌注扫描协议(19圈容积采集);试验组13例,通过合理改变采集间隔,减少扫描期相,采用一组新的灌注扫描协议(11圈容积采集).图像分析感兴趣区(ROI)设为两侧额叶白质、顶叶白质、半卵圆区、基底节区、枕叶、小脑,大小约(20±2)mm2.计算得到各感兴趣区的灌注参数值,包括脑血容量(rCBV)、达峰时间(TTP)、脑血流量(rCBF)、平均通过时间(MTT)及延迟时间(DT).结果 试验组剂量长度乘积(DLP)和有效剂量(E)较对照组降低了42.02%.两组不同层面左右两侧ROI区的各灌注参数的差异无统计学意义.两组组间上述各个对应部位的ROI区各灌注参数无明显差别.结论 优化后的扫描协议得到了与厂家推荐的标准协议无差异的全脑灌注参数值且降低了辐射剂量,推荐常规使用.%Objective To evaluate the feasibility of optimized scan protocol in whole-brain perfusion imaging with 320-MDCT scanner.Methods Twenty healthy volunteers were randomly divided into control group (13 patients) and test group (7 patients).The standard perfusion scan protocol (collecting 19 volumes)was applied in control group.The optimized perfusion CT scan protocol(collecting ll volumes)formulated by reducing scanning phases reasonably and changing the collection intervals was applied in test group.The regions of interest(ROI) with area of(20 ± 2)mm2 were located in the bilateral frontal white matter,parietal white matter,centrum semiovate,basal ganglia,occipital lobe and cerebellum.Bilateral perfusion values from ROI were measured,including cerebral blood volume(CBV),mean transit time (TTP),cerebral blood flow (CBF),mean transit time (MTT) and delay time (DT).Results Dose length product (DLP)and effective dose (ED)in optimized protocol were decreased 42.02

  15. Prosthetic heart valve assessment with multidetector-row CT: imaging characteristics of 91 valves in 83 patients

    Energy Technology Data Exchange (ETDEWEB)

    Habets, Jesse; Mali, Willem P.T.M.; Budde, Ricardo P.J. [UMC Utrecht, Department of Radiology, P.O. Box 85500, E01.132, GA, Utrecht (Netherlands); Symersky, Petr [Onze Lieve Vrouwe Gasthuis, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Academic Medical Center Amsterdam, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Herwerden, Lex A. van [University Medical Center Utrecht, Department of Cardiothoracic Surgery, Utrecht (Netherlands); Mol, Bas A.J.M. de [Academic Medical Center Amsterdam, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Spijkerboer, Anje M. [Academic Medical Center Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2011-07-15

    Multidetector CT (MDCT) has shown potential for prosthetic heart valve (PHV) assessment. We assessed the image quality of different PHV types to determine which valves are suitable for MDCT evaluation. All ECG-gated CTs performed in our institutions since 2003 were reviewed for the presence of PHVs. After reconstruction in 3 specific PHV planes, image quality of the supravalvular, perivalvular, subvalvular and valvular regions was scored on a four-point scale (1 = non-diagnostic, 2 = moderate, 3 = good and 4 = excellent) by two independent observers. Eighty-four CT examinations (66 cardiac, 18 limited-dose aortic protocols) of 83 patients with a total of 91 PHVs in the aortic (n = 71), mitral (n = 17), pulmonary (n = 1) and tricuspid (n = 2) position were included. CT was performed on a 16-slice (n = 4), 64-slice (n = 28) or 256-slice (n = 52) MDCT system. Median image quality scores for the supra-, peri- and subvalvular regions and valvular detail were (3.5, 3.3, 3.5 and 3.5, respectively) for bileaflet PHV; (3.0, 3.0, 3.5 and 3.0, respectively) for Medtronic Hall PHV; (1.0, 1.0, 1.0 and 1.0, respectively) for Bjoerk-Shiley and Sorin monoleaflet PHV and (3.5, 3.5, 4.0 and 2.0 respectively) for biological PHV. Currently implanted PHVs have good image quality on MDCT and are suitable for MDCT evaluation. (orig.)

