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Sample records for cardiac multidetector ct

  1. 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 ...

  2. Cardiac causes of pulmonary arterial hypertension: assessment with multidetector CT

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    Hoey, Edward T.D.; Gopalan, Deepa; Agrawal, S.K.B. [Papworth Hospital, Cambridge (United Kingdom); Screaton, Nicholas J. [Papworth Hospital, Cambridge (United Kingdom); Papworth Hospital NHS Trust, Diagnostic Centre, Department of Radiology, Papworth Everard, Cambridgeshire (United Kingdom)

    2009-11-15

    The causes of pulmonary arterial hypertension (PAH) are diverse and include multiple congenital and acquired cardiac diseases as well as diseases primarily affecting the pulmonary vasculature, lung, pleura and chest wall. The traditional role of CT in evaluating PAH includes assessment of pulmonary vasculature and lung parenchyma with limited assessment of the heart. Advances in multidetector CT technology with improved spatial and temporal resolution now permit accurate delineation of cardiac morphology. CT pulmonary angiography (CTPA) is widely utilised in the workup of patients with suspected pulmonary vascular disease and can identify both pulmonary and cardiac causes. As the initial presentation for CTPA is often precipitated by nonspecific, unexplained symptoms and therefore undertaken by a general radiologist, it is important that a systematic approach to the interpretation of these studies, including cardiac evaluation, is routinely adopted. This paper reviews the CT evaluation in pulmonary hypertension with a particular focus on the cardiac causes, their subclassification into congenital systemic to pulmonary shunts and secondary to left heart disease, and their imaging features. It emphasises the use of a systematic approach to interpretation of CTPA examinations both in patients with known PAH and those with previously unsuspected disease. (orig.)

  3. Accessory cardiac bronchus: Proposed imaging classification on multidetector CT

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    Kim, Kang Min; Kim, Young Tong; Han, Jong Kyu; Jou, Sung Shick [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of)

    2016-02-15

    To propose the classification of accessory cardiac bronchus (ACB) based on imaging using multidetector computed tomography (MDCT), and evaluate follow-up changes of ACB. This study included 58 patients diagnosed as ACB since 9 years, using MDCT. We analyzed the types, division locations and division directions of ACB, and also evaluated changes on follow-up. We identified two main types of ACB: blind-end (51.7%) and lobule (48.3%). The blind-end ACB was further classified into three subtypes: blunt (70%), pointy (23.3%) and saccular (6.7%). The lobule ACB was also further classified into three subtypes: complete (46.4%), incomplete (28.6%) and rudimentary (25%). Division location to the upper half bronchus intermedius (79.3%) and medial direction (60.3%) were the most common in all patients. The difference in division direction was statistically significant between the blind-end and lobule types (p = 0.019). Peribronchial soft tissue was found in five cases. One calcification case was identified in the lobule type. During follow-up, ACB had disappeared in two cases of the blind-end type and in one case of the rudimentary subtype. The proposed classification of ACB based on imaging, and the follow-up CT, helped us to understand the various imaging features of ACB.

  4. 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.

  5. Method for Automatic Tube Current Selection for Obtaining a Consistent Image Quality and Dose Optimization in a Cardiac Multidetector CT

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    Qi, Weiwei; Du, Xiangke [Peking University People' s Hospital, Beijing (China); Li, Jianying [GE Healthcare China, Beijing (China)

    2009-12-15

    To evaluate a quantitative method for individually adjusting the tube current to obtain images with consistent noise in electrocardiogram (ECG)-gated CT cardiac scans. The image noise from timing bolus and cardiac CT scans of 80 patients (Group A) who underwent a 64-row multidetector (MD) CT cardiac examination with patient-independent scan parameters were analyzed. A formula was established using the noise correlation between the timing bolus and cardiac scans. This formula was used to predict the required tube current to obtain the desired cardiac CT image noise based on the timing bolus noise measurement. Subsequently, 80 additional cardiac patients (Group B) were scanned with individually adjusted tube currents using an established formula to evaluate its ability to obtain accurate and consistent image noise across the patient population. Image quality was evaluated using score scale of 1 to 5 with a score of 3 or higher being clinically acceptable. Using the formula, we obtained an average CT image noise of 28.55 Hounsfield unit (HU), with a standard deviation of only 1.7 HU, as opposed to a target value of 28 HU. Image quality scores were 4.03 and 4.27 for images in Groups A and B, respectively, and there was no statistical difference between the image quality scores between the two groups. However, the average CT dose index (CTDIvol) was 30% lower for Group B. Adjusting the tube current based on timing bolus scans may provide a consistent image quality and dose optimization for cardiac patients of various body mass index values.

  6. Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility

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    Lee, Tain; Tsai, I.C.; Chen, Min-Chi [Taichung Veterans General Hospital, 407 Department of Radiology, Taichung (Taiwan); Medical College of Chung Shan Medical University, Faculty of Medicine, Taichung (Taiwan); National Yang Ming University School of Medicine, Department of Medicine, Taipei (Taiwan); Fu, Yun-Ching; Jan, Sheng-Lin [Taichung Veterans General Hospital, Department of Paediatrics, Taichung (Taiwan); National Yang-Ming University, Institute of Clinical Medicine, Taipei (Taiwan); Wang, Chung-Chi; Chang, Yen [Taichung Veterans General Hospital, Section of Cardiovascular Surgery, Department of Surgery, Taichung (Taiwan)

    2006-12-15

    Echocardiography is the first-line modality for the investigation of neonatal congenital heart disease. Diagnostic cardiac catheterization, which has a small but recognized risk, is usually performed if echocardiography fails to provide a confident evaluation of the lesions. To verify the technical and clinical feasibilities of replacing diagnostic cardiac catheterization with multidetector-row CT (MDCT) in neonatal complex congenital heart disease. Over a 1-year period we prospectively enrolled all neonates with complex congenital heart disease referred for diagnostic cardiac catheterization after initial assessment by echocardiography. MDCT was performed using a 40-detector-row CT scanner with dual syringe injection. A multidisciplinary congenital heart disease team evaluated the MDCT images and decided if further diagnostic cardiac catheterization was necessary. The accuracy of MDCT in detecting separate cardiovascular anomalies and bolus geometry of contrast enhancement were calculated. A total of 14 neonates were included in the study. No further diagnostic cardiac catheterization was needed in any neonate. The accuracy of MDCT in diagnosing separate cardiovascular anomalies was 98% (53/54) with only one atrial septal defect missed in a patient with coarctation syndrome. The average cardiovascular enhancement in evaluated chambers was 471 HU. No obvious beam-hardening artefact was observed. The technical and clinical feasibility of MDCT in complex congenital heart disease in neonates is confirmed. After initial assessment with echocardiography, MDCT could probably replace diagnostic cardiac catheterization for further anatomical clarification in neonates. (orig.)

  7. Intracardiac Eustachian Valve Cyst in an Adult Detected with Other Cardiac Anomalies: Usefulness of Multidetector CT in Diagnosis

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    Cho, Hyung Ji; Jung, Jung Im; Kim, Hwan Wook; Lee, Kyo Young [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2012-07-15

    We present an unusual case of an intracardiac Eustachian valve cyst observed concurrently with atresia of the coronary sinus ostium, a persistent left superior vena cava (LSVC) and a bicuspid aortic valve. There have been several echocardiographic reports of Eustachian valve cysts; however, there is no report of multidetector computed tomography (MDCT) findings related to a Eustachian valve cyst. Recently, we observed a Eustachian valve cyst diagnosed on MDCT showing a hypodense cyst at the characteristic location of the Eustachian valve (the junction of the right atrium and inferior vena cava). MDCT also demonstrated additional cardiovascular anomalies including atresia of the coronary sinus ostium and a persistent LSVC and bicuspid aortic valve.

  8. Cardiac CT Scan

    Science.gov (United States)

    ... combine these pictures to create a three-dimensional (3D) model of the whole heart. This imaging test ... findings from earlier chest x rays. Different CT scanners are used for different purposes. A multidetector CT ...

  9. Multidetector CT of the Pancreas

    Directory of Open Access Journals (Sweden)

    Rossella Graziani

    2008-07-01

    Full Text Available Purpose. This book is a practical overview of pancreatic computer tomography (CT based on the large experience of the contributors. It is dedicated to Carlo Procacci a well known radiologist of Verona who died in 2004. Content. The book is divided into 10 chapters covering the different aspects of diagnostic CT of the pancreas. The various radiological aspects of acute and chronic pancreatitis, exocrine and endocrine pancreatic cancer (adenocarcinoma, neuroendocrine tumors, cystic cancer, rare neoplasms, traumatic abnormalities, imaging aspects of the gland after surgery and finally imaging findings after pancreas transplantation are reported in detail. Comment. We would emphasize that the characteristics of imaging of the common pancreatic diseases are described in addition to unusual or rare aspects of pancreatic pathology. The iconography is very rich and it is of excellent quality and it will help the radiologist to deal with individual cases particularly complex. Another important aspect of the book is that the initial approach of the various pancreatic diseases is based on clinical, surgical and pathological aspects and their relationship with imaging findings. Limitation. It is a great pity that the book for its importance is written in Italian language and for this reason it can not have an international appreciation. Final note. The radiologists will find in the book all the information useful for their daily practice. The internists, gastroenterologists and surgeons also will found useful information to better understand the information given by the modern CT radiology.

  10. Multidetector CT of emergent biliary pathologic conditions.

    Science.gov (United States)

    Patel, Neel B; Oto, Aytekin; Thomas, Stephen

    2013-01-01

    Various biliary pathologic conditions can lead to acute abdominal pain. Specific diagnosis is not always possible clinically because many biliary diseases have overlapping signs and symptoms. Imaging can help narrow the differential diagnosis and lead to a specific diagnosis. Although ultrasonography (US) is the most useful imaging modality for initial evaluation of the biliary system, multidetector computed tomography (CT) is helpful when US findings are equivocal or when biliary disease is suspected. Diagnostic accuracy can be increased by optimizing the CT protocol and using multiplanar reformations to localize biliary obstruction. CT can be used to diagnose and stage acute cholecystitis, including complications such as emphysematous, gangrenous, and hemorrhagic cholecystitis; gallbladder perforation; gallstone pancreatitis; gallstone ileus; and Mirizzi syndrome. CT also can be used to evaluate acute biliary diseases such as biliary stone disease, benign and malignant biliary obstruction, acute cholangitis, pyogenic hepatic abscess, hemobilia, and biliary necrosis and iatrogenic complications such as biliary leaks and malfunctioning biliary drains and stents. Treatment includes radiologic, endoscopic, or surgical intervention. Familiarity with CT imaging appearances of emergent biliary pathologic conditions is important for prompt diagnosis and appropriate clinical referral and treatment.

  11. Acute pulmonary embolism: prediction of cor pulmonale and short-term patient survival from assessment of cardiac dimensions in routine multidetector-row CT; Mehrschicht-Spiral-CT bei vermuteter und inzidenteller akuter Lungenembolie: prognostischer Wert morpholoqischer Herzparameter

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    Engeike, C. [Radiologie, Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany); Rummeny, E.; Marten, K. [Inst. fuer Roentgendiagnostik, Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany)

    2006-10-15

    Purpose: evaluation of the prognostic value of morphological cardiac parameters in patients with suspected and incidental acute pulmonary embolism (PE) using multidetector-row chest CT (MSCT). Materials and methods: 2335 consecutive MSCT scans were evaluated for the presence of PE. The arterial enhancement and analysability of pulmonary arteries and the heart were assessed as parameters of the scan quality. The diastolic right and left ventricular short axes (RV{sub D}, LV{sub D}) and the interventricular septal deviation (ISD) were measured in all PE-positive patients and the echocardiography reports were reviewed. The clinical data assessment included cardio-respiratory and other co-morbidities, systemic anticoagulant therapy (ACT), and the 30-day outcome. Predictors of acute cor pulmonale and the short-term outcome were calculated by univariate and multivariate logistic regressions including odds ratios (OR) and ROC analyses using positive (PPV) and negative predictive values (NPV). Results: 90 patients with acute PE were included (36 with clinically suspected PE, 54 with incidental PE). 26 patients had cardio-respiratory co-morbidities. Four patients underwent systemic thrombolysis, 43 underwent anticoagulation in therapeutic doses, 19 underwent anticoagulation in prophylactic doses, and 24 patients did not undergo ACT. 15 of 41 patients had echocardiographic evidence of acute cor pulmonale. 8 patients died within 30 days. The RV{sub D} was the best independent predictor of acute cor pulmonale (p = 0,002, OR = 9.16, PPV = 0.68, NPV=1 at 4.49 cm cut off) and short-term outcome (p= 0,0005, OR = 2.82, PPV = 0.23, NPV = 0.98 at 4.75 cm cut off). The RV{sub D}/LV{sub D} ratio had a PPV of 0.85 for cor pulmonale. (orig.)

  12. Use of multidetector CT in the diagnosis of Moyamoya disease

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    Gonzales-de Larrazabal, C.; Bhoey, H.K.; Lim, M.C.L. [Singapore Heart, Stroke and Cancer Centre, Ngee Ann City (Singapore)

    2005-07-01

    This article presents an adult case of moyamoya disease, diagnosed with CT angiography, and discusses the value of using a multidetector CT scan in the diagnosis of the disease. The patient's previous MRA and conventional angiography are used for comparison. (orig.)

  13. Multidetector CT angiography in Takayasu arteritis

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

    2011-02-15

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

  14. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  15. CT paging arteriography with a multidetector-row CT. Advantages in splanchnic arterial imaging

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    Kobayashi, Seiji [Keio Univ., Tokyo (Japan). School of Medicine

    1999-11-01

    The purpose of this study is to assess the utility of CT paging arteriography with a multidetector-row CT as a replacement for conventional angiography in the evaluation of splanchnic arterial anomalies. Sixty-three patients underwent CT paging arteriography with a multidetector-row CT. In the 56 patients with conventional angiographic correlation, there was only one minor disagreement with CT paging arteriography. In the 7 patients who underwent IVDSA (intra venous digital subtraction angiography), CT paging arteriography defined four hepatic arterial anomalies which could not be depicted by IVDSA. In conclusion, CT paging arteriography provides noninvasive means to identify splanchnic arterial anomalies. (author)

  16. Multidetector Row CT Detection of a Patent Foramen Ovale Causing Neurologic Deficits in an Adolescent: A Case Report

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    Lee, Jung Bin [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kim, Dong Hun; Oh, Jae Hee [Dept. of Radiology, Chosun University College of Medicine, Gwangju (Korea, Republic of); Seo, Hye Sun [Dept. of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Suk, Eun Ha [Dept. of Anesthesiology and Pain Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2012-02-15

    A patent foramen ovale (PFO) is a persisting fetal circulation structural abnormality that can cause neurologic deficits such as migraine and cryptogenic stroke. Here we report a case of PFO diagnosed by cardiac multidetector row CT in an adolescent male with chronic migraine and stroke.

  17. Sacroiliitis in Ankylosing Spondylitis: Comparison with Multidetector Row CT and Plain Radiography

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    Yu, Ji Youn; Joo, Kyung Bin; Choi, Byeong Kyoo; Ryu, Jeong Ah; Kim, Tae Hwan; Choi, Woo Jung [Hanyang University Hospital, Seoul (Korea, Republic of)

    2009-03-15

    The objective of our study was to compare multidetector row CT and the plain radiographs for making the diagnosis and grading the sacroiliitis that accompanies ankylosing spondylitis. We wanted to determine the role of multidetector row CT for the evaluation of the sacroilitis in patients with ankylosing spondylitis. One hundred ninety two patients with clinically suspected ankylosing spondylitis were evaluated by conventional radiography and multidetector row CT. Two musculoskeletal radiologists retrospectively analyzed the images, and they graded the sacroiliitis using the modified New York Criteria. Multidetector row CT demonstrated a significantly higher sensitivity (74.5%, 83.3%) than did plain radiography (59.9%, 66.7%) for detecting early sacroiliitis (p<0.05). Multidetector row CT showed a higher grade of sacroiliitis in 114 and 127 of 384 sacroiliac joints. Performing multidetector row CT rather than plain radiography for making the diagnoses of accompanying ankylosing spondylitis allows an early start of treatment with a subsequently improved prognosis

  18. Esophageal injuries: Spectrum of multidetector row CT findings

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    Lutio di Castelguidone, Elisabetta de [Department of Radiology, I.N.T., IRCCS Fondazione G. Pascale, Via M. Semmola, I-80131 Naples (Italy)]. E-mail: e.delutio@virgilio.it; Merola, Stefanella [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, I-80131 Naples (Italy); Pinto, Antonio [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, I-80131 Naples (Italy); Raissaki, Maria [Department of Radiology, University Hospital of Iraklion, University of Crete Medical School, P.O. Box 1352, 711 10 Iraklion Crete (Greece); Gagliardi, Nicola [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, I-80131 Naples (Italy); Romano, Luigia [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, I-80131 Naples (Italy)

    2006-09-15

    Background: Aim of this study is to illustrate the multidetector row computed tomographic findings related to oesophageal injuries and their significance for therapeutic decisions. Method: From April 2002 to April 2005 we studied 16 patients with suspected oesophageal injury. Ten patients underwent standard chest radiograph, while five patients with suspected foreign body ingestion were submitted to cervical plain film and gastrografin swallow study. All 16 patients underwent multidetector row CT examination. Results: In six patients with cervical, thoracic and abdominal trauma, CT showed the presence of thoracic traumatic lesions and findings suggestive of perforation of the oesophagus. In five patients with foreign body ingestion cervical radiography was positive in only one case, while CT showed the presence of a foreign body in all cases. In three patients with post-intubation complications, CT showed the presence of perioesophageal fluid collection containing small gas bubbles in two cases and an oesophageal-aortic fistula in one case. In the remaining two patients with suspected spontaneous oesophageal perforation, CT demonstrated an oesophageal wall oedema and thickening in one case, and oesophageal fluid distension with perioesophageal small bubbles gas and fluid in the second case. Conclusion: Oesophageal injuries, when complicated with perforation, constitute a life-threatening condition. Knowledge of the CT signs of oesophageal injuries has important implications for the role of imaging at the time of initial diagnosis.

  19. ROLE OF MULTIDETECTOR CT IN EVALUATION OF NECK LESIONS

    Directory of Open Access Journals (Sweden)

    Reena Mathur

    2016-06-01

    Full Text Available AIMS AND OBJECTIVES To find out the role of multidetector computed tomography in the evaluation of neck lesions with respect to evaluation of the size, location and extent of tumour. Extension of tumour infiltrating into surrounding vascular and visceral structures. To correlate the findings of MD-CT with final diagnosis by biopsy. MATERIAL AND METHODS Data for the study was collected from patients with suspected neck lesions attending Department of Radio-diagnosis, J.L.N. Medical College and Associated Group of Hospitals, Ajmer, Rajasthan. A prospective study was conducted over a period (From 1st March 2014 to 31 Aug. 2015 on patients with clinically suspected neck lesions or patients who were diagnosed to have neck lesion on ultrasound and were referred to CT for further characterisation. The patients presented with symptoms of palpable neck mass and neck pain. Patients were evaluated using multidetector CT. A provisional diagnosis was made after CT scan and these findings were correlated with histopathology/surgical findings as applicable. RESULT In the present study, 97 out of 100 cases were correctly characterised by computed tomography giving an accuracy of 97%. One case of buccal carcinoma was wrongly diagnosed as benign lesion and another case of malignant lymph node was inaccurately diagnosed as benign lymph node, also another case of benign lymph node was inaccurately diagnosed as malignant lymph node. CONCLUSION Multidetector Computed Tomography of the neck has improved the localisation and characterisation of neck lesions. Accurate delineation of disease by CT scan provides a reliable preoperative diagnosis, plan for radiotherapy ports and posttreatment followup. However, histopathology still remains the gold standard as CT is not 100% accurate.

  20. MULTIDETECTOR CT STUDY OF ANATOMICAL VARIANTS OF ETHMOID SINUS

    Institute of Scientific and Technical Information of China (English)

    李玉华; 薛建平; 朱铭

    2004-01-01

    Objective To evaluate the significance of multidetector CT 3D reconstruction technique in showing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also discussed. Methods 250 cases of ethmoid sinuses were scanned transversally by multidetector scaner, coronal and sagittal views were reconstructed. Results Coronal and sagittal views were good enough to make diagnosis. 5 kinds of common ethmoid sinus variations were seen, including pneumatization of ethmoid bulla (56. 5% ) , Onodi air cell(26% ) , Hailer cell(6. 5% ) ,low ethmoid foveolas( 4. 3% )and over intromigratiny lamella papyracea (6. 5% ). Conclusion The coronal and other special views of ethmoid sinus are showed clearly by 3 D reconstruction which can provide detailed image informations for functional endoscopic sinus surgery.

  1. CT portography by multidetector helical CT. Comparison of three rendering models

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    Nakayama, Yoshiharu; Imuta, Masanori; Funama, Yoshinori; Kadota, Masataka; Utsunomiya, Daisuke; Shiraishi, Shinya; Hayashida, Yoshiko; Yamashita, Yasuyuki [Kumamoto Univ. (Japan). School of Medicine

    2002-12-01

    The purpose of this study was to assess the value of multidetector CT portography in visualizing varices and portosystemic collaterals in comparison with conventional portography, and to compare the visualizations obtained by three rendering models (volume rendering, VR; minimum intensity projection, MIP; and shaded surface display, SSD). A total of 46 patients with portal hypertension were examined by CT and conventional portography for evaluation of portosystemic collaterals. CT portography was performed by multidetector CT (MD-CT) scanner with a slice thickness of 2.5 mm and table feed of 7.5 mm. Three types of CT portographic models were generated and compared with transarterial portography. Among 46 patients, 48 collaterals were identified on CT transverse images, while 38 collaterals were detected on transarterial portography. Forty-four of 48 collaterals identified on CT transverse images were visualized with the MIP model, while 34 and 29 collaterals were visualized by the VR and SSD methods, respectively. The average CT value for the portal vein and varices was 198 HU with data acquisition of 50 sec after contrast material injection. CT portography by multidetector CT provides excellent images in the visualization of portosystemic collaterals. The images of collaterals produced by MD-CT are superior to those of transarterial portography. Among the three rendering techniques, MIP provides the best visualization of portosystemic collaterals. (author)

  2. Stress myocardial perfusion imaging with multidetector CT

    NARCIS (Netherlands)

    A. Rossi (Alexia); D. Merkus (Daphne); E. Klotz (Ernst); N.R.A. Mollet (Nico); P.J. de Feyter (Pim); G.P. Krestin (Gabriel)

    2014-01-01

    textabstractComputed tomographic (CT) coronary angiography is a well-established, noninvasive imaging modality for detection of coronary stenosis, but it has limited accuracy in demonstrating whether a coronary stenosis is hemodynamically significant. An additional functional test is often required

  3. Cardiac pathologies incidentally detected with non-gated chest CT; Inzidentelle Pathologien des Herzens im Thorax-CT

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    Scherer, Axel; Kroepil, P.; Lanzman, R.S.; Moedder, U. [Inst. fuer Radiologie, Universitaetsklinikum Duesseldorf, Heinrich-Heine-Univ. (Germany); Choy, G.; Abbara, S. [Cardiovascular Imaging Section, Massachusetts General Hospital, Harvard Medical School (United States)

    2009-12-15

    Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits noninvasive diagnosis of congenital and acquired cardiac pathologies and has thus become increasingly important in the last years. Several studies investigated the incidence and relevance of incidental extracardiac structures within the lungs, mediastinum, chest wall, and abdomen with gated coronary CT. This resulted in the general acceptance of the review of extracardiac structures as a routine component of coronary CT interpretation. On the other hand radiologists tend to neglect pericardial and cardiac pathologies in non-gated chest CT, which is primarily performed for the evaluation of the respiratory system or for tumor staging. Since the introduction of multi-detector spiral CT technology, the incidental detection of cardiac and pericardial findings has become possible using non-gated chest CT. This article reviews the imaging appearances and differential diagnostic considerations of incidental cardiac entities that may be encountered in non-gated chest CT. (orig.)

  4. Multidetector CT for congenital heart patients: what a paediatric radiologist should know

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    Paul, Jean-Francois; Rohnean, Adela; Sigal-Cinqualbre, Anne [Radiology Unit, Marie Lannelongue Hospital, Plessis-Robinson (France)

    2010-06-15

    Multidetector CT (MDCT) is increasingly used for imaging congenital heart disease (CHD) patients in addition to echocardiography, due to its ability to provide high quality three-dimensional images, giving a comprehensive evaluation of complex heart malformations. Using 4-slice or 16-slice CT, diagnostic information in CHD patients is limited to extra-cardiac anatomy, mainly the pulmonary arteries, aorta and venous connections. Due to high heart rates in babies however, coronary evaluation and intra-cardiac analysis were not reliable with the first generations of MDCT. Larger detector size with 64-slice CT and faster acquisition time, up to 75 ms for one slice, has progressively improved coronary and intra-cardiac visualization. Because radiation dose is the main concern, especially in children, every attempt to minimize dose whilst preserving image quality is important: the ALARA concept should always be applied in this population. The 80 kVp setting is now well accepted as a standard for more and more radiological teams involved in CT of children. Different acquisition strategies are now possible for childhood coronary imaging, using retrospective or even prospective gating. Using the latest technology, sub-mSv acquisitions are now attainable for scanning a whole thorax, providing a complete analysis of any 3-D cardiac malformation, including coronary artery course visualisation. This review will describe how technological developments have improved image quality with continuous reduction of radiation dose. (orig.)

  5. Pneumomediastinum on Multidetector CT: The Radiologic Signs and Underlying Disorders

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    Oh, Soo Jin; Kim, Young Tong [Soonchunhyang University Chunan Hospital, Cheonan (Korea, Republic of)

    2011-02-15

    We can see the typical signs of pneumomediastinum on chest radiography and we can also see them on the multiplanar reformatted (MPR) image of multidetector CT (MDCT). MDCT can help to understand the anatomical feature of these signs and differentiate pneumomediastinum from pneumothorax, pneumopericardium and the Mach band effect. MDCT shows the peribronchovascular air, which reveals the Macklin effect, and it can also evaluate the underlying disorders that cause pneumomediastinum. The purpose of this pictorial essay is to inform physicians about the mechanism and anatomical features of pneumomediastinum, and to help them understand the imaging findings and underlying disorders of pneumomediastinum as seen on MDCT

  6. Multidetector CT of pulmonary cavitation: filling in the holes.

    Science.gov (United States)

    Mortensen, K H; Babar, J L; Balan, A

    2015-04-01

    Pulmonary cavitation causes significant morbidity and mortality. Early diagnosis of the presence and aetiology of a cavity is therefore crucial in order to avoid further demise in both the localized pulmonary and systemic disorders that may manifest with pulmonary cavity formation. Multidetector CT has become the principal diagnostic technique for detecting pulmonary cavitation and its complications. This review provides an overview of the aetiologies and their imaging findings using this technique. Combining a literature review with case illustration, a synopsis of the different imaging features and constellations is provided, which may suggest a particular cause and aid the differentiation from diseases with similar findings.

  7. Evaluation of the influence of acquisition and reconstruction parameters for 16-row multidetector CT on coronary calcium scoring using a stationary and dynamic cardiac phantom

    Energy Technology Data Exchange (ETDEWEB)

    Begemann, Philipp G.C.; Koops, Andreas; Adam, Gerhard; Nolte-Ernsting, Claus [University Medical Center Hamburg-Eppendorf, Center of Diagnostic Imaging and Intervention, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Stevendaal, Udo van; Grass, Michael [Philips Research Laboratories Hamburg, Hamburg (Germany); Koester, Ralph [University Medical Center Hamburg-Eppendorf, Center of Cardiology and Cardiovascular Surgery, Department of Cardiology/Angiology, Hamburg (Germany); Mahnken, Andreas H. [University of Technology Aachen, University Hospital, Department of Diagnostic Radiology, Aachen (Germany)

    2007-08-15

    A calcium-scoring phantom with hydroxyapatite-filled cylindrical holes (0.5 to 4 mm) was used. High-resolution scans were performed for an accuracy baseline. The phantom was mounted to a moving heart phantom. Non-moving data with the implementation of an ECG-signal were acquired for different pitches (0.2/0.3), heart rates (60/80/95 bpm) and collimations (16 x 0.75/16 x 1.5 mm). Images were reconstructed with a cone-beam multi-cycle algorithm at a standard thickness/increment of 3 mm/1.5 mm and the thinnest possible thickness (0.8/0.4 and 2/1). Subsequently, ECG-gated moving calcium-scoring phantom data were acquired. The calcium volume and Agatston score were measured. The temporal resolution and reconstruction cycles were calculated. High-resolution scans determine the calcium volume with a high accuracy (mean overestimation, 0.8%). In the non-moving measurements, the volume underestimation ranged from about 6% (16 x 0.75 mm; 0.8/0.4 mm) to nearly 25% (16 x 1.5 mm; 3/1.5 mm). Moving scans showed increased measurement errors depending on the reconstructed RR interval, collimation, pitch, heart rate and gantry rotation time. Also, a correlation with the temporal resolution could be found. The reliability of calcium-scoring results can be improved with the use of a narrower collimation, a lower pitch and the reconstruction of thinner images, resulting in higher patient doses. The choice of the correct cardiac phase within the RR interval is essential to minimize measurement errors. (orig.)

  8. Aortic Stenosis: Evaluation with Multidetector CT Angiography and MR Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Eun Ju; Choi, Sang Il; Lim, Cheong; Park, Kye Hyun; Chang, Hyuk Jae; Choi, Dong Ju [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kim, Dong Hun [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Lee, Whal; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of)

    2008-10-15

    Aortic valvular stenosis (AS) is the most common valve disease which results in the need for a valve replacement. Although a Doppler echocardiography is the current reference imaging method, the multidetector computerized tomography (MDCT) and magnetic resonance imaging (MRI) have recently emerged as a promising method for noninvasive valve imaging. In this study, we briefly describe the usefulness and comparative merits of the MDCT and MRI for the evaluation of AS in terms of valvular morphology (as the causes of AS), quantification of aortic valve area, pressure gradient of flow (for assessment severity of AS), and the evaluation of the ascending aorta and cardiac function (as the secondary effects of AS). The familiarity with the MDCT and MRI features of AS is considered to be helpful for the accurate diagnosis and proper management of patients with a poor acoustic window.

  9. Study of Coronary Arteries by Means of Multidetector CT; Estudio de las arterias coronarias mediante tomografia computarizada multidetector

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, G. C.; Costas, M. I.; Delgado, C.; Velasco, M.; Tardaguila, F. [Hospital POVISA. Vigo. Pontevedra (Spain)

    2004-07-01

    Radiological study of coronary arteries has undergone major advances,especially with the incorporation of new CT multidetectors which afford temporary spatial resolution sufficient for the acquisition of high-quality images and diagnoses concerning various coronary artery abnormalities. The technique is described in terms of both facilitating data within a procedure making use of beta-blockers to slow heart rate and postprocess image reconstruction. Accordingly, our experience with a 16-detector CT and its clinical applications are illustrated. (Author)

  10. Trapping volumetric measurement by multidetector CT in chronic obstructive pulmonary disease: Effect of CT threshold

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaohua; Yuan, Huishu [Department of Radiology, Peking University Third Hospital, Beijing 100191 (China); Duan, Jianghui [Medical School, Peking University, Beijing 100191 (China); Du, Yipeng; Shen, Ning; He, Bei [Department of Respiration Internal Medicine, Peking University Third Hospital, Beijing 100191 (China)

    2013-08-15

    Purpose: The purpose of this study was to evaluate the effect of various computed tomography (CT) thresholds on trapping volumetric measurements by multidetector CT in chronic obstructive pulmonary disease (COPD).Methods: Twenty-three COPD patients were scanned with a 64-slice CT scanner in both the inspiratory and expiratory phase. CT thresholds of −950 Hu in inspiration and −950 to −890 Hu in expiration were used, after which trapping volumetric measurements were made using computer software. Trapping volume percentage (Vtrap%) under the different CT thresholds in the expiratory phase and below −950 Hu in the inspiratory phase was compared and correlated with lung function.Results: Mean Vtrap% was similar under −930 Hu in the expiratory phase and below −950 Hu in the inspiratory phase, being 13.18 ± 9.66 and 13.95 ± 6.72 (both lungs), respectively; this difference was not significant (P= 0.240). Vtrap% under −950 Hu in the inspiratory phase and below the −950 to −890 Hu threshold in the expiratory phase was moderately negatively correlated with the ratio of forced expiratory volume in one second to forced vital capacity and the measured value of forced expiratory volume in one second as a percentage of the predicted value.Conclusions: Trapping volumetric measurement with multidetector CT is a promising method for the quantification of COPD. It is important to know the effect of various CT thresholds on trapping volumetric measurements.

  11. Prevalence of thoracolumbar vertebral fractures on multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Bartalena, Tommaso [Department of Radiology, S. Orsola University Hospital, Via Massarenti 9 - 40138 Bologna (Italy)], E-mail: t.bartalena@email.it; Giannelli, Giovanni; Rinaldi, Maria Francesca [Department of Radiology, S. Orsola University Hospital, Via Massarenti 9 - 40138 Bologna (Italy); Rimondi, Eugenio [Department of Radiology, Rizzoli Orthopaedic Institute, Via G.C. Pupilli 1 - 40136 Bologna (Italy); Rinaldi, Giovanni [Department of Radiology, S. Orsola University Hospital, Via Massarenti 9 - 40138 Bologna (Italy); Sverzellati, Nicola [Department of Clinical Sciences, Section of Radiology, University of Parma, Via Gramsci, 14 - 43100 Parma (Italy); Gavelli, Giampaolo [Department of Radiology, S. Orsola University Hospital, Via Massarenti 9 - 40138 Bologna (Italy)

    2009-03-15

    Objective: To evaluate the prevalence of osteoporotic vertebral fractures in patients undergoing multidetector computed tomography (MDCT) of the chest and/or abdomen. Materials and methods: 323 consecutive patients (196 males, 127 females) with a mean age of 62.6 years (range 20-88) who had undergone chest and/or abdominal MDCT were evaluated. Sagittal reformats of the spine obtained from thin section datasets were reviewed by two radiologists and assessed for vertebral fractures. Morphometric analysis using electronic calipers was performed on vertebral bodies which appeared abnormal upon visual inspection. A vertebral body height loss of 15% or more was considered a fracture and graded as mild (15-24%), moderate (25-49%) or severe (more than 50%). Official radiology reports were reviewed and whether the vertebral fractures had been reported or not was noted. Results: 31 out of 323 patients (9.5%) had at least 1 vertebral fracture and 7 of those patients had multiple fractures for a total of 41 fractures. Morphometric grading revealed 10 mild, 16 moderate and 15 severe fractures. Prevalence was higher in women (14.1%) than men (6.6%) and increased with patients age with a 17.1% prevalence in post-menopausal women. Only 6 out 41 vertebral fractures (14.6%) had been noted in the radiology final report while the remaining 35 (85.45) had not. Conclusion: although vertebral fractures represent frequent incidental findings on multidetector CT studies and may be easily identified on sagittal reformats, they are often underreported by radiologists, most likely because of unawareness of their clinical importance.

  12. Spine fractures in falling accidents: analysis of multidetector CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Bensch, Frank V.; Kiuru, Martti J.; Koivikko, Mika P.; Koskinen, Seppo K. [Department of Radiology, Toeoeloe Trauma Center, Helsinki University Central Hospital, Topeliuksenkatu 5, 00029, Helsinki (Finland)

    2004-04-01

    The purpose of the present study was to assess incidence, fracture type, and location of spine fractures due to falls. All emergency room CT requests during a time period of 26 months were reviewed retrospectively. Patients who had fallen or jumped and were initially examined with multidetector CT (MDCT) were included. The MDCT studies were evaluated by two radiologists for trauma location, fracture type, and multiple level involvement. A total of 237 patients (184 males, 53 female, age range 16-86 years, mean age 42 years) met the inclusion criteria. A total of 203 vertebral fractures were seen in 127 patients. Burst fracture (n=78) was the most frequent type of trauma, usually located in the thoracolumbar junction (50%). Also, compression fracture (n=52) was most common in the thoracolumbar junction (39%). Posterior column fracture (n=52) was most frequently detected in the cervical spine (40%). Multiple-level spine fractures were seen in 41 (32%) of the injured patients, of which 12 (29%) had fractures at noncontinuous levels. With increasing height the overall incidence of fractures increased, and burst fractures and multiple level spine fractures became more frequent. Age had no effect on fracture type or location. Spine fractures due to falls are common. Burst fracture is the most common fracture type and most frequently seen in the thoracolumbar junction. Multiple-level fractures were seen in 32% of the cases, of which 29% were seen at noncontinuous levels. Serious spine fractures are seen in all falling height and age groups. (orig.)

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

    Science.gov (United States)

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

    2013-01-01

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

  14. Multidetector row-CT in evaluation of living renal donors

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ji-qing; HU Xiao-peng; WANG Wei; LI Xiao-bei; YIN Hang; ZHANG Xiao-dong

    2010-01-01

    Background Multidetector-row CT (MDCT) has been evolving to the standard evaluating method of potential living donor in most centers, and can provide excellent details for selecting candidates and determining surgical technique.This study aimed to assess the value of MDCT in evaluation of the anatomy of living kidney donors and to reveal the prevalence of renal vascular variations in a Chinese population.Methods One hundred and four potential donors underwent MDCT and the data sets were post-processed for reformatted images with various techniques, such as maximum intensity projection (MIP), a volume-rendering technique (VR), and multiplanar reformation (MPR). Donor nephrectomies were performed on 97 candidates after MDCT evaluation with the findings during surgery constituting the standard of reference. Resulting MDCT images were compared with actual anatomy found during surgery. Results The MDCT images accurately displayed the anatomic structure of the main renal arteries and veins as well as the upper ureters, except in one case with horseshoe kidney. The prevalence of accessory arteries revealed in images was 27.2% (28/103) and early branching was found in 12.6% (13/103). Compared with findings during surgery, the detection of accessory arteries in MDCT images was 85.7% (6/7), and the detection of larger accessory arteries (>1.5 mm in diameter) was 100%. Detection of early branching was 100%.Conclusion MDCT helps accurately evaluate the renal anatomy of potential donors thus facilitating the planning of surgery.

  15. First experiences with multidetector CT in traumatized children

    Energy Technology Data Exchange (ETDEWEB)

    Hoermann, Marcus E-mail: marcus.hoermann@univie.ac.at; Scharitzer, Martina; Philipp, M.; Metz, Viktor M.; Lomoschitz, F

    2003-10-01

    Introduction: The aim of this study was to describe and discuss first experiences with multidetector CT (MDCT) in the assessment of traumatized children. Material and methods: Since the implementation of a MDCT scanner in April 2002, 85 children (31 girls, 54 boys with a mean age of 9.2 years) consecutively underwent MDCT (Siemens, Erlangen, Germany) with different protocols depending on age, weight, trauma mechanism and clinical presentation. In all patients in whom pathology was suspected, multiplanar reformations (MPR) in coronal and or sagittal orientation was performed. Examinations were evaluated by two radiologists retrospectively and in consensus. Results: In 55 (65%) children, a MDCT solely of the head was performed, in 46 there was no pathology found. In six (7%), head and facial bones were scanned. Head and abdomen was examined in two (2%), in two (2%) the abdomen only and in one (1%) the pelvis solely. Scans of the spine were obtained in seven (8%) children. A thorax and abdomen examination only was obtained in one (1%) child each. In 11 (13%) children, a polytrauma protocol was performed. In all patients, the time of examination did not exceed 17 min, including setup time. All children survived at the writing of this report. Conclusion: MDCT was promising in the management of traumatized children and seems to shorten the necessary time to reach diagnosis and to initiate life-saving treatment.