  16. Impact of sirolimus-eluting stent fractures without early cardiac events on long-term clinical outcomes: A multislice computed tomography study

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    Ito, Tsuyoshi [Toyohashi Heart Center, Oyama-cho, Toyohashi (Japan); Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan); Kimura, Masashi; Ehara, Mariko; Terashima, Mitsuyasu; Nasu, Kenya; Kinoshita, Yoshihisa; Habara, Maoto; Tsuchikane, Etsuo; Suzuki, Takahiko [Toyohashi Heart Center, Oyama-cho, Toyohashi (Japan)

    2014-05-15

    This study sought to evaluate the impact of sirolimus-eluting stent (SES) fractures on long-term clinical outcomes using multislice computed tomography (MSCT). In this study, 528 patients undergoing 6- to 18-month follow-up 64-slice MSCT after SES implantation without early clinical events were followed clinically (the median follow-up interval was 4.6 years). A CT-detected stent fracture was defined as a complete gap with Hounsfield units (HU) <300 at the site of separation. The major adverse cardiac events (MACEs), including cardiac death, stent thrombosis, and target lesion revascularisation, were compared according to the presence of stent fracture. Stent fractures were observed in 39 patients (7.4 %). MACEs were more common in patients with CT-detected stent fractures than in those without (46 % vs. 7 %, p < 0.01). Univariate Cox regression analysis indicated a significant relationship between MACE and stent fracture [hazard ratio (HR) 7.65; p < 0.01], age (HR 1.03; p = 0.04), stent length (HR 1.03; p < 0.01), diabetes mellitus (HR 1.77; p = 0.04), and chronic total occlusion (HR 2.54; p = 0.01). In the multivariate model, stent fracture (HR 5.36; p < 0.01) and age (HR 1.03; p = 0.04) remained significant predictors of MACE. An SES fracture detected by MSCT without early clinical events was associated with long-term clinical adverse events. (orig.)

  17. Effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies

    Science.gov (United States)

    Murase, Kenya; Nanjo, Takafumi; Satoshi, Ii; Miyazaki, Shohei; Hirata, Masaaki; Sugawara, Yoshifumi; Kudo, Masayuki; Sasaki, Kousuke; Mochizuki, Teruhito

    2005-11-01

    The purpose of this study was to investigate the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using multi-detector row CT (MDCT). Following the standard CT perfusion study protocol, continuous (cine) scans (1 s/rotation × 60 s) consisting of four 5 mm thick contiguous slices were performed using an MDCT scanner with a tube voltage of 80 kVp and a tube current of 200 mA. We generated the simulated images with tube currents of 50 mA, 100 mA and 150 mA by adding the corresponding noise to the raw scan data of the original image acquired above using a noise simulation tool. From the original and simulated images, we generated the functional images of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in seven patients with cerebrovascular disease, and compared the correlation coefficients (CCs) between the perfusion parameter values obtained from the original and simulated images. The coefficients of variation (CVs) in the white matter were also compared. The CC values deteriorated with decreasing tube current. There was a significant difference between 50 mA and 100 mA for all perfusion parameters. The CV values increased with decreasing tube current. There were significant differences between 50 mA and 100 mA and between 100 mA and 150 mA for CBF. For CBV and MTT, there was also a significant difference between 150 mA and 200 mA. This study will be useful for understanding the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using MDCT, and for selecting the tube current.

  18. The correlation between stroma analysis and MDCT early phase contrast enhancement in small solid lung adenocarcinoma%肺腺癌实性结节肿瘤间质与多排螺旋CT早期增强间的关系研究

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To evaluate correlations between proportion and distribution of tumor stroma and MDCT early phase enhancement character in solid lung adenocarcinoma, and compare with microvessel density and histological subtypes.Methods: Thirty-one patients with lung adenocarcinoma shown as solid solitary pulmonary nodules underwent routine contrast-enhanced MDCT followed by surgical resections. CT character included net enhancement and distribution of enhancement. The largest cut surface of tumor specimens were stained by hematoxylin and eosin. About 25 fields of view of each specimen were scanned as digitized pictures at low magnification. Semi-auto segmentation software was used to calculate mean stroma proportion. Pearson correlation coefficient was used to represent the relationships between extent of tumor enhancement, proportion of tumor stroma and MVD respectively. Fisher's exact test was used to analyze statistical differences in degree of CT enhancement among groups of different histological subtypes. Results: Proportion of invasive tumor stroma (13.2%-54.5%, mean 26.2 ± 8.8%) was correlated positively with net enhancement (8-60.8 HU, mean 31.2 ± 13.6 HU; r =0.483, P= 0.006) which was more than MVD. 58.1% cases showed homogenous enhancement, 32.3% cases showed peripheral inhomogenous enhancement, 3.2% cases showed central inhomogenous enhancement, 3.2% cases showed asymmetrical inhomogenous enhancement, and 3.2% cases showed no enhancement. 58.1% cases' stroma showed mixed distribution,35.5% cases showed peripheral distribution, 3.2% cases showed central distribution, and 3.2% cases showed asymmetrical distribution. Significantly more adenocarcinomas classified with "net enhancement > 20 HU" were found in the acinar group than in the solid with mucin subtype (P = 0.005). Conclusion: Extent of CT enhancement reflects underlying not only the tumor angiogenesis but also stroma proliferation in solid small lung adenocarcinoma. Tumor stroma proportion could

  19. A Three-Dimensional Reconstructive Study of Pelvic Cavity in the New Zealand Rabbit (Oryctolagus cuniculus

    Directory of Open Access Journals (Sweden)

    Sema Özkadif

    2014-01-01

    Full Text Available The present study has been performed to reveal biometrical aspects and diameter-related differences in terms of sexes regarding pelvic cavity via three-dimensional (3D reconstruction by using multidetector computed tomography (MDCT images of pelvic cavity of the New Zealand rabbit. A total of 16 adult New Zealand rabbits, including 8 males and 8 females, were used in this study. Under anesthesia, the images obtained from MDCT were stacked and overlaid to reconstruct the 3D model of the pelvic cavity using 3D modeling software (Mimics 13.1. Measurements, such as the conjugate, transverse, and vertical diameters of the pelvic cavity, and the pelvic inclination were calculated and analyzed statistically. Biometrical differences of the pelvic diameters in New Zealand rabbits of both sexes were shown clearly. It was concluded that the pelvic diameters revealed by 3D modeling techniques can shed light on medical students who take both anatomy training and gynecological applications. The authors hope that the synchronization of medical approaches may give rise to novel diagnostic and therapeutic developments related to pelvic cavity.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-15

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

  1. Assessment of three root canal preparation techniques on root canal geometry using micro-computed tomography: In vitro study

    Directory of Open Access Journals (Sweden)

    Shaikha M Al-Ali

    2012-01-01

    Full Text Available Aim: To assess the effects of three root canal preparation techniques on canal volume and surface area using three-dimensionally reconstructed root canals in extracted human maxillary molars. Materials and Methods: Thirty extracted Human Maxillary Molars having three separate roots and similar root shape were randomly selected from a pool of extracted teeth for this study and stored in normal saline solution until used. A computed tomography scanner (Philips Brilliance CT 64-slice was used to analyze root canals in extracted maxillary molars. Specimens were scanned before and after canals were prepared using stainless steel K-Files, Ni-Ti rotary ProTaper and rotary SafeSiders instruments. Differences in dentin volume removed, the surface area, the proportion of unchanged area and canal transportation were calculated using specially developed software. Results: Instrumentation of canals increased volume and surface area. Statistical analysis found a statistically significant difference among the 3 groups in total change in volume (P = 0.001 and total change in surface area (P = 0.13. Significant differences were found when testing both groups with group III (SafeSiders. Significant differences in change of volume were noted when grouping was made with respect to canal type (in MB and DB (P < 0.05. Conclusion: The current study used computed tomography, an innovative and non destructive technique, to illustrate changes in canal geometry. Overall, there were few statistically significant differences between the three instrumentation techniques used. SafeSiders stainless steel 40/0.02 instruments exhibit a greater cutting efficiency on dentin than K-Files and ProTaper. CT is a new and valuable tool to study root canal geometry and changes after preparation in great details. Further studies with 3D-techniques are required to fully understand the biomechanical aspects of root canal preparation.