  16. Imaging of aortopulmonary collateral arteries with high-resolution multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Greil, Gerald F.; Hofbeck, Michael; Sieverding, Ludger [University of Tuebingen, Department of Pediatric Cardiology, Children' s Hospital, Tuebingen (Germany); Schoebinger, Max; Meinzer, Hans-Peter [German Cancer Research Center, Division of Medical and Biological Informatics, Heidelberg (Germany); Kuettner, Axel; Schaefer, Juergen F.; Dammann, Florian; Claussen, Claus D. [University of Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany)

    2006-06-15

    Precise visualization of the pulmonary vasculature is mandatory for adequate treatment of patients with pulmonary atresia and ventricular septal defect (PA-VSD). Aortopulmonary collateral arteries (APCs) can be visualized by selective injections of contrast agent in the catheterization laboratory. To evaluate multidetector CT (MDCT) and different image postprocessing methods for analysis of complex pulmonary blood supply in patients with PA-VSD. Eight patients (6 weeks to 27.8 years of age) with PA-VSD and APCs underwent MDCT and cardiac catheterization. Using multiplanar reformatting, volume rendering and semiautomatic segmentation algorithms, the aorta, pulmonary arteries and APCs were displayed. MDCT and cardiac catheterization were analyzed by two independent observers. MDCT accurately imaged central pulmonary arteries (n=8), aortopulmonary shunts (n=2), right ventricular to pulmonary artery conduits (n=2) and origin, course and intrapulmonary connections of APCs (n=25), compared to X-ray angiography. A high correlation was found between the MDCT vessel diameter measurements by two independent observers (n=70, r=0.96, P<0.01) and between MDCT and angiographic vessel diameter measurements (n=68, r=0.96, P<0.01). Using three-dimensional imaging software, a complex pulmonary blood supply can be non-invasively and accurately imaged with high-resolution MDCT. This technique may help to reduce the number of cardiac catheterizations or guide interventional or surgical therapy. (orig.)

  17. Acute aortic syndromes: Role of multi-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Salvolini, Luca; Renda, Pietro [Department of Radiology, University ' Politecnica delle Marche' , Ancona (Italy); Fiore, Davide [Department of Radiology, University of Padova, Padova (Italy); Scaglione, Mariano [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Naples (Italy); Piccoli, GianPiero [Cardiosurgery Division, Ospedali Riuniti ' Torrette-Lancisi-Salesi' , Ancona (Italy); Giovagnoni, Andrea [Department of Radiology, University ' Politecnica delle Marche' , Ancona (Italy)], E-mail: a.giovagnoni@univpm.it

    2008-03-15

    Acute thoracic aortic syndromes encompass a spectrum of emergencies including aortic dissection, intramural haematoma, penetrating atherosclerotic ulcer and aneurysm rupture. All these life-threatening conditions require prompt diagnosis and appropriate management. To date multi-detector row Computed Tomography represents a valuable diagnostic tool especially in the emergency setting. This paper focus on the use of multi-detector row Computed Tomography in the evaluation of acute thoracic aortic syndromes and illustrates the key imaging findings related to each disease.

  18. Guideline for appropriate use of cardiac CT in heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jin; Hong, Yoo Jin [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Yong, Hwan Seok [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Sung Mok [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jeong A [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of); Yang, Dong Hyun [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2014-02-15

    Heart disease is one of the leading causes of deaths in Korea, along with malignant neoplasms and cerebrovascular diseases. The proper diagnosis and management for patients with suspected heart diseases should be warranted for the public health care. Advances in CT technology have allowed detailed images of the heart to be obtained, which enable evaluations not only of the coronary arteries but also of other cardiac structures. Currently, the latest multi-detector CT machines are widespread around Korea. The appropriate use of cardiac CT may lead to improvements of the physicians' medical performances and to reduce medical costs which eventually contribute to promotions of public health. However, until now, there has been no guidelines regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist the clinicians and other health professionals when using cardiac CT for diagnosis and treatments of heart diseases.

  19. Correlation between Acute Coronary Syndrome Classification and Multi-detector CT Characterization of Plaque

    Institute of Scientific and Technical Information of China (English)

    Zhi-guo Wang; Lu-yue Gai; Jing-jing Gai; Ping Li; Xia Yang; Qin-hua Jin; Yun-dai Chen; Zhi-jun Sun; Zhi-wei Guan

    2011-01-01

    Objective To determine if multi-detector CT (MDCT) characterization of plaque is correlated with the classification of acute coronary syndrome (ACS). Methods Altogether 1900 patients were examined by MDCT from December 2007 to May 2009,of whom 95 patients fulfilled the criteria of ACS. Those patients were divided into the discrete plaque group (n=61) and diffuse plaque group (n=34) based on the findings in MDCT. The clinical diagnosis of ACS and CT results were analyzed, including segment stenosis score, segment involvement score, 3-vessel plaque score, left main score, calcification score, and remodeling index. The incidences of major adverse cardiac events in follow-up period were also recorded.Results The patients of the diffuse plaque group were older than those of the discrete plaque group (P<0.0001). The diffuse plaque group presented more cases of hypertension, peripheral artery disease, diabetes, and heart failure than discrete plaque group (all P<0.05). All the 5 patients with ST-segment elevation myocardial infarction were found in discrete plaque group. The segment stenosis score of the discrete plaque group was lower than that of the diffuse plaque group (5.15+3.55 vs. 14.91+5.37, P<0.001). The other four scores demonstrated significant inter-group difference as well (all P<0.05). The remodeling index of the discrete plaque group was higher (1.12+0.16 vs. 0.97+0.20, P<0.05). Follow-up data showed that major adverse cardiac events occurred more frequently in diffuse plaque group than in discrete group (29.41% vs.11.48%, P=0.0288).Conclusions Characteristics of discrete and diffuse plaques may be significandy different among different classes of ACS. The diffuse plaque may present higher risk, correlated to higher mortality. The diagnosis of discrete and diffuse plaques by MDCT would provide a new insight into the prognosis and treatment of ACS.

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

    Science.gov (United States)

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

    2011-01-01

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

  1. Deepgoing study on intrathoracic tuberculous lymphadenitis in adults using multidetector CT

    Institute of Scientific and Technical Information of China (English)

    LUO Ming-yue; LIU Li; LAI Li-sha; DONG Yun-xu; LIANG Wen-wei; QIN Jie

    2010-01-01

    Background Studies on intrathoracic tuberculous lymphadenitis in adults are confined to the preliminary CT findings with ordinary CT and ordinary spiral CT.There has been no deepgoing study of multidetector CT to date.Multidetector CT could contribute to better imaging of intrathoracic tuberculous lymphadenitis in adults.The purpose of this study was to explore the multidetector CT features of intrathoracic tuberculous lymphadenitis in adults, and the correlation with clinical symptoms and pathologic changes.Methods Multidetector CT findings from 42 consecutive adult patients with intrathoracic tuberculous lymphadenitis were analyzed retrospectively with regard to locations, sizes, numbers, shapes, margins, and densities reviewing precontrast and enhanced images.CT results were correlated with clinical symptoms and pathologic results (n=37).Results One hundred and eighty-five intrathoracic lymph nodes that had tuberculous lymphadenitis in 42 patients were distributed mainly in regions 4R (n=37), 2R (n=33), 7 (n=31) and 10R (n=21), more than 2 regions were implicated in 34 patients.One hundred and twenty-two (72.2%) of the tuberculous lymphadenitis without confluence were oval or round with clear margins.On precontrast scanning, 78.4% of tuberculous lymphadenitis had a homogeneous density.Seven enhancement patterns were demonstrated in 169 tuberculous lymphadenitis from 37 patients with pathologic results:homogeneous enhancement with no clinical symptom (n=12), corresponded pathologically to tuberculous hyperplasia without caseous necrosis; heterogeneous enhancement with a small central no enhancement area, slight clinical symptoms (n=22), tuberculous granulomas with a little caseous necroses; peripheral irregular thick wall enhancement with a central area with no enhancement, slight clinical symptoms (n=52), tuberculous granulomas with some caseous necroses in the center; peripheral thin rim enhancement with a central area having no enhancement, moderate clinical

  2. Multidetector CT evaluation of total anomalous pulmonary venous connections: comparison with echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ki Ho; Choo, Ki Seok [Pusan National University Hospital, Department of Radiology, Medical Institute, Pusan (Korea); Lim, Soo Jin [Kim Hae Joong Ang Hospital, Department of Cardiology, Kimhae (Korea); Lee, Hyoung Doo; Park, Ji Ae; Jo, Min Jung [Pusan National University Hospital, Department of Paediatrics, Pusan (Korea); Sung, Si Chan; Chang, Yun Hee [Pusan National University Hospital, Department of Thoracic and Cardiovascular Surgery, Pusan (Korea); Jeong, Dong Wook [Pusan National University Hospital, Department of Family Medicine, Pusan (Korea); Kim, Siho [Dong-A University Hospital, Department of Thoracic and Cardiovascular Surgery, Pusan (Korea)

    2009-09-15

    Although echocardiography is the first-line imaging modality in the diagnosis of total anomalous pulmonary venous connection (TAPVC), multidetector CT (MDCT) could have advantages in the diagnosis of TAPVC in certain cases. To compare MDCT with echocardiography in the evaluation of TAPVC. Enrolled in the study were 23 patients with surgically proven TAPVC. The echocardiography and MDCT findings were independently interpreted by a paediatric cardiologist and cardiac radiologist in terms of: (1) the drainage site of the common pulmonary vein, (2) stenosis of the vertical vein, and (3) the course of the atypical vessel into the systemic vein in the case of vertical vein stenosis. The findings from both modalities were correlated with the results obtained at surgery (n=22) or autopsy (n=1). In all patients, MDCT correctly depicted the drainage site of the common pulmonary vein, stenosis of the vertical vein and the course of the atypical vessel into the systemic vein (sensitivity 100%, specificity 100%). The specificity of echocardiography was 100% for the three defined findings. The sensitivity of echocardiography, however, was 87%, 71% and 0%, respectively. MDCT can facilitate the diagnosis of TAPVC in certain cases. (orig.)

  3. Advances in multidetector CT diagnosis of pediatric pulmonary thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Thacker, Paul G. [Dept. of Radiology and Radiological Science, Medical University of South Carolina, Charleston (United States); Lee, Edward Y. [Divi. of Thoracic Imaging, Dept. of Radiology and Medicine, Pulmonary Division Boston Children' s Hospital, Harvard Medical School, Boston (United States)

    2016-04-15

    Although pediatric pulmonary thromboembolism is historically believed to be rare with relatively little information available in the medical literature regarding its imaging evaluation, it is more common than previously thought. Thus, it is imperative for radiologists to be aware of the most recent advances in its imaging information, particularly multidetector computed tomography (MDCT), the imaging modality of choice in the pediatric population. The overarching goal of this article is to review the most recent updates on MDCT diagnosis of pediatric pulmonary thromboembolism.

  4. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-03-15

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

  6. Multidetector CT Findings of Bowel Transection in Blunt Abdominal Trauma

    NARCIS (Netherlands)

    Cho, H.S.; Woo, J.Y.; Hong, H.S.; Park, M.H.; Ha, H.I.; Yang, I.; Lee, Y.; Jung, A.Y.; Hwang, J.Y.

    2013-01-01

    OBJECTIVE: Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blu

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-15

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

  8. Multi-detector CT in the paediatric urinary tract

    Energy Technology Data Exchange (ETDEWEB)

    Damasio, M.B., E-mail: mariabdamasio@ospedale-gaslini.ge.it [Paediatric Radiology, Giannina Gaslini Institute, Genoa (Italy); Darge, K. [Department of Radiology, Children' s Hospital of Philadelphia, Philadelphia (United States); Riccabona, M. [Department of Radiology, Division of Paediatric Radiology, University Hospital Graz (Austria)

    2013-07-15

    The use of paediatric multi-slice CT (MSCT) is rapidly increasing worldwide. As technology advances its application in paediatric care is constantly expanding with an increasing need for radiation dose control and appropriate utilization. Recommendations on how and when to use CT for assessment of the paediatric urinary tract appear to be an important issue. Therefore the European Society of Paediatric Radiology (ESPR) uroradiology task force and European Society of Urogenital Radiology (ESUR) paediatric working groups created a proposal for performing renal CT in children that has recently been published. The objective of this paper is to discuss paediatric urinary tract CT (uro-CT) in more detail and depth. The specific aim is not only to offer general recommendations on clinical indications and optimization processes of paediatric CT examination, but also to address various childhood characteristics and phenomena that facilitate understanding the different approach and use of uro-CT in children compared to adults. According to ALARA principles, paediatric uro-CT should only be considered for selected indications provided high-level comprehensive US is not conclusive and alternative non-ionizing techniques such as MR are not available or appropriate. Optimization of paediatric uro-CT protocols (considering lower age-adapted kV and mAs) is mandatory, and the number of phases and acquisition series should be kept as few as possible.

  9. Multi-detector CT imaging in the postoperative orthopedic patient with metal hardware.

    Science.gov (United States)

    Vande Berg, Bruno; Malghem, Jacques; Maldague, Baudouin; Lecouvet, Frederic

    2006-12-01

    Multi-detector CT imaging (MDCT) becomes routine imaging modality in the assessment of the postoperative orthopedic patients with metallic instrumentation that degrades image quality at MR imaging. This article reviews the physical basis and CT appearance of such metal-related artifacts. It also addresses the clinical value of MDCT in postoperative orthopedic patients with emphasis on fracture healing, spinal fusion or arthrodesis, and joint replacement. MDCT imaging shows limitations in the assessment of the bone marrow cavity and of the soft tissues for which MR imaging remains the imaging modality of choice despite metal-related anatomic distortions and signal alteration.

  10. Determination of the weighted CT dose index in modern multi-detector CT scanners.

    Science.gov (United States)

    Perisinakis, K; Damilakis, J; Tzedakis, A; Papadakis, A; Theocharopoulos, N; Gourtsoyiannis, N

    2007-11-07

    The aim of the present study was to (a) evaluate the underestimation in the value of the free-in-air (CTDI(air)) and the weighted CT dose index (CTDI(w)) determined with the standard 100 mm pencil chamber, i.e. the CTDI(100) concept, for the whole range of nominal radiation beam collimations selectable in a modern multi-slice CT scanner, (b) estimate the optimum length of the pencil-chamber and phantoms for accurate CTDI(w) measurements and (c) provide CTDI(w) values normalized to free-in-air CTDI for different tube-voltage, nominal radiation beam collimations and beam filtration values. The underestimation in the determination of CTDI(air) and CTDI(w) using the CTDI(100) concept was determined from measurements obtained with standard polymethyl-methacrylate (PMMA) phantoms and arrays of thermoluminescence dosimeters. The Monte Carlo N-Particle transport code was used to simulate standard CTDI measurements on a 16-slice CT scanner. The optimum pencil-chamber length for accurate determination of CTDI(w) was estimated as the minimum chamber length for which a further increase in length does not alter the value of the CTDI. CTDI(w)/CTDI(air) ratios were determined using Monte Carlo simulation and the optimum detector length for all selectable tube-voltage values and for three different values of beam filtration. To verify the Monte Carlo results, measured values of CTDI(w)/CTDI(air) ratios using the standard 100 mm pencil ionization chamber were compared with corresponding values calculated with Monte Carlo experiments. The underestimation in the determination of CTDI(air) using the 100 mm pencil chamber was less than 1% for all beam collimations. The underestimation in CTDI(w) was 15% and 27% for head and body phantoms, respectively. The optimum detector length for accurate CTDI(w) measurements was found to be 50 cm for the beam collimations commonly employed in modern multi-detector (MD) CT scanners. The ratio of CTDI(w)/CTDI(air) determined using the optimum

  11. Value of three-dimensional reconstructions in pancreatic carcinoma using multidetector CT: Initial results

    Institute of Scientific and Technical Information of China (English)

    Miriam Klauβ; Max Sch(o)binger; Ivo Wolf; Jens Werner; Hans-Peter Meinzer; Hans-Ulrich Kauczor; Lars Grenacher

    2009-01-01

    AIM: To evaluate the use of three-dimensional imaging of pancreatic carcinoma using multidetector computed tomography (CT) in a prospective study. METHODS: Ten patients with suspected pancreatic tumors were examined prospectively using multidetector CT (Somatom Sensation 16, Siemens, Erlangen, Germany). The images were evaluated for the presence of a pancreatic carcinoma and invasion of the peripancreatic vessels and surrounding organs. Using the isotropic CT data sets, a three-dimensional image was created with automatic vascular analysis and semiautomatic segmentation of the organs and pancreatic tumor by a radiologist. The CT examinations and the three-dimensional images were presented to the surgeon directly before and during the patient's operation using the Medical Imaging Interaction Toolkit-based software "ReLiver". Immediately after surgery, the value of the two images was judged by the surgeon. The operation and the histological results served as the gold standard. RESULTS: Nine patients had a pancreatic carcinoma (all pT3), and one patient had a serous cystadenoma. One tumor infiltrated the superior mesenteric vein. The infiltration was correctly evaluated. All carcinomas were resectable. In comparison to the CT image with axial and coronal reconstructions, the three-dimensional image was judged by the surgeons as better for operation planning and consistently described as useful. CONCLUSION: A 3D-image of the pancreas represents an invaluable aid to the surgeon. However, the 3D-software must be further developed in order to be integrated into daily clinical routine.

  12. Acute mediastinitis: multidetector computed tomography findings following cardiac surgery

    Energy Technology Data Exchange (ETDEWEB)

    Macedo, Clarissa Aguiar de [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Instituto do Coracao (InCor)]. E-mail: clarissaaguiarm@yahoo.com.br; Baena, Marcos Eduardo da Silva [Instituto do Coracao (InCor), Sao Paulo, SP (Brazil). Unit of Ultrasonography; Uezumi, Kiyomi Kato [Instituto do Coracao (InCor), Sao Paulo, SP (Brazil). Unit of Computed Tomography; Castro, Claudio Campi de [Instituto do Coracao (InCor), Sao Paulo, SP (Brazil). Unit of Magnetic Resonance Imaging; Lucarelli, Claudio Luiz [Instituto do Coracao (InCor), Sao Paulo, SP (Brazil). Center of Diagnosis; Cerri, Giovanni Guido [Universidade de Sao Paulo (USP), SP (Brazil). School of Medicine. Dept. of Radiology

    2008-07-15

    Postoperative mediastinitis is defined as an infection of the organs and tissues in the mediastinal space, with an incidence ranging between 0.4% and 5% of cases. This disease severity varies from infection of superficial tissues in the chest wall to fulminant mediastinitis with sternal involvement. Diagnostic criterion for postoperative detection of acute mediastinitis at computed tomography is the presence of fluid collections and gas in the mediastinal space, which might or might not be associated with peristernal abnormalities such as edema of soft tissues, separation of sternal segments with marginal bone resorption, sclerosis and osteomyelitis. Other associated findings include lymphadenomegaly, pulmonary consolidation and pleural/ pericardial effusion. Some of these findings, such as mediastinal gas and small fluid collections can be typically found in the absence of infection, early in the period following thoracic surgery where the effectiveness of computed tomography is limited. After approximately two weeks, computed tomography achieves almost 100% sensitivity and specificity. Patients with clinical suspicion of mediastinitis should be submitted to computed tomography for investigating the presence of fluid collections to identify the extent and nature of the disease. Multidetector computed tomography allows 3D images reconstruction, contributing particularly to the evaluation of the sternum. (author)

  13. 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.)

  14. Estudio vascular renal por TC multidetector de 64 canales 64-Multidetector row CT for the Renal Vascular Study

    Directory of Open Access Journals (Sweden)

    Daniela Stoisa

    2009-03-01

    Full Text Available Objetivo: Mostrar las diversas variantes anatómicas vasculares tanto arteriales como venosas en el estudio angiográfico renal por tomografìa computada multidetector (TCMD de 64 canales, dada su implicancia en un eventual planeamiento quirúrgico. Material y métodos: Evaluamos retrospectivamente 26 estudios realizados con tomógrafo Philips Brilliance de 64 canales. Se obtuvieron secuencias sin contraste y postcontraste e.v. en fases arterial y venosa, administrado con bomba inyectora doble cabezal. Para una fase arterial apropiada se utilizó técnica de bolus track. Las imágenes fueron posteriormente procesadas en Workstation Philips Brilliance 190P en un tiempo promedio de 30 minutos y reconstruidas con técnicas MIP y volumétrica. Resultados: Dentro de las variantes anatómicas arteriales, encontramos: bifurcaciones prehiliares (n=3, arterias accesorias (n=4 y arterias polares (n=9. Dentro de las variantes venosas fueron halladas: venas renales múltiples (n=5, venas circumaórticas (n=2, retroaórticas (n=2 y vena tributaria lumbar prominente (n=1. Conclusión: El estudio vascular renal adquiere importancia en el planeamiento quirúrgico en casos de nefrectomías parciales, laparoscópicas y en el transplante renal. Esto otorga suma utilidad al estudio de TCMD de 64 canales por su eficacia diagnóstica, dada la alta calidad de las reconstrucciones obtenidas, llegando a igualar a la angiografía digital, sin ser un método invasivo.Purpose: To show the wide range of anatomical vascular variants, arterial and venous, that can be seen in the angiographic renal study using 64-multidetector-row computed tomography (64-MDCT, due to its importance in an eventual surgical planning. Material and Methods: We have evaluated retrospectively 26 studies that have been done using a 64 channels Philips Brilliance CT scanner. We have obtained non enhanced and both in arterial and venous enhanced sequences. For the injection of the contrast material we

  15. [Multidetector row CT in assessment of coronary artery calcification on hemodialisis].

    Science.gov (United States)

    Caro, P; Delgado, R; Dapena, F; Núñez, A

    2007-01-01

    Vascular calcification is a strong predictor of cardiovascular and all-cause mortality. Coronary artery calcification is more frequent, more extensive and progresses more rapidly in CKD than in general population. They are also considered a marker of coronary heart disease, with high prevalence and functional significance. It suggests that detection and surveillance may be worthwhile in general clinical practice. New non-invasive image techniques, like Multi-detector row CT, a type of spiral scanner, assess density and volume of calcification at multiple sites and allow quantitative scoring of vascular calcification using calcium scores analogous to those from electron-beam CT. We have assessed and quantified coronary artery calcification with 16 multidetector row CT in 44 patients on hemodialysis and their relationship with several cardiovascular risk factors. Coronary artery calcification prevalence was of 84 % with mean calcium score of 1580 +/- 2010 ( r 0-9844) with calcium score > 400 in 66% of patients. It was usually multiple, affecting more than two vessels in more than 50%. In all but one patient, left anterior descending artery was involved with higher calcium score level at right coronary artery. Advanced age, male, diabetes, smoking, more morbidity, cerebrovascular disease previous, and calcium-binders phosphate and analogous vitamin D treatment would seem to be associated with coronary artery calcification. Coronary artery calcification is very frequent and extensive, usually multiple and associated to modifiable risk factors in hemodialysis patients. Multi-detector-row CT seems an effective, suitable, readily applicable method to assess and quantify coronary artery calcification.

  16. Pitfalls in detection of acute gastrointestinal bleeding with multi-detector row helical CT.

    Science.gov (United States)

    Stuber, T; Hoffmann, M H K; Stuber, G; Klass, O; Feuerlein, S; Aschoff, A J

    2009-07-01

    Contrast-enhanced multi-detector row helical CT angiography is establishing itself as an accurate, rapid, and non-invasive diagnostic modality in patients with acute gastrointestinal bleeding. On arterial phase MDCT images ongoing hemorrhage can be revealed as an area of active extravasation of contrast material within the bowel lumen. This pictorial essay gives a short overview of current diagnostic modalities in assessing acute GI tract bleeding, typical MDCT findings, and depicts potential pitfalls in the detection of acute GI bleeding with MDCT.

  17. T-staging of gastric cancer of air-filling multidetector-row CT: Comparison with hydro-multidetector-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Kumano, Seishi, E-mail: kumano@radiol.med.kindai.ac.jp [Department of Radiology, Kinki University School of Medicine, Osakasayama, Osaka 589-8511 (Japan); Okada, Masahiro; Shimono, Taro; Kuwabara, Masatomo; Yagyu, Yukinobu; Imaoka, Izumi; Ashikaga, Ryuichiro; Ishii, Kazunari; Murakami, Takamichi [Department of Radiology, Kinki University School of Medicine, Osakasayama, Osaka 589-8511 (Japan)

    2012-11-15

    Purpose: The purpose of this study was to evaluate the accuracy of T-staging of gastric cancer by air-filling multidetector-row CT (air-MDCT) compared with water-filling MDCT (hydro-MDCT). Materials and methods: One hundred fifteen patients with histologically diagnosed gastric cancer were included in this study. Fifty-eight patients underwent air-MDCT, and the remaining 57 had hydro-MDCT using a 64-channel scanner. Based on the volumetric data of contrast-enhanced MDCT obtained about 75 s after intravenously injecting 525 mg iodine per kilogram patients weight (525 mgI/kg) nonionic contrast material at the rate of 2 ml/s, oblique coronal and oblique sagittal multi-planar reformatted images perpendicular to the stomach wall, including the tumor, were reconstructed on a workstation. Mural invasion of gastric cancer into the gastric wall, as visualized by CT, was classified according to the TNM classification, and the results of T-staging by MDCT were compared with those by pathologic analysis after surgery. Results: Correct assessment of T-staging by air-CT was achieved in 48 of 58 patients (83%), and that by hydro-MDCT was 49 of 57 patients (86%). The sensitivity, specificity, and accuracy of the technique in determining the invasion of serosa were 88%, 93%, and 91% for air-CT and 83%, 95%, and 91% for hydro-CT. There were no significant differences between hydro-MDCT and air-MDCT in sensitivity (P = 0.73), specificity (P = 0.71) and accuracy (P = 0.98). Conclusion: Air-MDCT is a very valuable tool in T-staging of gastric cancer as well as hydro-MDCT.

  18. Virtual anthropology and forensic identification using multidetector CT.

    Science.gov (United States)

    Dedouit, F; Savall, F; Mokrane, F-Z; Rousseau, H; Crubézy, E; Rougé, D; Telmon, N

    2014-04-01

    Virtual anthropology is made possible by modern cross-sectional imaging. Multislice CT (MSCT) can be used for comparative bone and dental identification, reconstructive identification and lesion identification. Comparative identification, the comparison of ante- and post-mortem imaging data, can be performed on both teeth and bones. Reconstructive identification, a considerable challenge for the radiologist, identifies the deceased by determining sex, geographical origin, stature and age at death. Lesion identification combines virtual autopsy and virtual anthropology. MSCT can be useful in palaeopathology, seeking arthropathy, infection, oral pathology, trauma, tumours, haematological disorders, stress indicators or occupational stress in bones and teeth. We examine some of the possibilities offered by this new radiological subspeciality that adds a new dimension to the work of the forensic radiologist. A multidisciplinary approach is crucial and involves communication and data exchange between radiologists, forensic pathologists, anthropologists and radiographers.

  19. Multidetector CT and MRI findings in periportal space pathologies

    Energy Technology Data Exchange (ETDEWEB)

    Karcaaltincaba, Musturay [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey)]. E-mail: musturayk@yahoo.com; Haliloglu, Mithat [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey); Akpinar, Erhan [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey); Akata, Deniz [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey); Ozmen, Mustafa [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey); Ariyurek, Macit [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey); Akhan, Okan [Department of Radiology, Hacettepe University School of Medicine, Ankara 06100 (Turkey)

    2007-01-15

    Periportal region is an anatomic space around portal vein comprising hepatic artery, bile duct, nerves, lymphatics and a potential space. Periportal pathologies may involve any of these structures diffusely or focally with characteristic radiologic findings. Radiologic findings can be helpful in differential diagnosis of pathologies of periportal structures including periportal cavernomatous transformation, hepatic artery aneurysm, biliary diseases, neurofibromatosis, lymphoma, langerhans' cell histiocytosis, periportal fatty infiltration and other causes of periportal halo in adult and pediatric patients. Lobar/segmental intrahepatic involvement can be seen in neurofibromatosis, cavernomatous transformation, fatty infiltration and periportal edema. In this review, we discuss CT and MRI findings of periportal pathologies which can be in the form of diffuse or segmental/lobar involvement.

  20. Importance of multidetector CT imaging in multiple trauma; Stellenwert der Multidetektor-CT bei Polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmaier, U. [HELIOS Kliniken Muenchen West, HELIOS Klinik Muenchen Perlach, Institut fuer Diagnostische und Interventionelle Radiologie, Muenchen (Germany); Geyer, L.L.; Reiser, M.; Wirth, S. [Klinikum der Ludwig-Maximilians-Universitaet, Institut fuer Klinische Radiologie, Muenchen (Germany); Koerner, M. [Radiologie Muehleninsel, Landshut (Germany)

    2014-09-15

    Diagnostic imaging of complex multiple trauma remains a challenge for any department providing modern emergency radiology (ER) service. An early and comprehensive approach for ER imaging is crucial for a priority-oriented and timely therapy concept with the aim of identifying potentially life-threatening injuries early and initiating appropriate treatment. The basic diagnostic approach still consists of focused ultrasound using focused assessment with sonography for trauma (FAST) and conventional radiography (CR), usually limited to a single supine chest x-ray for triaging patients undergoing immediate operations. Multidetector computed tomography (MDCT) has become established as early whole body CT (WBCT) as the undisputable diagnostic method. The detection rate of injuries by WBCT is outstanding and it improves the probability of survival by 20-25 % compared with all other previous methods. At the same time, the spatial and temporal resolution of MDCT was improved resulting in considerably shortened examination times but WBCT is still associated with a significant radiation exposure, even in the acute single use setting. Using modern scanner and dose reduction technology, including iterative reconstruction, a dose reduction of up to 40 % could be achieved. The substantial number of images in WBCT is another challenge; images must be processed priority-oriented, read and transferred to the picture archiving and communications system (PACS). For rapid diagnosis, volume image reading (VIR) offers additional options to keep the diagnostic process on time. Modern WBCT after multiple trauma is performed early, comprehensively and personalized so that WBCT improves the probability of survival by 20-25 %. (orig.) [German] Die Diagnostik komplexer Mehrfachverletzungen ist eine Herausforderung fuer die moderne radiologische Notfalldiagnostik. Eine umfassend angelegte, fruehe und praezise radiologische Diagnostik ist entscheidend fuer eine prioritaetenorientierte und

  1. Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery

    Energy Technology Data Exchange (ETDEWEB)

    Pouleur, Anne-Catherine; Polain de Waroux, Jean-Benoit le; Kefer, Joelle; Pasquet, Agnes; Vanoverschelde, Jean-Louis; Gerber, Bernhard L. [Cliniques Universitaires St. Luc UCL, Cardiology Division, Woluwe St. Lambert (Belgium); Coche, Emmanuel [Cliniques Universitaires St. Luc UCL, Radiology Division, Woluwe St. Lambert (Belgium)

    2007-12-15

    Preoperative identification of significant coronary artery disease (CAD) in patients prior to valve surgery requires systematic invasive coronary angiography. The purpose of this current prospective study was to evaluate whether exclusion of CAD by multi-detector CT (MDCT) might potentially avoid systematic cardiac catheterization in these patients. Eighty-two patients (53 males, 62 {+-} 13 years) scheduled to undergo valve surgery underwent 40-slice MDCT before invasive quantitative coronary angiography (QCA). According to QCA, 15 patients had CAD (5 one-vessel, 6 two-vessel and 4 three-vessel disease). The remaining 67 patients had no CAD. On a per-vessel basis, MDCT correctly identified 27/29 (sensitivity 93%) vessels with and excluded 277/299 vessels (specificity 93%) without CAD. On a per-patient basis, MDCT correctly identified 14/15 patients with (sensitivity 93%) and 60/67 patients without CAD (specificity 90%). Positive and negative predictive values of MDCT were 67% and 98%. Performing invasive angiography only in patients with abnormal MDCT might have avoided QCA in 60/82 (73%). MDCT could be potentially useful in the preoperative evaluation of patients with valve disease. By selecting only those patients with coronary lesions to undergo invasive coronary angiography, it could avoid cardiac catheterization in a large number of patients without CAD. (orig.)

  2. Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery.

    Science.gov (United States)

    Pouleur, Anne-Catherine; le Polain de Waroux, Jean-Benoît; Kefer, Joëlle; Pasquet, Agnès; Coche, Emmanuel; Vanoverschelde, Jean-Louis; Gerber, Bernhard L

    2007-12-01

    Preoperative identification of significant coronary artery disease (CAD) in patients prior to valve surgery requires systematic invasive coronary angiography. The purpose of this current prospective study was to evaluate whether exclusion of CAD by multi-detector CT (MDCT) might potentially avoid systematic cardiac catheterization in these patients. Eighty-two patients (53 males, 62 +/- 13 years) scheduled to undergo valve surgery underwent 40-slice MDCT before invasive quantitative coronary angiography (QCA). According to QCA, 15 patients had CAD (5 one-vessel, 6 two-vessel and 4 three-vessel disease). The remaining 67 patients had no CAD. On a per-vessel basis, MDCT correctly identified 27/29 (sensitivity 93%) vessels with and excluded 277/299 vessels (specificity 93%) without CAD. On a per-patient basis, MDCT correctly identified 14/15 patients with (sensitivity 93%) and 60/67 patients without CAD (specificity 90%). Positive and negative predictive values of MDCT were 67% and 98%. Performing invasive angiography only in patients with abnormal MDCT might have avoided QCA in 60/82 (73%). MDCT could be potentially useful in the preoperative evaluation of patients with valve disease. By selecting only those patients with coronary lesions to undergo invasive coronary angiography, it could avoid cardiac catheterization in a large number of patients without CAD.

  3. Scenes from the past: multidetector CT of Egyptian mummies of the Redpath Museum.

    Science.gov (United States)

    Wade, Andrew D; Garvin, Gregory J; Hurnanen, Jaana H; Williams, Licd Lana; Lawson, Barbara; Nelson, Andrew J; Tampieri, Donatella

    2012-01-01

    As a nondestructive method of historical and anthropologic inquiry, imaging has played an important role in mummy studies over the past several decades. Recent technologic advances have made multidetector computed tomography (CT) an especially useful means for deepening the present understanding of ancient cultures by examining preserved human remains. In April 2011, three ancient Egyptian human mummies from the Redpath Museum of McGill University were examined with 320-section multidetector CT as part of the IMPACT Radiological Mummy Database project headquartered at the University of Western Ontario. Whole-body scanning was performed with a section thickness of 0.5 mm and a peak voltage of 120 kVp, and the raw CT datasets were postprocessed by using smooth body and high-resolution bone convolution filters. Two of the mummies were scanned at different energy levels (80 and 135 keV). The high-resolution CT scans revealed the details of mummification and allowed observations about the socioeconomic and health status of the human subjects based on both the mummification technique used and the appearance of the remains, particularly the bones and teeth. The paleopathologic information obtained from the scans confirmed some findings in studies performed in the same mummies in the late 19th and 20th centuries. The CT scans also demonstrated a high degree of variability in Egyptian mortuary practice, variability that is not generally recognized in the literature. Unusual features that were observed included a relatively uncommon retained heart in mummy RM2718, retained lungs in a mummy from which the heart had been extracted (RM2720), and a cartonnage plaque placed over the left abdomen of a mummy that had been eviscerated transperineally (RM2717).

  4. A portable cadmium telluride multidetector probe for cardiac function monitoring

    CERN Document Server

    Arntz, Y; Dumitresco, B; Eclancher, B; Prat, V

    1999-01-01

    A new nuclear stethoscope based on a matrix of small CdTe semiconductor detectors has been developed for studying the cardiac performance by gamma ventriculography at the equilibrium, in rest and stress conditions, in the early and recovery phases of the coronary disease and to follow the long-term therapy. The light-weight probe consists of an array of 64 detectors 5x5x2 mm grouped in 16 independent units in a lead shielded aluminum box including 16 preamplifiers. The probe is connected to an electronic box containing DC power supply, 16 channel amplifiers, discriminators and counters, two analog-triggering ECG channels, and interface to a PC. The left ventricle activity is, preferentially, detected by using a low-resolution matching convergent collimator. A physical evaluation of the probe has been performed, both with static tests and dynamically with a hydraulic home-built model of beating heart ventricle paced by a rhythm simulator. The sum of the 16 detectors activity provided a radiocardiogram (RCG) wh...

  5. Quantitative assessment of bone defect healing by multidetector CT in a pig model

    Energy Technology Data Exchange (ETDEWEB)

    Riegger, Carolin; Kroepil, Patric; Lanzman, Rotem S.; Miese, Falk R.; Antoch, Gerald; Scherer, Axel [University Duesseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany); Jungbluth, Pascal; Hakimi, Mohssen; Wild, Michael [University Duesseldorf, Medical Faculty, Department of Traumatology and Hand Surgery, Duesseldorf (Germany); Hakimi, Ahmad R. [Universtity Duesseldorf, Medical Faculty, Department of Oral Surgery, Duesseldorf (Germany)

    2012-05-15

    To evaluate multidetector CT volumetry in the assessment of bone defect healing in comparison to histopathological findings in an animal model. In 16 mini-pigs, a circumscribed tibial bone defect was created. Multidetector CT (MDCT) of the tibia was performed on a 64-row scanner 42 days after the operation. The extent of bone healing was estimated quantitatively by MDCT volumetry using a commercially available software programme (syngo Volume, Siemens, Germany).The volume of the entire defect (including all pixels from -100 to 3,000 HU), the nonconsolidated areas (-100 to 500 HU), and areas of osseous consolidation (500 to 3,000 HU) were assessed and the extent of consolidation was calculated. Histomorphometry served as the reference standard. The extent of osseous consolidation in MDCT volumetry ranged from 19 to 92% (mean 65.4 {+-} 18.5%). There was a significant correlation between histologically visible newly formed bone and the extent of osseous consolidation on MDCT volumetry (r = 0.82, P < 0.0001). A significant negative correlation was detected between osseous consolidation on MDCT and histological areas of persisting defect (r = -0.9, P < 0.0001). MDCT volumetry is a promising tool for noninvasive monitoring of bone healing, showing excellent correlation with histomorphometry. (orig.)

  6. Congenital heart diseases: post-operative appearance on multi-detector CT - a pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Tomasian, Anderanik; Malik, Sachin; Shamsa, Kamran; Krishnam, Mayil S. [UCLA Medical Center, Department of Radiological Science, Los Angeles, CA (United States)

    2009-12-15

    Echocardiography is considered as an initial imaging modality of choice in patients with congenital heart disease (CHD), and magnetic resonance (MR) imaging is preferred for detailed functional information. Multi-detector computed tomography (CT) plays an important role in clinical practice in assessing post-operative morphological and functional information of patients with complex CHD when echocardiography and MR imaging are not contributory. Radiologists should understand and become familiar with the complex morphology and physiology of CHD, as well as with various palliative and corrective surgical procedures performed in these patients, to obtain CT angiograms with diagnostic quality and promptly recognise imaging features of normal post-operative anatomy and complications of these complex surgeries. (orig.)

  7. 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.

  8. Normal or abnormal? Demystifying uterine and cervical contrast enhancement at multidetector CT.

    Science.gov (United States)

    Yitta, Silaja; Hecht, Elizabeth M; Mausner, Elizabeth V; Bennett, Genevieve L

    2011-01-01

    Computed tomography (CT) is not generally advocated as the first-line imaging examination for disorders of the female pelvis. However, multidetector CT is often the modality of choice for evaluating nongynecologic pelvic abnormalities, particularly in emergent settings, in which all the pelvic organs are invariably assessed. Incidental findings of uterine and cervical contrast enhancement in such settings may easily be mistaken for abnormalities, given the broad spectrum of anatomic variants and enhancement patterns that may be seen in the normal uterus and cervix. The authors' review of CT and magnetic resonance (MR) imaging enhancement patterns, augmented by case examples from their clinical radiology practice, provides a solid foundation for understanding the spectrum of normal uterine and cervical appearances and avoiding potential pitfalls in the diagnosis of benign cervical lesions, adenomyosis, infection, malignancy, and postpartum effects. This information should help radiologists more confidently differentiate between normal and abnormal CT findings and, when CT findings are not definitive, offer appropriate recommendations for follow-up ultrasonography or MR imaging.