  2. PROspective Multicenter Imaging Study for Evaluation of Chest Pain: Rationale and Design of the PROMISE Trial

    Science.gov (United States)

    Douglas, Pamela S.; Hoffmann, Udo; Lee, Kerry L.; Mark, Daniel B.; Al-Khalidi, Hussein R.; Anstrom, Kevin; Dolor, Rowena J.; Kosinski, Andrzej; Krucoff, Mitchell W.; Mudrick, Daniel W.; Patel, Manesh R.; Picard, Michael H.; Udelson, James E.; Velazquez, Eric J.; Cooper, Lawton

    2014-01-01

    Background Suspected coronary artery disease (CAD) is one of the most common, potentially life threatening diagnostic problems clinicians encounter. However, no large outcome-based randomized trials have been performed to guide the selection of diagnostic strategies for these patients. Methods The PROMISE study is a prospective, randomized trial comparing the effectiveness of two initial diagnostic strategies in patients with symptoms suspicious for CAD. Patients are randomized to either: 1) functional testing (exercise electrocardiogram, stress nuclear imaging, or stress echocardiogram); or 2) anatomic testing with >=64 slice multidetector coronary computed tomographic angiography. Tests are interpreted locally in real time by subspecialty certified physicians and all subsequent care decisions are made by the clinical care team. Sites are provided results of central core lab quality and completeness assessment. All subjects are followed for ≥1 year. The primary end-point is the time to occurrence of the composite of death, myocardial infarction, major procedural complications (stroke, major bleeding, anaphylaxis and renal failure) or hospitalization for unstable angina. Results Over 10,000 symptomatic subjects were randomized in 3.2 years at 193 US and Canadian cardiology, radiology, primary care, urgent care and anesthesiology sites. Conclusion Multi-specialty community practice enrollment into a large pragmatic trial of diagnostic testing strategies is both feasible and efficient. PROMISE will compare the clinical effectiveness of an initial strategy of functional testing against an initial strategy of anatomic testing in symptomatic patients with suspected CAD. Quality of life, resource use, cost effectiveness and radiation exposure will be assessed. Clinical trials.gov identifier NCT01174550 PMID:24890527

  3. ECG-gated HYPR reconstruction for undersampled CT myocardial perfusion imaging

    Science.gov (United States)

    Speidel, Michael A.; Van Lysel, Michael S.; Reeder, Scott B.; Supanich, Mark; Nett, Brian E.; Zambelli, Joseph; Chang, Su Min; Hsieh, Jiang; Chen, Guang-Hong; Mistretta, Charles A.

    2007-03-01

    In this study we develop a novel ECG-gated method of HYPR (HighlY constrained backPRojection) CT reconstruction for low-dose myocardial perfusion imaging and present its first application in a porcine model. HYPR is a method of reconstructing time-resolved images from view-undersampled projection data. Scanning and reconstruction techniques were explored using x-ray projections from a 50 sec contrast-enhanced axial scan of a 47 kg swine on a 64-slice MDCT system. Scans were generated with view undersampling factors from 2 to 10. A HYPR reconstruction algorithm was developed in which a fully-sampled composite image is generated from views collected from multiple cardiac cycles within a diastolic window. A time frame image for a heartbeat was produced by modifying the composite with projections from the cycle of interest. Heart rate variations were handled by automatically selecting cardiac window size and number of cycles per composite within defined limits. Cardiac window size averaged 35% of the R-R interval for 2x undersampling and increased to 64% R-R using 10x undersampling. The selected window size and cycles per composite was sensitive to synchrony between heart rate, gantry rate, and the view undersampling pattern. Temporal dynamics and perfusion metrics measured in conventional short-scan (FBP) images were well-reproduced in the undersampled HYPR time series. Mean transit times determined from HYPR myocardial time-density curves agreed to within 8% with the FBP results. The results indicate potential for an order of magnitude reduction in dose requirement per image in cardiac perfusion CT via undersampled scanning and ECG-gated HYPR reconstruction.