  9. 64 multidetector CT findings of influenza A (H1N1) virus in patients with hematologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    El-Badrawy, Adel [Dept. of Radiology, Mansoura Faculty of Medicine, Mansoura (Egypt)], E-mail: adelelbadrawy@hotmail.com; Zeidan, Amany [Dept. of Thoracic Medicine, Mansoura Faculty of Medicine, Mansoura (Egypt); Ebrahim, Mohamed A. [Dept. of Medical Oncology, Mansoura Faculty of Medicine, Mansoura (Egypt)

    2012-07-15

    Background. The pandemic of swine-origin H1N1 influenza that began in early 2009 has provided evidence that radiology can assist in the early diagnosis of severe cases. Immunocompromised patients are at increased risk for morbidity and mortality. MDCT is superior to radiography in showing the distribution of the disease. Purpose. To review the 64 multidetector CT thoracic findings of novel swine-origin influenza A (H1N1) virus in patients with hematologic malignancies. Material and Methods. This study included 12 patients (3 women, 9 men; mean age, 32.2 years). All patients proved to be infected with influenza A (H1N1) virus. The hematologic malignancies were acute myeloid leukemia (n = 8), chronic lymphocytic leukemia (n = 2), multiple myeloma (n = 1), and myelodysplastic syndrome (n = 1). All the patients underwent CT scanning using a 64 multidetector CT scanner. Chest CT scans were reviewed for ground-glass opacities (GGOs), consolidation, airway thickening/dilatation, nodules, mediastinal lymphadenopathy, and pleural effusion. Results. More than one CT finding was detected in every patient. Pulmonary affection was bilateral, more on the left side. The affections were mainly peribronchial. Airway wall thickening and dilatation were detected in all 12 patients, GGO in 9/12 patients, nodules in 6/12 patients, consolidation in 6/12 patients, hilar lymphadenopathy in 3/12 patients, and pleural effusion in 2/12 patients. Conclusion. Acute myeloid leukemia is the most common hematologic malignancy affected by influenza A (H1N1) virus. The left lung is affected more than the right one. The most common multidetector CT findings are unilateral or bilateral airway thickening and dilatation. Multidetector CT can be used for early and accurate assessment of pulmonary affection with influenza A H1N1 virus infection.

  10. Bronchial anatomy of left lung: a study of multi-detector row CT.

    Science.gov (United States)

    Zhao, Xinya; Ju, Yuanrong; Liu, Cheng; Li, Jianfeng; Huang, Min; Sun, Jian; Wang, Tao

    2009-02-01

    Familiarity with prevailing pattern and variations in the bronchial tree is not only essential for the anatomist to explain bronchial variation in bronchial specimens, but also useful for guiding bronchoscopy and instructing pulmonary segmental resection. The purpose of this study was designed to demonstrate various branching patterns of left lung with 3D images, with special attention given to identify the major types at transverse thin-section CT. Two hundred and sixteen patients with routine thorax scans were enrolled. The images of bronchial tree, virtual bronchoscopy were reconstructed using post-processing technique of multi-detector row CT. We attempted to classify the segmental bronchi by interpreting the post-processing images, and identified them in transverse thin-section CT. Our results showed that the segmental bronchial ramifications of the left superior lobe were classified into three types mainly, i.e., common stem of apical and posterior segmental bronchi (64%, 138/216); trifurcation (23%, 50/216); common stem of apical and anterior segmental bronchi (10%, 22/216), and they could be identified at two typical sections of transverse thin-section CT. There were two major types in left basal segmental bronchi, i.e., bifurcation (75%, 163/216), trifurcation (18%, 39/216), and they could also be identified at two typical sections of transverse thin-section CT. In conclusion, our study have offered simplified branching patterns of bronchi and demonstrated various unusual bronchial branching patterns perfectly with 3D images, and have also revealed how to identify the main branching patterns in transverse thin-section CT.

  11. Comparison of 4 cm Z-axis and 16 cm Z-axis multidetector CT perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Page, Mark; Nandurkar, Dee; Crossett, Marcus Peter; Stuckey, Stephen L.; Lau, Kenneth P.; Kenning, Nicholas; Troupis, John M. [Monash Medical Centre, Department of Diagnostic Imaging, Southern Health Network, Clayton, Victoria (Australia)

    2010-06-15

    The aim of the study was to compare 4 cm with 16 cm Z-axis coverage in the assessment of brain CT perfusion (CTP) using. 320 slice multidetector CT A retrospective non-randomised review of CTP performed on MD320 CT between September 2008 and January 2009 was undertaken. Two experienced readers reviewed the studies along with the 4 cm and 16 cm Z-axis CTP image data set. The outcome parameters assessed were the extent of the original finding, any additional findings and a change of diagnosis. 14 out of 27 patients were found to have abnormal CTP (mean age 58.1 years, 9 male). The 16 cm Z-axis increased the accuracy of the infarct core in 78% and ischaemic penumbra quantification in 100% of the cases. It also diagnosed additional infarcts in the same vascular territory in 28% of cases and in a different vascular territory in 14%. The increased field of view with MD320 better defines the true extent of the infarct core and ischaemic penumbra. It also identified other areas of infarction that were not identified on the 4 cm Z-axis. (orig.)

  12. Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings.

    Science.gov (United States)

    Gui, Benedetta; Danza, Francesco Maria; Valentini, Anna Lia; Laino, Maria Elena; Caruso, Alessandro; Carducci, Brigida; Rodolfino, Elena; Devicienti, Ersilia; Bonomo, Lorenzo

    2016-01-01

    Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture. Pelvic infections include endometritis, abscess, wound infection, and retained product of conception. Radiologists play an important role in the diagnosis and management of postoperative complications as a result of increasing use of multidetector CT in emergency room. The knowledge of normal and abnormal postsurgical anatomy and findings should facilitate the correct diagnosis so that the best management can be chosen for the patient, avoiding unnecessary surgical interventions and additional treatments. In this article we review the surgical cesarean technique and imaging CT technique followed by description of normal and abnormal post-CS CT findings.

  13. Chronic thromboembolic pulmonary hypertension (CTEPH). Potential role of multidetector-row CT (MD-CT) and MR imaging in the diagnosis and differential diagnosis of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Wirth, G.; Brueggemann, K.; Bostel, T.; Dueber, C.; Kreitner, K.F. [Universitaetsmedizin Mainz (Germany). Dept. of Radiology; Mayer, E. [Kerckhoff Hospital, Bad Nauheim (Germany). Dept. of Thoracic Surgery

    2014-08-15

    Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension (resting mean pulmonary arterial pressure of 25 mm Hg or more determined at right heart catheterization) with persistent pulmonary perfusion defects. It is a rare, but underdiagnosed disease with estimated incidences ranging from 0.5% to 3.8% of patients after an acute pulmonary embolism (PE), and in up to 10% of those with a history of recurrent PE. CTEPH is the only form of pulmonary hypertension that can be surgically treated leading to normalization of pulmonary hemodynamics and exercise capacity in the vast majority of patients. The challenges for imaging in patients with suspected CTEPH are fourfold: the imaging modality should have a high diagnostic accuracy with regard to the presence of CTEPH and allow for differential diagnosis. It should enable detection of patients suitable for PEA with great certainty, and allow for quantification of PH by measuring pulmonary hemodynamics (mPAP and PVR), and finally, it can be used for therapy monitoring. This overview tries to elucidate the potential role of ECG-gated multidetector CT pulmonary angiography (MD-CTPA) and MR imaging, and summarizes the most important results that have been achieved so far. Generally speaking, ECG-gated MD-CTPA is superior to MR in the assessment of parenchymal and vascular pathologies of the lung, and allows for the assessment of cardiac structures. The implementation of iodine maps as a surrogate for lung perfusion enables functional assessment of lung perfusion by CT. MR imaging is the reference standard for the assessment of right heart function and lung perfusion, the latter delineating typical wedge-shaped perfusion defects in patients with CTEPH. New developments show that with MR techniques, an estimation of hemodynamic parameters like mean pulmonary arterial pressure and pulmonary vascular resistance will be possible. CT and MR imaging should be considered as complementary

  14. 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

  15. 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.)

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

    Science.gov (United States)

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

    2009-02-01

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

  17. Unenhanced multidetector CT (CT KUB) in the initial imaging of suspected acute renal colic: evaluating a new service

    Energy Technology Data Exchange (ETDEWEB)

    Chowdhury, F.U. [Departments of Clinical Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); Kotwal, S. [Urology, Leeds Teaching Hospitals, Leeds (United Kingdom); Raghunathan, G.; Wah, T.M. [Departments of Clinical Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); Joyce, A. [Urology, Leeds Teaching Hospitals, Leeds (United Kingdom); Irving, H.C. [Departments of Clinical Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom)], E-mail: henry.irving@leedsth.nhs.uk

    2007-10-15

    Aim: To evaluate a new imaging pathway for the investigation of patients presenting with suspected acute renal colic. Materials and methods: A retrospective review of 500 consecutive cases of suspected acute renal colic was undertaken to evaluate the initial results of a new imaging pathway introduced at our institution, which completely replaced the intravenous urogram (IVU) with unenhanced multidetector CT (CT KUB). Results: The positive rate for urolithiasis was 44% (221/500), the negative rate 46% (229/500) and the rate of other significant findings was 12% (59/500). Female patients had a low positive rate compared with male patients (27.5 versus 57.5%; p < 0.001). Urological intervention was required in 28% (61/221) and these patients had a larger average stone size (6.6 versus 3.7 mm; p < 0.001) and the stone was located more proximally. Out-of-hours imaging was performed in 37% (186/500), and these patients had a higher positive rate (52 versus 40%; p < 0.001). Other findings included a wide range of acute non-urological conditions. Conclusion: The feasibility of replacing the acute IVU with CT KUB in the initial assessment of suspected acute renal colic was demonstrated in the present study. The technique enables rapid diagnosis of urolithiasis, stratification of patients likely to proceed to urological intervention, and prompt diagnosis of a variety of other acute pathological conditions.

  18. Multi-Detector row CT urography on a 16-row CT scanner in the evaluation of urothelial tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tsili, A.C. [University Hospital of Ioannina, Department of Clinical Radiology, Ioannina (Greece); University of Ioannina, Medical School, Ioannina (Greece); Efremidis, S.C.; Tsampoulas, C. [University Hospital of Ioannina, Department of Clinical Radiology, Ioannina (Greece); Kalef-Ezra, J. [University Hospital of Ioannina, Department of Medical Physics, Ioannina (Greece); Giannakis, D.; Sofikitis, N. [University Hospital of Ioannina, Department of Urology, Ioannina (Greece); Alamanos, Y. [University Hospital of Ioannina, Department of Hygiene and Public Health, Ioannina (Greece)

    2007-04-15

    The purpose of this study was to assess the role of multi-detector row CT urography (MDCTU), on a 16-row CT scanner in the evaluation of patients with painless hematuria, with emphasis placed in the detection of urothelial tumors. We retrospectively reviewed the MDCT urographies of 75 patients, referred for painless hematuria. The CT protocol included unenhanced images, obtained with a detector configuration of 16 x 1.5 mm and pitch of 1.2, nephrographic and excretory-phase images, obtained with a detector collimation of 16 x 0.75 mm and pitch of 1.2. Axial and coronal reformatted images were evaluated. Three-dimensional reformation of the excretory-phase images was performed using the volume-rendering technique. The standard of reference included clinical and imaging follow-up, cystoscopic, surgical and histologic findings. In 55 (73%) of 75 patients, the cause of hematuria was identified on MDCTU; the most common cause was urothelial cancer, including seven tumors with a diameter equal or smaller than 0.5 cm in diameter. Sixteen-row MDCTU provided satisfactory results in the investigation of patients with painless hematuria. The main advantage of the technique is its ability to detect uroepithelial malignancies. (orig.)

  19. Cardiac CT for the assessment of chest pain: Imaging techniques and clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Hans-Christoph, E-mail: christoph.becker@med.uni-muenchen.de [Ludwig-Maximilians-University, Grosshadern Clinic, Department of Clinical Radiology, Marchioninistr. 15, 81377 Munich (Germany); Johnson, Thorsten [Ludwig-Maximilians-University, Grosshadern Clinic, Department of Clinical Radiology, Marchioninistr. 15, 81377 Munich (Germany)

    2012-12-15

    Immediate and efficient risk stratification and management of patients with acute chest pain in the emergency department is challenging. Traditional management of these patients includes serial ECG, laboratory tests and further on radionuclide perfusion imaging or ECG treadmill testing. Due to the advances of multi-detector CT technology, dedicated coronary CT angiography provides the potential to rapidly and reliably diagnose or exclude acute coronary artery disease. Life-threatening causes of chest pain, such as aortic dissection and pulmonary embolism can simultaneously be assessed with a single scan, sometimes referred to as “triple rule out” scan. With appropriate patient selection, cardiac CT can accurately diagnose heart disease or other sources of chest pain, markedly decrease health care costs, and reliably predict clinical outcomes. This article reviews imaging techniques and clinical results for CT been used to evaluate patients with chest pain entering the emergency department.

  20. Investigating the low-dose limits of multidetector CT in lung nodule surveillance.

    Science.gov (United States)

    Paul, N S; Siewerdsen, J H; Patsios, D; Chung, T B

    2007-09-01

    The purpose of this study was to evaluate the factors limiting nodule detection in thoracic computed tomography (CT) and to determine whether prior knowledge of nodule size and attenuation, available from a baseline CT study, influences the minimum radiation dose at which nodule surveillance CT scans can be performed while maintaining current levels of nodule detectability. Multiple nodules varying in attenuation (-509 to + 110 HU) and diameter (1.6 to 9.5 mm) were layered in random and ordered sequences within 2 lung cylinders made of Rando lung material and suspended within a custom-built CT phantom. Multiple CT scans were performed at varying kVp (120, 100, and 80), mA (200, 150, 100, 50, 20, and 10), and beam collimation (5, 2.5, and 1.25 mm) on a four-row multidetector scanner (Lightspeed, General Electric, Milwaukee, WI) using 0.8 s gantry rotation. The corresponding range of radiation dose over which images were acquired was 0.3-26.4 mGy. Nine observers independently performed three specific tasks, namely: (1) To detect a 3.2 mm nodule of 23 HU; (2) To detect 3.2 mm nodules of varying attenuation (-509 to -154 HU); and (3) To detect nodules varying in size (1.6-9 mm) and attenuation (-509 to 110 HU). A two-alternative forced-choice test was used in order to determine the limits of nodule detection in terms of the proportion of correct responses (Pcorr, related to the area under the ROC curve) as a summary metric of observer performance. The radiation dose levels for detection of 99% of nodules in each task were as follows: Task 1 (1 mGy); Task 2 (5 mGy); and Task 3 (7 mGy). The corresponding interobserver confidence limits were 1, 5, and 10 mGy for Tasks 1, 2, and 3, respectively. There was a fivefold increase in the radiation dose required for detection of lower-density nodules (Tasks 1 to 2). Absence of prior knowledge of the nodule size and density (Task 3) corresponds to a significant increase in the minimum required radiation dose. Significant image

  1. Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Kyung [Department of Radiology, Gachon University Gil Medical Center, Incheon 21565 (Korea, Republic of); Kim, Jeung Sook [Department of Radiology, Dongguk University Ilsan Hospital, Goyang 10326 (Korea, Republic of); Lee, Kyung Won [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 13620 (Korea, Republic of); Yi, Chin A [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351 (Korea, Republic of); Koo, Jin Mo [Department of Radiology, Seoul National University College of Medicine, Seoul 03080 (Korea, Republic of); Jung, Soon-Hee [Department of Pathology, Yonsei University Wonju College of Medicine, Wonju 26426 (Korea, Republic of)

    2016-11-01

    To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.

  2. Multidetector CT findings and differential diagnoses of malignant pleural mesothelioma and metastatic pleural diseases in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Kyung [Dept. of Radiology, Gachon University Gil Medical Center, Incheon (Korea, Republic of); Kim, Jeung Sook [Dept. of Radiology, Dongguk University Ilsan Hospital, Goyang (Korea, Republic of); Lee, Kyung Won [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Yi, Chin A [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Koo, Jin Mo [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Soon Hee [Dept. of Pathology, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2016-07-15

    To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.

  3. Pancreatic adenocarcinomas without secondary signs on multiphasic multidetector CT: association with clinical and histopathologic features

    Energy Technology Data Exchange (ETDEWEB)

    Tamada, Tsutomu; Ito, Katsuyoshi; Sone, Teruki; Kanki, Akihiko; Higaki, Atsushi; Hayashida, Minoru; Yamamoto, Akira [Kawasaki Medical School, Departments of Radiology, Kurashiki City, Okayama (Japan); Kanomata, Naoki [Kawasaki Medical School, Department of Pathology, Kurashiki City, Okayama (Japan)

    2016-03-15

    To determine the clinical, histopathologic and imaging features of pancreatic adenocarcinomas without secondary signs on dynamic CT. Seventy patients (mean age 70 years) with histologically proven pancreatic adenocarcinoma underwent preoperative contrast material-enhanced multiphasic multidetector CT before pancreatic resection. In each patient, clinical data including carbohydrate antigen 19-9, frequency of isoattenuating tumours, and presence of secondary signs and histopathologic findings such as tumour location, tumour stage, and microscopic infiltrative growth grade were evaluated. Ten tumours (14 %) were without secondary signs, and 60 (86 %) were with secondary signs. Tumours without and with secondary signs were located in the uncinate process in 5 (50 %) and 3 (5 %), head in 3 (30 %) and 29 (48 %), body in 2 (20 %) and 22 (37 %), and tail in 0 (0 %) and 6 (10 %), respectively (p =.001). The frequency of isoattenuating pancreatic adenocarcinomas without secondary signs was significantly higher than those with secondary signs (p = 0.034). The tumour stage of pancreatic adenocarcinomas without secondary signs was earlier than that in tumours with secondary signs (p = 0.041). Pancreatic adenocarcinomas without secondary signs is characterized by the presence of uncinate and isoattenuating tumours and earlier tumour stage compared to tumours with secondary signs. (orig.)

  4. Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma

    Institute of Scientific and Technical Information of China (English)

    Luigi; Camera; Rosa; Severino; Antongiulio; Faggiano; Stefania; Masone; Gelsomina; Mansueto; Simone; Maurea; Rosa; Fonti; Marco; Salvatore

    2014-01-01

    Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography(CT) or magnetic resonance(MR) is pivotal for surgical planning. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved bysomatostatin-receptor scintigraphy(SRS). We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR(Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT(Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure(3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-11-15

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

  6. Optimised low-dose multidetector CT protocol for children with cranial deformity

    Energy Technology Data Exchange (ETDEWEB)

    Vazquez, Jose Luis [Complejo Hospitalario Universitario de Vigo, Department of Radiology, Vigo, Pontevedra (Spain); Pombar, Miguel Angel [Complejo Hospitalario Universitario de Santiago, Department of Radiophysics, Santiago de Compostela, La Coruna (Spain); Pumar, Jose Manuel [Complejo Hospitalario Universitario de Santiago, Department of Radiology, Santiago de Compostela, La Coruna (Spain); Campo, Victor Miguel del [Complejo Hospitalario Universitario de Vigo, Department of Public Health, Vigo, Pontevedra (Spain)

    2013-08-15

    To present an optimised low-dose multidetector computed tomography (MDCT) protocol for the study of children with cranial deformity. Ninety-one consecutive MDCT studies were performed in 80 children. Studies were performed with either our standard head CT protocol (group 1, n = 20) or a low-dose cranial deformity protocol (groups 2 and 3). Group 2 (n = 38), initial, and group 3 (n = 33), final and more optimised. All studies were performed in the same 64-MDCT equipment. Cranial deformity protocol was gradationally optimised decreasing kVp, limiting mA range, using automatic exposure control (AEC) and increasing the noise index (NI). Image quality was assessed. Dose indicators such us CT dose index volume (CTDIvol), dose-length product (DLP) and effective dose (E) were used. The optimised low-dose protocol reached the following values: 80 kVp, mA range: 50-150 and NI = 23. We achieved a maximum dose reduction of 10-22 times in the 1- to 12-month-old cranium in regard to the 2004 European guidelines for MDCT. A low-dose MDCT protocol that may be used as the first diagnostic imaging option in clinically selected patients with skull abnormalities. (orig.)

  7. Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma.

    Science.gov (United States)

    Camera, Luigi; Severino, Rosa; Faggiano, Antongiulio; Masone, Stefania; Mansueto, Gelsomina; Maurea, Simone; Fonti, Rosa; Salvatore, Marco

    2014-10-28

    Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography (CT) or magnetic resonance (MR) is pivotal for surgical planning. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved by somatostatin-receptor scintigraphy (SRS). We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR (Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT (Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure (3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis.

  8. Multidetector computed tomography in abdominal emergencies; Multidetektor-CT bei abdominellen Notfaellen

    Energy Technology Data Exchange (ETDEWEB)

    Zorger, N.; Schreyer, A.G. [Universitaetsklinikum Regensburg (Germany). Institut fuer Roentgendiagnostik

    2009-06-15

    Abdominal emergencies encompass traumatic events in the region of the abdomen as well as the clinical term acute abdomen. Multidetector CT (MDCT) represents one of the most important imaging modalities for detection and correct diagnosis in such abdominal emergencies. Based on the acquired data MDCT allows a stable imaging of the abdomen in an extremely short time even in critically ill patients. Multiplanar reconstructions can be created based on the high resolution data allowing an impressive visualization of the pathology. In this review article the most important abdominal pathologies of the abdomen diagnosed by MDCT are presented with special emphasis on the liver, bile ducts, spleen and kidneys as well as the gastro-intestinal tract. Additionally, MDCT imaging of the individual organ regions will be dealt with in detail. (orig.) [German] Abdominelle Notfaelle beinhalten sowohl traumatische Ereignisse im Bereich des Bauchraums als auch den klinischen Begriff des ''akuten Abdomens''. Die Darstellung solcher Notfaelle mittels Multidetektor-Computertomographie (MDCT) ist eine leistungsfaehige Methode zur Detektion und richtigen Diagnosefindung der abdominellen Notfaelle. Die MDCT erlaubt eine stabile Bildgebung des Abdomens in extrem kurzer Zeit bei schwerkranken Patienten und zudem multiplanare Rekonstruktionen, basierend auf den akquirierten Rohdatensaetzen mit der Moeglichkeit, zusaetzlich Befunde anschaulicher zu visualisieren. In diesem Uebersichtsartikel werden die MDCT-Charakteristika verschiedener abdomineller Notfaelle der wichtigsten Organregionen des Abdomens, wie der Leber und der Gallenwege, des Pankreas, der Milz und der Niere sowie des Gastrointestinaltrakts erlaeutert. Dabei wird speziell auf die Multidetektor-CT-Technik der einzelnen Organregionen eingegangen. (orig.)

  9. Diagnosis of deep vein thrombosis using multi-detector helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Masashi; Minamiguchi, Hiroki; Sahara, Shinya [Wakayama Medical Coll. (Japan)] [and others

    2002-11-01

    The purpose of this study was to evaluate the usefulness of multi-detector helical CT (MDHCT) with contrast medium in the diagnosis of deep vein thrombosis (DVT). The bilateral veins of the dorsal pedis in 45 patients (12 men, 33 women; average age, 64 years) under clinical suspicion of DVT were first punctured using 22-G needles. Then CT scanning from the level of the foot to the inferior vena cava was started 20 sec after the initial injection of 200 mL of dilute contrast medium (50 mL nonionic iodinated contrast medium of 300 mgI/mL and 150 mL saline) at a rate of 5 mL/sec. Two patients were excluded because of unsuccessful venous puncture. The average scanning time in 43 patients was 38.5{+-}7.9 seconds. Images of veins from the foot to the inferior vena cava were clearly demonstrated in each case. MDHCT showed DVT in 32 cases and patent deep vein in 11 cases. Simultaneous venography of the lower extremity in 18 patients clearly visualized DVT at the same level detected by contrast MDHCT. MDHCT for the diagnosis of DVT has the advantages of wider scanning rage, shorter scanning time, and finer Z-axis resolution than the other diagnostic modalities. (author)

  10. Role of curved planar reformations using multidetector spiral CT in diagnosis of pancreatic and peripancreatic diseases

    Institute of Scientific and Technical Information of China (English)

    Jing-Shan Gong; Jian-Min Xu

    2004-01-01

    AIM: To investigate the role of curved planar reformations using multidetector spiral CT (MSCT) in diagnosis of pancreatic and peripancreatic diseases.METHODS: From October 2001 to September 2003, 47consecutive patients with pancreatic or peripancreatic diseases, which were confirmed by operation, endoscopic retrograde cholangiopancreatography and clinical follow-up,were enrolled in this study. CT scanning was performed at a MSCT with four rows of detector. A set of images with an effective thickness of 1.0-2.0 mm and a gap of 0.5-1.0 mm(50% overlap) were acquired in all patients for postprocessing. Curved planar reformations were carried out by drawing a curved line on transverse source images, coronal or sagittal multiplanar reformations according to certain anatomic structures (such as cholangiopancreatic ducts or peripancreatic vessels) and the position of lesion.RESULTS: With thin collimation, MSCT could acquire highquality curved planar reformations to display the profile of the whole pancreas, to trace the cholangiopancreatic ducts and peripancreatic vessels, and to show the relationship of lesions with pancreas and peripancreatic anatomic structures in one curved plane, which facilitates diagnosis and rapid communication of diagnostic information with referring physicians.CONCLUSION: MSCT with thin collimation could be used to create high-quality curved planar reformations in evaluating pancreatic and peripancreatic diseases with pertinent anatomic information and relative pathologic signs to facilitate the diagnosis and enhance communication with the referring physician. Curved planar reformations can serve as supplements for transverse images in diagnosis and management of pancreatic and peripancreatic diseases.

  11. Contrast extravasation into an acute spontaneous intracerebral hematoma: multidetector CT angiographic findings and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Eun; Yu, Hyeon; Baik, Hye Won; Lee, Hwa Yeon; Kwak, Byung Kook; Lee, Jong Beum; Kim, Yang Soo; Lee, Yong Chul [Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2007-05-15

    The purpose of this study was to evaluate multidetector row CT (MDCT) angiographic findings and their clinical significance for contrast extravasation into a spontaneous intracerebral hematoma (ICH). MDCT angiographic studies and clinical records of 115 patients with spontaneous ICH were retrospectively reviewed. Cases were divided into two groups according to the presence or absence of contrast extravasation. The cases in the two groups were compared to determine the differences in radiological and clinical findings. The contrast extravasation group was divided into two subgroups according to radiological findings as follows: single or multiple dot-like contrast extravasation (Type A) and beaded-tubular (with or without dot-like extravasation) contrast extravasation (Type B). Contrast extravasation was seen in 38 patients (33%). It was associated with a larger hematoma volume, more frequent intraventricular hemorrhage (IVH) and subarachnoid hemorrhage (SAH), a shorter time interval from onset to the time of the CT scan, lower Glasgow coma scale (GCS), and a higher mortality rate. Type A and B contrast extravasation were observed in 16 (42%) and 22 (58%) patients, respectively. The rate of IVH and the clinical outcome of patients with Type B showed a significant correlation. Two types of contrast extravasation into an ICH show a significant difference in the rate of IVH and in clinical outcome. Detecting the presence of contrast extravasation and classifying them according to the morphologic patterns are important in predicting a prognosis.

  12. Cardiac CT Angiography in Congestive Heart Failure.

    Science.gov (United States)

    Levine, Avi; Hecht, Harvey S

    2015-06-01

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

  13. Practical textbook of cardiac CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Tae-Hwan (ed.) [ASAN Medical Center, Seoul (Korea, Republic of). Dept. of Radiology

    2015-04-01

    Guide to the interpretation of cardiac CT and MRI for the purposes of diagnosis, treatment planning, and follow-up. Emphasis on applications in a wide range of real clinical situations. Numerous informative illustrations. Summarizing sections permitting rapid retrieval of information. QR codes allowing access to references, additional figures, and motion pictures from the internet. This up-to-date textbook comprehensively reviews all aspects of cardiac CT and MRI and demonstrates the value of these techniques in clinical practice. A wide range of applications are considered, including imaging of atherosclerotic and non-atherosclerotic coronary artery disease, coronary revascularization, ischemic heart disease, non-ischemic cardiomyopathy, valvular heart disease, cardiac tumors, and pericardial disease. The numerous high-quality images illustrate how to interpret cardiac CT and MRI correctly for the purposes of diagnosis, treatment planning, and follow-up. Helpful summarizing sections in every chapter will facilitate rapid retrieval of information. This book will be of great value to radiologists and cardiologists seeking a reliable guide to the optimal use of cardiac CT and MRI in real clinical situations.

  14. Evaluation of angiogenesis in colorectal carcinoma with multidetector-row CT multislice perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Feng Shiting, E-mail: fst1977@163.co [Department of Radiology, First Affiliated Hospital of SunYat-sen University, Guangzhou 510080 (China); Sun Canhui, E-mail: canhuisun@sina.co [Department of Radiology, First Affiliated Hospital of SunYat-sen University, Guangzhou 510080 (China); Li Ziping, E-mail: liziping163@tom.co [Department of Radiology, First Affiliated Hospital of SunYat-sen University, Guangzhou 510080 (China); Mak, Henry Ka-Fung, E-mail: makkf@hkucc.hku.h [Department of Diagnostic Radiology, University of Hong Kong, Hong Kong (China); Peng Zhenpeng, E-mail: ppzhen@21cn.co [Department of Radiology, First Affiliated Hospital of SunYat-sen University, Guangzhou 510080 (China); Guo Huanyi, E-mail: guohuanyi@163.co [Department of Radiology, First Affiliated Hospital of SunYat-sen University, Guangzhou 510080 (China); Meng Quanfei, E-mail: mzycoco@gmail.co [Department of Radiology, First Affiliated Hospital of SunYat-sen University, Guangzhou 510080 (China)

    2010-08-15

    To evaluate the correlation between 64 multidetector-row CT (64MDCT) perfusion imaging in colorectal carcinoma and microvessel density (MVD) and vascular endothelial growth factor (VEGF), 64MDCT perfusion imaging was performed in 33 patients with pathologically verified colorectal carcinoma. These images were analyzed with perfusion functional software, and time-density curves (TDC) were created for the region of interest (ROI) encompassing the tumor, the target artery and vein. The individual perfusion maps generated indicated blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability-surface area product (PS). MVD and VEGF were evaluated by immunohistochemical staining with anti-CD34 and anti-VEGF, respectively. Correlations between MVD or VEGF with CT perfusion parameters and clinicopathological factors (Dukes' stages, invasion depth, and lymph node and liver metastasis) were also investigated. MVD in the colorectal carcinoma was 22.61 {+-} 9.01 per x200 field. The scores obtained for VEGF expression were 4.15 {+-} 1.09. VEGF staining was positive in 25 of 29 tumors (86.2%). There was no significant correlation between the presence of MVD, VEGF expression and clinicopathological factors (P > 0.05). There was also no correlation between MVD, VEGF expression, and any dynamic CT parameters (P > 0.05). The BV and MTT were significantly higher in tumors demonstrating serous coat invasion than in those without it (t = -2.63, -2.24, P = 0.0137, 0.0331, respectively). BV was also significantly correlated with tumor size (r = 0.41, P = 0.02). Neither BF nor PS was correlated with clinicopathological factors. In conclusion, 64MDCT perfusion imaging, MVD, and VEGF may reflect angiogenic activity, but no significant correlation among these factors.

  15. Life-threatening gastrointestinal system bleeding in Hodgkin disease: multidetector CT findings and review of the literature.

    Science.gov (United States)

    Akpinar, Erhan; Türkbey, Bariş; Cil, Barbaros Erhan; Canyiğit, Murat; Dündar, Ziya; Balkanci, Ferhun

    2007-06-01

    Acute lower gastrointestinal system (GIS) bleeding is a life-threatening condition. Immediate determination of the origin of the bleeding is crucial, since hemostatic management must be initiated as rapidly as possible. Colonoscopy, radionuclide studies, and conventional angiography are considered the most important methods for assessing the origin of the bleeding. There are few published reports about the feasibility of computed tomography (CT) in acute GIS bleeding. We present multidetector CT (MDCT) findings in a case of Hodgkin disease status one month post-chemotherapy (CHOP protocol; cyclophosphamide, doxorubicin, vincristine, prednisone) that presented with acute lower GIS bleeding.

  16. Optimisation of vascular input and output functions in CT-perfusion imaging using 256(or more)-slice multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Niesten, Joris M.; Schaaf, Irene C. van der; Riordan, Alan J.; Jong, Hugo W.A.M. de; Mali, Willem P.T.M.; Velthuis, Birgitta K. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

    2013-05-15

    To evaluate the accuracy and reproducibility of CT-perfusion (CTP) by finding the optimal artery for the arterial input function (AIF) and re-evaluating the necessity of the venous output function (VOF). Forty-four acute ischaemic stroke patients who underwent non-enhanced CT, CTP and CT-angiography using 256-slice multidetector computed tomography (MDCT) were evaluated. The anterior cerebral artery (ACA), middle cerebral artery (MCA), internal carotid artery (ICA) and basilar artery were selected as the AIF. Subsequently the resulting area under the time-enhancement curve of the AIF (AUC{sub AIF}) and quantitative perfusion measurements were analysed by repeated measures ANOVA and subsequently the paired t test. To evaluate reproducibility we examined if the VOF could be deleted by comparing the perfusion measurements using versus not using the VOF (paired t test). The AUC{sub AIF} and perfusion measurements resulting from the different AIFs showed significant group differences (all P < 0.0001). The ICA had the largest AUC{sub AIF} and resulted in the highest mean transient time (MTT) and lowest cerebral blood flow (CBF), whereas the basilar artery showed the lowest cerebral blood volume (CBV). Not using the VOF showed significantly higher CBV and CBF in 66 % of patients on the ipsilateral (P < 0.0001 and P = 0.007, respectively) and contralateral hemisphere (P < 0.0001 and P = 0.019, respectively). Selecting the ICA as the AIF and continuing the use of the VOF would improve the accuracy of CTP. (orig.)

  17. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Ichikawa, Tomoaki, E-mail: ichikawa@yamanashi.ac.jp [Department of Radiology, University of Yamanashi, Yamanashi (Japan); Motosugi, Utaroh; Morisaka, Hiroyuki; Sou, Hironobu; Onohara, Kojiro; Sano, Katsuhiro; Araki, Tsutomu [Department of Radiology, University of Yamanashi, Yamanashi (Japan)

    2012-09-15

    Purpose: To clarify the optimal iodine dose of contrast material for 3-dimensional multidetector-row CT angiography (3D-MDCTA) of the venous vasculature of the liver using volume rendering technique. Materials and methods: This study included 103 patients who were randomly assigned to 5 contrast-enhanced MDCT protocol groups with different body-weight-tailored doses of contrast material: 500, 600, 630, 650, and 700 mgI/kg body weight. The arterial, portal, and hepatic parenchymal phases were obtained to evaluate enhancement values of the aorta, portal vein, and hepatic vein. Visualization of the portal and hepatic veins on the volume-rendering images of 3D-MDCTA was evaluated using a 5-point grade. Dunnett's test was used to compare the mean enhancement value and mean grades of image quality (700 mgI/kg dose group was control). Results: The mean enhancement values of portal and hepatic vein in the group with 500 and 600 mgI/kg were significantly lower than those of the control group. During visual assessment, a significantly lower mean grades were observed in 500 mgI/kg groups for the portal vein, and 500 and 600 mgI/kg groups for hepatic vein. There were no significant intergroup differences in mean enhancement values and visual assessment among the groups using 630 mgI/kg or more. Conclusion: Iodine doses of 630 mgI/kg was recommended for 3D-MDCTA.

  19. Optimized image reconstruction for detection of deep venous thrombosis at multidetector-row CT venography

    Energy Technology Data Exchange (ETDEWEB)

    Das, Marco; Muehlenbruch, Georg; Mahnken, Andreas Horst; Guenther, Rolf W.; Wildberger, Joachim Ernst [University Hospital, University of Technology (RWTH), Department of Diagnostic Radiology, Aachen (Germany); Weiss, Claudia [RWTH Aachen, Institute of Medical Statistics, Aachen (Germany); Schoepf, U. Joseph [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Leidecker, Christianne [Institute of Medical Physics, University of Erlangen, Erlangen (Germany)

    2006-02-01

    The aims of this study were to optimize image quality for indirect CT venography (sequential versus spiral), and to evaluate different image reconstruction parameters for patients with suspected deep venous thrombosis (DVT). Fifty-one patients (26/25 with/without DVT) were prospectively evaluated for pulmonary embolism (PE) with standard multidetector-row computed tomography (MDCT) protocols. Retrospective image reconstruction was done with different slice thicknesses and reconstruction increments in sequential and spiral modes. All reconstructions were read for depiction of DVT and to evaluate best reconstruction parameters in comparison with the thinnest reconstruction (''gold standard''). Image noise and venous enhancement were measured as objective criteria for image quality. Subjective image quality was rated on a four-point scale. Effective dose was estimated for all reconstructions. In sequential 10/50 reconstruction DVT was completely detected in 13/26 cases, partially in 10/26 cases and was not detected at all in 3/26 cases, and 15/26, 9/26 and 2/26 cases for the 10/20 reconstruction, respectively. DVT was completely detected in all spiral reconstructions. Image noise ranged between 14.8-29.1 HU. Median image quality was 2. Estimated effective dose ranged between 2.3 mSv and 11.8 mSv. Gaps in sequential protocols may lead to false negative results. Therefore, spiral scanning protocols for complete depiction of DVT are mandatory. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-01

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

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

    Science.gov (United States)

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

    2010-02-01

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

  2. Evaluation of bone substitute materials: comparison of flat-panel based volume CT to conventional multidetector CT.

    Science.gov (United States)

    Sauerbier, Sebastian; Duttenhoefer, Fabian; Sachlos, Elefterios; Haberstroh, Jörg; Scheifele, Christian; Wrbas, Karl-Thomas; Voss, Pit Jacob; Veigel, Egle; Smedek, Jörg; Ganter, Philip; Tuna, Taskin; Gutwald, Ralf; Palmowski, Moritz

    2013-10-01

    Over the last decade tissue engineering has emerged as a key factor in bone regeneration within the field of cranio-maxillofacial surgery. Despite this in vivo analysis of tissue-engineered-constructs to monitor bone rehabilitation are difficult to conduct. Novel high-resolving flat-panel based volume CTs (fp-VCT) are increasingly used for imaging bone structures. This study compares the potential value of novel fp-VCT with conventional multidetector CT (MDCT) based on a sheep sinus floor elevation model. Calcium-hydroxyapatite reinforced collagen scaffolds were populated with autologous osteoblasts and implanted into sheep maxillary sinus. After 8, 16 and 24 weeks MDCT and fp-VCT scans were performed to investigate the volume of the augmented area; densities of cancellous and compact bone were assessed as comparative values. fp-VCT imaging resulted in higher spatial resolution, which was advantageous when separating closely related anatomical structures (i.e. trabecular and compact bone, biomaterials). Fp-VCT facilitated imaging of alterations occurring in test specimens over time. fp-VCTs therefore displayed high volume coverage, dynamic imaging potential and superior performance when investigating superfine bone structures and bone remodelling of biomaterials. Thus, fp-VCTs may be a suitable instrument for intraoperative imaging and future in vivo tissue-engineering studies.

  3. Coronary CT angiography for acute chest pain triage: Techniques for radiation exposure reduction; 128 vs. 64 multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Goitein, Orly; Eshet, Yael; Konen, Eli (Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel)), email: orly.goitein@sheba.health.gov.il; Matetzky, Shlomi (Heart Inst., Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel)); Goitein, David (Surgery C, Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel)); Hamdan, Ashraf; Di Segni, Elio (Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel); Heart Inst., Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv Univ., Tel Aviv (Israel))

    2011-10-15

    Background. Coronary CT angiography (CCTA) is used daily in acute chest pain triage, although exposing patients to significant radiation dosage. CCTA using prospective ECG gating (PG CCTA) enables significant radiation reduction Purpose. To determine whether the routine use of 128 vs. 64 multidetector CT (MDCT) can increase the proportion of patients scanned using PG CCTA technique, lowering radiation exposure, without decreasing image quality. Material and Methods. The study comprised 232 patients, 116 consecutive patients scanned using 128 MDCT (mean age 49 years, 79 men, BMI 28) and 116 consecutive patients (mean age 50 years, 75 men, BMI 28) which were scanned using 64 MDCT. PG CCTA was performed whenever technically permissible by each type of scanner: 64 MDCT = stable heart rate (HR) <60/min and weight <110 kg; 128 MDCT = stable HR < 70/min and weight <140 kg. All coronary segments were evaluated for image quality using a visual scale of 1-5. An estimated radiation dose was recorded. Results. PC CCTA was performed in 84% and 49% of the 128 and 64 MDCT groups, respectively (P < 0.0001). Average image quality score were 4.6 +- 0.3 and 4.7 +- 0.1 for the 128 and 64 MDCT, respectively (P = 0.08). The mean radiation dose exposure was 6.2 +- 4.8 mSv and 10.4 +- 7.5 mSv for the 128 and 64 MDCT, respectively (P = 0.008). Conclusion. The 128 MDCT scanner enables utilization of PG CCTA technique in a greater proportion of patients, thereby decreasing the related radiation significantly, without hampering image quality

  4. Multi-detector CT enterography with iso-osmotic mannitol as oral contrast for detecting small bowel disease

    Institute of Scientific and Technical Information of China (English)

    Lian-He Zhang; Shi-Zheng Zhang; Hong-Jie Hu; Min Gao; Ming Zhang; Qian Cao; Qiao-wei Zhang

    2005-01-01

    AIM: To assess the feasibility and usefulness of multi-detector CT enterography with orally administered iso-osmotic mannitol as negative contrast in demonstrating small bowel disease.METHODS: Thirteen volunteers and 38 patients with various kinds of small bowel disease were examined. We administered about 1 500 mL iso-osmotic mannitol as negative contrast agent and then proceeded with helical CT scanning on a Siemens Sensation 16 scanner. All volunteers and patients were interviewed about their tolerance of the procedure. Two radiologists postprocessed imaging data with MPR, thin MIP, VRT and INSPACE when necessary and then interpreted the scans,and adequacy of luminal distention was evaluated on a four-point scale. Demonstration of features of various kinds of small bowel disease was analyzed.RESULTS: The taste of iso-osmotic mannitol is good (slightly sweet) and acceptable by all. Small bowel distention was excellent and moderate in most volunteers and patients. CT features of many kinds of diseases such as tumors, Crohn's disease,and small bowel obstruction,etc. were clearly displayed.CONCLUSION: Multi-detector CT enterography with iso-osmotic mannitol as negative contrast to distend the small bowel is a simple, rapid, noninvasive and effective method of evaluating small bowel disease.

  5. A method of estimating conceptus doses resulting from multidetector CT examinations during all stages of gestation

    Energy Technology Data Exchange (ETDEWEB)

    Damilakis, John; Tzedakis, Antonis; Perisinakis, Kostas; Papadakis, Antonios E. [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Department of Medical Physics, University Hospital of Iraklion, P.O. Box 1352, 71003 Iraklion, Crete (Greece); Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Department of Medical Physics, University Hospital of Iraklion, P.O. Box 1352, 71003 Iraklion, Crete (Greece)

    2010-12-15

    Purpose: Current methods for the estimation of conceptus dose from multidetector CT (MDCT) examinations performed on the mother provide dose data for typical protocols with a fixed scan length. However, modified low-dose imaging protocols are frequently used during pregnancy. The purpose of the current study was to develop a method for the estimation of conceptus dose from any MDCT examination of the trunk performed during all stages of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study to model the Siemens Sensation 16 and Sensation 64 MDCT scanners. Four mathematical phantoms were used, simulating women at 0, 3, 6, and 9 months of gestation. The contribution to the conceptus dose from single simulated scans was obtained at various positions across the phantoms. To investigate the effect of maternal body size and conceptus depth on conceptus dose, phantoms of different sizes were produced by adding layers of adipose tissue around the trunk of the mathematical phantoms. To verify MCNP results, conceptus dose measurements were carried out by means of three physical anthropomorphic phantoms, simulating pregnancy at 0, 3, and 6 months of gestation and thermoluminescence dosimetry (TLD) crystals. Results: The results consist of Monte Carlo-generated normalized conceptus dose coefficients for single scans across the four mathematical phantoms. These coefficients were defined as the conceptus dose contribution from a single scan divided by the CTDI free-in-air measured with identical scanning parameters. Data have been produced to take into account the effect of maternal body size and conceptus position variations on conceptus dose. Conceptus doses measured with TLD crystals showed a difference of up to 19% compared to those estimated by mathematical simulations. Conclusions: Estimation of conceptus doses from MDCT examinations of the trunk performed on pregnant patients during all stages of gestation can be made

  6. Multidetector-row CT with a 64-row amorphous silicon flat panel detector

    Science.gov (United States)

    Shapiro, Edward G.; Colbeth, Richard E.; Daley, Earl T.; Job, Isaias D.; Mollov, Ivan P.; Mollov, Todor I.; Pavkovich, John M.; Roos, Pieter G.; Star-Lack, Josh M.; Tognina, Carlo A.

    2007-03-01

    A unique 64-row flat panel (FP) detector has been developed for sub-second multidetector-row CT (MDCT). The intent was to explore the image quality achievable with relatively inexpensive amorphous silicon (a-Si) compared to existing diagnostic scanners with discrete crystalline diode detectors. The FP MDCT system is a bench-top design that consists of three FP modules. Each module uses a 30 cm x 3.3 cm a-Si array with 576 x 64 photodiodes. The photodiodes are 0.52 mm x 0.52 mm, which allows for about twice the spatial resolution of most commercial MDCT scanners. The modules are arranged in an overlapping geometry, which is sufficient to provide a full-fan 48 cm diameter scan. Scans were obtained with various detachable scintillators, e.g. ceramic Gd IIO IIS, particle-in-binder Gd IIO IIS:Tb and columnar CsI:Tl. Scan quality was evaluated with a Catphan-500 performance phantom and anthropomorphic phantoms. The FP MDCT scans demonstrate nearly equivalent performance scans to a commercial 16-slice MDCT scanner at comparable 10 - 20 mGy/100mAs doses. Thus far, a high contrast resolution of 15 lp/cm and a low contrast resolution of 5 mm @ 0.3 % have been achieved on 1 second scans. Sub-second scans have been achieved with partial rotations. Since the future direction of MDCT appears to be in acquiring single organ coverage per scan, future efforts are planned for increasing the number of detector rows beyond the current 64- rows.

  7. Prenatal diagnosis of chondrodysplasia punctata tibia-metacarpal type using multidetector CT and three-dimensional reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Miyazaki, Osamu [National Centre for Child Health and Development, Department of Radiology, Tokyo (Japan); Nishimura, Gen [Tokyo Metropolitan Kiyose Children' s Hospital, Department of Radiology, Tokyo (Japan); Sago, Haruhiko; Watanabe, Noriyoshi; Ebina, Shunsuke [National Centre for Child Health and Development, Department of Perinatal Medicine and Maternal Care, Tokyo (Japan)

    2007-11-15

    We report a case of chondrodysplasia punctata tibia-metacarpal type (CDP-TM) that was diagnosed prenatally using multidetector CT (MDCT) with three-dimensional (3-D) CT reconstructions. Prenatal US had shown severe thoracic hypoplasia and rhizomelic shortening of the limbs, raising the suspicion of thanatophoric dysplasia. However, MDCT showed punctate calcifications in the epiphyseal cartilage of the humeri and femora, carpal bones, and paravertebral region. On 3-D CT, the tibiae were much shorter than the fibulae, the humeri were very short and bowed, and severe platyspondyly was evident. These findings led to the diagnosis of CDP-TM. The diagnosis was confirmed on postnatal radiographs. Prenatal MDCT with 3-D images may make a useful contribution to prenatal diagnosis in selected fetuses with severe skeletal dysplasia. (orig.)

  8. Calcified pulmonary thromboembolism in a child with sickle cell disease: value of multidetector CT in patients with acute chest syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Staser, Jonathan A. [Indiana University Medical Center, Department of Radiology, Indianapolis, IN (United States); Alam, Tariq [Medical College of Ohio, Department of Radiology, Toledo, OH (United States); Applegate, Kimberly [Indiana University Medical Center, Sections of Pediatric Radiology and Health Services Research, Indianapolis, IN (United States); Indiana University Medical Center, Department of Radiology, Riley Hospital for Children, Indianapolis, IN (United States)

    2006-06-15

    The incidence of pulmonary embolism in children is not clearly known, but is believed to be low. Risk factors for pulmonary thromboembolism include central venous catheter, malignancy, surgery, infection, trauma, and congenital hypercoagulable disorders. Children with sickle cell disease are prothrombotic and are at an increased risk of thromboembolism. The incidence of this event is unknown because these children are often not thoroughly imaged. We report here a case of a calcified pulmonary thromboembolism in a child with sickle cell disease and emphasize the use of multidetector CT in detection of pulmonary thromboembolism in children with sickle cell disease. (orig.)

  9. Korean guidelines for the appropriate use of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jin [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul(Korea, Republic of); Yong, Hwan Seok [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul(Korea, Republic of); Kim, Sung Mok [Dept. of Radiology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jung A [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-04-15

    The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.

  10. Obscure gastrointestinal bleeding and small bowel pathology: comparison between wireless capsule endoscopy and multidetector-row CT enteroclysis.

    Science.gov (United States)

    Filippone, Antonella; Cianci, Roberta; Milano, Angelo; Valeriano, Sergio; Di Mizio, Veronica; Storto, Maria Luigia

    2008-01-01

    Obscure gastrointestinal bleeding is defined as bleeding of unknown origin, that persists or recurs after negative conventional barium contrast studies and upper and lower tract endoscopy. The causes of such a bleeding frequently arise in the small bowel, and they are represented by mucosal vascular abnormalities, neoplasms and other conditions such as Crohn's disease, Meckel's diverticulum, and vasculitis. Conventional barium contrast studies and push enteroscopy allow only a limited small bowel examination; moreover, intraoperative endoscopy may be inconclusive, since the small bowel is difficult to evaluate given its length and tortuous course. In the same way, angiographic diagnosis is stricktly related to the activity rate of hemorrhage. Wireless capsule endoscopy and multidetector-row CT enteroclysis are two recently developed minimally invasive techniques that may provide a complete small bowel examination, the first offering a direct visualization of the mucosal aspect, the second allowing evaluation of mural and extramural pathologies. This review is an update of the technique and clinical application of capsule endoscopy and multidetector-row CT enteroclysis in patients suffering from obscure small bowel bleeding.

  11. Measuring temporal resolution of cardiac CT reconstructions

    Science.gov (United States)

    Matthews, David; Heuscher, Dominic

    2005-04-01

    Multi-slice CT today is capable of imaging the heart with excellent temporal resolution. Algorithms have been developed to perform reconstructions combining data from multiple cardiac cycles. This paper presents a simulation phantom that enables a direct measurement of the actual temporal resolution achieved by these algorithms. This is not only useful for assessing the temporal resolution but also for validating the algorithms themselves. A simulation phantom was developed that consists of a 20 cm. diameter water phantom containing an array of cylinders whose intensities are pulsed for various durations ranging from 10 msec. to 250 msec. The intensity varied between the background value of water (0 HU) and 800 HU. By measuring the nominal attenuation value at the center of each cylinder, a curve can be derived representing the response over the given temporal range. A temporal resolution representing the FWHM value is determined based on the half-max value of this curve. Reconstructions were performed using a multi-cycle cardiac algorithm described previously in the literature. The measured FWHM values agree quite well to the temporal resolution predicted by the cardiac algorithm itself. Even the variation along the longitudinal axis can be accounted for by the predicted values. A simulated phantom can be used to accurately assess the temporal resolution of cardiac reconstruction algorithms. Excellent agreement was achieved between the predicted and measured temporal resolution values for the multi-cycle algorithm used in this study.

  12. Cardiac MRI and CT features of inheritable and congenital conditions associated with sudden cardiac death

    Energy Technology Data Exchange (ETDEWEB)

    Sparrow, Patrick; Merchant, Naeem; Provost, Yves; Doyle, Deirdre; Nguyen, Elsie; Paul, Narinder [University Health Network and Mount Sinai Hospital, Division of Cardiothoracic Imaging, Department of Medical Imaging, Toronto, Ontario (Canada)

    2009-02-15

    Cardiac MRI (CMR) and electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) are increasingly important tools in the identification and assessment of cardiac-related disease processes, including those associated with sudden cardiac death (SCD). While the commonest cause of SCD is coronary artery disease (CAD), in patients under 35 years inheritable cardiomyopathies such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy are important aetiologies. CMR in particular offers both accurate delineation of the morphological abnormalities associated with these and other conditions and the possibility for risk stratification for development of ventricular arrhythmias with demonstration of macroscopic scar by delayed enhancement imaging with intravenous gadolinium. (orig.)

  13. Multidetector-Row CT Findings of a Preduodenal Portal Vein Associated with Polysplenic Syndrome in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Hyun; Lee, Su Lim; Ku, Young Mi; Chun, Chang Woo [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Uijeongbu (Korea, Republic of)

    2012-03-15

    Preduodenal portal vein (PDPV) is a rare developmental anomaly in which the portal vein runs at the ventral side of the duodenum instead of at an intrapancreatic location. Understanding of this anomaly is of considerable surgical importance, because it may cause unintended portal vein injury during operations involving the gall bladder or duodenum. We recently experienced PDPV associated with polysplenia syndrome in a 49-year-old male patient who complained of persistent epigastric pain. CT portal venography with thin slab maximal intensity projection and volume rendering demonstrated the unique feature of convex anastomosis between the L-shaped mesenterico-portal vein and mesenterico-splenic vein in the mid abdomen. We report here the Multidetector-row CT findings of a rare case of PDPV.

  14. Angiographic frequency of blunt cerebrovascular injury in patients with carotid canal or vertebral foramen fractures on multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, Alexander [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States)]. E-mail: mckin022@umn.edu; Ott, Frederick [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States); Short, James [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States); McKinney, Zeke [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States); Truwit, Charles [Department of Radiology, Hennepin County and University of Minnesota-Fairview and Medical Centers, Minneapolis, MN (United States)

    2007-06-15

    Purpose: Blunt carotid injuries (BCI's) and blunt vertebral artery injuries (BVI's), known jointly as BCVI's, are common in 'high risk' patients. The purpose is to evaluate the rate of occurrence of BCI/BVI in patients screened purely by the radiologic criteria of fracture through the carotid canal or vertebral transverse foramina, or significant cervical subluxation, noted by multidetector CT. Methods: Seventy-one patients with 108 catheterized vessels were included over a 13-month interval. The angiographic examinations were prompted by current hospital protocol, solely by the presence of fractures involving/adjacent to the carotid canal, cervical fractures involving/adjacent to the foramen transversarium, or cervical fractures with significant subluxation. The incidence of each grade of blunt injury was calculated after review of the CT scans and catheter angiograms by two neuroradiologists. Results: Two thousand and seventy-three total blunt trauma admissions occurred during the time period, with a BCVI rate of 0.92-1.0% (depending on the reviewer), similar to previous studies. Mean time to catheter angiography was 16.6 h. Of the 71 included patients, there were 11-12 BCI's and 10-12 BVI's, an overall rate of 27-30% of BCVI in the patients with foraminal fractures. Interobserver agreement in reviewing the catheter angiograms was excellent (Kappa 0.795). Of note, three internal carotid pseudoaneurysms resolved spontaneously after anticoagulation or aspirin. Conclusion: This study confirms that there is a high rate of BCVI in the presence of carotid canal or vertebral foramen fractures that are noted by multidetector CT. Utilization of purely radiologic criteria of foraminal involvement may be a significant screening tool in the decision of whether to evaluate these patients acutely by catheter or CT angiography, and for early detection of patients at risk for symptomatology, to initiate prompt, prophylactic treatment.

  15. Computed tomography angiography of carotid and coronary artery via a single-bolus injection protocol: a feasibility study using 320-row multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, WeiGuo [The First Affiliated Hospital of Soochow University, Department of Radiology, SuZhou (China); Fudan University, Department of Radiology, Zhongshan Hospital, Shanghai (China); Jin, Hang; Chen, Gang; Chen, Wenfang; Gu, Junying; Zeng, Mengsu [Fudan University, Department of Radiology, Zhongshan Hospital, Shanghai (China)

    2014-07-15

    To investigate the feasibility of using a single-dose injection protocol in CT angiography (CTA) of the carotid and coronary artery with 320-row multidetector CT. A total of 82 consecutive patients with suspected carotid artery disease underwent an original CTA protocol aiming at capturing the extra-cranial carotid arteries and coronary arteries simultaneously using 320-row MDCT. The image quality, attenuation, and CNRs of the carotid and coronary arteries were assessed. The lag time (between two separated volumetric acquisitions) was compared between patients with and without cardiac venous opacification (CVO). The contrast medium volume and radiation dose were recorded. The image quality was 99.4 % diagnostic in carotid and 86.9 % in coronary artery segments. The mean attenuation of carotid and coronary arteries ranged from 462.2 Hu to 533.7 Hu, 415.9 Hu to 454.7 Hu respectively. The mean CNR of the carotid and coronary artery ranged from 15.8 to 18.9 and 17.7 to 20.4 respectively. The lag time in patients with and without CVO was 5.75 ± 1.64 s vs. 4.21 ± 1.14 s (p < 0.05). The mean radiation dose was 6.6 ± 4.1 mSv.The mean contrast media volume was 71.9 ± 9.1 ml. The carotid and coronary artery can be imaged simultaneously via our original single-dose injection CTA protocol using 320-row CT with adequate image quality. (orig.)

  16. Accurate estimation of global and regional cardiac function by retrospectively gated multidetector row computed tomography: comparison with cine magnetic resonance imaging.

    Science.gov (United States)

    Belge, Bénédicte; Coche, Emmanuel; Pasquet, Agnès; Vanoverschelde, Jean-Louis J; Gerber, Bernhard L

    2006-07-01

    Retrospective reconstruction of ECG-gated images at different parts of the cardiac cycle allows the assessment of cardiac function by multi-detector row CT (MDCT) at the time of non-invasive coronary imaging. We compared the accuracy of such measurements by MDCT to cine magnetic resonance (MR). Forty patients underwent the assessment of global and regional cardiac function by 16-slice MDCT and cine MR. Left ventricular (LV) end-diastolic and end-systolic volumes estimated by MDCT (134+/-51 and 67+/-56 ml) were similar to those by MR (137+/-57 and 70+/-60 ml, respectively; both P=NS) and strongly correlated (r=0.92 and r=0.95, respectively; both P<0.001). Consequently, LV ejection fractions by MDCT and MR were also similar (55+/-21 vs. 56+/-21%; P=NS) and highly correlated (r=0.95; P<0.001). Regional end-diastolic and end-systolic wall thicknesses by MDCT were highly correlated (r=0.84 and r=0.92, respectively; both P<0.001), but significantly lower than by MR (8.3+/-1.8 vs. 8.8+/-1.9 mm and 12.7+/-3.4 vs. 13.3+/-3.5 mm, respectively; both P<0.001). Values of regional wall thickening by MDCT and MR were similar (54+/-30 vs. 51+/-31%; P=NS) and also correlated well (r=0.91; P<0.001). Retrospectively gated MDCT can accurately estimate LV volumes, EF and regional LV wall thickening compared to cine MR.

  17. Accurate estimation of global and regional cardiac function by retrospectively gated multidetector row computed tomography. Comparison with cine magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Belge, Benedicte; Pasquet, Agnes; Vanoverschelde, Jean-Louis J. [Universite Catholique de Louvain, Division of Cardiology, Brussels (Belgium); Coche, Emmanuel [Universite Catholique de Louvain, Division of Radiology, Brussels (Belgium); Gerber, Bernhard L. [Universite Catholique de Louvain, Division of Cardiology, Brussels (Belgium); Cliniques Universitaires St. Luc UCL, Department of Cardiology, Woluwe St. Lambert (Belgium)

    2006-07-15

    Retrospective reconstruction of ECG-gated images at different parts of the cardiac cycle allows the assessment of cardiac function by multi-detector row CT (MDCT) at the time of non-invasive coronary imaging. We compared the accuracy of such measurements by MDCT to cine magnetic resonance (MR). Forty patients underwent the assessment of global and regional cardiac function by 16-slice MDCT and cine MR. Left ventricular (LV) end-diastolic and end-systolic volumes estimated by MDCT (134{+-}51 and 67{+-}56 ml) were similar to those by MR (137{+-}57 and 70{+-}60 ml, respectively; both P=NS) and strongly correlated (r=0.92 and r=0.95, respectively; both P<0.001). Consequently, LV ejection fractions by MDCT and MR were also similar (55{+-}21 vs. 56{+-}21%; P=NS) and highly correlated (r=0.95; P<0.001). Regional end-diastolic and end-systolic wall thicknesses by MDCT were highly correlated (r=0.84 and r=0.92, respectively; both P<0.001), but significantly lower than by MR (8.3{+-}1.8 vs. 8.8{+-}1.9 mm and 12.7{+-}3.4 vs. 13.3{+-}3.5 mm, respectively; both P<0.001). Values of regional wall thickening by MDCT and MR were similar (54{+-}30 vs. 51{+-}31%; P=NS) and also correlated well (r=0.91; P<0.001). Retrospectively gated MDCT can accurately estimate LV volumes, EF and regional LV wall thickening compared to cine MR. (orig.)

  18. Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Mei-ping; Liang, Chang-hong; Zhao, Zhen-jun; Liu, Hui; Li, Jing-lei; Zhang, Jin-e; Cui, Yan-hai; Yang, Lin; Liu, Qi-shun [Guangdong Academy of Medical Sciences, Guangdong General Hospital, Department of Radiology, Guangzhou (China); Ivanc, Thomas B.; Vembar, Mani [Philips Healthcare, CT Clinical Science, Highland Heights, OH (United States)

    2011-07-15

    There are a limited number of reports on the technical and clinical feasibility of prospective electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) in infants with congenital heart disease (CHD). To evaluate image quality and radiation dose at weight-based low-dose prospectively gated 256-slice MDCT angiography in infants with CHD. From November 2009 to February 2010, 64 consecutive infants with CHD referred for pre-operative or post-operative CT were included. All were scanned on a 256-slice MDCT system utilizing a low-dose protocol (80 kVp and 60-120 mAs depending on weight: 60 mAs for {<=}3 kg, 80 mAs for 3.1-6 kg, 100 mAs for 6.1-10 kg, 120 mAs for 10.1-15 kg). No serious adverse events were recorded. A total of 174 cardiac deformities, confirmed by surgery or heart catheterization, were studied. The sensitivity of MDCT for cardiac deformities was 97.1%; specificity, 99.4%; accuracy, 95.9%. The mean heart rate during scan was 136.7 {+-} 14.9/min (range, 91-160) with a corresponding heart rate variability of 2.8 {+-} 2.2/min (range, 0-8). Mean scan length was 115.3 {+-} 11.7 mm (range, 93.6-143.3). Mean volume CT dose index, mean dose-length product and effective dose were 2.1 {+-} 0.4 mGy (range, 1.5-2.8), 24.7 {+-} 5.9 mGy.cm (range, 14.7-35.8) and 1.6 {+-} 0.3 mSv (range, 1.1-2.5), respectively. Diagnostic-quality images were achieved in all cases. Satisfactory diagnostic quality for visualization of all/proximal/distal coronary artery segments was achieved in 88.4/98.8/80.0% of the scans. Low-dose prospectively gated axial 256-slice CT angiography is a valuable tool in the routine clinical evaluation of infants with CHD, providing a comprehensive three-dimensional evaluation of the cardiac anatomy, including the coronary arteries. (orig.)

  19. Multidetector CT diagnosis of massive hemobilia due to gallbladder polyposis in a child with metachromatic leukodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Wanner, Matthew R.; Karmazyn, Boaz [Indiana University School of Medicine, Riley Hospital for Children, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Fan, Rong [Indiana University School of Medicine, Riley Hospital for Children, Department of Pathology and Laboratory Medicine, Indianapolis, IN (United States)

    2015-12-15

    Hemobilia secondary to gallbladder polyposis is rare in children but has been reported in a few children with metachromatic leukodystrophy. We present a case with preoperative multidetector computed tomography (MDCT) diagnosis of massive hemobilia caused by gallbladder polyposis in a patient with metachromatic leukodystrophy. Our report highlights the importance of both awareness of the association of gallbladder polyposis with other syndromes such as metachromatic leukodystrophy as well as the possibility of this entity presenting with life-threatening bleeding. (orig.)

  20. Evaluation of Deep Vein Thrombosis with Multidetector Row CT after Orthopedic Arthroplasty: a Prospective Study for Comparison with Doppler Sonography

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Sung Su; Kim, Youn Jeong; Chun, Yong Sun; Kim, Won Hong [Inha University, College of Medicine, Incheon (Korea, Republic of); Kim, Jeong Ho; Park, Chul Hi [Gachon University, Gil Medical Center, Incheon (Korea, Republic of)

    2008-02-15

    This prospective study evaluated the ability of indirect 16-row multidetector CT venography, in comparison with Doppler sonography, to detect deep vein thrombosis after total hip or knee replacement. Sixty-two patients had undergone orthopedic replacement surgery on a total of 30 hip joints and 54 knee joints. The CT venography (scan delay time: 180 seconds; slice thickness/increment: 2/1.5 mm) and Doppler sonography were performed 8 to 40 days after surgery. We measured the z-axis length of the beam hardening artifact that degraded the image quality so that the presence of deep vein thrombosis couldn't be evaluated on the axial CT images. The incidence and location of deep vein thrombosis was analyzed. The diagnostic performance of the CT venograms was evaluated and compared with that of Doppler sonography as a standard of reference. The z-axis length (mean{+-}standard deviation) of the beam hardening artifact was 4.5{+-}0.8 cm in the arthroplastic knees and 3.9{+-}2.9 cm in the arthroplastic hips. Deep vein thrombosis (DVT) was found in the popliteal or calf veins on Doppler sonography in 30 (48%) of the 62 patients. The CT venography has a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 90%, 97%, 96%, 91% and 94%, respectively. The ability of CT venography to detect DVT was comparable to that of Doppler sonography despite of beam hardening artifact. Therefore, CT venography is feasible to use as an alternative modality for evaluating postarthroplasty patients.

  1. Evaluation of the effective dose and image quality of low-dose multi-detector CT for orthodontic treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Gi Chung; Han, Won Jeong; Kim, Eun Kyung [Department of Oral and Maxillofacial Radiology, School of Dentistry, Dankook University, Cheonan (Korea, Republic of)

    2010-03-15

    This study was designed to compare the effective doses from low-dose and standard-dose multi-detector CT (MDCT) scanning protocols and evaluate the image quality and the spatial resolution of the low-dose MDCT protocols for clinical use. 6-channel MDCT scanner (Siemens Medical System, Forschheim, Germany), was used for this study. Protocol of the standard-dose MDCT for the orthodontic analysis was 130 kV, 35 mAs, 1.25 mm slice width, 0.8 pitch. Those of the low-dose MDCT for orthodontic analysis and orthodontic surgery were 110 kV, 30 mAs, 1.25 mm slice width, 0.85 pitch and 110 kV, 45 mAs, 2.5 mm slice width, 0.85 pitch. Thermoluminescent dosimeters (TLDs) were placed at 31 sites throughout the levels of adult female ART head and neck phantom. Effective doses were calculated according to ICRP 1990 and 2007 recommendations. A formalin-fixed cadaver and AAPM CT performance phantom were scanned for the evaluation of subjective image quality and spatial resolution. Effective doses in {mu}Sv (E2007) were 699.1, 429.4 and 603.1 for standard-dose CT of orthodontic treatment, low-dose CT of orthodontic analysis, and low-dose CT of orthodontic surgery, respectively. The image quality from the low-dose protocol were not worse than those from the standard-dose protocol. The spatial resolutions of both standard-dose and low-dose CT images were acceptable. From the above results, it can be concluded that the low-dose MDCT protocol is preferable in obtaining CT images for orthodontic analysis and orthodontic surgery.

  2. Analysis of 64-row multidetector CT images for preoperative angiographic evaluation of potential living kidney donors; Analyse der mehrphasigen 64-Zeilen-Multidetektor-Computertomographie zur praeoperativen angiographischen Evaluation potenzieller Lebendnierenspender

    Energy Technology Data Exchange (ETDEWEB)

    Blondin, D.; Andersen, K.; Kroepil, P.; Cohnen, M.; Moedder, U.; Jung, G. [Universitaetsklinikum Duesseldorf, Institut fuer Diagnostische Radiologie, Duesseldorf (Germany); Sandmann, W. [Universitaetsklinikum Duesseldorf, Klinik fuer Gefaesschirurgie und Nierentransplantation, Duesseldorf (Germany); Ivens, K. [Universitaetsklinikum Duesseldorf, Klinik fuer Nephrologie, Duesseldorf (Germany)

    2008-07-15

    Anatomical imaging and the ascertainment of any anomalies in the renal vessels and the ureters are essential in the planning of a kidney donation. The aim of the present study was to assess the value of 64-row multidetector CT in noninvasive examination of the renal vessels and ureters of potential living kidney donors. The evaluation embraced 63 living renal donors (LNS) who underwent preoperative CT examination from December 2004 to January 2007. The examinations were all carried out using a Somatom Sensation -Cardiac 64 (Siemens Medical Solutions, Germany). As well as CT angiography (CTA), a venous phase of the abdomen and a late phase after 15 min using low-dose technique were performed for CT urography (CTU). The radiological findings were compared with the surgical results, or with the angiograms in 2 cases. Sensitivity, specificity and both negative and positive predictive value were calculated. In the 63 (31 female, 32 male) donors CTA had a sensitivity of 100% in examination of the main and accessory renal arteries and of 98.3% when the venous and ureteric anatomy were assessed. The sensitivity of low-dose CTU was also 100%. The findings recorded in this study indicate that noninvasive preoperative planning with 64-row multidetector CTA and CTU is a reliable 'one-stop shopping' method of examination for potential living kidney donors. (orig.) [German] Die anatomische Darstellung und Erfassung moeglicher Anomalien der Nierengefaesse und Ureteren ist fuer die Planung einer Lebendnierenspende von essenzieller Bedeutung. Die vorliegende Untersuchung soll die Wertigkeit der nichtinvasiven Evaluation mit der 64-Zeilen-Multidetektor-CT untersuchen. In die Auswertung wurden 63 Lebendnierenspender (LNS) eingeschlossen, die im Zeitraum 12.2004 bis 01.2007 mit der CT praeoperativ untersucht wurden. Die Untersuchungen erfolgten mit einem Somatom-Sensation-Cardiac-64 (Siemens Medical Solutions, Deutschland). Neben einer CT-Angiographie (CTA) wurden eine

  3. Cardiac CT angiography in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-15

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

  4. Jejunal GIST causing acute massive gastrointestinal bleeding: role of multidetector row helical CT in the preoperative diagnosis and management.

    Science.gov (United States)

    Daldoul, Sami; Moussi, Amir; Triki, Wissem; Baraket, Rym Bennaceur; Zaouche, Abdeljelil

    2012-09-01

    In this report, we describe a 34-year-old man with a jejunal gastrointestinal stromal tumour (GIST) accompanied by an unusual severe haemorrhage. Because oesophagogastroduodenoscopy proved inconclusive in determining the source of the bleeding and also because of gradually dropping haemoglobin levels and persistence of the melena not allowing colonic preparation, colonoscopy was cancelled and a mesenteric angio-computed tomography (angio-CT) was deemed necessary. The results of this analysis showed a 5-cm heterogeneous mass located in the jejunal loop surrounded by abnormal arterial structures. This multidetector computed tomography (MDCT) appearance was highly suggestive of GIST. The patient then underwent an urgent laparotomy and, peroperative findings being compatible with angio-CT descriptions, a small-bowel resection was performed. The results of the histopathological examination confirmed the diagnosis of GIST. Angio-CT helps define the size of GIST as well as its range and location and can be used as the primary routine test for patients suffering from lower-GI bleeding.

  5. Multidetector row computed tomography of acute pancreatitis: Utility of single portal phase CT scan in short-term follow up

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Yongwonn [Department of Radiology, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729 (Korea, Republic of); Park, Hee Sun, E-mail: heesun.park@gmail.com [Department of Radiology, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729 (Korea, Republic of); Kim, Young Jun; Jung, Sung Il; Jeon, Hae Jeong [Department of Radiology, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729 (Korea, Republic of)

    2012-08-15

    Objective: The purpose of this study is to evaluate the question of whether nonenhanced CT or contrast enhanced portal phase CT can replace multiphasic pancreas protocol CT in short term monitoring in patients with acute pancreatitis. Materials and methods: This retrospective study was approved by the Institutional Review Board. From April 2006 to May 2010, a total of 52 patients having acute pancreatitis who underwent initial dual phase multidetector row CT (unenhanced, arterial, and portal phase) at admission and a short term (within 30 days) follow up dual phase CT (mean interval 10.3 days, range 3-28 days) were included. Two abdominal radiologists performed an independent review of three sets of follow up CT images (nonenhanced scan, single portal phase scan, and dual phase scan). Interpretation of each image set was done with at least 2-week interval. Radiologists evaluated severity of acute pancreatitis with regard to pancreatic inflammation, pancreatic necrosis, and extrapancreatic complication, based on the modified CT severity index. Scores of each image set were compared using a paired t-test and interobserver agreement was evaluated using intraclass correlation coefficient statistics. Results: Mean scores of sum of CT severity index on nonenhanced scan, portal phase scan, and dual phase scan were 5.7, 6.6, and 6.5 for radiologist 1, and 5.0, 5.6, and 5.8 for radiologist 2, respectively. In both radiologists, contrast enhanced scan (portal phase scan and dual phase scan) showed significantly higher severity score compared with that of unenhanced scan (P < 0.05), while portal phase and dual phase scan showed no significant difference each other. The trend was similar regarding pancreatic inflammation and extrapancreatic complications, in which contrast enhanced scans showed significantly higher score compared with those of unenhanced scan, while no significant difference was observed between portal phase scan and dual phase scan. In pancreatic necrosis

  6. Identification of Cardiac and Aortic Injuries in Trauma with Multi-detector Computed Tomography.

    Science.gov (United States)

    Shergill, Arvind K; Maraj, Tishan; Barszczyk, Mark S; Cheung, Helen; Singh, Navneet; Zavodni, Anna E

    2015-01-01

    Blunt and penetrating cardiovascular (CV) injuries are associated with a high morbidity and mortality. Rapid detection of these injuries in trauma is critical for patient survival. The advent of multi-detector computed tomography (MDCT) has led to increased detection of CV injuries during rapid comprehensive scanning of stabilized major trauma patients. MDCT has the ability to acquire images with a higher temporal and spatial resolution, as well as the capability to create multiplanar reformats. This pictorial review illustrates several common and life-threatening traumatic CV injuries from a regional trauma center.

  7. Identification of Cardiac and Aortic Injuries in Trauma with Multi-detector Computed Tomography

    Directory of Open Access Journals (Sweden)

    Arvind K Shergill

    2015-01-01

    Full Text Available Blunt and penetrating cardiovascular (CV injuries are associated with a high morbidity and mortality. Rapid detection of these injuries in trauma is critical for patient survival. The advent of multi-detector computed tomography (MDCT has led to increased detection of CV injuries during rapid comprehensive scanning of stabilized major trauma patients. MDCT has the ability to acquire images with a higher temporal and spatial resolution, as well as the capability to create multiplanar reformats. This pictorial review illustrates several common and life-threatening traumatic CV injuries from a regional trauma center.

  8. 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.

  9. The in vivo relationship between cross-sectional area and CT dose index in abdominal multidetector CT with automatic exposure control

    Energy Technology Data Exchange (ETDEWEB)

    Meeson, S; Alvey, C M; Golding, S J, E-mail: stuart.meeson@nds.ox.ac.u [Radiology Group, Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU (United Kingdom)

    2010-06-15

    The relationship between patient cross-sectional area and both volume CT dose index (CTDI) and dose length product was explored for abdominal CT in vivo, using a 16 multidetector row CT (MDCT) scanner with automatic exposure control. During a year-long retrospective survey of patients with MDCT for symptoms of abdominal sepsis, cross-sectional areas were estimated using customised ellipses at the level of the middle of vertebra L3. The relationship between cross-sectional area and the exposure parameters was explored. Scans were performed using a LightSpeed 16 (GE Healthcare Medical Systems, Milwaukee, WI) operated with tube current modulation. From a survey of 94 patients it was found that the CTDI increased with the increase in patient cross-sectional area. The relationship was logarithmic rather than linear, with a least-squares fit to the data (R{sup 2} = 0.80). For abdominal CT the cross-sectional area gave a measure of patient size based on the region of the body to be exposed. Exposure parameters increased with increasing cross-sectional area and the greater radiation exposure of larger patients was partly a consequence of their size. Given increasing obesity levels we believe that cross-sectional area and scan length should be added to future dose surveys, allowing patient size to be considered as a factor of relevance when examining population doses.

  10. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Differentiation of early gastric cancer with ulceration and resectable advanced gastric cancer using multiphasic dynamic multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Tsurumaru, Daisuke; Miyasaka, Mitsutoshi; Nishimuta, Yusuke; Asayama, Yoshiki; Nishie, Akihiro; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan); Kawanami, Satoshi [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Fukuoka (Japan); Oki, Eiji [Kyushu University, Department of Surgery and Sciences, Graduate School of Medical Sciences, Fukuoka (Japan); Hirahashi, Minako [Kyushu University, Department of Anatomic Pathology and Pathological Sciences, Graduate School of Medical Sciences, Fukuoka (Japan)

    2016-05-15

    Early gastric cancer with ulceration (EGC-U) mimics advanced gastric cancer (AGC), as EGC-Us and ACGs often have similar endoscopic appearance to ulceration. The purpose of this retrospective study was to determine whether multiphasic dynamic multidetector CT (MDCT) can help differentiate EGC-Us from AGCs. Patients with EGC-Us with ulcer stages Ul-III or IV and AGCs with tumour stages T2 to T4a were enrolled. MDCT images were obtained 40 s (arterial phase), 70 s (portal phase) and 240 s (delayed phase) after injection of non-ionic contrast material. Two readers independently measured the attenuation values of the lesions by placing regions of interest. We compared the EGC-Us and AGCs using the mean attenuation values in each phase and peak enhancement phase. We analysed the diagnostic performance of CT for differentiating EGC-Us from AGCs. Forty cases (16 EGC-Us and 24 AGCs) were analysed. The mean attenuation values of the EGC-Us were significantly lower than those of the AGCs in both the arterial and portal phases (all p < 0.0001 for each reader). The peak enhancement was significantly different between the EGC-Us and AGCs for both readers (Reader 1, p = 0.0131; Reader 2, p = 0.0006). Multiphasic dynamic contrast-enhanced MDCT can help differentiate EGC-Us from AGCs. (orig.)

  13. Acute gastrointestinal bleeding: emerging role of multidetector CT angiography and review of current imaging techniques.

    Science.gov (United States)

    Laing, Christopher J; Tobias, Terrence; Rosenblum, David I; Banker, Wade L; Tseng, Lee; Tamarkin, Stephen W

    2007-01-01

    Acute gastrointestinal bleeding is a common cause of hospitalization, morbidity, and mortality in the United States. The evaluation and treatment of acute gastrointestinal bleeding are complex and often require a multispecialty approach involving gastroenterologists, surgeons, internists, emergency physicians, and radiologists. The multitude of pathologic processes that can result in gastrointestinal bleeding, the length of the gastrointestinal tract, and the often intermittent nature of gastrointestinal bleeding further complicate patient evaluation. In addition, there are multiple imaging modalities and therapeutic interventions that are currently being used in the evaluation and treatment of acute gastrointestinal hemorrhage, each with its own strengths and weaknesses. Initial experience indicates that multidetector computed tomographic angiography is a promising first-line modality for the time-efficient, sensitive, and accurate diagnosis or exclusion of active gastrointestinal hemorrhage and may have a profound impact on the evaluation and subsequent treatment of patients who present with acute gastrointestinal bleeding.