  4. 64排螺旋 CT 及三维容积测量系统对肺叶容积的定量研究%The quantitative measurement of pulmonary lobar volume using 3-dimensional volumetric diagnosis system and 64 row MDCT

    Institute of Scientific and Technical Information of China (English)

    刘斋; 何丽; 贾立镯; 任庆云

    2016-01-01

    Objective To explore the value of 3‐dimensional volumetric diagnosis system in quantitative measurement of pulmona‐ry lobar volumetry using a 64 row MDCT .Methods Seventy‐seven adult volunteers were scanned twice on a 64 row MDCT at the end of the maximum inspiratory and maximum expiratory end respectively .On a volumetric computer‐aided diagnosis system ,the en‐tire lung was semiautomatically separated into 5 anatomy lobes including the right upper lobe ,right middle lobe ,right lower lobe ,left upper lobe ,and left lower lobe .Each lobar volume was measured .Results The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in male volunteers were 1 303 .90 mL and 938 .31 mL ,1 276 .90 mL and 737 .69 mL , 1 204 .47 mL and 678 .67 mL ,1 048 .49 mL and 754 .83 mL ,519 .53 mL and 407 .86 mL at the end of the inspiratory and expiratory respectively .The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in female volun‐teers were 915 .78 mL and 666 .23 mL ,913 .87 mL and 576 .62 mL ,822 .17 mL and 509 .30 mL ,734 .20 mL and 530 .23 mL ,389 .13 mL and 316 .70 mL at the end of the inspiratory and expiratory respectively .The values of each lobe volume between the full inspiration phase and expiration phase group showed significant difference the same sex group (P<0 .05) .The values of each lobe volume in the man group were significantly larger than those of female group in both respiratory phase (P<0 .05) .Of the D‐value in the each lobe volume in 5 anatomy lobe at full inspiration phase and expiration phase in both sex group ,both of the lower lobes were the largest , followed by the left upper lobe ,right upper lobe and right middle lobe .The D‐value in the each lobe volume at full inspiration phase and expiration phase in the man group were significantly larger than those of female group .Conclusion Three‐dimensional volumet‐ric diagnosis system

  5. TU-EF-204-10: A Preliminary Study Evaluating Calculation Variations of Local Noise Power Spectra for CT Simulation in Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dolly, S [Washington University School of Medicine, Saint Louis, MO (United States); University of Missouri, Columbia, MO (United States); Chen, H; Anastasio, M; Mutic, S; Li, H [Washington University School of Medicine, Saint Louis, MO (United States)

    2015-06-15

    Purpose: Local noise power spectrum (NPS) properties are significantly affected by calculation variables and CT acquisition and reconstruction parameters, but a thoughtful analysis of these effects is absent. In this study, we performed a complete analysis of the effects of calculation and imaging parameters on the NPS. Methods: The uniformity module of a Catphan phantom was scanned with a Philips Brilliance 64-slice CT simulator using various scanning protocols. Images were reconstructed using both FBP and iDose4 reconstruction algorithms. From these images, local NPS were calculated for regions of interest (ROI) of varying locations and sizes, using four image background removal methods. Additionally, using a predetermined ground truth, NPS calculation accuracy for various calculation parameters was compared for computer simulated ROIs. A complete analysis of the effects of calculation, acquisition, and reconstruction parameters on the NPS was conducted. Results: The local NPS varied with ROI size and image background removal method, particularly at low spatial frequencies. The image subtraction method was the most accurate according to the computer simulation study, and was also the most effective at removing low frequency background components in the acquired data. However, first-order polynomial fitting using residual sum of squares and principle component analysis provided comparable accuracy under cer