  14. 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...

  15. Temporal evolution of multidetector CT findings after endoscopic submucosal dissection in patients with early gastric cancer: Correlation with endoscopy

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    Yeo, Dong Myung, E-mail: duehdaud@gmail.com [Department of Radiology, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of); Chung, Dong Jin, E-mail: bookdoo7@catholic.ac.kr [Department of Radiology, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of); Cheung, Dae Young, E-mail: adagio@catholic.ac.kr [Department of Internal Medicine, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of); Lee, Jae Mun, E-mail: jaemun@catholic.ac.kr [Department of Radiology, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of)

    2014-06-15

    Objective: To assess changes over time in imaging findings retrospectively by multidetector CT (MDCT) with two-dimensional (2D) multiplanar reconstruction and three-dimensional (3D) CT gastrography (CTG), after endoscopic submucosal dissection (ESD) in patients with early gastric cancer (EGC), and to correlate 3D CT images with endoscopic appearance. Materials and methods: In this retrospective study, a total of 84 patients underwent ESD and were followed up with MDCT. Fifteen patients underwent CT twice, and 3 patients underwent CT 3 times. A total of 105 CTs were included in this study and 43 CTs contained 3D CTGs. Two radiologists in consensus interpreted CT images for lesion detectability, presence and characteristics of ulcer, focal wall thickening, perigastric fat infiltration, and overlying enhancing layer in 2D images. The presence of ulcer or subtle mucosal nodularity, ulcer mound, and fold convergence were analysed in 3D CT images. We also assessed the time interval between ESD and CT and analysed the temporal evolution of CT findings. The sensitivity, specificity, and overall accuracy of 3D CTG were assessed regarding endoscopic features as the gold standard. Results: The mean interval between ESD and follow up CT was 76.9 days (median, 62; range, 2–223). No tumour recurrence in any lesion was found on follow-up endoscopic biopsy and also lymph node or distant metastasis was not observed on CT exams in the follow-up period. The lesion detectability in a total of 105 post-ESD 2D CT images was 42.0% (44/105), and 93.2% (41/44) of the detected lesions were visualizable 2 months after ESD. Focal wall thickening was observed during the entire follow-up period in all patients. Perigastric fat infiltration was observed in 4 lesions within 1 week of ESD. Overlying enhancing layer appeared in 27 lesions without temporal evolution. On a total of 43 post-ESD 3D CTG, lesion detectability was 76.7% (33/43), and lesions could be visualized for a longer period than

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

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

    2015-04-01

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

  17. Is It Possible to Predict Heart Rate and Range during Enhanced Cardiac CT Scan from Previous Non-enhanced Cardiac CT?

    OpenAIRE

    Horiguchi, Jun; Yamamoto, Hideya; Arie, Ryuichi; Kiguchi, Masao; Fujioka, Chikako; Ohtaki, Megu; Kihara, Yasuki; Awai, Kazuo

    2010-01-01

    The effect of heart rate and variation during cardiac computed tomography (CT) on the examination quality. The purpose of this study is to investigate whether it is possible to predict heart rate and range during enhanced cardiac computed CT scan from previous non-enhanced cardiac CT scan. Electrocardiograph (ECG) files from 112 patients on three types of cardiac 64-slice CT (non-enhanced, prospective ECG-triggered and retrospective ECG-gated enhanced scans) were recorded. The mean heart rate...

  18. Comparison of Multidetector CT and Gadobutrol-Enhanced MR Imaging for Evaluation of Small, Solid Pancreatic Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Tae Won [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Lee, Jeong Min; Kim, Jung Hoon [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Yu, Mi Hye [Department of Radiology, Konkuk University Medical Center, Seoul 05030 (Korea, Republic of); Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital, Seoul 03080 (Korea, Republic of)

    2016-11-01

    To compare multidetector computed tomography (MDCT) and MRI for lesion conspicuity, as well as the detection and characterization of small solid pancreatic lesions (SPLs). 193 patients with small SPLs (< 3 cm) and 52 patients with normal pancreas who underwent both multiphasic MDCT and gadobutrol-enhanced MRI were included in our study. Two radiologists blinded to the pathologic diagnoses independently reviewed those images, and determined the detection of 'SPL per se' and 'SPL in consideration of secondary features', the lesion conspicuity, the probability of pancreatic ductal adenocarcinoma (PDAC), and the most likely specific diagnosis. The sensitivity of MRI for 'detection of SPL per se' was significantly higher than that of CT in both reviewers: 92.7% (179/193) and 97.9% (189/193), respectively, for reviewer 1 (p = 0.031) and 90.7% (175/193) and 99.5% (192/193), respectively, for reviewer 2 (p < 0.001). In addition, MRI provided better lesion conspicuity than MDCT for both reviewers (p < 0.001). However, CT and MRI did not show significant difference in sensitivity for 'detection of SPL in consideration of secondary features', specificity for SPL detection, and differentiation of PDAC vs. non-PDAC (p > 0.05). The accuracies of CT and MRI for making a specific diagnosis were as follows: 85.7% (210/245) vs. 86.9% (213/245), respectively, for reviewer 1 (p = 0.736), and 91.8% (225/245) vs. 93.5% (229/245), respectively, for reviewer 2 (p = 0.454). MRI showed better lesion conspicuity than MDCT, but did not show significantly different diagnostic performance compared with MDCT for detecting and characterizing small SPLs.

  19. Comparison of multidetector CT and gadobutrol-enhanced MR imaging for evaluation of small, solid pancreatic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Tae Won; Lee, Jeong Min; Kim, Jung Hoon; Han, Joon Koo; Choi, Byung Ihn [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Yu, Mi Hye [Dept. of Radiology, Konkuk University Medical Center, Seoul (Korea, Republic of)

    2016-07-15

    To compare multidetector computed tomography (MDCT) and MRI for lesion conspicuity, as well as the detection and characterization of small solid pancreatic lesions (SPLs). 193 patients with small SPLs (< 3 cm) and 52 patients with normal pancreas who underwent both multiphasic MDCT and gadobutrol-enhanced MRI were included in our study. Two radiologists blinded to the pathologic diagnoses independently reviewed those images, and determined the detection of 'SPL per se' and 'SPL in consideration of secondary features', the lesion conspicuity, the probability of pancreatic ductal adenocarcinoma (PDAC), and the most likely specific diagnosis. The sensitivity of MRI for 'detection of SPL per se' was significantly higher than that of CT in both reviewers: 92.7% (179/193) and 97.9% (189/193), respectively, for reviewer 1 (p = 0.031) and 90.7% (175/193) and 99.5% (192/193), respectively, for reviewer 2 (p < 0.001). In addition, MRI provided better lesion conspicuity than MDCT for both reviewers (p < 0.001). However, CT and MRI did not show significant difference in sensitivity for {sup d}etection of SPL in consideration of secondary features{sup ,} specificity for SPL detection, and differentiation of PDAC vs. non-PDAC (p > 0.05). The accuracies of CT and MRI for making a specific diagnosis were as follows: 85.7% (210/245) vs. 86.9% (213/245), respectively, for reviewer 1 (p = 0.736), and 91.8% (225/245) vs. 93.5% (229/245), respectively, for reviewer 2 (p = 0.454). MRI showed better lesion conspicuity than MDCT, but did not show significantly different diagnostic performance compared with MDCT for detecting and characterizing small SPLs.

  20. MRI and CT appearances of cardiac tumours in adults

    Energy Technology Data Exchange (ETDEWEB)

    Hoey, E.T.D. [Department of Radiology, Leeds Teaching Hopsitals NHS Trust (United Kingdom); Department of Radiology, Papworth Hospital, Cambridge (United Kingdom); Department of Radiology, Heart of England NHS Trust (United Kingdom); Mankad, K.; Puppala, S. [Department of Radiology, Leeds Teaching Hopsitals NHS Trust (United Kingdom); Gopalan, D. [Department of Radiology, Papworth Hospital, Cambridge (United Kingdom); Sivananthan, M.U., E-mail: Jill_E.Taylor@leedsth.nhs.u [Department of Radiology, Leeds Teaching Hopsitals NHS Trust (United Kingdom); Department of Cardiology, Leeds Teaching Hopsitals NHS Trust (United Kingdom)

    2009-12-15

    Primary cardiac tumours are rare, and metastases to the heart are much more frequent. Myxoma is the commonest benign primary tumour and sarcomas account for the majority of malignant lesions. Clinical manifestations are diverse, non-specific, and governed by the location, size, and aggressiveness. Imaging plays a central role in their evaluation, and familiarity with characteristic features is essential to generate a meaningful differential diagnosis. Cardiac magnetic resonance imaging (MRI) has become the reference technique for evaluation of a suspected cardiac mass. Computed tomography (CT) provides complementary information and, with the advent of electrocardiographic gating, has become a powerful tool in its own right for cardiac morphological assessment. This paper reviews the MRI and CT features of primary and secondary cardiac malignancy. Important differential considerations and potential diagnostic pitfalls are also highlighted.

  1. Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer

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    Saito, Takuro; Kurokawa, Yukinori; Takiguchi, Shuji; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Yamasaki, Makoto; Miyata, Hiroshi; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro [Osaka University, Graduate School of Medicine, Department of Gastroenterological Surgery, Suita, Osaka (Japan)

    2014-08-06

    The purpose of this study was to determine the optimal cut-off value of lymph node size for diagnosing metastasis in gastric cancer with multidetector-row computed tomography (MDCT) after categorizing perigastric lymph nodes into three regions. The study included 90 gastric cancer patients who underwent gastrectomy. The long-axis diameter (LAD) and short-axis diameter (SAD) of all visualized lymph nodes were measured with transverse MDCT images. The locations of lymph nodes were categorized into three regions: lesser curvature, greater curvature, and suprapancreatic. The diagnostic value of lymph node metastasis was assessed with receiver operating characteristic (ROC) analysis. The area under the curve was larger for SAD than LAD in all groups. The optimal cut-off values of SAD were determined as follows: overall, 9 mm; differentiated type, 9 mm; undifferentiated type, 8 mm; lesser curvature region, 7 mm; greater curvature region, 6 mm; and suprapancreatic region, 9 mm. The diagnostic accuracies for lymph node metastasis using individual cut-off values were 71.1 % based on histological type and 76.6 % based on region of lymph node location. The diagnostic accuracy of lymph node metastasis in gastric cancer was improved by using individual cut-off values for each lymph node region. (orig.)

  2. Comparison of neutral oral contrast versus positive oral contrast medium in abdominal multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Berther, Ralph; Eckhardt, Boris; Zollikofer, Christoph L. [Kantonsspital, Institute of Radiology, Winterthur (Switzerland); Patak, Michael A. [Kantonsspital, Institute of Radiology, Winterthur (Switzerland); Inselspital, University Hospital of Bern, Institute of Diagnostic, Interventional and Paediatric Radiology, Bern (Switzerland); Erturk, Sukru M. [Sisli Etfal Education and Research Hospital, Department of Radiology, Istanbul (Turkey)

    2008-09-15

    To determine whether neutral contrast agents with water-equivalent intraluminal attenuation can improve delineation of the bowel wall and increase overall image quality for a non-selected patient population, a neutral oral contrast agent (3% mannitol) was administered to 100 patients referred for abdominal multidetector row computed tomography (MDCT). Their results were compared with those of 100 patients given a positive oral contrast agent. Qualitative and quantitative measurements were done on different levels of the gastrointestinal tract by three experienced readers. Patients given the neutral oral contrast agent showed significant better qualitative results for bowel distension (P<0.001), homogeneity of the luminal content (P<0.001), delineation of the bowel-wall to the lumen (P<0.001) and to the mesentery (P<0.001) and artifacts (P<0.001), leading to a significant better overall image quality (P<0.001) than patients receiving positive oral contrast medium. The quantitative measurements revealed significant better distension (P<0.001) and wall to lumen delineation (P<0.001) for the patients receiving neutral oral contrast medium. The present results show that the neutral oral contrast agent (mannitol) produced better distension, better homogeneity and better delineation of the bowel wall leading to a higher overall image quality than the positive oral contrast medium in a non-selected patient population. (orig.)

  3. A comparative review of multidetector CT angiography and MRI in the diagnosis of jugular foramen lesions

    Energy Technology Data Exchange (ETDEWEB)

    Christie, A., E-mail: andychristie90@hotmail.co [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom); Teasdale, E. [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom)

    2010-03-15

    Aim: To compare the efficiency of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the diagnosis of jugular foramen lesions. Materials and methods: The imaging of 15 patients with tumours predominantly occurring at the jugular foramen was retrospectively reviewed, with postoperative pathology data available for 11 patients. MDCT was performed at arterial phase and MRI with standard sequences and contrast enhancement. All imaging was blindly re-reported by an experienced neuroradiologist. Results: Pathology reported six glomus jugulare tumours and five neuromas, which were all correctly diagnosed using MDCT. A confident diagnosis was also made in the remaining four cases based on the pattern of enhancement. Only glomus tumours enhanced in the arterial phase. Overall, MRI was used to make a confident diagnosis in eight patients. One showed no enhancement and was correctly diagnosed as a neuroma, and seven demonstrated the tumour flow voids characteristic of a glomus tumour. The remaining seven cases all showed a similar enhancement pattern and could not be confidently differentiated between a neuroma or a glomus tumour. MDCT angiography enabled a confident assessment of the jugular vein in all cases, but MRI was inconclusive in a third of cases. Also, in the nine cases of glomus tumour diagnosed using MDCT, an enlarged feeding artery was identified in eight patients. Conclusion: MDCT is more accurate than MRI in diagnosing glomus tumours, and in particular, neuromas. It also offers valuable preoperative vascular information to the surgeon.

  4. Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours

    Energy Technology Data Exchange (ETDEWEB)

    Cappelli, Carla [University of Pisa, Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa (Italy); Azienda Ospedaliero-Universitaria Pisana-Radiodiagnostica I, Pisa (Italy); Boggi, Ugo [University of Pisa, General and Transplant Surgery, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa (Italy); Mazzeo, Salvatore; Cervelli, Rosa; Contillo, Benedetta Pontillo; Bartolozzi, Carlo [University of Pisa, Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa (Italy); Campani, Daniela; Funel, Niccola [University of Pisa, Pathology, Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa (Italy)

    2014-12-02

    Preoperative suspicion of malignancy in pancreatic neuroendocrine tumours (pNETs) is mostly based on tumour size. We retrospectively reviewed the contrast enhancement pattern (CEP) of a series of pNETs on multiphasic multidetector computed tomography (MDCT), to identify further imaging features predictive of lesion aggressiveness. Sixty pNETs, diagnosed in 52 patients, were classified based on CEP as: type A showing early contrast enhancement and rapid wash-out; type B presenting even (B1) or only (B2) late enhancement. All tumours were resected allowing pathologic correlations. Nineteen pNETs showed type A CEP (5-20 mm), 29 type B1 CEP (5-80 mm) and 12 type B2 (15-100 mm). All tumours were classified as well differentiated tumours, 19 were benign (WDt-b), 15 with uncertain behaviour (WDt-u) and 26 carcinomas (WDC). None of A lesions were malignant (12 WDt-b; 7 WDt-u), all B2 lesions were WDC, 7 B1 lesions were WDt-b, 8 WDt-u and 14 WDC; 4/34 (12 %) lesions ≤2cm were WDC. CEP showed correlation with all histological prognostic indicators. Correlating with the lesion grading and other histological prognostic predictors, CEP may preoperatively suggest the behaviour of pNETs, assisting decisions about treatment. Moreover CEP allows recognition of malignant small tumours, incorrectly classified on the basis of their dimension. (orig.)

  5. Multidetector CT Enterography versus Double-Balloon Enteroscopy: Comparison of the Diagnostic Value for Patients with Suspected Small Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Jingjing Wang

    2016-01-01

    Full Text Available Aim. To compare the diagnostic value of multidetector CT enterography (MDCTE and double-balloon enteroscopy (DBE for patients with suspected small bowel diseases. Methods. From January 2009 to January 2014, 190 patients with suspected small bowel diseases were examined with MDCTE and DBE. The characteristics of the patients, detection rates, diagnostic yields, sensitivity, specificity, positive predictive value, and negative predictive value were described and analyzed. Results. The overall detection rates of DBE and MDCTE were 92.6% and 55.8%, respectively (P<0.05, while the overall diagnostic yields were 83.2% and 33.7%, respectively (P<0.05. The sensitivity, specificity, positive predictive value, and negative predictive value of DBE were all higher than those of MDCTE. DBE had a higher diagnostic yield for OGIB (87.3% versus 20.9%, P<0.05. The diagnostic yields of DBE were higher than those of MDCTE for inflammatory diseases, angioma/angiodysplasia, and diverticulums, while being not for gastrointestinal tumors/polyps. Conclusions. The diagnostic value of DBE for small bowel diseases is better than that of MDCTE as a whole, but if gastrointestinal tumors are suspected, MDCTE is also needed to gain a comprehensive and accurate diagnosis.

  6. Detection and localization of acute upper and lower gastrointestinal (GI) bleeding with arterial phase multi-detector row helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Jaeckle, T.; Stuber, G.; Hoffmann, M.H.K.; Jeltsch, M.; Schmitz, B.L.; Aschoff, A.J. [University Hospital of Ulm, Diagnostic and Interventional Radiology, Ulm (Germany)

    2008-07-15

    The purpose of this study was to evaluate the accuracy of multi-detector row helical CT (MDCT) for detection and localization of acute upper and lower gastrointestinal (GI) hemorrhage or intraperitoneal bleeding. Thirty-six consecutive patients with clinical signs of acute bleeding underwent biphasic (16- or 40-channel) MDCT. MDCT findings were correlated with endoscopy, angiography or surgery. Among the 36 patients evaluated, 26 were examined for GI bleeding and 10 for intraperitoneal hemorrhage. Confirmed sites of GI bleeding were the stomach (n = 5), duodenum (n = 5), small bowel (n = 6), large bowel (n = 8) and rectum (n = 2). The correct site of bleeding was identifiable on MDCT in 24/26 patients with GI bleeding. In 20 of these 24 patients, active CM extravasation was apparent during the exam. Among the ten patients with intraperitoneal hemorrhage, MDCT correctly identified the bleeding source in nine patients. Our findings suggest that fast and accurate localization of acute gastrointestinal and intraperitoneal bleeding is achievable on MDCT. (orig.)

  7. Preoperative multidetector CT manifestations of perigastric lymph nodes in patients with early gastric cancer and pN0

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jung Hyun; Yu, Jeong Sik; Chung, Jae Joon; Lim, Joo Hee; Cho, Eun Suk; Kim, Ki Whang [Dept. of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2013-11-15

    To find the determinant of lymph node (LN) manifestations on preoperative multidetector CT (MDCT) in early gastric cancer (EGC) patients with pN0. One hundred and eighty-six consecutive patients with pT1pN0, the largest perigastric LN on preoperative MDCT, were categorized into two groups according to 8 different parameters [short (SD) and long diameter (LD) 4/6/8 mm, average attenuation 100 Hounsfield unit, short-to-long diameter-ratio (SLR) 0.7], and correlated with the size, gross type, depth of invasion and microscopic type of their primary lesions by the chi-square test and multiple logistic regression analysis. When the primary lesion was larger than 3 cm, the LNs were larger in 4 parameters (SD or LD, 4/6 mm; p < 0.05); gross type IIb patients showed smaller LNs in 5 parameters (SD 4/6 mm, LD 4/6/8 mm; p < 0.05); and patients with microscopically-undifferentiated lesions showed larger LNs in SD 4 mm or LD 8 mm by the chi-square test and multiple logistic regression analysis. The depth of invasion showed no significant difference in LN size. No factors revealed significant difference in LN attenuation or SLR. Benign regional LN enlargement is more frequent in EGC patients with larger size primary lesions or lesion with poor microscopic differentiation. However, this condition is less frequent in gross type IIb patients.

  8. Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Feng; Li, Ming; Ge, Xiaojun; Ren, Qingguo; Hua, Yanqing [Huadong Hospital Fudan University, Department of Radiology, Shanghai (China); Zheng, Xiangpeng [Huadong Hospital Fudan University, Department of Radiation Oncology, Shanghai (China); Chen, Yan [Huadong Hospital Fudan University, Department of Pathology, Shanghai (China); Lv, Fangzhen [Huadong Hospital Fudan University, Department of Thoracic Surgery, Shanghai (China)

    2013-12-15

    To investigate the relationships between pulmonary ground-glass nodules (GGN) and blood vessels and their diagnostic values in differentiating GGNs. Multi-detector spiral CT imaging of 108 GGNs was retrospectively reviewed. The spatial relationships between GGNs and supplying blood vessels were categorized into four types: I, vessels passing by GGNs; II, intact vessels passing through GGNs; III, distorted, dilated or tortuous vessels seen within GGNs; IV, more complicated vasculature other than described above. Relationship types were correlated to pathologic and/or clinical findings of GGNs. Of 108 GGNs, 10 were benign, 24 preinvasive nodules and 74 adenocarcinomas that were pathologically proven. Types I, II, III and IV vascular relationships were observed in 9, 58, 21 and 20 GGNs, respectively. Type II relationship was the dominating relationship for each GGN group, but significant differences were shown among them. Correlation analysis showed strong correlation between invasive adenocarcinoma and type III and IV relationships. Subgroup analysis indicated that type III was more commonly seen in IAC with comparison to type IV more likely seen in MIA. Different GGNs have different relationships with vessels. Understanding and recognising characteristic GGN-vessel relationships may help identify which GGNs are more likely to be malignant. (orig.)

  9. Multidetector CT radiation dose optimisation in adults: short- and long-term effects of a clinical audit

    Energy Technology Data Exchange (ETDEWEB)

    Tack, Denis [EpiCURA Hospital, Clinique Louis Caty, Department of Radiology, Baudour (Belgium); Jahnen, Andreas; Kohler, Sarah [CRP Henri Tudor, Luxembourg (Luxembourg); Harpes, Nico; Back, Carlo [Ministry of Health, Department of Radiation Protection, Luxembourg (Luxembourg); Maertelaer, Viviane de [Universite libre de Bruxelles, Institut de Recherche Interdisciplinaire en Biologie Humaine et Moleculaire and SBIM, Statistical Unit, Brussels (Belgium); Gevenois, Pierre Alain [Hopital Erasme, Department of Radiology, Brussels (Belgium)

    2014-01-15

    To report short- and long-term effects of an audit process intended to optimise the radiation dose from multidetector row computed tomography (MDCT). A survey of radiation dose from all eight MDCT departments in the state of Luxembourg performed in 2007 served as baseline, and involved the most frequently imaged regions (head, sinus, cervical spine, thorax, abdomen, and lumbar spine). CT dose index volume (CTDIvol), dose-length product per acquisition (DLP/acq), and DLP per examination (DLP/exa) were recorded, and their mean, median, 25th and 75th percentiles compared. In 2008, an audit conducted in each department helped to optimise doses. In 2009 and 2010, two further surveys evaluated the audit's impact on the dose delivered. Between 2007 and 2009, DLP/exa significantly decreased by 32-69 % for all regions (P < 0.001) except the lumbar spine (5 %, P = 0.455). Between 2009 and 2010, DLP/exa significantly decreased by 13-18 % for sinus, cervical and lumbar spine (P ranging from 0.016 to less than 0.001). Between 2007 and 2010, DLP/exa significantly decreased for all regions (18-75 %, P < 0.001). Collective dose decreased by 30 % and the 75th percentile (diagnostic reference level, DRL) by 20-78 %. The audit process resulted in long-lasting dose reduction, with DRLs reduced by 20-78 %, mean DLP/examination by 18-75 %, and collective dose by 30 %. (orig.)

  10. Multidetector CT of pancreatic ductal adenocarcinoma: Effect of tube voltage and iodine load on tumour conspicuity and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Loizou, L.; Leidner, B.; Axelsson, E.; Fischer, M.A.; Grigoriadis, A.; Kartalis, N. [Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); C1-46 Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden); Albiin, N. [Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Ersta Hospital, Department of Radiology, Stockholm (Sweden); Del Chiaro, M.; Segersvaerd, R. [Karolinska University Hospital Huddinge, Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Center for Digestive Diseases, Stockholm (Sweden); Verbeke, C. [Karolinska Institutet and Karolinska University Hospital Huddinge, Division of Pathology, Department of Laboratory Medicine, Stockholm (Sweden); Sundin, A. [Uppsala University Hospital, Department of Surgical Sciences, Division of Radiology, Uppsala University and Department of Radiology, Uppsala (Sweden)

    2016-11-15

    To compare a low-tube-voltage with or without high-iodine-load multidetector CT (MDCT) protocol with a normal-tube-voltage, normal-iodine-load (standard) protocol in patients with pancreatic ductal adenocarcinoma (PDAC) with respect to tumour conspicuity and image quality. Thirty consecutive patients (mean age: 66 years, men/women: 14/16) preoperatively underwent triple-phase 64-channel MDCT examinations twice according to: (i) 120-kV standard protocol (PS; 0.75 g iodine (I)/kg body weight, n = 30) and (ii) 80-kV protocol A (PA; 0.75 g I/kg, n = 14) or protocol B (PB; 1 g I/kg, n = 16). Two independent readers evaluated tumour delineation and image quality blindly for all protocols. A third reader estimated the pancreas-to-tumour contrast-to-noise ratio (CNR). Statistical analysis was performed with the Chi-square test. Tumour delineation was significantly better in PB and PA compared with PS (P = 0.02). The evaluation of image quality was similar for the three protocols (all, P > 0.05). The highest CNR was observed with PB and was significantly better compared to PA (P = 0.02) and PS (P = 0.0002). In patients with PDAC, a low-tube-voltage, high-iodine-load protocol improves tumour delineation and CNR leading to higher tumour conspicuity compared to standard protocol MDCT. (orig.)

  11. Accuracy of hepatocellular carcinoma detection on multidetector CT in a transplant liver population with explant liver correlation

    Energy Technology Data Exchange (ETDEWEB)

    Addley, H.C., E-mail: helenclareaddley@hotmail.co.u [Department of Radiology, Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Griffin, N.; Shaw, A.S.; Mannelli, L. [Department of Radiology, Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Parker, R.A. [Department of Medical Statistics, Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Aitken, S.; Wood, H. [Department of Radiology, Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Davies, S. [Department of Histopathology, Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Alexander, G.J. [Department of Hepatology, Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Lomas, D.J. [Department of Radiology, Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom)

    2011-04-15

    Aim: To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) for hepatocellular carcinoma (HCC) in cirrhotic patients undergoing liver transplantation. Secondary aims were to examine the effect of radiologist experience and lesion size on diagnostic accuracy. Materials and methods: Thirty-nine patients (72% male with a mean age of 56.5 years) underwent liver transplantation following preoperative triple-phase MDCT examination of the liver. MDCT examinations were retrospectively independently reviewed by three radiologists for the presence and location of suspected HCCs, with the diagnostic confidence recorded using a five-point confidence scale. MDCT examinations were compared with explant specimens for histopathological correlation. Results: Histopathological results demonstrated 46 HCCs in 29 of the 39 patients. Analysis demonstrated a sensitivity of 65-75% and specificity of 47-88% for detection of HCC lesions. The sensitivity dropped to 48-57% for lesions of size {<=}20 mm. As the diagnostic confidence increased, there was a further decrease in the sensitivity (4-26%). The radiologist with the greatest number of years experience was found to have a significantly higher accuracy of detection of HCC lesions compared with the least experienced radiologist. Conclusion: Larger lesion size of HCC and greater number of years experience of the radiologist resulted in significantly higher accuracy of HCC lesion detection. The overall sensitivity and specificity results for MDCT detection of HCC are comparable to previous helical CT imaging.

  12. Detection and localization of acute upper and lower gastrointestinal (GI) bleeding with arterial phase multi-detector row helical CT.

    Science.gov (United States)

    Jaeckle, T; Stuber, G; Hoffmann, M H K; Jeltsch, M; Schmitz, B L; Aschoff, A J

    2008-07-01

    The purpose of this study was to evaluate the accuracy of multi-detector row helical CT (MDCT) for detection and localization of acute upper and lower gastrointestinal (GI) hemorrhage or intraperitoneal bleeding. Thirty-six consecutive patients with clinical signs of acute bleeding underwent biphasic (16- or 40-channel) MDCT. MDCT findings were correlated with endoscopy, angiography or surgery. Among the 36 patients evaluated, 26 were examined for GI bleeding and 10 for intraperitoneal hemorrhage. Confirmed sites of GI bleeding were the stomach (n = 5), duodenum (n = 5), small bowel (n = 6), large bowel (n = 8) and rectum (n = 2). The correct site of bleeding was identifiable on MDCT in 24/26 patients with GI bleeding. In 20 of these 24 patients, active CM extravasation was apparent during the exam. Among the ten patients with intraperitoneal hemorrhage, MDCT correctly identified the bleeding source in nine patients. Our findings suggest that fast and accurate localization of acute gastrointestinal and intraperitoneal bleeding is achievable on MDCT.

  13. 320-Multidetector row whole-head dynamic subtracted CT angiography and whole-brain CT perfusion before and after carotid artery stenting: Technical note

    Energy Technology Data Exchange (ETDEWEB)

    San Millan Ruiz, Diego, E-mail: dsanmil1@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Murphy, Kieran, E-mail: KMURPHY@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Gailloud, Philippe, E-mail: pgailloud@cerebrovascular.ne [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States)

    2010-06-15

    Introduction: Multidetector CT (MDCT) is increasingly used for the investigation of neurovascular disorders, but restricted z-axis coverage (3.2 cm for 64-MDCT) currently limits perfusion to a small portion of the brain close to the circle of Willis, and precludes dynamic angiographic appreciation of the entire brain circulation. We illustrate the clinical potential of recently developed 320-MDCT extending the z-axis coverage to 16 cm in a patient with symptomatic carotid artery stenosis. Methods: In a 74-year-old patient presenting with critical symptomatic stenosis of the left CCA, pre- and post-carotid artery stenting whole-head subtracted dynamic MDCT angiography and perfusion were obtained in addition to CT angiography of the supra-aortic trunks. Both whole-head subtracted MDCT angiography and perfusion demonstrated delayed left ICA circulation, which normalized after carotid stenting. Discussion: 320-MDCT offers unprecedented z-axis coverage allowing for whole-brain perfusion and subtracted dynamic angiography of the entire intracranial circulation. These innovations can consolidate the role of MDCT as a first intention imaging technique for cerebrovascular disorders, in particular for the acute management of stroke.

  14. Haemodynamic findings on cardiac CT in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-02-15

    In patients with congenital heart disease, haemodynamic findings demonstrated on cardiac CT might provide useful hints for understanding the haemodynamics of cardiac defects. In contrast to morphological features depicted on cardiac CT, such haemodynamic findings on cardiac CT have not been comprehensively reviewed in patients with congenital heart disease. This article describes normal haemodynamic phenomena of cardiovascular structures and various abnormal haemodynamic findings with their mechanisms and clinical significance on cardiac CT in patients with congenital heart disease. (orig.)

  15. Clinical Utility of Iopamidol (Pamiray 370) for Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mok Hee; Seon, Hyun Ju [Dept. of Radiology, Chonnam National University Hospital, Kwangju (Korea, Republic of); Choi, Song [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Kim, Yun Hyeon; Kim, Jae Kyu; Park, Jin Gyoon; Kang, Heong Keun [Dept. of Radiology, Chonnam National University Medicine School, Kwangju (Korea, Republic of)

    2011-07-15

    We evaluated the utility of iopamidol-based nonionic contrast media (Pamiray 370) for cardiac CT, with assessment of its image quality and safety. The study included 100 patients who underwent cardiac CT with Pamiray 370 (experimental group), and 100 patients who underwent cardiac CT with Ultravist 370 (control group). A comparison of the image qualities and degree of vascular contrast enhancement was made between the two groups and evaluated statistically by an independent t-test. Changes in vital signs and adverse events during cardiac CT were evaluated in the experimental group. There were no statistically significant differences in the image quality (image quality score in experimental group vs. control group: 4.26 {+-} 0.63 vs. 4.24 {+-} 0.62), and mean attenuation values at the coronary arteries(p > 0.05) between two groups. For the experimental group, 12% experienced adverse events, including mild and transient reactions such as dizziness (7%), nausea (4%), and fatigue (1%). Further, 94% of patients complained of mild to moderate febrile sense just after contrast agent administration, which spontaneously disappeared within 3 minutes without any specific management. For cardiac CT, Pamiray 370 was comparable to the widely-used contrast agent (Ultravist 370) in terms of image quality and safety without any severe adverse reaction.

  16. 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

  17. Can multidetector CT detect the site of gastrointestinal tract injury in trauma? – A retrospective study

    Science.gov (United States)

    Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Das, Ranjita; Paliwal, Swati; Gupta, Amit; Kumar, Subodh

    2017-01-01

    PURPOSE We aimed to assess the performance of computed tomography (CT) in localizing site of traumatic gastrointestinal tract (GIT) injury and determine the diagnostic value of CT signs in site localization. METHODS CT scans of 97 patients with surgically proven GIT or mesenteric injuries were retrospectively reviewed by radiologists blinded to surgical findings. Diagnosis of either GIT or mesenteric injuries was made. In patients with GIT injuries, site of injury and presence of CT signs such as focal bowel wall hyperenhancement, hypoenhancement, wall discontinuity, wall thickening, extramural air, intramural air, perivisceral infiltration, and active vascular contrast leak were evaluated. RESULTS Out of 97 patients, 90 had GIT injuries (70 single site injuries and 20 multiple site injuries) and seven had isolated mesenteric injury. The overall concordance between CT and operative findings for exact site localization was 67.8% (61/90), partial concordance rate was 11.1% (10/90), and discordance rate was 21.1% (19/90). For single site localization, concordance rate was 77.1% (54/70), discordance rate was 21.4% (15/70), and partial concordance rate was 1.4% (1/70). In multiple site injury, concordance rate for all sites of injury was 35% (7/20), partial concordance rate was 45% (9/20), and discordance rate was 20% (4/20). For upper GIT injuries, wall discontinuity was the most accurate sign for localization. For small bowel injury, intramural air and hyperenhancement were the most specific signs for site localization, while for large bowel injury, wall discontinuity and hypoenhancement were the most specific signs. CONCLUSION CT performs better in diagnosing small bowel injury compared with large bowel injury. CT can well predict the presence of multiple site injury but has limited performance in exact localization of all injury sites. PMID:27924777

  18. Low-dose multidetector-row CT-angiography of abdominal aortic aneurysm after endovascular repair

    Energy Technology Data Exchange (ETDEWEB)

    Iezzi, R., E-mail: iezzir@virgilio.it [Department of Bioimaging and Radiological Sciences, Institute of Radiology, ' A. Gemelli' Hospital - Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Department of Clinical Science and Bioimaging, Section of Radiology, University ' G. D' Annunzio' , Chieti (Italy); Cotroneo, A.R.; Giammarino, A. [Department of Clinical Science and Bioimaging, Section of Radiology, University ' G. D' Annunzio' , Chieti (Italy); Spigonardo, F. [Department of Vascular Surgery, University ' G. D' Annunzio' , Chieti (Italy); Storto, M.L. [Department of Clinical Science and Bioimaging, Section of Radiology, University ' G. D' Annunzio' , Chieti (Italy)

    2011-07-15

    Purpose: To investigate the possibility of reducing radiation dose exposure while maintaining image quality using multidetector computed tomography angiography (MDCTA) with high-concentration contrast media in patients undergoing follow-up after endovascular aortic repair (EVAR) to treat abdominal aortic aneurysm. Materials and methods: In this prospective, single center, intra-individual study, patients underwent two consecutive MDCTA scans 6 months apart, one with a standard acquisition protocol (130 mAs/120 kV) and 120 mL of iomeprol 300, and one using a low dose protocol (100 mAs/80 kV) and 90 mL of iomeprol 400. Images acquired during the arterial phase of contrast enhancement were evaluated both qualitatively and quantitatively for image noise and intraluminal contrast enhancement. Results: Thirty adult patients were prospectively enrolled. Statistically significantly higher attenuation values were measured in the low-dose acquisition protocol compared to the standard protocol, from the suprarenal abdominal aorta to the common femoral artery (p < 0.0001; all vascular segments). Qualitatively, image quality was judged significantly (p = 0.0002) better with the standard protocol than with the low-dose protocol. However, no significant differences were found between the two protocols in terms of contrast-to-noise ratio (CNR) (13.63 {+-} 6.97 vs. 11.48 {+-} 8.13; p = 0.1058). An overall dose reduction of up to 74% was observed for the low-dose protocol compared with the standard protocol. Conclusion: In repeat follow-up examinations of patients undergoing EVAR for abdominal aortic aneurysm, a low-dose radiation exposure acquisition protocol provides substantially reduced radiation exposure while maintaining a constant CNR and good image quality.

  19. Development of a noise reduction filter algorithm for pediatric body images in multidetector CT.

    Science.gov (United States)

    Nishimaru, Eiji; Ichikawa, Katsuhiro; Okita, Izumi; Tomoshige, Yukihiro; Kurokawa, Takehiro; Nakamura, Yuko; Suzuki, Masayuki

    2010-12-01

    Recently, several types of post-processing image filter which was designed to reduce noise allowing a corresponding dose reduction in CT images have been proposed and these were reported to be useful for noise reduction of CT images of adult patients. However, these have not been reported on adaptation for pediatric patients. Because they are not very effective with small (<20 cm) display fields of view, they could not be used for pediatric (e.g., premature babies and infants) body CT images. In order to solve this restriction, we have developed a new noise reduction filter algorithm which can be applicable for pediatric body CT images. This algorithm is based on a three-dimensional post processing, in which output pixel values are calculated by multi-directional, one-dimensional median filters on original volumetric datasets. The processed directions were selected except in in-plane (axial plane) direction, and consequently the in-plane spatial resolution was not affected by the filter. Also, in other directions, the spatial resolutions including slice thickness were almost maintained due to a characteristic of non-linear filtering of the median filter. From the results of phantom studies, the proposed algorithm could reduce standard deviation values as a noise index by up to 30% without affecting the spatial resolution of all directions, and therefore, contrast-to-noise ratio was improved by up to 30%. This newly developed filter algorithm will be useful for the diagnosis and radiation dose reduction of pediatric body CT images.

  20. Multi-detector CT: review of its use in acute GI haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Anthony, S.; Milburn, S. [Department of Radiology, John Radcliffe Hospital, Oxford (United Kingdom); Uberoi, R. [Department of Radiology, John Radcliffe Hospital, Oxford (United Kingdom)], E-mail: raman.uberoi@orh.nhs.uk

    2007-10-15

    The advent of multi-section computed tomography (CT) technology allows the non-invasive assessment of the arterial tree. Using current software, it is now possible to produce high-quality, angiographic-like images that can be used to plan and guide therapeutic procedures. One such clinical situation is the assessment of patients with acute gastrointestinal (GI) haemorrhage. Multi-section CT has a number of advantages over conventional angiography in this situation. The simplicity and non-invasive nature of the technique compared with conventional angiography make CT angiography possible in situations where conventional angiography is not available. Movement artefact from respiration and peristalsis is a common problem in the interpretation of conventional angiography; this is essentially abolished with rapid acquisition times and the use of multi-planar images to remove overlying bowel loops. Cross-sectional imaging with the ability for multi-planar reconstruction allows the accurate anatomical localization of the bleeding site, as well as an assessment of the underlying pathology: this can be used to plan therapy (embolization or surgery). The aim of this paper is to review the current use of CT in the investigation of patients with GI haemorrhage, illustrated with images from our Institution. For patients in whom GI endoscopy has failed to establish a diagnosis, we propose multi-section CT angiography as the initial imaging investigation in acute GI haemorrhage.

  1. Value of oral effervescent powder administration for multidetector CT evaluation of esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ringe, Kristina I., E-mail: ringe.kristina@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Meyer, Simone, E-mail: Meyer.simone.rad@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Ringe, Bastian P., E-mail: Ringe.bastian@mh-hannover.de [Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Winkler, Michael, E-mail: Winkler.michael@mh-hannover.de [Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Wacker, Frank, E-mail: Wacker.frank@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Raatschen, Hans-Juergen, E-mail: Raatschen.hans-juergen@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover (Germany)

    2015-02-15

    Highlights: • Oral effervescent powder improves esophageal distension and wall assessment at CT. • This technique improves detection and T staging of esophageal cancer at CT. • It can be easily adopted in clinical routine in patients with esophageal pathology. - Abstract: Purpose: To assess the value of oral effervescent powder (EP) for evaluation of esophageal distension, and for detection and staging of esophageal cancer with contrast-enhanced CT. Materials and methods: 84 patients without esophageal pathology and 52 patients with histological confirmed diagnosis of esophageal cancer were included in this prospective IRB-approved study. Half of the patients in both groups received EP prior to CT. Esophageal distension was assessed by planimetry of the inner (IA) and outer area (OA). Two blinded readers evaluated the datasets separately with regard to diagnosis of esophageal cancer (yes/no) and staging (T0-T4), if applicable. Distension results were compared (t-Test). In patients with cancer sensitivity, specificity, NPV and PPV were calculated. CT staging results were compared to histopathology (Cohen-k). Results: IA and IA/OA were significantly larger after EP as compared to the group without EP (p < 0.05). Sensitivity, specificity, NPV and PPV for cancer detection cancer were as follows: 78%/78%, 98%/98%, 95%/95%, 87%/87% with EP; 60%/68%, 98%/98%, 94%/94%, 80%/83% without EP. Staging with EP was good (k = 0.84/0.67) and moderate without EP (k = 0.58/0.59). Conclusions: Administration of EP prior to CT results in good distension of the esophagus, and improves detection and staging of esophageal cancer, as compared to control studies without EP.

  2. Lung cancer perfusion at multi-detector row CT: reproducibility of whole tumor quantitative measurements.

    Science.gov (United States)

    Ng, Quan-Sing; Goh, Vicky; Fichte, Heinz; Klotz, Ernst; Fernie, Pat; Saunders, Michele I; Hoskin, Peter J; Padhani, Anwar R

    2006-05-01

    Institutional review board approval and informed consent were obtained for this study. The aim of the study was to prospectively assess, in patients with lung cancer, the reproducibility of a quantitative whole tumor perfusion computed tomographic (CT) technique. Paired CT studies were performed in 10 patients (eight men, two women; mean age, 66 years) with lung cancer. Whole tumor permeability and blood volume were measured, and reproducibility was evaluated by using Bland-Altman statistics. Coefficient of variation of 9.49% for permeability and 26.31% for blood volume and inter- and intraobserver variability ranging between 3.30% and 6.34% indicate reliable assessment with this whole tumor technique.

  3. Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT.

    Science.gov (United States)

    Maintz, David; Burg, Matthias C; Seifarth, Harald; Bunck, Alexander C; Ozgün, Murat; Fischbach, Roman; Jürgens, Kai Uwe; Heindel, Walter

    2009-01-01

    The aim of this study was to test a large sample of the latest coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in dual-source multidetector row CT (DSCT) in vitro and to provide a CT catalogue of currently used coronary artery stents. Twenty-nine different coronary artery stents (19 steel, 6 cobalt-chromium, 2 tantalum, 1 iron, 1 magnesium) were examined in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70 HU). Stents were imaged in axial orientation with standard parameters: 32 x 0.6 collimation, pitch 0.24, 400 mAs, 120 kV, rotation time 0.33 s. Image reconstructions were obtained with four different convolution kernels (soft, medium-soft, standard high-resolution, stent-dedicated). To evaluate visualization characteristics of the stent, the lumen diameter, intraluminal density, and noise were measured. The stent-dedicated kernel offered best average lumen visualization (54 +/- 8.3%) and most realistic lumen attenuation (222 +/- 44 HU) at the expense of increased noise (23.9 +/- 1.9 HU) compared with standard CTA protocols (p magnesium stent showed the least artifacts with a lumen visibility of 90%. The majority of stents (79%) exhibited a lumen visibility of 50-59%. Less than half of the stent lumen was visible in only six stents. Stent lumen visibility largely varies depending on the stent type. Magnesium is by far more favorable a stent material with regard to CT imaging when compared with the more common materials steel, cobalt-chromium, or tantalum. The magnesium stent exhibits a lumen visibility of 90%, whereas the majority of the other stents exhibit a lumen visibility of 50-59%.

  4. Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Maintz, David; Burg, Matthias C.; Seifarth, Harald; Bunck, Alexander C.; Oezguen, Murat; Juergens, Kai Uwe; Heindel, Walter [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Fischbach, Roman [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Asklepios Klinikum Altona, Department of Radiology and Nuclear Medicine, Hamburg (Germany)

    2009-01-15

    The aim of this study was to test a large sample of the latest coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in dual-source multidetector row CT (DSCT) in vitro and to provide a CT catalogue of currently used coronary artery stents. Twenty-nine different coronary artery stents (19 steel, 6 cobalt-chromium, 2 tantalum, 1 iron, 1 magnesium) were examined in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70 HU). Stents were imaged in axial orientation with standard parameters: 32 x 0.6 collimation, pitch 0.24, 400 mAs, 120 kV, rotation time 0.33 s. Image reconstructions were obtained with four different convolution kernels (soft, medium-soft, standard high-resolution, stent-dedicated). To evaluate visualization characteristics of the stent, the lumen diameter, intraluminal density, and noise were measured. The stent-dedicated kernel offered best average lumen visualization (54{+-}8.3%) and most realistic lumen attenuation (222{+-}44 HU) at the expense of increased noise (23.9{+-}1.9 HU) compared with standard CTA protocols (p<0.001 for all). The magnesium stent showed the least artifacts with a lumen visibility of 90%. The majority of stents (79%) exhibited a lumen visibility of 50-59%. Less than half of the stent lumen was visible in only six stents. Stent lumen visibility largely varies depending on the stent type. Magnesium is by far more favorable a stent material with regard to CT imaging when compared with the more common materials steel, cobalt-chromium, or tantalum. The magnesium stent exhibits a lumen visibility of 90%, whereas the majority of the other stents exhibit a lumen visibility of 50-59%. (orig.)

  5. Clinical–radiologic evaluation of the complications of laparoscopic sleeve gastrectomy: Value of multidetector CT

    Directory of Open Access Journals (Sweden)

    Tamir A. Hassan

    2015-12-01

    Conclusions: As LSG is performed increasingly and frequently, it is essential for radiologists to recognize the normal postoperative anatomy and identify the complications of this procedure. CT is an important imaging tool to diagnose suspected complications of laparoscopic sleeve gastrectomy procedure to ensure accurate diagnosis.

  6. Quantitative image quality evaluation for cardiac CT reconstructions

    Science.gov (United States)

    Tseng, Hsin-Wu; Fan, Jiahua; Kupinski, Matthew A.; Balhorn, William; Okerlund, Darin R.

    2016-03-01

    Maintaining image quality in the presence of motion is always desirable and challenging in clinical Cardiac CT imaging. Different image-reconstruction algorithms are available on current commercial CT systems that attempt to achieve this goal. It is widely accepted that image-quality assessment should be task-based and involve specific tasks, observers, and associated figures of merits. In this work, we developed an observer model that performed the task of estimating the percentage of plaque in a vessel from CT images. We compared task performance of Cardiac CT image data reconstructed using a conventional FBP reconstruction algorithm and the SnapShot Freeze (SSF) algorithm, each at default and optimal reconstruction cardiac phases. The purpose of this work is to design an approach for quantitative image-quality evaluation of temporal resolution for Cardiac CT systems. To simulate heart motion, a moving coronary type phantom synchronized with an ECG signal was used. Three different percentage plaques embedded in a 3 mm vessel phantom were imaged multiple times under motion free, 60 bpm, and 80 bpm heart rates. Static (motion free) images of this phantom were taken as reference images for image template generation. Independent ROIs from the 60 bpm and 80 bpm images were generated by vessel tracking. The observer performed estimation tasks using these ROIs. Ensemble mean square error (EMSE) was used as the figure of merit. Results suggest that the quality of SSF images is superior to the quality of FBP images in higher heart-rate scans.

  7. Multidetector CT angiography with volumetric three-dimentional rendering to evaluate bronchial arteries in primary lung cancer

    Institute of Scientific and Technical Information of China (English)

    YU Hong; LI Hui-min; LIU Shi-yuan; XIAO Xiang-sheng; TAO Xiao-feng

    2006-01-01

    Objective:To evaluate the imageologic characteristics of the bronchial arteries (BAs) in primary lung cancer (PLC) with multidetector CT (MDCT) angiography. Methods: Thin-section enhanced CT scanning (with an Toshiba Aquilion 16 scanner) was performed in 164 PLC patients, of whom 123were confirmed by pathology and the remaining 41 were confirmed by typical radiological and clinical findings. Another 46 patients with normal thoracic CT presentations were served as control. Three-dimensional (3D) images of the BAs were processed at workstation (Vitrea 2, Vital Corp, USA). Spatial anatomical characters of the BAs were observed using volume rendering (VR) and multiplanar reconstruction (MPR) or maximum intensity projection (MIP). Results: At least one bronchial artery was displayed clearly on VR in 152 (92.7%) of the 164 PLC patients and 32 (69.6%) of the 46 controls. There were 48. 92% of the right BAs originating from the descending aorta and 46. 24% from the right intercostal artery. 97.53% of the left BAs originated from the descending aorta, and 94.87% of the common trunk from the descending aorta. There were 10 distribution patterns of the BAs, with one on the right and one on the left predominating (48. 68%). More BA branches were found to reach far from the segmental bronchi or enter into the lesions in the PLC group than those in the control group (25.8% vs 1.7%), and also the ipsilateral side of the PLC than the contralateral side (40% vs 8.8% ). The diameter and the total transaxial areas of the BAs on the ipsilateral side of the PLC lesions were significantly larger than those on the contralateral side or those of the control group (P<0.05). Conclusion:The anatomic characters and pathologic changes can be depicted in vivo stereographically and clearly by CTA with volumetric 3D rendering. Dilation of the BAs and increase of total blood flow in patients with PLC can be evaluated quantitatively, which may be useful in the diagnosis and assessment of PLC, and

  8. Evaluation of right ventricular volume and mass using retrospective ECG-gated cardiac multidetector computed tomography: comparison with first-pass radionuclide angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hoon [Yonsei University College of Medicine, Department of Radiology, Seoul (Korea); Yongdong Severance Hospital, Department of Radiology, Seoul (Korea); Ryu, Young Hoon; Hur, Jin; Kim, Sang Jin; Kim, Hyun Soo; Choi, Byoung Wook [Yonsei University College of Medicine, Department of Radiology, Seoul (Korea); Kim, Young; Kim, Hyung Jung [Yonsei University College of Medicine, Department of Pulmonology, Seoul (Korea)

    2005-09-01

    The purposes of this study were to evaluate the right ventricular (RV) volume and mass using cardiac multidetector computed tomography (MDCT) and to compare the cardiac MDCT results with those from first-pass radionuclide angiography (FPRA). Twenty patients were evaluated for the RV end-diastolic volume (RVEDV), the RV end-systolic volume (RVESV), the RV ejection fraction (RVEF), and RV mass using cardiac MDCT with a two-phase reconstruction method based on ECG. The end-diastolic phase was reconstructed at the starting point of the QRS complex on ECG, and the end-systolic phase was reconstructed at the halfway point of the ascending T-wave on ECG. The RV mass was measured for the end-systole. The RVEF was also obtained by FPRA. The mean RVEF (47{+-}7%) measured by cardiac MDCT was well correlated with that (44{+-}6%) measured by FPRA (r=0.854). A significant difference in the mean RVEF was found between cardiac MDCT and FPRA (p=0.001), with an overestimation of 2.9{+-}5.3% by cardiac MDCT versus FPRA. The interobserver variability was 4.4% for the RVEDV, 6.8% for the RVESV, and 7.9% for the RV mass, respectively. Cardiac MDCT is relatively simple and allows the RV volume and mass to be assessed, and the RVEF obtained by cardiac MDCT correlates well with that measured by FPRA. (orig.)

  9. Automated characterization of normal and pathologic lung tissue by topological texture analysis of multidetector CT

    Science.gov (United States)

    Boehm, H. F.; Fink, C.; Becker, C.; Reiser, M.

    2007-03-01

    Reliable and accurate methods for objective quantitative assessment of parenchymal alterations in the lung are necessary for diagnosis, treatment and follow-up of pulmonary diseases. Two major types of alterations are pulmonary emphysema and fibrosis, emphysema being characterized by abnormal enlargement of the air spaces distal to the terminal, nonrespiratory bronchiole, accompanied by destructive changes of the alveolar walls. The main characteristic of fibrosis is coursening of the interstitial fibers and compaction of the pulmonary tissue. With the ability to display anatomy free from superimposing structures and greater visual clarity, Multi-Detector-CT has shown to be more sensitive than the chest radiograph in identifying alterations of lung parenchyma. In automated evaluation of pulmonary CT-scans, quantitative image processing techniques are applied for objective evaluation of the data. A number of methods have been proposed in the past, most of which utilize simple densitometric tissue features based on the mean X-ray attenuation coefficients expressed in terms of Hounsfield Units [HU]. Due to partial volume effects, most of the density-based methodologies tend to fail, namely in cases, where emphysema and fibrosis occur within narrow spatial limits. In this study, we propose a methodology based upon the topological assessment of graylevel distribution in the 3D image data of lung tissue which provides a way of improving quantitative CT evaluation. Results are compared to the more established density-based methods.

  10. Strategies to reduce radiation dose in cardiac PET/CT

    Science.gov (United States)

    Wu, Tung Hsin; Wu, Nien-Yun; Wang, Shyh-Jen; Wu, Jay; S. P. Mok, Greta; Yang, Ching-Ching; Huang, Tzung-Chi

    2011-08-01

    Our aim was to investigate CT dose reduction strategies on a hybrid PET/CT scanner for cardiac applications.MaterialsImage quality and dose estimation of different CT scanning protocols for CT coronary angiography (CTCA), and CT-based attenuation correction for PET imaging were investigated. Fifteen patients underwent CTCA, perfusion PET imaging at rest and under stress, and FDG PET for myocardial viability. These patients were divided into three groups based on the CTCA technique performed: retrospectively gated helical (RGH), ECG tube current modulation (ETCM), and prospective gated axial (PGA) acquisitions. All emission images were corrected for photon attenuation using CT images obtained by default setting and an ultra-low dose CT (ULDCT) scan.ResultsRadiation dose in RGH technique was 22.2±4.0 mSv. It was reduced to 10.95±0.82 and 4.13±0.31 mSv using ETCM and PGA techniques, respectively. Radiation dose in CT transmission scan was reduced by 96.5% (from 4.53±0.5 to 0.16±0.01 mSv) when applying ULDCT as compared to the default CT. No significant difference in terms of image quality was found among various protocols.ConclusionThe proposed CT scanning strategies, i.e. ETCM or PGA for CTCA and ULDCT for PET attenuation correction, could reduce radiation dose up to 47% without degrading imaging quality in an integrated cardiac PET/CT coronary artery examination.

  11. 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.

  12. Comparison of low dose with standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer under surveillance

    Energy Technology Data Exchange (ETDEWEB)

    O' Malley, Martin E. [Joint Department of Medical Imaging, Toronto, ON (Canada); Chung, Peter; Warde, Padraig [Princess Margaret Hospital, Department of Radiation Oncology, Toronto, ON (Canada); Haider, Masoom; Jhaveri, Kartik; Khalili, Korosh [Princess Margaret Hospital, Joint Department of Medical Imaging, Toronto, ON (Canada); Jang, Hyun-Jung [Toronto General Hospital, Joint Department of Medical Imaging, Toronto, ON (Canada); Panzarella, Tony [Princess Margaret Hospital, Department of Biostatistics, Toronto, ON (Canada)

    2010-07-15

    To compare the image quality and acceptability of a low dose with those of standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer managed by surveillance. One hundred patients (median age 31 years; range 19-83 years), 79 with seminoma and 21 with non-seminoma, underwent abdominal/pelvic imaging with low and standard dose protocols on 64-slice multidetector CT. Three reviewers independently evaluated images for noise and diagnostic quality on a 5-point scale and for diagnostic acceptability. On average, each reader scored noise and diagnostic quality of standard dose images significantly better than corresponding low dose images (p < 0.0001). One reader found all CT examinations acceptable; two readers each found 1/100 (1%) low dose examinations unacceptable. Median and mean dose-length product for low and standard dose protocols were 416.0 and 452.2 (range 122.9-913.4) and 931.9 and 999.8 (range 283.8-1,987.7) mGy cm, respectively. The low dose protocol provided diagnostically acceptable images for at least 99% of patients and achieved mean dose reduction of 55% compared with the standard dose protocol. (orig.)

  13. Crossed Fused Renal Ectopia: Presentations on 99mTc-MAG3 Scan, 99mTc-DMSA SPECT, and Multidetector CT.

    Science.gov (United States)

    Moon, Eun Ha; Kim, Min-Woo; Kim, Young Jun; Sun, In O

    2015-10-01

    Crossed renal ectopia is an uncommon developmental anomaly in which both kidneys are located on the same side of the body. The present case describes a 20-year-old man who underwent the military entrance physical examination. The ultrasound showed the right kidney in normal site with slightly increased size, but the left kidney was not identified. Tc-MAG3 scan showed a single kidney with 2 ureters, and the orifices of the ureters were connected at both sides of bladder. Tc-DMSA SPECT and contrast-enhanced multidetector CT were performed and revealed crossed fused renal ectopia.

  14. Are pancreatic calcifications specific for the diagnosis of chronic pancreatitis? A multidetector-row CT analysis

    Energy Technology Data Exchange (ETDEWEB)

    Campisi, A. [Department of Radiology, University of Palermo, via del Vespro 127, 90127 Palermo (Italy); Brancatelli, G. [Department of Radiology, University of Palermo, via del Vespro 127, 90127 Palermo (Italy); Department of Radiology, University of Pittsburgh School of Medicine, 200 Lothrop street, 15213, Pittsburgh, PA (United States); Radiology Unit, La Maddalena hospital, 90146, Palermo (Italy)], E-mail: gbranca@yahoo.com; Vullierme, M.-P.; Levy, P.; Ruzniewski, P. [Universite Paris 7 Denis Diderot, Paris, F-75018 (France); AP-HP, Hopital Beaujon, Department of Radiology, Clichy F-92100 (France); Vilgrain, V. [Universite Paris 7 Denis Diderot, Paris, F-75018 (France); AP-HP, Hopital Beaujon, Department of Radiology, Clichy F-92100 (France); INSERM, U773, Centre de recherche biomedicale Bichat-Beaujon, CRB3, Paris F-75018 (France)

    2009-09-15

    Aim: To retrospectively establish the most frequently encountered diagnoses in patients with pancreatic calcifications and to investigate whether the association of certain findings could be helpful for diagnosis. Materials and methods: One hundred and three patients were included in the study. The location and distribution of calcifications; presence, nature, and enhancement pattern of pancreatic lesions; pancreatic atrophy and ductal dilatation were recorded. Differences between patients with chronic pancreatitis and patients with other entities were compared by using Fisher's exact test. Results: Patients had chronic pancreatitis (n = 70), neuroendocrine tumours (n = 14), intraductal papillary mucinous neoplasm (n = 11), pancreatic adenocarcinoma (n = 4), serous cystadenoma (n = 4). Four CT findings had a specificity of over 60% for the diagnosis of chronic pancreatitis: parenchymal calcifications, intraductal calcifications, parenchymal atrophy, and cystic lesions. When at least two of these four criteria were used in combination, 54 of 70 (77%) patients with chronic pancreatitis could be identified, but only 17 of 33 (51%) patients with other diseases. When at least three of these four criteria were present, a specificity of 79% for the diagnosis of chronic pancreatitis was achieved. Conclusion: Certain findings are noted more often in chronic pancreatitis than in other pancreatic diseases. The presence of a combination of CT findings can suggest chronic pancreatitis and be helpful in diagnosis.

  15. Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration

    Energy Technology Data Exchange (ETDEWEB)

    Adaletli, Ibrahim; Kurugoglu, Sebuh; Ulus, Sila; Ozer, Harun; Kantarci, Fatih; Mihmanli, Ismail; Akman, Canan [Istanbul University, Department of Radiology, Cerrahpasa Medical Faculty, Istanbul (Turkey); Elicevik, Mehmet [Istanbul University, Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul (Turkey)

    2007-01-15

    Foreign body aspiration is common in children, especially those under 3 years of age. Chest radiography and CT are the main imaging modalities for the evaluation of these children. Management of children with suspected foreign body aspiration (SFBA) mainly depends on radiological findings. To investigate the potential use of low-dose multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation and management of SFBA in children. Included in the study were 37 children (17 girls, 20 boys; age 4 months to 10 years, mean 32 months) with SFBA. Chest radiographs were obtained prior to MDCT in all patients. MDCT was performed using a low-dose technique. VB images were obtained in the same session. Conventional bronchoscopy (CB) was performed within 24 h on patients in whom an obstructive abnormality had been found by MDCT and VB. Obstructive pathology was found in 16 (43.25%) of the 37 patients using MDCT and VB. In 13 of these patients, foreign bodies were detected and removed via CB. The foreign bodies were located in the right main bronchus (n = 5), in the bronchus intermedius (n = 6), in the medial segment of the middle lobe bronchus (n = 1), and in the left main bronchus (n = 1). In the remaining three patients, the diagnosis was false-positive for an obstructive pathology by MDCT and VB; the final diagnoses were secretions (n = 2) and schwannoma (n = 1), as demonstrated by CB. In 21 patients in whom no obstructive pathology was detected by MDCT and VB, CB was not performed. These patients were followed for 5-20 months without any recurrent obstructive symptomatology. Low-dose MDCT and VB are non-invasive radiological modalities that can be used easily in the investigation of SFBA in children. MDCT and VB provide the exact location of the obstructive pathology prior to CB. If obstructive pathology is depicted with MDCT and VB, CB should be performed either for confirmation of the diagnosis or for the diagnosis of an alternative cause for the obstruction

  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. 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).

  18. Measurement of cardiac output from dynamic pulmonary circulation time CT

    Energy Technology Data Exchange (ETDEWEB)

    Yee, Seonghwan, E-mail: Seonghwan.Yee@Beaumont.edu [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan 48073 (United States); Scalzetti, Ernest M. [Department of Radiology, SUNY Upstate Medical University, Syracuse, New York 13210 (United States)

    2014-06-15

    Purpose: To introduce a method of estimating cardiac output from the dynamic pulmonary circulation time CT that is primarily used to determine the optimal time window of CT pulmonary angiography (CTPA). Methods: Dynamic pulmonary circulation time CT series, acquired for eight patients, were retrospectively analyzed. The dynamic CT series was acquired, prior to the main CTPA, in cine mode (1 frame/s) for a single slice at the level of the main pulmonary artery covering the cross sections of ascending aorta (AA) and descending aorta (DA) during the infusion of iodinated contrast. The time series of contrast changes obtained for DA, which is the downstream of AA, was assumed to be related to the time series for AA by the convolution with a delay function. The delay time constant in the delay function, representing the average time interval between the cross sections of AA and DA, was determined by least square error fitting between the convoluted AA time series and the DA time series. The cardiac output was then calculated by dividing the volume of the aortic arch between the cross sections of AA and DA (estimated from the single slice CT image) by the average time interval, and multiplying the result by a correction factor. Results: The mean cardiac output value for the six patients was 5.11 (l/min) (with a standard deviation of 1.57 l/min), which is in good agreement with the literature value; the data for the other two patients were too noisy for processing. Conclusions: The dynamic single-slice pulmonary circulation time CT series also can be used to estimate cardiac output.

  19. Cardiac CT: coronary arteries and beyond

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H. [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital, Aachen (Germany); RWTH Aachen University, Applied Medical Engineering, Aachen (Germany); Muehlenbruch, Georg; Guenther, Rolf W.; Wildberger, Joachim E. [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital, Aachen (Germany)

    2007-04-15

    Multi-detector-row computed tomography (MDCT) has emerged as a rapidly developing method for non-invasive imaging of the heart. An understanding of ECG synchronization, contrast material administration, patient preparation and image post-processing is needed to optimize image quality. The basic technical principles and essentials of these technical basics are described here. Correctly applied cardiac MDCT allows imaging of the coronary arteries including coronary anatomy and stenosis detection. The same is true for evaluation of coronary artery bypass grafts and, to some extent, coronary artery stents. While quantification of total calcified plaque burden has been long established, coronary MDCT allows assessing plaque morphology and constitution. Recent approaches go beyond the coronaries and include evaluation of left ventricular function at rest and myocardial viability. In combination with experimental approaches for assessing aortic valve function and myocardial perfusion imaging, cardiac MDCT offers the potential for a comprehensive examination of the heart using a single breath-hold examination. (orig.)

  20. Cardiopulmonary manifestations of isolated pulmonary valve infective endocarditis demonstrated with cardiac CT.

    Science.gov (United States)

    Passen, Edward; Feng, Zekun

    2015-01-01

    Right-sided infective endocarditis involving the pulmonary valve is rare. This pictorial essay discusses the use and findings of cardiac CT combined with delayed chest CT and noncontrast chest CT of pulmonary valve endocarditis. Cardiac CT is able to show the full spectrum of right-sided endocarditis cardiopulmonary features including manifestations that cannot be demonstrated by echocardiography.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-09-15

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

  2. Multidetector CT and MRI in diseases of the GI tract; Scanner multidetecteur face a l'IRM dans la pathologie du tube digestif

    Energy Technology Data Exchange (ETDEWEB)

    Bruel, J.M.; Gallix, B. [Hopital Saint-Eloi, Service de Radiologie, 34 - Montpellier (France)

    2003-04-01

    With the introduction of spiral scanning then multidetector technologies, the accuracy for diagnosing digestive tract diseases with CT has been highly improved, and CT is used more and more in the evaluation of patients with suspected gastrointestinal disorders. CT is able to demonstrate both the intramural and the extra-mural components of the disease, and has a major role in the preoperative staging and the follow-up Improvements of CT protocols, such as CT-enteroclysis, or multiplanar 2D and 3D post-processing, including now techniques for 'virtual endoscopy', lead to discuss new indications in which CT could now compete with conventional X-rays series and video-endoscopy. This precise study of the digestive wall, the peri-digestive fat, the digestive tract blood supply, may be performed by MRI, under the condition of access to high level machines and standardized protocols. MR-enteroclysis and MR-virtual colonoscopy could be performed with much lower risk for the patient, in terms of radiation dose or contrast adverse effects. Endo-luminal coils should give to MR an ultra-high resolution for analysing the different layers of the gastrointestinal wall. Learning objectives: to review how to perform CT and MRI protocols for digestive tract imaging, to recognize the CT arid MR patterns of the main digestive tract diseases, to discuss the value, limits and role of CT and MR in digestive tract diseases, to discuss the potential role of CT and MR new technological developments for digestive tract imaging in the upcoming future Conclusion: CT is nowadays a modality of choice for digestive imaging. Improvements in technologies and indications, the necessary discussion of the risks and benefits for the patient should let the radiologists consider MRI in gastrointestinal disorders as an important part of the routine activity in clinical MRI. (authors)

  3. Measurements of pericardial adipose tissue using contrast enhanced cardiac multidetector computed tomography—comparison with cardiac magnetic resonance imaging

    DEFF Research Database (Denmark)

    Elming, Marie Bayer; Lønborg, Jacob; Rasmussen, Thomas;

    2013-01-01

    Recent studies have suggested that pericardial adipose tissue (PAT) located in close vicinity to the epicardial coronary arteries may play a role in the development of coronary artery disease. PAT has primarily been measured with cardiac magnetic resonance imaging (CMRI) or with non...... tested, and the smallest difference in PAT was noted when -30 to -190 HU were used in MDCT measures. The median difference between MDCT and CMRI for the assessment of PAT was 9 ml (SD 50) suggesting a reasonable robust method for the assessment of PAT in a large-scale study. Pericardial adipose tissue...... and CMRI scans were performed. The optimal fit for measuring PAT using contrast MDCT was developed and validated by the corresponding measures on CMRI. The median for PAT volume in patients was 175 ml (SD 68) and 153 ml (SD 60) measured by MDCT and CMRI respectively. Four different attenuation values were...

  4. Measurement of the aortic diameter in the asymptomatic Korean population: Assessment with multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hwan; Lee, Whal; Choi, Hyuck Jae; Kim, Dae Jin; Park, Eun Ah; Chung, Jin Wook; Park, Jae Hyung [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-08-15

    To determine normal reference values for aortic diameters in asymptomatic Korean adults. Three hundred adults without signs or symptoms of cardiovascular diseases were enrolled in this study. Aortic diameters were measured at nine predetermined levels on CT images. Aortic diameter measurements were adjusted for body surface area. Analysis of data was performed with regard to age, sex, weight, height and hypertension. Aortic diameters were 2.99 ± 0.57 cm at the ascending aorta, 2.54 ± 0.35 cm at the transverse aortic arch, 2.36 ± 0.35 cm at the proximal descending thoracic aorta (DTA), 2.23 ± 0.37 cm at the mid DTA, 2.17 ± 0.38 cm at the distal DTA, 2.16 ± 0.37 cm at the thoracoabdominal junction, 2.10, 00B1, 0.35 cm at the level of the celiac axis, 1.94, 00B1, 0.36 cm at the suprarenal aorta, 1.58 ± 0.24 cm at the aortic bifurcation. Men had slightly larger diameters than women (p < 0.05). All diameters increased with age and hypertension, with statistical significance (p < 0.01). And all aortic diameters increased with height (p < 0.05) except at the level of the aortic arch (p = 0.056), and increased with weight (p < 0.05) except at the level of the suprarenal aorta (p = 0.067). Male sex, higher weight and height, age and hypertension are associated with larger aortic diameters in asymptomatic Korean adults.

  5. Congenital left ventricular wall abnormalities in adults detected by gated cardiac multidetector computed tomography: Clefts, aneurysms, diverticula and terminology problems

    Energy Technology Data Exchange (ETDEWEB)

    Erol, Cengiz, E-mail: drcengizerol@yahoo.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Koplay, Mustafa, E-mail: koplaymustafa@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Olcay, Ayhan, E-mail: drayhanolcay@gmail.com [29 May Hospital, Department of Cardiology, Vatan Street, Fatih, 34150 Istanbul (Turkey); Kivrak, Ali Sami, E-mail: alisamikivrak@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Ozbek, Seda, E-mail: dsadr@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Seker, Mehmet, E-mail: hikmet.irfan@hotmail.com [29 May Hospital, Department of Radiology, Vatan Street, Fatih, 34150 Istanbul (Turkey); Paksoy, Yahya, E-mail: yahyapaksoy@yahoo.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey)

    2012-11-15

    Objectives: Our aim was to evaluate congenital left ventricular wall abnormalities (clefts, aneurysms and diverticula), describe and illustrate imaging features, discuss terminology problems and determine their prevalence detected by cardiac CT in a single center. Materials and methods: Coronary CT angiography images of 2093 adult patients were evaluated retrospectively in order to determine congenital left ventricular wall abnormalities. Results: The incidence of left ventricular clefts (LVC) was 6.7% (141 patients) and statistically significant difference was not detected between the sexes regarding LVC (P = 0.5). LVCs were single in 65.2% and multiple in 34.8% of patients. They were located at the basal to mid inferoseptal segment of the left ventricle in 55.4%, the basal to mid anteroseptal segment in 24.1%, basal to mid inferior segment in 17% and septal-apical septal segment in 3.5% of cases. The cleft length ranged from 5 to 22 mm (mean 10.5 mm) and they had a narrow connection with the left ventricle (mean 2.5 mm). They were contractile with the left ventricle and obliterated during systole. Congenital left ventricular septal aneurysm that was located just under the aortic valve was detected in two patients (0.1%). No case of congenital left ventricular diverticulum was detected. Conclusion: Cardiac CT allows us to recognize congenital left ventricular wall abnormalities which have been previously overlooked in adults. LVC is a congenital structural variant of the myocardium, is seen more frequently than previously reported and should be differentiated from aneurysm and diverticulum for possible catastrophic complications of the latter two.

  6. Multi-detector CT-colonography in inflammatory bowel disease: Prospective analysis of CT-findings to high-resolution video colonoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Kjel [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany)]. E-mail: kjel_andersen@web.de; Vogt, Christoph [Department of Gastroenterology, Hepatology and Infectiology, University Hospital Duesseldorf (Germany); Blondin, Dirk [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany); Beck, Andreas [Institute of Informatics, Heinrich-Heine-University, Duesseldorf (Germany); Heinen, Wolfram [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany); Aurich, Volker [Institute of Informatics, Heinrich-Heine-University, Duesseldorf (Germany); Haeussinger, Dieter [Department of Gastroenterology, Hepatology and Infectiology, University Hospital Duesseldorf (Germany); Moedder, Ulrich [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany); Cohnen, Mathias [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany)

    2006-04-15

    Aim: Prospective analysis of multi-detector CT-colonography (MDCTC) in patients with inflammatory bowel disease (IBD) compared to high-resolution video-endoscopy (HRVC). Materials and methods: Twenty-one patients (mean age 49.6 years) with Crohn's disease or ulcerative colitis underwent MDCTC (Somatom Volume Zoom, Siemens, Erlangen; 1 mm collimation, Pitch 8, 100 mAs, 120 kVp). HRVC was performed within 2 h after MDCTC. MDCTC was analyzed by two blinded readers. MDCTC-findings including bowel wall alterations and extraintestinal changes were compared to results of HRVC. Results: Over-all-sensitivity was 100% for endoluminal lesions with correct diagnosis of two cancers. Acute and chronic IBD were correctly identified by MDCTC in 63.6%, and 100%, respectively, with a specificity of 75%, and 100%. Sensitivity, specificity, positive and negative predictive values of MDCTC for diagnosis of acute and chronic disease were best for chronic disease. Sensitivity was worst for acute ulcerative colitis and specificity was worst for acute Crohn's disease. Haustral loss was seen only in ulcerative colitis. Pseudopolyps and fistulae were findings exclusive to Crohn's disease. Particularly extraintestinal findings as increased vascularization and local lymphadenopathy correlated well with endoscopic definition of acute disease. Because of the possibly more vulnerable colonic wall in acute inflammatory bowel disease, the air inflation for MDCTC should be performed most carefully to avoid any risk of colonic perforation. Conclusion: MDCTC may help to distinguish between patients with acute and chronic IBD. Especially extraintestinal complications, tumorous as well as pseudo-tumorous lesions can be detected with high sensitivity and specificity.

  7. Dynamic multidetector CT and non-contrast-enhanced MR for right adrenal vein imaging: comparison with catheter venography in adrenal venous sampling

    Energy Technology Data Exchange (ETDEWEB)

    Ota, Hideki; Seiji, Kazumasa; Kawabata, Masahiro; Satani, Nozomi; Matsuura, Tomonori; Tominaga, Junya; Takase, Kei [Tohoku University Hospital, Department of Diagnostic Radiology, Sendai (Japan); Omata, Kei; Ono, Yoshikiyo; Iwakura, Yoshitsugu; Morimoto, Ryo; Kudo, Masataka; Satoh, Fumitoshi; Ito, Sadayoshi [Tohoku University Hospital, Division of Nephrology, Endocrinology and Vascular Medicine, Sendai (Japan)

    2016-03-15

    To evaluate visualization of the right adrenal vein (RAV) with multidetector CT and non-contrast-enhanced MR imaging in patients with primary aldosteronism. A total of 125 patients (67 men) scheduled for adrenal venous sampling (AVS) were included. Dynamic 64-detector-row CT and balanced steady-state free precession-based non-contrast-enhanced 3-T MR imaging were performed. RAV visualization based on a four-point score was documented. Both anatomical location and variation on cross-sectional imaging were evaluated, and the findings were compared with catheter venography as the gold standard. The RAV was visualized in 93.2 % by CT and 84.8 % by MR imaging (p = 0.02). Positive predictive values of RAV visualization were 100 % for CT and 95.2 % for MR imaging. Imaging score was significantly higher in CT than MR imaging (p < 0.01). The RAV formed a common trunk with an accessory hepatic vein in 16 % of patients. The RAV orifice level on cross-sectional imaging was concordant with catheter venography within the range of 1/3 vertebral height in >70 % of subjects. Success rate of AVS was 99.2 %. Dynamic CT is a reliable way to map the RAV prior to AVS. Non-contrast-enhanced MR imaging is an alternative when there is a risk of complication from contrast media or radiation exposure. (orig.)

  8. Multidetector CT imaging of mechanical prosthetic heart valves : quantification of artifacts with a pulsatile in-vitro model

    NARCIS (Netherlands)

    Symersky, Petr; Budde, Ricardo P. J.; Westers, Paul; de Mol, Bas A. J. M.; Prokop, Mathias

    2011-01-01

    Objectives Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. Methods

  9. Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model

    NARCIS (Netherlands)

    Symersky, P.; Budde, R.P.; Westers, P.; Mol, B.A. de; Prokop, M.

    2011-01-01

    OBJECTIVES: Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. METHODS

  10. Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model

    NARCIS (Netherlands)

    Symersky, P.; Budde, R.P.J.; Westers, P.; de Mol, B.A.J.M.; Prokop, M.

    2011-01-01

    Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. A Medtronic Hall ti

  11. Simulation evaluation of quantitative myocardial perfusion assessment from cardiac CT

    Science.gov (United States)

    Bindschadler, Michael; Modgil, Dimple; Branch, Kelley R.; La Riviere, Patrick J.; Alessio, Adam M.

    2014-03-01

    Contrast enhancement on cardiac CT provides valuable information about myocardial perfusion and methods have been proposed to assess perfusion with static and dynamic acquisitions. There is a lack of knowledge and consensus on the appropriate approach to ensure 1) sufficient diagnostic accuracy for clinical decisions and 2) low radiation doses for patient safety. This work developed a thorough dynamic CT simulation and several accepted blood flow estimation techniques to evaluate the performance of perfusion assessment across a range of acquisition and estimation scenarios. Cardiac CT acquisitions were simulated for a range of flow states (Flow = 0.5, 1, 2, 3 ml/g/min, cardiac output = 3,5,8 L/min). CT acquisitions were simulated with a validated CT simulator incorporating polyenergetic data acquisition and realistic x-ray flux levels for dynamic acquisitions with a range of scenarios including 1, 2, 3 sec sampling for 30 sec with 25, 70, 140 mAs. Images were generated using conventional image reconstruction with additional image-based beam hardening correction to account for iodine content. Time attenuation curves were extracted for multiple regions around the myocardium and used to estimate flow. In total, 2,700 independent realizations of dynamic sequences were generated and multiple MBF estimation methods were applied to each of these. Evaluation of quantitative kinetic modeling yielded blood flow estimates with an root mean square error (RMSE) of ~0.6 ml/g/min averaged across multiple scenarios. Semi-quantitative modeling and qualitative static imaging resulted in significantly more error (RMSE = ~1.2 and ~1.2 ml/min/g respectively). For quantitative methods, dose reduction through reduced temporal sampling or reduced tube current had comparable impact on the MBF estimate fidelity. On average, half dose acquisitions increased the RMSE of estimates by only 18% suggesting that substantial dose reductions can be employed in the context of quantitative myocardial

  12. Noncardiac findings on cardiac CT part I: Pros and cons.

    LENUS (Irish Health Repository)

    Killeen, Ronan P

    2012-02-01

    Cardiac computed tomography (CT) has evolved into an effective imaging technique for the evaluation of coronary artery disease in selected patients. Two distinct advantages over other noninvasive imaging modalities include its ability to evaluate directly the coronary arteries and to provide an opportunity to evaluate extracardiac structures, such as the lungs and mediastinum. Some centers reconstruct a small field of view (FOV) cropped around the heart, but a full FOV (from skin to skin in the irradiated area) is obtainable in the raw data of every scan so that clinically relevant noncardiac findings are identifiable. Debate in the scientific community has centered on the necessity for this large FOV evaluation. A review of noncardiac structures provides the opportunity to make alternative diagnoses that may account for the patient\\'s presentation or to detect important but clinically silent problems such as lung cancer. Critics argue that the yield of biopsy-proven cancers is low and that the follow-up of incidental noncardiac findings is expensive, resulting in increased radiation exposure and possibly unnecessary further testing. In this two-part review we outline the issues surrounding the concept of the noncardiac read looking for noncardiac findings on cardiac CT. Part I focuses on the pros and cons of the practice of identifying noncardiac findings on cardiac CT.

  13. 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

  14. Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the 18F-FDG Positron Emission Tomography CT Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Yoom, Soo Kyung; Jung, Jung Im; Ahn, Myeong Im; Park, Jae Gil; Yoo, Ie Ryung; Park, Seog Hee [Catholic University Seoul St. Mary' s Hospital, Seoul (Korea, Republic of); Park, Mi Jung [Gyeongsang National University Hospital, Junju (Korea, Republic of); Park, Hyun Jin [Catholic University St. Vincent Hospital, Suwon (Korea, Republic of)

    2010-03-15

    To investigate the size criteria of multidetector computed tomography (MDCT) for the evaluation metastatic lymph nodes (LNs) for potentially operable squamous esophageal cancer, and to compare this information with the results of positron emission tomography-CT (PET-CT). Twenty-four patients who underwent radical esophagectomy for esophageal cancer were studied. All patients had preoperative MDCT and PET-CT. The MDCT findings were compared with those of PET-CT and were correlated with the surgical records. The receiver operating characteristic (ROC) curve method was used to determine the appropriate cut-off value to distinguish benign from metastatic LNs. The size of metastatic LNs (9.35 {+-} 3.41 mm) was significantly larger than that of benign LNs (5.74 {+-} 1.64 mm) (p<0.001). The best cut-off value was 7 mm (81.8% sensitivity, 80.8% specificity). PET-CT detected all metastatic LNs except for four in the peritumoral region. The sensitivity and specificity of metastatic LN evaluation on PET-CT were 82.6% and 99.4%, respectively. Only one LN without metastasis showed increased fluoro-2-deoxy-D-glucose uptake on PET-CT. Size of metastatic LNs can typically be < 10 mm. For MDCT, the short diameter of 7 mm may be the optimal criterion. PET-CT is very accurate for the assessment of metastatic LNs except for those in the peritumoral region.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

  16. Current Roles and Future Applications of Cardiac CT: Risk Stratification of Coronary Artery Disease

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeonyee Elizabeth [Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Lim, Tae-Hwan [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736 (Korea, Republic of)

    2014-07-01

    Cardiac computed tomography (CT) has emerged as a noninvasive modality for the assessment of coronary artery disease (CAD), and has been rapidly integrated into clinical cares. CT has changed the traditional risk stratification based on clinical risk to image-based identification of patient risk. Cardiac CT, including coronary artery calcium score and coronary CT angiography, can provide prognostic information and is expected to improve risk stratification of CAD. Currently used conventional cardiac CT, provides accurate anatomic information but not functional significance of CAD, and it may not be sufficient to guide treatments such as revascularization. Recently, myocardial CT perfusion imaging, intracoronary luminal attenuation gradient, and CT-derived computed fractional flow reserve were developed to combine anatomical and functional data. Although at present, the diagnostic and prognostic value of these novel technologies needs to be evaluated further, it is expected that all-in-one cardiac CT can guide treatment and improve patient outcomes in the near future.

  17. Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT: an anthropomorphic phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Xueqian; Zhao, Yingru; Ooijen, Peter M.A. van; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Department of Radiology, EB44, P.O. Box 30.001, Groningen (Netherlands); University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, Department of Radiology, Groningen (Netherlands); Snijder, Roland A.; Greuter, Marcel J.W. [University of Groningen, University Medical Center Groningen, Department of Radiology, EB44, P.O. Box 30.001, Groningen (Netherlands); Jong, Pim A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Oudkerk, Matthijs [University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, Department of Radiology, Groningen (Netherlands); Bock, Geertruida H. de [University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen (Netherlands)

    2013-01-15

    To assess the sensitivity of detection and accuracy of volumetry by manual and semi-automated quantification of artificial pulmonary nodules in an anthropomorphic thoracic phantom on low-dose CT. Fifteen artificial spherical nodules (diameter 3, 5, 8, 10 and 12 mm; CT densities -800, -630 and +100 HU) were randomly placed inside an anthropomorphic thoracic phantom. The phantom was examined on 16- and 64-row multidetector CT with a low-dose protocol. Two independent blinded observers screened for pulmonary nodules. Nodule diameter was measured manually, and volume calculated. For solid nodules (+100 HU), diameter and volume were also evaluated by semi-automated software. Differences in observed volumes between the manual and semi-automated method were evaluated by a t-test. Sensitivity was 100 % for all nodules of >5 mm and larger, 60-80 % for solid and 0-20 % for non-solid 3-mm nodules. No false-positive nodules but high inter-observer reliability and inter-technique correlation were found. Volume was underestimated manually by 24.1 {+-} 14.0 % for nodules of any density, and 26.4 {+-} 15.5 % for solid nodules, compared with 7.6 {+-} 8.5 % (P < 0.01) semi-automatically. In an anthropomorphic phantom study, the sensitivity of detection is 100 % for nodules of >5 mm in diameter. Semi-automated volumetry yielded more accurate nodule volumes than manual measurements. (orig.)

  18. Assessment of coronary artery aneurysms in paediatric patients with Kawasaki disease by multidetector row CT angiography: feasibility and comparison with 2D echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Chu, W.C.W.; Lam, W.W.M. [Department of Diagnostic Radiology and Organ Imaging, Chinese Univ. of Hong Kong, Shatin (China); Mok, G.C.F.; Yam, M.; Sung, R.Y.T. [Dept. of Pediatrics, Chinese Univ. of Hong Kong, Shatin (China)

    2006-11-15

    Transthoracic ECHO is the locally accepted method for coronary surveillance of patients with Kawasaki disease but it may have limited visualization in the older child. To assess the feasibility of multidetector CT (MDCT) angiography in the follow-up of coronary artery aneurysms in children with previous Kawasaki disease. Six children (5 boys, 1 girl; mean age 11.5 years) with known Kawasaki disease and coronary artery involvement underwent CT coronary angiography using 16-detector MDCT. The visualized lengths and diameter of all coronary segments were measured. The number, size and location of coronary artery aneurysms were recorded and compared with recent ECHO. Twelve coronary artery aneurysms (seven saccular, five fusiform) were identified by MDCT angiography. One saccular aneurysm at the junction of the distal right coronary artery and posterior descending artery was not detected by ECHO while the remaining six in proximal segments were detected by both modalities. Two of five fusiform aneurysms were not detected by ECHO due to their small sizes. Excellent agreement was found between CT and ECHO for maximal diameter and length of the visualized aneurysms. MDCT angiography accurately defines coronary artery aneurysms. It is more sensitive for detecting aneurysms at distal coronary segments and fusiform aneurysms of small size.

  19. Wide coverage by volume CT: benefits for cardiac imaging

    Science.gov (United States)

    Sablayrolles, Jean-Louis; Cesmeli, Erdogan; Mintandjian, Laura; Adda, Olivier; Dessalles-Martin, Diane

    2005-04-01

    With the development of new technologies, computed tomography (CT) is becoming a strong candidate for non-invasive imaging based tool for cardiac disease assessment. One of the challenges of cardiac CT is that a typical scan involves a breath hold period consisting of several heartbeats, about 20 sec with scanners having a longitudinal coverage of 2 cm, and causing the image quality (IQ) to be negatively impacted since beat to beat variation is high likely to occur without any medication, e.g. beta blockers. Because of this and the preference for shorter breath hold durations, a CT scanner with a wide coverage without the compromise in the spatial and temporal resolution of great clinical value. In this study, we aimed at determining the optimum scan duration and the delay relative to beginning of breath hold, to achieve high IQ. We acquired EKG data from 91 consecutive patients (77 M, 14 F; Age: 57 +/- 14) undergoing cardiac CT exams with contrast, performed on LightSpeed 16 and LightSpeed Pro16. As an IQ metric, we adopted the standard deviation of "beat-to-beat variation" (stdBBV) within a virtual scan period. Two radiologists evaluated images by assigning a score of 1 (worst) to 4 best). We validated stdBBV with the radiologist scores, which resulted in a population distribution of 9.5, 9.5, 31, and 50% for the score groups 1, 2, 3, and 4, respectively. Based on the scores, we defined a threshold for stdBBV and identified an optimum combination of virtual scan period and a delay. With the assumption that the relationship between the stdBBV and diagnosable scan IQ holds, our analysis suggested that the success rate can be improved to 100% with scan durations equal or less than 5 sec with a delay of 1 - 2 sec. We confirmed the suggested conclusion with LightSpeed VCT (GE Healthcare Technologies, Waukesha, WI), which has a wide longitudinal coverage, fine isotropic spatial resolution, and high temporal resolution, e.g. 40 mm coverage per rotation of 0.35 sec

  20. Adult Moyamoya disease: 320-Multidetector row CT for evaluation of revascularization in STA–MCA bypasses surgery

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Bing; Xu, Bing; Liu, Qi; Hao, Qiang; Lu, Jianping, E-mail: cjr.lujianping@vip.163.com

    2013-12-01

    Purpose: To evaluate the utility of 320-multidetector row whole-brain computed tomography perfusion (WBCTP) and whole-head subtracted dynamic angiography (WHSDCTA) for assessing the revascularization of blood flow after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery in adults with Moyamoya disease (MD) in the short and long term. Patients and methods: 320-multidetector row WBCTP and WHSDCTA were applied in 20 patients with MD before and after surgery (for an average of 3 days and 3 months). The bypass arteries were investigated using WHSDCTA and compared with DSA. The regions of interests (ROIs) in the surgical and mirror sides of the cerebral cortex were drawn on a Vitrea Workstation. Cerebral blood volume (CBV), time to peak (TTP), cerebral blood flow (CBF), mean transit time (MTT), and delay time were recorded. Preoperative and postoperative perfusion parameters in the MCA distribution were compared using the paired t-test. Results: WHSDCTA could clearly demonstrate 24 bypass arteries in 26 arteries for 20 patients, results which were in accordance with the results of digital subtraction angiography (DSA). When comparing preoperative values to those within 3 days after surgery, only TTP and delay time were significantly different (P < 0.05). Values of CBV, TTP, CBF, delay time, and MTT 3 months after surgery were significantly different (P < 0.05) from those of preoperative perfusion. Conclusion: These data suggest that 320-multidetector row WBCTP and WHSDCTA can be used to evaluate the revascularization of blood flow after STA–MCA bypass surgery in patients with MD in the short and long term.

  1. Clinical and multidetector CT follow-up results of renal artery aneurysms treated by detachable coil embolization using 3D rotational angiography

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jung Min; Park, Kwang Bo; Kim, Keon Ha; Jeon, Pyoung; Shin, Sung Wook; Park, Hong Suk; Do, Young Soo (Dept. of Radiology and the Center for Imaging Science, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)), email: kbparksmc@skku.edu; Kim, Dong-Ik; Kim, Young-Wook (Div. of Vascular Surgery, Dept. of Surgery, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of))

    2011-10-15

    Background: There are very few reports regarding the use of 3D rotational angiography (3D RA) in embolization of renal artery aneurysms (RAAs). No valuable data have been reported on the follow-up result of coil embolization for RAAs on computed tomography (CT). Purpose: To evaluate the clinical and multidetector computed tomography (MDCT) follow-up results of renal artery aneurysms treated by detachable coil embolization using 3D RA. Material and Methods: Six patients diagnosed with RAAs were included. Five patients underwent detachable coil embolization. Five patients underwent 3D RA and the parameters used for planning endovascular treatment obtained by 2D CT, reformatted 3D CT angiography (3D CTA), 2D digital subtraction angiography (2D DSA) and 3D RA were compared. The post embolization MDCT follow-up findings were analyzed retrospectively. Results: The technical success rate for detachable coil embolization was 40%. The 3D CTA showed the dome-to-neck ratio (DNR) and tangential view of the renal artery aneurysm in five patients (83.3%) and the 2D CT showed it in four (66.7%). An optimal working angle assessment could not be obtained on the 2D CT and 3D CTA. The 3D RA showed the DNR, tangential view, and optimal working angle in all patients. Renal infarction occurred in three patients and Postprocedural hypertension developed in two patients during the follow-up period. Conclusion: The 3D RA was useful in preoperative determination of adequate working angle for detachable coil embolization of RAAs. Late complications of detachable coil embolization for RAAs were renal infarction and hypertension

  2. Segmentation of the thoracic aorta in noncontrast cardiac CT images.

    Science.gov (United States)

    Avila-Montes, Olga C; Kurkure, Uday; Nakazato, Ryo; Berman, Daniel S; Dey, Damini; Kakadiaris, Ioannis A

    2013-09-01

    Studies have shown that aortic calcification is associated with cardiovascular disease. In this study, a method for localization, centerline extraction, and segmentation of the thoracic aorta in noncontrast cardiac-computed tomography (CT) images, toward the detection of aortic calcification, is presented. The localization of the right coronary artery ostium slice is formulated as a regression problem whose input variables are obtained from simple intensity features computed from a pyramid representation of the slice. The localization, centerline extraction, and segmentation of the aorta are formulated as optimal path detection problems. Dynamic programming is applied in the Hough space for localizing key center points in the aorta which guide the centerline tracing using a fast marching-based minimal path extraction framework. The input volume is then resampled into a stack of 2-D cross-sectional planes orthogonal to the obtained centerline. Dynamic programming is again applied for the segmentation of the aorta in each slice of the resampled volume. The obtained segmentation is finally mapped back to its original volume space. The performance of the proposed method was assessed on cardiac noncontrast CT scans and promising results were obtained.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  4. Quantification of myocardial blood flow using dynamic 320-row multi-detector CT as compared with {sup 15}O-H{sub 2}O PET

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Yasuka; Oyama-Manabe, Noriko; Kudo, Kohsuke [Hokkaido University Hospital, Department of Diagnostic and Interventional Radiology, Sapporo (Japan); Naya, Masanao [Hokkaido University Graduate School of Medicine, Department of Cardiovascular Medicine, Sapporo (Japan); Manabe, Osamu; Tomiyama, Yuuki; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan); Sasaki, Tsukasa [Hokkaido University Hospital, Department of Radiology, Sapporo (Japan); Katoh, Chietsugu [Hokkaido University Faculty of Health Sciences, Sapporo (Japan); Shirato, Hiroki [Hokkaido University Graduate School of Medicine, Department of Radiation Medicine, Sapporo (Japan)

    2014-07-15

    This study introduces a method to calculate myocardium blood flow (MBF) and coronary flow reserve (CFR) using the relatively low-dose dynamic 320-row multi-detector computed tomography (MDCT), validates the method against {sup 15}O-H{sub 2}O positron-emission tomography (PET) and assesses the CFRs of coronary artery disease (CAD) patients. Thirty-two subjects underwent both dynamic CT perfusion (CTP) and PET perfusion imaging at rest and during pharmacological stress. In 12 normal subjects (pilot group), the calculation method for MBF and CFR was established. In the other 13 normal subjects (validation group), MBF and CFR obtained by dynamic CTP and PET were compared. Finally, the CFRs obtained by dynamic CTP and PET were compared between the validation group and CAD patients (n = 7). Correlation between MBF of MDCT and PET was strong (r = 0.95, P < 0.0001). CFR showed good correlation between dynamic CTP and PET (r = 0.67, P = 0.0126). CFR{sub CT} in the CAD group (2.3 ± 0.8) was significantly lower than that in the validation group (5.2 ± 1.8) (P = 0.0011). We established a method for measuring MBF and CFR with the relatively low-dose dynamic MDCT. Lower CFR was well demonstrated in CAD patients by dynamic CTP. (orig.)

  5. Multi-detector CT angiography for the assessment of anterior spinal artery and artery of Adamkiewicz patency in patients suspected of having thoracic aortic pathology

    Institute of Scientific and Technical Information of China (English)

    Shaohong ZHAO; Laura Logan; Pamela Schraedley; Geoffrey D.Rubin

    2006-01-01

    Objective To evaluate the visualization of the anterior spinal artery (ASA) and the artery of Adamkiewicz (AKA) as well as the affecting factors for the detection rate using multidetector row CT (MDCT). Methods Ninety-nine consecutive patients (31 women and 68 men; age range, 25-90 years; average age 61.3 years) with suspicion for thoracic aortic lesions necessitating surgical intervention (31 aortic aneurysm, 45 dissection, 5 intramural hematoma, and 18 normal), underwent 16-slice MDCT angiography from the aortic arch to the aortic bifurcation. Transverse sections, multiplanar reformations (MPR) and thin maximum intensity projections (MIP) were used to assess the ASA and AKA. The level of the ASA and AKA origins and CT acquisition parameters were recorded. The contrast-to-noise ratio (CNR) of the image, an index of the mass of the T11 body (vertebral mass index), the subcutaneous fat thickness,and the CT value within the aortic arch and at the T11 level were measured. The detection of the ASA and AKA was evaluated relative to the acquisition parameters, scan characteristics, and aortic lesion type. Differences were assessed with Wilcoxon rank-sum and t tests. Results The ASA was visualized in 51 patients (52%) and the AKA in 18 patients (18 %). The ASA was identified in 36/67 (54%)patients with 1.25 mm thickness and in15/32 (47%) patients with 2.5-3.0 mm thickness. This difference did not achieve significance (P=0.13). The detection rate of the ASA and the AKA was influenced by vertebral mass index and the CNR (P<0.05). The amount of subcutaneous fat affected the detection rate of the ASA (P<0.05) but not the AKA. In CT scans with ASA detection, the mean CT values in the aorta at the arch and at T11 were 360 and 358 HU, respectively; whereas in CT scans without ASA detection, the CT values in the aorta at the arch and at T11 were lower (297 and 317 HU, respectively; both P<0.05). Conclusion The ASA and AKA were less frequently detected in our cohorts than

  6. Validity of blood flow measurement using 320 multi-detectors CT and first-pass distribution theory: a phantom study

    Science.gov (United States)

    Chen, Jun; Yu, Xuefang; Xu, Shaopeng; Zhou, Kenneth J.

    2015-03-01

    To evaluate the feasibility of measuring the myocardial blood flow using 320 row detector CT by first-pass technique. Heart was simulated with a container that was filled with pipeline of 3mm diameter; coronary artery was simulated with a pipeline of 2 cm diameter and connected with the simulated heart. The simulated coronary artery was connected with a big container with 1500 ml saline and 150ml contrast agent. One pump linking with simulated heart will withdraw with a speed of 10 ml/min, 15 ml/min, 20 ml/min, 25 ml/min and 30 ml/min. First CT scan starts after 30 s of pumpback with certain speed. The second CT scan starts 5 s after first CT scans. CT images processed as follows: The second CT scan images subtract first CT scan images, calculate the increase of CT value of simulated heart and the CT value of the unit volume of simulated coronary artery and then to calculate the total inflow of myocardial blood flow. CT myocardial blood flows were calculated as: 0.94 ml/s, 2.09 ml/s, 2.74 ml/s, 4.18 ml/s, 4.86 ml/s. The correlation coefficient is 0.994 and r2 = 0.97. The method of measuring the myocardial blood flow using 320 row detector CT by 2 scans is feasible. It is possible to develop a new method for quantitatively and functional assessment of myocardial perfusion blood flow with less radiation does.

  7. The effects of emphysema on airway disease: Correlations between multi-detector CT and pulmonary function tests in smokers

    Energy Technology Data Exchange (ETDEWEB)

    Yahaba, Misuzu, E-mail: mis_misuzu@yahoo.co.jp; Kawata, Naoko, E-mail: chumito_03@yahoo.co.jp; Iesato, Ken, E-mail: iesato_k@yahoo.co.jp; Matsuura, Yukiko, E-mail: matsuyuki_future@yahoo.co.jp; Sugiura, Toshihiko, E-mail: sugiura@js3.so-net.ne.jp; Kasai, Hajime, E-mail: daikasai6075@yahoo.co.jp; Sakurai, Yoriko, E-mail: yoliri@nifty.com; Terada, Jiro, E-mail: jirotera@chiba-u.jp; Sakao, Seiichiro, E-mail: sakao@faculty.chiba-u.jp; Tada, Yuji, E-mail: ytada@faculty.chiba-u.jp; Tanabe, Nobuhiro, E-mail: ntanabe@faculty.chiba-u.jp; Tatsumi, Koichiro, E-mail: tatsumi@faculty.chiba-u.jp

    2014-06-15

    Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and small airway narrowing. Quantitative evaluation of airway dimensions by multi-detector computed tomography (MDCT) has revealed a correlation between airway dimension and airflow limitation. However, the effect of emphysema on this correlation is unclear. Objective: The goal of this study was to determine whether emphysematous changes alter the relationships between airflow limitation and airway dimensions as measured by inspiratory and expiratory MDCT. Methods: Ninety-one subjects underwent inspiratory and expiratory MDCT. Images were evaluated for mean airway luminal area (Ai), wall area percentage (WA%) from the third to the fifth generation of three bronchi (B1, B5, B8) in the right lung, and low attenuation volume percent (LAV%). Correlations between each airway index and airflow limitation were determined for each patient and compared between patients with and without evidence of emphysema. Results: In patients without emphysema, Ai and WA% from both the inspiratory and expiratory scans were significantly correlated with FEV{sub 1.} No correlation was detected in patients with emphysema. In addition, emphysematous COPD patients with GOLD stage 1 or 2 disease had significantly lower changes in B8 Ai than non-emphysematous patients. Conclusions: A significant correlation exists between airway parameters and FEV{sub 1} in patients without emphysema. Emphysema may influence airway dimensions even in patients with mild to moderate COPD.

  8. 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.)

  9. The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: Emphasis on detection and localization of the tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Lim, Hyo Soon; Park, Young Kyu; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of); Lim, Nam Yeol [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2015-02-15

    Multidetector CT (MDCT) gastrography has been regarded as a promising technique for the preoperative imaging of gastric cancer. It has the ability to produce various three-dimensional (3D) images. Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging. In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies. In this article, we discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin.

  10. Multi-Detector CT Findings of the Normal Appendix in Children: Evaluation of the Position, Diameter, and Presence or Absence of Intraluminal Gas

    Energy Technology Data Exchange (ETDEWEB)

    Park, Woon Ju; Kim, Jong Chul [Dept. of Radiology, Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    2011-08-15

    To assess the usefulness of multi-detector CT (MDCT) with multiplanar reformations (MPR) for the evaluation of the position, diameter and presence or absence of intraluminal gas in the normal appendix in children. From 2007 to 2010, we retrospectively analyzed the MDCT images of normal appendices in 133 children, and evaluated the position, diameter, and presence or absence of intraluminal gas in the appendix. Among the 133 appendices, type I (postileal and medial paracecal position) was found in 64 children, type II (subcecal position) in 22, type III (retrocecal and retrocolic/laterocolic position) in 15, type IV (preileal and medial colic position) in 16, and type V (lower pelvic position) in 16 children. The mean diameter was 5.8 mm {+-} 1.2 (SD) (range; 3.2-8.7 mm). There was a high correlation between the appendiceal diameter and age (p = 0.000).There was no statistically significant difference in the appendiceal diameter between boys and girls (p = 0.470). Intraluminal gas was found in 115 appendices and there was no statistically significant correlation between the appendiceal diameter and intraluminal gas (p = 0.502). The MDCT with MPR was useful for the evaluation of the normal appendices in children. The procedure may be useful for the diagnosis of equivocal or unusual appendicitis in children.

  11. Evaluation of living liver donors using contrast enhanced multidetector CT – The radiologists impact on donor selection

    Directory of Open Access Journals (Sweden)

    Ringe Kristina

    2012-07-01

    Full Text Available Abstract Background Living donor liver transplantation (LDLT is a valuable and legitimate treatment for patients with end-stage liver disease. Computed tomography (CT has proven to be an important tool in the process of donor evaluation. The purpose of this study was to evaluate the significance of CT in the donor selection process. Methods Between May 1999 and October 2010 170 candidate donors underwent biphasic CT. We retrospectively reviewed the results of the CT and liver volumetry, and assessed reasons for rejection. Results 89 candidates underwent partial liver resection (52.4%. Based on the results of liver CT and volumetry 22 candidates were excluded as donors (31% of the cases. Reasons included fatty liver (n = 9, vascular anatomical variants (n = 4, incidental finding of hemangioma and focal nodular hyperplasia (n = 1 and small (n = 5 or large for size (n = 5 graft volume. Conclusion CT based imaging of the liver in combination with dedicated software plays a key role in the process of evaluation of candidates for LDLT. It may account for up to 1/3 of the contraindications for LDLT.

  12. Quantitative assessment of first-pass perfusion using a low-dose method at multidetector CT in oesophageal squamous cell carcinoma: Correlation with VEGF expression

    Energy Technology Data Exchange (ETDEWEB)

    Chen, T.-W. [Department of Radiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China) and Sichuan Province Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wen Hua Lu, Nanchong, Sichuan 637000 (China); Yang, Z.-G., E-mail: yangzg1117@yahoo.com.cn [Department of Radiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China); State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Chen, H.-J. [Department of Pathology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Li, Y.; Tang, S.-S.; Yao, J.; Dong, Z.-H. [Department of Radiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China); He, D. [Department of Pathology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China)

    2012-08-15

    Aim: To investigate the correlation between vascular endothelial cell growth factor (VEGF) expression and first-pass perfusion parameters at multidetector computed tomography (MDCT) using a low-dose technique, and to determine how to discriminate VEGF positivity from VEGF negativity by perfusion CT in oesophageal squamous cell carcinomas. Materials and methods: Thirty-two patients with oesophageal squamous cell carcinomas underwent first-pass perfusion with 64-section MDCT at 50 mAs. Perfusion parameters, including perfusion, peak enhanced density (PED), time to peak (TTP), and blood volume (BV), were measured. Postoperative specimens were assessed for VEGF expression. Correlation tests were performed to determine the associations between each CT perfusion parameter and VEGF expression. The cut-off values of perfusion parameters were obtained statistically to discriminate VEGF positivity from VEGF negativity. Results: Mean perfusion, PED, TTP, and BV were 38.47 {+-} 30.26 ml/min/ml, 24.68 {+-} 9.65 HU, 28.35 {+-} 9.03 s, and 11.82 {+-} 6.06 ml/100 g, respectively. PED or BV were significantly higher in the VEGF-positive group than in the VEGF-negative group (all p < 0.05), but no significant difference in perfusion or TTP was found between the VEGF-positive and VEGF-negative groups (all p > 0.05). In VEGF positivity, PED and BV were correlated with VEGF expression (r = 0.576 and 0.765, respectively; all p < 0.05), whereas perfusion and TTP were not (r = 0.361 and 0.239, respectively; all p > 0.05). A threshold of BV (10.23 ml/100 g) achieved a sensitivity of 94.4%, and a specificity of 92.9% for discriminating VEGF positivity from VEGF negativity. Conclusion: BV could reflect tumour VEGF expression, and could be an indicator for evaluating angiogenesis in oesophageal tumours.

  13. Regenerative nodules in patients with chronic Budd-Chiari syndrome: A longitudinal study using multiphase contrast-enhanced multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Flor, Nicola [Unita Operativa di Radiologia Diagnostica Interventistica, University of Milan School of Medicine, Ospedale San Paolo, Milan (Italy)], E-mail: flornic@hotmail.com; Zuin, Massimo [Unita Operativa di Epatologia e Gastroenterologia Medica, University of Milan School of Medicine, Ospedale San Paolo, Via A. di Rudini 8, 20142 Milan (Italy); Brovelli, Francesca [Department of Radiology, Centro Diagnostico Italiano, Milan (Italy); Maggioni, Marco [Servizio di Anatomia Patologica, Ospedale San Paolo, Milan (Italy); Tentori, Augusta [Servizio di Radiologia, Ospedale di Voghera (Italy); Sardanelli, Francesco [Radiology, IRCCS Policlinico San Donato, University of Milan School of Medicine, Milan (Italy); Cornalba, Gian Paolo [Unita Operativa di Radiologia Diagnostica Interventistica, University of Milan School of Medicine, Ospedale San Paolo, Milan (Italy)

    2010-03-15

    Objective: Our aim was to evaluate the serial evolution of regenerative nodules in patients with Budd-Chiari syndrome (BCS) treated with portal-systemic shunts, using multiphasic multidetector computed tomography (MDCT). Materials and methods: Five patients each underwent three MDCT exams over an extended period ranging from 36 to 42 months. Two radiologists in consensus retrospectively reviewed each exam for each patient. Individual nodules were grouped according to size (size I: nodules with diameter {<=}15 mm; size II: >15 mm but <30 mm; size III: {>=}30 mm), pattern of enhancement (A: homogeneously hypervascular or B: with central scar), and segmental location. Four nodules classified as size II, which increased in size over time, were needle-biopsied. Results: We detected 61 nodules at the first exam, 66 nodules at the second exam (7 nodules disappeared and 12 new nodules), and 85 nodules at the third exam (8 disappeared and 27 new) for a total of 212 findings. Nodules were mostly found in the right hepatic lobe. Fourteen of the 15 nodules that disappeared over time were size I and enhancement pattern A. At unenhanced MDCT, 204 (96%) of the 212 findings were isodense. Overall, 100 nodules, including the 61 initially detected, were considered newly diagnosed; of these 84 (84%) were size I and pattern A. Of 57 nodules considered size I and pattern A at the first or second exam, 24 (42%) changed to pattern B at the third exam and either size II (n = 18) or III (n = 6). The four biopsied nodules were each confirmed as benign regenerative nodule. No patient developed HCC at 5-year follow-up period. Conclusion: Hepatic nodules in BCS patients not only increase in number over time but may also increase in size and develop a central scar.

  14. Anatomical analysis of incidental left atrial diverticula in patients with suspected coronary artery disease using 64-channel multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Shin, S.Y. [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kwon, S.H., E-mail: Kwon98@khu.ac.kr [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Oh, J.H. [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2011-10-15

    Aim: To describe and evaluate anatomical characterizations of incidental left atrial (LA) diverticula in patients with suspected coronary artery disease using 64-channel multidetector computed tomography (MDCT). Materials and methods: From October 2008 to June 2009, 2059 patients with suspected coronary artery disease underwent electrocardiogram-gated 64-channel MDCT. Five hundred and thirty-two LA diverticula were identified in 377 patients (18.3%, male to female ratio: 216:161, mean age 59 {+-} 10.89 years, range from 20 to 91 years). Two radiologists retrospectively analysed the number (single or multiple), size (diameter and length), shape (cystiform or tubiform), surface (smooth or irregular), and location (right or mid or left/upper or lower/lateral or posterior). If the length/diameter was <1.5, the diverticular shape was considered to be cystiform. Results: Among 532 LA diverticula, single (270/532, 51.1%), cystiform (411/532, 77.3%), and smooth (332/532, 62.4%) diverticula were found. The right upper region (255/532, 47.9%) was the most common location, followed by the left lateral area (172/532, 32.3%). The average diameter was 4.7 {+-} 2 mm (range from 1-19 mm), and the average length was 4.7 {+-} 2.1 mm (range 1-13 mm). The average ratio of length to diameter was 1.15 (range 0.25-1.45). The average number of diverticula was 2 {+-} 1.06 (range 1-5). Conclusion: Incidental LA diverticulum is not an uncommon finding in patients with suspected coronary artery disease. MDCT can provide anatomical details of LA diverticula. However, further studies are needed to determine their clinical significance.

  15. Cardiac CT for planning redo cardiac surgery: effect of knowledge-based iterative model reconstruction on image quality

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Seitaro [MedStar Washington Hospital Center, Department of Cardiology, Washington, DC (United States); Kumamoto University, Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto (Japan); Weissman, Gaby; Weigold, W. Guy [MedStar Washington Hospital Center, Department of Cardiology, Washington, DC (United States); Vembar, Mani [Philips Healthcare, CT Clinical Science, Cleveland, OH (United States)

    2015-01-15

    The purpose of this study was to investigate the effects of knowledge-based iterative model reconstruction (IMR) on image quality in cardiac CT performed for the planning of redo cardiac surgery by comparing IMR images with images reconstructed with filtered back-projection (FBP) and hybrid iterative reconstruction (HIR). We studied 31 patients (23 men, 8 women; mean age 65.1 ± 16.5 years) referred for redo cardiac surgery who underwent cardiac CT. Paired image sets were created using three types of reconstruction: FBP, HIR, and IMR. Quantitative parameters including CT attenuation, image noise, and contrast-to-noise ratio (CNR) of each cardiovascular structure were calculated. The visual image quality - graininess, streak artefact, margin sharpness of each cardiovascular structure, and overall image quality - was scored on a five-point scale. The mean image noise of FBP, HIR, and IMR images was 58.3 ± 26.7, 36.0 ± 12.5, and 14.2 ± 5.5 HU, respectively; there were significant differences in all comparison combinations among the three methods. The CNR of IMR images was better than that of FBP and HIR images in all evaluated structures. The visual scores were significantly higher for IMR than for the other images in all evaluated parameters. IMR can provide significantly improved qualitative and quantitative image quality at in cardiac CT for planning of reoperative cardiac surgery. (orig.)

  16. Estimating radiation doses from multidetector CT using Monte Carlo simulations: effects of different size voxelized patient models on magnitudes of organ and effective dose.

    Science.gov (United States)

    DeMarco, J J; Cagnon, C H; Cody, D D; Stevens, D M; McCollough, C H; Zankl, M; Angel, E; McNitt-Gray, M F

    2007-05-07

    The purpose of this work is to examine the effects of patient size on radiation dose from CT scans. To perform these investigations, we used Monte Carlo simulation methods with detailed models of both patients and multidetector computed tomography (MDCT) scanners. A family of three-dimensional, voxelized patient models previously developed and validated by the GSF was implemented as input files using the Monte Carlo code MCNPX. These patient models represent a range of patient sizes and ages (8 weeks to 48 years) and have all radiosensitive organs previously identified and segmented, allowing the estimation of dose to any individual organ and calculation of patient effective dose. To estimate radiation dose, every voxel in each patient model was assigned both a specific organ index number and an elemental composition and mass density. Simulated CT scans of each voxelized patient model were performed using a previously developed MDCT source model that includes scanner specific spectra, including bowtie filter, scanner geometry and helical source path. The scan simulations in this work include a whole-body scan protocol and a thoracic CT scan protocol, each performed with fixed tube current. The whole-body scan simulation yielded a predictable decrease in effective dose as a function of increasing patient weight. Results from analysis of individual organs demonstrated similar trends, but with some individual variations. A comparison with a conventional dose estimation method using the ImPACT spreadsheet yielded an effective dose of 0.14 mSv mAs(-1) for the whole-body scan. This result is lower than the simulations on the voxelized model designated 'Irene' (0.15 mSv mAs(-1)) and higher than the models 'Donna' and 'Golem' (0.12 mSv mAs(-1)). For the thoracic scan protocol, the ImPACT spreadsheet estimates an effective dose of 0.037 mSv mAs(-1), which falls between the calculated values for Irene (0.042 mSv mAs(-1)) and Donna (0.031 mSv mAs(-1)) and is higher relative

  17. "Porcelain heart" cardiomyopathy secondary to hyperparathyroidism: radiographic, echocardiographic, and cardiac CT appearances.

    LENUS (Irish Health Repository)

    Freeman, James

    2010-11-01

    We report the radiographic, echocardiographic and cardiac CT appearances of \\'porcelain heart\\' in an 85-year-old woman who presented with progressive heart failure. The extensive myocardial calcification was secondary to hyperparathyroidism with renal failure.

  18. Highlights of the 12th International Conference on Nuclear Cardiology and Cardiac CT.

    Science.gov (United States)

    Kitsiou, Anastasia; Dorbala, Sharmila; Scholte, Arthur J H A

    2015-09-01

    The 12th International Conference on Nuclear Cardiology and Cardiac CT was held from 3 to 5 May 2015 in Madrid, Spain. In this article, the three Congress Program Committee Chairs summarize selected highlights of the presented abstracts.

  19. Atresia of the bilateral pulmonary veins: a rare and dismal anomaly identified on cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Park, Sang-Hyub; Koo, Hyun Jung; Cho, Young Hoon; Lee, Eunsol [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

    2014-08-15

    Imaging findings of bilateral pulmonary vein atresia have not been described. To describe cardiac CT findings and clinical outcomes of bilateral pulmonary vein atresia. Three newborns with bilateral pulmonary vein atresia were encountered at our institution during a period of 8 years. We evaluated prenatal echocardiographic findings, clinical presentations, postnatal echocardiographic findings, chest radiographic findings, cardiac CT findings and clinical outcomes. All newborns presented immediately after birth with severe cyanosis, respiratory distress and acidosis that were unresponsive to medical management. Prenatal and postnatal echocardiographic studies and chest radiography were misleading, inconclusive or nonspecific in making the diagnosis in these children; however cardiac CT clearly demonstrated atresia of the bilateral pulmonary veins with multiple small mediastinal collateral veins and pulmonary edema. Surgical treatments were not feasible for this anomaly. Their clinical outcomes were universally dismal and all infants died within 3 days. Cardiac CT provides an accurate diagnosis of bilateral pulmonary vein atresia and leads to prompt treatment decision in these children. (orig.)

  20. "Porcelain heart" cardiomyopathy secondary to hyperparathyroidism: radiographic, echocardiographic, and cardiac CT appearances.

    LENUS (Irish Health Repository)

    Freeman, James

    2012-02-01

    We report the radiographic, echocardiographic and cardiac CT appearances of \\'porcelain heart\\' in an 85-year-old woman who presented with progressive heart failure. The extensive myocardial calcification was secondary to hyperparathyroidism with renal failure.

  1. Enhancement patterns of pancreatic adenocarcinoma on conventional dynamic multi-detector row CT: Correlation with angiogenesis and fibrosis

    Institute of Scientific and Technical Information of China (English)

    Yuki Hattori; Toshifumi Gabata; Osamu Matsui; Kentaro Mochizuki; Hirohisa Kitagawa; Masato Kayahara; Tetsuo Ohta; Yasuni Nakanuma

    2009-01-01

    AIM: To evaluate retrospectively the correlation between enhancement patterns on dynamic computed tomography (CT) and angiogenesis and fibrosis in pancreatic adenocarcinoma.METHODS: Twenty-three patients with pancreatic adenocarcinoma underwent dynamic CT and tumor resection. In addition to the absolute and relative enhanced value that was calculated by subtracting the attenuation value on pre-contrast from those on contrast-enhanced CT in each phase, we defined one parameter, "tumor-aorta enhancement ratio", which was calculated by dividing enhancement of pancreatic cancer by enhancement of abdominal aorta in each phase. These enhancement patterns were correlated with the level of vascular endothelial growth factor (VEGF), microvessel density (MVD), and extent of fibrosis.RESULTS: The absolute enhanced value in the arterial phase correlated with the level of VEGF and MVD (P = 0.047, P = 0.001). The relative enhanced value in arterial phase and tumor-aorta enhancement ratio (arterial) correlated with MVD (P = 0.003, P = 0.022). Tumor-aorta enhancement ratio (arterial) correlated negatively with the extent of fibrosis (P = 0.004). The tumors with greater MVD and higher expression of VEGF tended to show high enhancement in the arterial dominant phase. On the other hand, the tumors with a larger amount of fibrosis showed a negative correlation with the grade of enhancement during the arterial phase.CONCLUSION: Enhancement patterns on dynamic CT correlated with angiogenesis and may be modified by the extent of fibrosis.

  2. Cardiac CT and cardiac MRI - competitive or complementary for nuclear cardiology; Kardio-CT und Kardio-MR - konkurrierend oder komplementaer zur Nuklearkardiologie?

    Energy Technology Data Exchange (ETDEWEB)

    Moshage, W. [Medizinische Abt. (Kardiologie, Angiologie, Pneumologie, Intensivmedizin), Klinikum Traunstein (Germany)

    2004-09-01

    In summary, cardiac computed tomography (CT) and cardiac magnetic resonance (MR) are two different technologies with distinct imaging properties that gain increasing importance in clinical cardiology. Even though images may look similar, the areas of application of CT and MR are quite different. Clinical applications of cardiac CT focus on on-invasive imaging of the coronary arteries. In this respect, the higher spatial resolution of cardiac CT constitutes a significant advantage as compared to MR and clinical results are superior. Clinical applications of cardiac MR, next to morphologic imaging of the heart, are most frequently found in the context of intra-and pericardial masses, complex congenital anomalies, and the assessment of left ventricular function (dobutamine) and perfusion (adenosine) under stress. The evaluation of the size and localization of myocardial necrosis, scars, and fibrosis gains increasing importance, for example in the workup of myocardial infarction, but also myocarditis and cardiomyopathies. In this respect, magnetic resonance imaging partly constitutes an alternative to nuclear medicine methods. Due to the lack of ionizing radiation and a relatively high spatial resolution, an increase of MR diagnostic procedures at the expense of nuclear medicine can be expected. (orig.)

  3. Investigation of sinonasal anatomy via low-dose multidetector CT examination in chronic rhinosinusitis patients with higher risk for perioperative complications.

    Science.gov (United States)

    Fraczek, Marcin; Guzinski, Maciej; Morawska-Kochman, Monika; Krecicki, Tomasz

    2017-02-01

    The aim of the study was to compare visualisation of the surgically relevant anatomical structures via low- and standard-dose multidetector CT protocol in patients with chronic rhinosinusitis (CRS) and higher risk for perioperative complications (i.e. presence of bronchial asthma, history of sinus surgery and advanced nasal polyposis). 135 adult CRS patients were divided randomly into standard-dose (120 kVp, 100 mAs) or low-dose CT groups (120 kVp, 45 mAs). The detectability of the vital anatomical structures (anterior ethmoid artery, optic nerve, cribriform plate and lamina papyracea) was scored using a five-point scale (from excellent to unacceptable) by a radiologist and sinus surgeon. Polyp sizes were quantified endoscopically according to the Lildholdt's scale (LS). Olfactory function was tested with the "Sniffin' Sticks" test. On the low-dose CT images, detectability ranged from 2.42 (better than poor) for cribriform plate among anosmic cases to 4.11 (better than good) for lamina papyracea in cases without nasal polyps. Identification of lamina papyracea on low-dose scans was significantly worse in each group and the same was the case with cribriform plates in patients with advanced polyposis and anosmia. Cribriform plates were the most poorly identified (between poor and average) among all the structures on low-dose images. Identification of anterior ethmoid artery (AEA) with reduced dose was insignificantly worse than with standard-dose examination. The AEA was scored as an average-defined structure and was the second weakest visualised. In conclusion, preoperatively, low-dose protocols may not sufficiently visualise the surgically relevant anatomical structures in patients with CRS and bronchial asthma, advanced nasal polyps (LS > 2) and history of sinus surgery. Low mAs value enables comparable detectability of sinonasal landmarks with standard-dose protocols in patients without analysed risk factors. In the context of planned surgery, the current

  4. Multidetector spiral CT arthrography of the shoulder. Clinical applications and limits, with MR arthrography and arthroscopic correlations.

    Science.gov (United States)

    Lecouvet, Frédéric E; Simoni, Paolo; Koutaïssoff, Sophie; Vande Berg, Bruno C; Malghem, Jacques; Dubuc, Jean-Emile

    2008-10-01

    Although MR imaging and MR arthrography are the first choice modalities for shoulder imaging, CT arthrography (CTA) may be used successfully to address many clinical questions. The advent of submillimeter multiple detector CT technology and subsequent excellent three-plane resolution has considerably increased the quality of CTA examinations and has propelled this technique to the forefront in a growing number of indications. The combined use of iodinated contrast material for fluoroscopic confirmation of the articular position of the needle before injection of gadolinium chelates for MR arthrography offers the unique opportunity to compare CTA and MRA findings in carefully selected cases. This paper illustrates capabilities and limits of CTA for the study of rotator cuff tears, shoulder instability, cartilage lesions, anatomical variants and abnormalities of the glenoid labrum, with correlations to MR arthrography and surgical findings.

  5. Multidetector CT of Locally Invasive Advanced Gastric Cancer: Value of Oblique Coronal Reconstructed Images for the Assessment of Local Invasion

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Hee; Kim, Ah Yong; Kim, Hye Jin; Yook, Jeong Hwan; Yu, Eun Sil; Jang, Yoon Jin; Park, Seong Ho; Shin, Yong Moon; Ha, Hyun Kwon [Asan Medical Center, Seoul (Korea, Republic of)

    2010-01-15

    To evaluate the diagnostic value of oblique coronal reconstructed CT images to determine the local invasion of advanced gastric cancer (AGC). Thirty-four consecutive patients, who were suspected to have locally invasive advanced gastric cancer (more than T3 stage) on a preoperative MDCT scan and underwent a diagnostic or curative laparotomy, were enrolled in this study. Two reviewers performed an independent blind review of three series of MDCT images in random order; axial (AXI), conventional coronal (CCI), and oblique coronal (OCI) (parallel to long axis of gastric body and pancreas) images. In assessing the local invasion, the reader's confidence for the local invasion of AGC was graded using a five point scale (1 = definitely negative, 5 = definitely positive: T4). With surgical findings and histopathological proofs as reference standards, the diagnostic performance of the three different plans of CT images was employed for the verification of local invasion of AGC on a preoperative CT scan using the receiver operating characteristic (ROC) method. Agreements between the two reviewers were analyzed using weighted kappa statistics. Results: In 19 out of 34 patients, local invasion was confirmed surgically or histopathologically (13 pancreas invasion, 6 liver invasion, 4 major vascular invasion, 3 colon and mesocolon invasion, and 2 spleen invasion). The diagnostic performance of OCI was superior to AXI or CCI in the local invasion of AGC. The differences in the area under the curve of AXI (0.770 {+-} 0.087, 0.700 {+-} 0.094), CCI (0.884 {+-} 0.058, 0.958 {+-} 0.038), and OCI (0.954 {+-} 0.050, 0.956 {+-} 0.049), were statistically significant for both reviewers. Inter-observer agreement was excellent for OCI ({kappa}= .973), which was greater than CCI (({kappa}= .839), and AXI (({kappa}= .763). On a CT scan, OCI might be a useful imaging technique in evaluating locally invasive advanced gastric cancer.

  6. A method to analyse observer disagreement in visual grading studies: example of assessed image quality in paediatric cerebral multidetector CT images.

    Science.gov (United States)

    Ledenius, K; Svensson, E; Stålhammar, F; Wiklund, L-M; Thilander-Klang, A

    2010-07-01

    The purpose was to demonstrate a non-parametric statistical method that can identify and explain the components of observer disagreement in terms of systematic disagreement as well as additional individual variability, in visual grading studies. As an example, the method was applied to a study where the effect of reduced tube current on diagnostic image quality in paediatric cerebral multidetector CT (MDCT) images was investigated. Quantum noise, representing dose reductions equivalent to steps of 20 mA, was artificially added to the raw data of 25 retrospectively selected paediatric cerebral MDCT examinations. Three radiologists, blindly and randomly, assessed the resulting images from two different levels of the brain with regard to the reproduction of high- and low-contrast structures and overall image quality. Images from three patients were assessed twice for the analysis of intra-observer disagreement. The intra-observer disagreement in test-retest assessments could mainly be explained by a systematic change towards lower image quality the second time the image was reviewed. The inter-observer comparisons showed that the paediatric radiologist was more critical of the overall image quality, while the neuroradiologists were more critical of the reproduction of the basal ganglia. Differences between the radiologists regarding the extent to which they used the whole classification scale were also found. The statistical method used was able to identify and separately measure a presence of bias apart from additional individual variability within and between the radiologists which is, at the time of writing, not attainable by any other statistical approach suitable for paired, ordinal data.

  7. Assessment of left ventricular ejection fraction: comparison of two dimensional echocardiography, cardiac magnetic resonance imaging and 64-row multi-detector computed tomography

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

    Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-detector computed tomography (64-row MDCT) with those determined from two dimensional echocardiography (2D echo) and cardiac magnetic resonance imaging (CMR). Methods Thirty-two patients with coronary artery disease underwent trans-thoracic 2D echo, CMR and contrast-enhanced 64-row MDCT for assessment of LVEF within 48 hours of each other. 64-row MDCT LVEF was derived using the Syngo Circulation software; CMR LVEF was by Area Length Ejection Fraction (ALEF) and Simpson method and 2D echo LVEF by Simpson method.Results The LVEF was 49.13 ± 15.91% by 2D echo, 50.72 ± 16.55% (ALEF method) and 47.65 ± 16.58%(Simpson method) by CMR and 50.00 ± 15.93% by 64-row MDCT. LVEF measurements by 64-row MDCT correlated well with LVEF measured with CMR using either the ALEF method (Pearson correlation r = 0.94, P <0.01) or Simpson method (r = 0.92, P<0.01). It also correlated well with LVEF measured using 2D echo (r = 0.80, P < 0.01). Conclusion LVEF measurements by 64-row MDCT correlated well with LVEF measured by CMR and 2D echo. The correlation between 64-row MDCT and CMR was better than the correlation between 2D echo with CMR. Standard data set from a 64-row MDCT coronary study can be reliably used to calculate the LVEF.

  8. Dual source multidetector CT-angiography before transcatheter aortic valve implantation (TAVI) using a high-pitch spiral acquisition mode

    Energy Technology Data Exchange (ETDEWEB)

    Wuest, W.; Anders, K.; May, M.S.; Uder, M. [University of Erlangen, Department of Radiology, Erlangen (Germany); Schuhbaeck, A.; Gauss, S.; Marwan, M.; Arnold, M.; Muschiol, G.; Daniel, W.G.; Achenbach, S. [University of Erlangen, Department of Cardiology, Erlangen (Germany); Ensminger, S. [University of Erlangen, Department of Cardiac Surgery, Erlangen (Germany)

    2012-01-15

    Transcatheter Aortic Valve Implantation (TAVI) is an alternative to surgical valve replacement in high risk patients. Angiography of the aortic root, aorta and iliac arteries is required to select suitable candidates, but contrast agents can be harmful due to impaired renal function. We evaluated ECG-triggered high-pitch spiral dual source Computed Tomography (CT) with minimized volume of contrast agent to assess aortic root anatomy and vascular access. 42 patients (82 {+-} 6 years) scheduled for TAVI underwent dual source (DS) CT angiography (CTA) of the aorta using a prospectively ECG-triggered high-pitch spiral mode (pitch = 3.4) with 40 mL iodinated contrast agent. We analyzed aortic root/iliac dimensions, attenuation, contrast to noise ratio (CNR), image noise and radiation exposure. Aortic root/iliac dimensions and distance of coronary ostia from the annulus could be determined in all cases. Mean aortic and iliac artery attenuation was 320 {+-} 70 HU and 340 {+-} 77 HU. Aortic/iliac CNR was 21.7 {+-} 6.8 HU and 14.5 {+-} 5.4 HU using 100 kV (18.8 {+-} 4.1 HU and 8.7 {+-} 2.6 HU using 120 kV). Mean effective dose was 4.5 {+-} 1.2 mSv. High-pitch spiral DSCTA can be used to assess the entire aorta and iliac arteries in TAVI candidates with a low volume of contrast agent while preserving diagnostic image quality. (orig.)

  9. Coronary artery anomalies: Assessment with electrocardiography-gate multidetector-row CT at a single center in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Bo Ram; Sun, Joo Sung; Yang, Hyoung Mo; Kang, Doo Kyoung [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2015-04-15

    To determine the prevalence of coronary anomalies using coronary computed tomography angiography (CCTA) and to evaluate the relationship between coronary artery anomalies and chest pain. A total of 12676 patients underwent CCTA scans at our institution between December 2006 and April 2013 using a 64-slice CT and a 128-slice dual-source CT. We determined the prevalence of coronary artery anomalies according to the classification system proposed by Greenberg. The presence or absence of chest pain with each coronary artery anomaly was also evaluated. Coronary anomalies were found in 176 patients (1.39%) at our institute. Anomalies of origination, course, and termination were detected in 118 (0.93%), 28 (0.22%), and 30 (0.24%) patients, respectively. After the exclusion of 32 patients with combined heart disease, typical (n = 16; 11.1%) or atypical (n = 28; 19.4%) chest pain was present in 44 (30.6%) of the 144 patients at the time of diagnosis. The prevalence of coronary artery anomalies was 1.39% at our hospital. After the exclusion of patients with combined heart disease, 11.1% had typical chest pain at the time of diagnosis.

  10. Cardiac CT Imaging of Plaque Vulnerability : Hype or Hope?

    NARCIS (Netherlands)

    Willemink, Martin J.; Leiner, Tim; Maurovich-Horvat, Pál

    2016-01-01

    Advances in cardiovascular computed tomography (CT) have resulted in an excellent ability to exclude coronary heart disease (CHD). Anatomical information, functional information, and spectral information can already be obtained with current CT technologies. Moreover, novel developments such as targe

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... additional view capabilities. Modern CT scanners are so fast that they can scan through large sections of ... after the procedure? CT exams are generally painless, fast and easy. With multidetector CT, the amount of ...

  12. Churg-Strauss Syndrome with Cardiac Involvement: A Case Report with CT and MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seong Joo; Cho, Young Jun; Kim, Keum; Hwang, Cheol Mok; Kim, Dae Ho [Dept. of Radiology, Konyang University College of Medicine, Daegu (Korea, Republic of); Choi, Eu Gene [Dept. of Internal Medicine, Konyang University College of Medicine, Daegu (Korea, Republic of)

    2012-02-15

    This is a case report of Churg-Strauss Syndrome (CSS) associated with cardiac involvement which is demonstrated in chest CT and cardiac MRI (CMR) without specific cardiac symptoms. A 32-year-old woman had a 3-year history of bronchial asthma, chronic sinusitis, and otitis media. The patient had various typical findings of CSS. The patient had no specific cardiac symptoms or signs such as chest pain, palpitations, syncope, or murmur, but she had diffuse low attenuation lesions in the inner wall of the left ventricle (LV) in contrast-enhanced CT. This corresponded to the area of subendocardial hyperenhancement in delayed contrast-enhanced CMR images. She was treated with steroids for 2 months. Follow-up delayed contrast-enhanced CMR of the LV showed a decrease in the size of the subendocardial enhancement area, and she had no symptoms. Therefore, the radiologist and clinician both should pay careful attention to observe possible cardiac involvement in case of CSS.

  13. Investigation techniques and importance of CT for diagnostics of cardiac valvular diseases; Untersuchungstechniken und Stellenwert der CT bei der Diagnostik von Herzklappenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Gordic, S.; Alkadhi, H. [Universitaetsspital Zuerich, Institut fuer Diagnostische und Interventionelle Radiologie, Zuerich (Switzerland)

    2013-10-15

    Cardiac computed tomography (CT) is the first-line modality for coronary assessment. In addition valvular morphology and function can be evaluated. The method of choice for the evaluation of cardiac valves is echocardiography, followed by magnetic resonance imaging. Recent technical improvements and advances in temporal resolution allow a detailed anatomical and functional evaluation of the cardiac valves. Cardiac CT provides an excellent image quality of the aortic and mitral valve thus enabling an evaluation of the morphology. In addition, cardiac CT allows an assessment of aortic valve function with respect to the grading of stenosis and regurgitation. Cardiac CT is not considered the first-line modality for the evaluation of cardiac valves; however, beyond coronary assessment CT provides important information on the morphology and function of cardiac valves. Cardiac CT can be a useful imaging alternative for patients in whom other more commonly used methods, such as echocardiography and magnetic resonance imaging fail to provide the necessary information. (orig.) [German] Die Herz-CT wird in erster Linie anlaesslich einer Koronarabklaerung durchgefuehrt. Sie ist aber auch in der Lage, wichtige Informationen ueber die Morphologie und teilweise auch Herzklappenfunktion zu liefern. Die primaere Modalitaet zur Evaluation der Herzklappen ist die Echokardiographie, gefolgt von der Magnetresonanztomographie. Durch die kontinuierliche technische Weiterentwicklung der CT-Geraete erfolgte eine markante Verbesserung der raeumlichen und zeitlichen Aufloesung, welche fuer die artefaktfreie Darstellung schnell bewegender und kleiner Strukturen, wie etwa der Koronargefaesse und Herzklappen, entscheidend sind. Die CT liefert eine ausgezeichnete Bildqualitaet der Aorten- und Mitralklappe und erlaubt somit eine praezise Beurteilung ihrer Morphologie. Zudem ermoeglicht die CT eine gute Beurteilung der Aortenklappenfunktion mit einer Graduierung von Stenose und Insuffizienz. Die

  14. 阑尾炎的MDCT诊断误区%Pitfalls in the Multidetector CT Diagnosis of Appendicitis

    Institute of Scientific and Technical Information of China (English)

    戚乐; 戴平丰; 丁建平; 向军益

    2011-01-01

    Objective To explore how to maximize reduce MDCT misdiagnosis in appendicitis,and make earlier diagnosis and treatment,reduce negative appendectomy. Materials and Methods MDCT signs and clinical history of 76 cases with appendicitis and 59 cases with non-appendicitis, were retrospectively analyzed, the reasons of misdiagnosis in the MDCT of appendicitis were summarized. Results In 76 cases of appendicitis,5 cases were misdiagnosed as normal,rate of misdiagnosis was 6.6%. In 59 cases of non - appendicitis ,6 cases were misdiagnosed as appendicitis, rate of misdiagnosis was 10.2%. Pitfalls in the MDCT diagnosis of appendicitis could be divided into four types; appendicitis showed normal appendix (3 cases) ,nonvisualized appendix (2 cases) ,mimics of appendicitis (4 cases) .similar appendix tissues (2 cases). Conclusion Being familiar with MDCT signs of appendicitis, perfect CT scanning method and combining clinical history tightly can improve diagnostic accuracy.%目的 探讨如何最大限度地降低阑尾炎的多排螺旋CT(MDCT)误诊率,做到阑尾炎早诊断、早治疗,减低延迟治疗率和阴性切除率.资料与方法 回顾性分析76例阑尾炎和59例非阑尾炎患者的MDCT影像和临床资料,对误诊的原因进行总结.结果 76例阑尾炎患者中诊断为正常阑尾5例,漏诊率6.6%.59例非阑尾炎患者中误诊为阑尾炎6例,误诊率10.2%.阑尾炎的MDCT诊断误区可以分为四类:炎性阑尾表现正常(3例),阑尾显示不清(2例),类似阑尾炎的疾病(4例),类似阑尾的组织(2例).结论 熟悉阑尾炎的MDCT征象,完善检查方法并密切结合临床资料可以提高对阑尾炎的诊断准确率.

  15. Liver tumour segmentation using contrast-enhanced multi-detector CT data: performance benchmarking of three semiautomated methods

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Jia-Yin [National University of Singapore, Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, Singapore (Singapore); Agency for Science, Technology and Research, Institute for Infocomm Research, Singapore (Singapore); Wong, Damon W.K.; Tian, Qi; Xiong, Wei; Liu, Jimmy J. [Agency for Science, Technology and Research, Institute for Infocomm Research, Singapore (Singapore); Ding, Feng; Venkatesh, Sudhakar K.; Qi, Ying-Yi [National University of Singapore, Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, Singapore (Singapore); Leow, Wee-Kheng [National University of Singapore, School of Computing, Singapore (Singapore)

    2010-07-15

    Automatic tumour segmentation and volumetry is useful in cancer staging and treatment outcome assessment. This paper presents a performance benchmarking study on liver tumour segmentation for three semiautomatic algorithms: 2D region growing with knowledge-based constraints (A1), 2D voxel classification with propagational learning (A2) and Bayesian rule-based 3D region growing (A3). CT data from 30 patients were studied, and 47 liver tumours were isolated and manually segmented by experts to obtain the reference standard. Four datasets with ten tumours were used for algorithm training and the remaining 37 tumours for testing. Three evaluation metrics, relative absolute volume difference (RAVD), volumetric overlap error (VOE) and average symmetric surface distance (ASSD), were computed based on computerised and reference segmentations. A1, A2 and A3 obtained mean/median RAVD scores of 17.93/10.53%, 17.92/9.61% and 34.74/28.75%, mean/median VOEs of 30.47/26.79%, 25.70/22.64% and 39.95/38.54%, and mean/median ASSDs of 2.05/1.41 mm, 1.57/1.15 mm and 4.12/3.41 mm, respectively. For each metric, we obtained significantly lower values of A1 and A2 than A3 (P < 0.01), suggesting that A1 and A2 outperformed A3. Compared with the reference standard, the overall performance of A1 and A2 is promising. Further development and validation is necessary before reliable tumour segmentation and volumetry can be widely used clinically. (orig.)

  16. MULTIDETECTOR CT ANGIOGRAPHY V/S COLOUR DOPPLER ULTRASONOGRAPHY IN THE DIAGNOSIS OF PERIPHERAL ARTERIAL DISEASES OF LOWER EXTREMITIES

    Directory of Open Access Journals (Sweden)

    Rezia Udinoor Peedikayil

    2016-08-01

    ultrasound, CT angiography is used prior to any vascular intervention is required in peripheral arterial diseases.

  17. 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.)

  18. Depiction of variants of the portal confluence venous system using multidetector row CT. Analysis of 916 cases

    Energy Technology Data Exchange (ETDEWEB)

    Krumm, P.; Schraml, C.; Bretschneider, C.; Seeger, A.; Klumpp, B.; Kramer, U.; Claussen, C.D.; Miller, S. [Universitaetsklinikum Tuebingen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie

    2011-12-15

    Purpose: Detailed knowledge of the venous mesenteric system is important for gastrointestinal surgery, particularly for transplantation planning and surgery and for the comprehension of perioperative complications that may influence patient outcome. Data about the mesenteric venous anatomy in the literature varies substantially. The purpose of this study was to categorize venous mesenteric variants and to determine their incidence. Materials and Methods: We included 916 patients requiring diagnostic abdominal CT in the portal venous phase. The mesenteric vein anatomy was categorized as follows: 1. the inferior mesenteric vein (IMV) enters the splenic vein (SV); 2. the IMV enters into the angle of the confluence of the SV and superior mesenteric vein (SMV) forming the portal vein (PV); 3. the IMV enters the SMV; 4. seven rare variants. We measured the diameters of the veins and distances from the confluence to the IMV origins. Results: The frequency of variants was: 1. 37.6 %, 2. 28.8 %; 3. 19.2 %. The rare variants totaled 14.4 %. The average vessel diameters measured in cm: PV 1.48; SV 1.02; SMV 1.2; IMV 0.5. The mean IMV entering distances were 1.66 cm in variant 1 and 0.75 cm in variant 3. Conclusion: The three common variants (1, 2 and 3) are the most relevant ones. 14.4 % of patients had different anatomic variants. The variability of the mesenteric venous system was higher than previously published. Knowledge of rare variants is important to avoid complications in abdominal surgery. (orig.)

  19. Diagnostic Value of Brain Perfusion Imaging with 64 Multi-Detector Spiral CT in Early Cerebral Infarction%64排螺旋 CT 脑灌注成像对早期脑梗死的诊断价值

    Institute of Scientific and Technical Information of China (English)

    奚彬; 盛伟华; 唐建伟; 黄松; 宋黎涛

    2014-01-01

    目的:探讨64排螺旋 CT 脑灌注成像(CT perfusion imaging,CTP)对早期脑梗死的诊断价值。方法:临床拟诊早期脑梗死患者38例,均在症状出现24 h 内行头颅 CT 平扫及 CTP 检查。将脑梗死核心区、缺血半暗带(ischemic penumbra,IP)区与健侧对应区的情况做对比分析。结果:38例患者中,15例头颅 CT 平扫发现可疑脑梗死区,主要位于大脑半球,表现为密度轻度减低、局部脑沟稍变浅等;其余23例患者 CT 平扫未发现异常。38例患者的 CTP 检查均发现灌注异常区,表现为脑梗死区脑血流量(cerebral blood flow,CBF)与脑血容量(cerebral blood volume,CBV)均较健侧对应区明显下降,对比剂平均通过时间(mean transit time,MTT)较健侧对应区缩短,对比剂达峰时间(time to peak,TTP)较健侧对应区明显延长,差异均有统计学意义(P <0.01)。早期脑梗死患者 IP 区与梗死核心区比较,CBF、CBV、MTT 及 TTP 差异均有统计学意义(P <0.01);IP区与健侧对应区比较,CBF、MTT、TTP 差异均有统计学意义(P <0.05、0.01),CBV 差异无统计学意义(P >0.05)。获得随访的18例患者中,经积极溶栓等治疗后梗死区缩小6例,梗死区消失5例,仅表现为梗死区 TTP 和 MTT 延长、CBF 和 CBV 变化不大3例,梗死区无明显变化4例。结论:64排螺旋 CTP 检查可以准确地提示早期脑梗死。%Objective:To explore the diagnostic value of CT perfusion imaging(CTP)with 64 multi-detector spiral CT in early cerebral infarction.Methods:A total of 38 patients with suspected early cerebral infarction underwent plain CT and CTP within 24 h after the onset of related symptoms.The imaging results in infarction core area,ischemic penumbra (IP) and the contralateral normal region were comparatively analyzed.Results:Early cerebral infarction,mainly in cerebral hemispheres, were suspected

  20. Correlation between morphologic carotid plaque findings based on color-Doppler and CT multidetector angiography with intraopertive findings in carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Savić Živorad N.

    2010-01-01

    Full Text Available Bacground/Aim. Vast majority of patients with corotid artery sclerosis do not have transitory ischemic attacks (TIA as working to the persistent silent disease, but stroke is the first sign. Precise and early diagnosis of the carotid artery disease and plaques are very important. The aim of this study was to determine how the composition / identity of diagnostic methods, color-Doppler, ultrasonography (US CT multidetector angio (MDCTA scan and intraoperative (IO findings, as well as the morphology of plaques in patients with haemodynamic significant stenosis of the internal carotid artery. Methods. Carotid plaques were observed by two diagnostic methods, US and MDCTA, and these findings were correlated with the IO findings. Results. In 62 patients both carotid artheries were examined and 83 plaques were observed. There were 68 surgical interventions. The structure of plaques was divided into four types: lipid, fibrous, fibrocalcified and calcified plaque. US showed: lipid plaques 10.8%; fibrous 1.2%; fibrocalcified 44.6% and calcified 43.4%, and the MDCTA lipid plaques 8.4%; fibrocalcified 48.2% and calcified 43.4%. Intraoperative findings were: lipid plaques 10.3%; fibrocalcified 41.2% and calcified 48.5%. A statistically highly significant agreement between the US and MDCTA in the diagnosis of plaque morphology was obtained (Cramer's V = 0.919, p < 0.01; Lambda = 0.921, p < 0.01 and also statistically significant agreement between US and IO findings (Cramer' s V = 0.831, p < 0.01; Lambda = 0.859, p < 0.01. A statistically highly significant agreement between MDCTA and IO findings in plaque morphology was found, as well (Cramer's V = 0.815, p < 0.01; Lambda = 0.829, p < 0.01. Conclusion. There is statistically highly significant correlation between US and MDCTA diagnostic methods in the evaluation of plaque morphology in surgically significant stenosis of internal carotid artery as well as their agreement with the intraoperative finding.

  1. Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors.

    Directory of Open Access Journals (Sweden)

    Mingyue Luo

    Full Text Available To evaluate the diagnostic value of multidetector CT (MDCT and its multiplanar reformation (MPR, volume rendering (VR and virtual bronchoscopy (VB postprocessing techniques for primary trachea and main bronchus tumors.Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology.Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6, tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16, extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1, longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1, morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1 and extents (mild, n = 5; moderate, n = 7; severe, n = 19, distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10, and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density

  2. Calibration free beam hardening correction for cardiac CT perfusion imaging

    Science.gov (United States)

    Levi, Jacob; Fahmi, Rachid; Eck, Brendan L.; Fares, Anas; Wu, Hao; Vembar, Mani; Dhanantwari, Amar; Bezerra, Hiram G.; Wilson, David L.

    2016-03-01

    Myocardial perfusion imaging using CT (MPI-CT) and coronary CTA have the potential to make CT an ideal noninvasive gate-keeper for invasive coronary angiography. However, beam hardening artifacts (BHA) prevent accurate blood flow calculation in MPI-CT. BH Correction (BHC) methods require either energy-sensitive CT, not widely available, or typically a calibration-based method. We developed a calibration-free, automatic BHC (ABHC) method suitable for MPI-CT. The algorithm works with any BHC method and iteratively determines model parameters using proposed BHA-specific cost function. In this work, we use the polynomial BHC extended to three materials. The image is segmented into soft tissue, bone, and iodine images, based on mean HU and temporal enhancement. Forward projections of bone and iodine images are obtained, and in each iteration polynomial correction is applied. Corrections are then back projected and combined to obtain the current iteration's BHC image. This process is iterated until cost is minimized. We evaluate the algorithm on simulated and physical phantom images and on preclinical MPI-CT data. The scans were obtained on a prototype spectral detector CT (SDCT) scanner (Philips Healthcare). Mono-energetic reconstructed images were used as the reference. In the simulated phantom, BH streak artifacts were reduced from 12+/-2HU to 1+/-1HU and cupping was reduced by 81%. Similarly, in physical phantom, BH streak artifacts were reduced from 48+/-6HU to 1+/-5HU and cupping was reduced by 86%. In preclinical MPI-CT images, BHA was reduced from 28+/-6 HU to less than 4+/-4HU at peak enhancement. Results suggest that the algorithm can be used to reduce BHA in conventional CT and improve MPI-CT accuracy.

  3. Noncardiac findings on cardiac CT. Part II: spectrum of imaging findings.

    LENUS (Irish Health Repository)

    Killeen, Ronan P

    2012-02-01

    Cardiac computed tomography (CT) has evolved into an effective imaging technique for the evaluation of coronary artery disease in selected patients. Two distinct advantages over other noninvasive cardiac imaging methods include its ability to directly evaluate the coronary arteries and to provide a unique opportunity to evaluate for alternative diagnoses by assessing the extracardiac structures, such as the lungs and mediastinum, particularly in patients presenting with the chief symptom of acute chest pain. Some centers reconstruct a small field of view (FOV) cropped around the heart but a full FOV (from skin to skin in the area irradiated) is obtainable in the raw data of every scan so that clinically relevant noncardiac findings are identifiable. Debate in the scientific community has centered on the necessity for this large FOV. A review of noncardiac structures provides the opportunity to make alternative diagnoses that may account for the patient\\'s presentation or to detect important but clinically silent problems such as lung cancer. Critics argue that the yield of biopsy-proven cancers is low and that the follow-up of incidental noncardiac findings is expensive, resulting in increased radiation exposure and possibly unnecessary further testing. In this 2-part review we outline the issues surrounding the concept of the noncardiac read, looking for noncardiac findings on cardiac CT. Part I focused on the pros and cons for and against the practice of identifying noncardiac findings on cardiac CT. Part II illustrates the imaging spectrum of cardiac CT appearances of benign and malignant noncardiac pathology.

  4. Cardiac tumors: CT and MR imaging features; Tumeurs cardiaques: aspects en scanner et en IRM

    Energy Technology Data Exchange (ETDEWEB)

    Moskovitch, G.; Chabbert, V.; Escourrou, G.; Desloques, L.; Otal, P.; Glock, Y.; Rousseau, H. [Centre Hospitalier Universitaire de Rangueil, Service de Radiologie Generale, 31 - Toulouse (France)

    2010-09-15

    The CT and MR imaging features of the main cardiac tumors will be reviewed. Cross-sectional imaging features may help differentiate between cardiac tumors and pseudo-tumoral lesions and identify malignant features. Based on clinical features, imaging findings are helpful to further characterize the nature of the lesion. CT and MR imaging can demonstrate the relationship of the tumor with adjacent anatomical structures and are invaluable in the pre-surgical work-up and post-surgical follow-up. (authors)

  5. The utility of cardiac CT beyond the assessment of suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Kakouros, N. [Johns Hopkins Hospital, Baltimore, MD (United States); Giles, J.; Crundwell, N.B. [Conquest Hospital, St Leonards-on-Sea, East Sussex (United Kingdom); McWilliams, E.T.M., E-mail: eric.mcwilliams@esht.nhs.uk [Conquest Hospital, St Leonards-on-Sea, East Sussex (United Kingdom)

    2012-07-15

    Extensive work has been done over recent years to improve the spatial and temporal resolution of electrocardiogram (ECG)-gated cardiac computed tomography (CT). Advances in both hardware and software analysis have enabled the development of non-invasive coronary angiography. However, these high-quality examinations lend themselves to multiple additional applications beyond coronary angiography. In this review, we illustrate and discuss some established and some emerging applications of ECG-gated cardiac CT beyond the assessment of suspected coronary disease, particularly in light of recent recommendations on the appropriate use of this technology.

  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. Anatomical-based Partial Volume Correction for Low-dose Dedicated Cardiac SPECT/CT

    OpenAIRE

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-01-01

    Due to the limited spatial resolution, partial volume effect (PVE) has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view (FOV) over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods ...

  8. Retrospectively ECG-gated multi-detector row CT of the chest: does ECG-gating improve three-dimensional visualization of the bronchial tree?

    Energy Technology Data Exchange (ETDEWEB)

    Schertler, T.; Wildermuth, S.; Willmann, J.K.; Crook, D.W.; Marincek, B.; Boehm, T. [Dept. Medical Radiology, Inst. of Diagnostic Radiology, Univ. Hospital Zurich (Switzerland)

    2004-04-01

    Purpose: To determine the impact of retrospectively ECG-gated multi-detector row CT (MDCT) on three-dimensional (3D) visualization of the bronchial tree and virtual bronchoscopy (VB) as compared to non-ECG-gated data acquisition. Materials and Methods: Contrast-enhanced retrospectively ECG-gated and non-ECG-gated MDCT of the chest was performed in 25 consecutive patients referred for assessment of coronary artery bypass grafts and pathology of the ascending aorta. ECG-gated MDCT data were reconstructed in diastole using an absolute reverse delay of -400 msec in all patients. In 10 patients additional reconstructions at -200 msec, -300 msec, and -500 msec prior to the R-wave were performed. Shaded surface display (SSD) and virtual bronchoscopy (VB) for visualization of the bronchial segments was performed with ECG-gated and non-ECG-gated MDCT data. The visualization of the bronchial tree underwent blinded scoring. Effective radiation dose and signal-to-noise ratio (SNR) for both techniques were compared. Results: There was no significant difference in visualizing single bronchial segments using ECG-gated compared to non-ECG-gated MDCT data. However, the total sum of scores for all bronchial segments visualized with non-ECG-gated MDCT was significantly higher compared to ECG-gated MDCT (P<0.05). The summary scores for visualization of bronchial segments for different diastolic reconstructions did not differ significantly. The effective radiation dose and the SNR were significantly higher with the ECG-gated acquisition technique (P<0.05). Conclusion: The bronchial tree is significantly better visualized when using non-ECG-gated MDCT compared to ECG-gated MDCT. Additionally, non-ECG-gated techniques require less radiation exposure. Thus, the current retrospective ECG-gating technique does not provide any additional benefit for 3D visualization of the bronchial tree and VB. (orig.) [German] Ziel: Untersuchung des Einflusses der retrospektiven EKG-Synchronisierung auf

  9. Noninvasive Physiologic Assessment of Coronary Stenoses Using Cardiac CT

    Directory of Open Access Journals (Sweden)

    Lei Xu

    2015-01-01

    Full Text Available Coronary CT angiography (CCTA has become an important noninvasive imaging modality in the diagnosis of coronary artery disease (CAD. CCTA enables accurate evaluation of coronary artery stenosis. However, CCTA provides limited information on the physiological significance of stenotic lesions. A noninvasive “one-stop-shop” diagnostic test that can provide both anatomical significance and functional significance of stenotic lesions would be beneficial in the diagnosis and management of CAD. Recently, with the introduction of novel techniques, such as myocardial CT perfusion, CT-derived fractional flow reserve (FFRCT, and transluminal attenuation gradient (TAG, CCTA has emerged as a noninvasive method for the assessment of both anatomy of coronary lesions and its physiological consequences during a single study. This review provides an overview of the current status of new CT techniques for the physiologic assessments of CAD.

  10. Automated segmentation of cardiac visceral fat in low-dose non-contrast chest CT images

    Science.gov (United States)

    Xie, Yiting; Liang, Mingzhu; Yankelevitz, David F.; Henschke, Claudia I.; Reeves, Anthony P.

    2015-03-01

    Cardiac visceral fat was segmented from low-dose non-contrast chest CT images using a fully automated method. Cardiac visceral fat is defined as the fatty tissues surrounding the heart region, enclosed by the lungs and posterior to the sternum. It is measured by constraining the heart region with an Anatomy Label Map that contains robust segmentations of the lungs and other major organs and estimating the fatty tissue within this region. The algorithm was evaluated on 124 low-dose and 223 standard-dose non-contrast chest CT scans from two public datasets. Based on visual inspection, 343 cases had good cardiac visceral fat segmentation. For quantitative evaluation, manual markings of cardiac visceral fat regions were made in 3 image slices for 45 low-dose scans and the Dice similarity coefficient (DSC) was computed. The automated algorithm achieved an average DSC of 0.93. Cardiac visceral fat volume (CVFV), heart region volume (HRV) and their ratio were computed for each case. The correlation between cardiac visceral fat measurement and coronary artery and aortic calcification was also evaluated. Results indicated the automated algorithm for measuring cardiac visceral fat volume may be an alternative method to the traditional manual assessment of thoracic region fat content in the assessment of cardiovascular disease risk.

  11. 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.

  12. 4D micro-CT for cardiac and perfusion applications with view under sampling

    Energy Technology Data Exchange (ETDEWEB)

    Badea, Cristian T; Johnston, Samuel M; Qi Yi; Johnson, G Allan, E-mail: Cristian.Badea@duke.edu [Center for In Vivo Microscopy, Box 3302, Duke University Medical Center, Durham, NC 27710 (United States)

    2011-06-07

    Micro-CT is commonly used in preclinical studies to provide anatomical information. There is growing interest in obtaining functional measurements from 4D micro-CT. We report here strategies for 4D micro-CT with a focus on two applications: (i) cardiac imaging based on retrospective gating and (ii) pulmonary perfusion using multiple contrast injections/rotations paradigm. A dual source micro-CT system is used for image acquisition with a sampling rate of 20 projections per second. The cardiac micro-CT protocol involves the use of a liposomal blood pool contrast agent. Fast scanning of free breathing mice is achieved using retrospective gating. The ECG and respiratory signals are used to sort projections into ten cardiac phases. The pulmonary perfusion protocol uses a conventional contrast agent (Isovue 370) delivered by a micro-injector in four injections separated by 2 min intervals to allow for clearance. Each injection is synchronized with the rotation of the animal, and each of the four rotations is started with an angular offset of 22.5 from the starting angle of the previous rotation. Both cardiac and perfusion protocols result in an irregular angular distribution of projections that causes significant streaking artifacts in reconstructions when using traditional filtered backprojection (FBP) algorithms. The reconstruction involves the use of the point spread function of the micro-CT system for each time point, and the analysis of the distribution of the reconstructed data in the Fourier domain. This enables us to correct for angular inconsistencies via deconvolution and identify regions where data is missing. The missing regions are filled with data from a high quality but temporally averaged prior image reconstructed with all available projections. Simulations indicate that deconvolution successfully removes the streaking artifacts while preserving temporal information. 4D cardiac micro-CT in a mouse was performed with adequate image quality at isotropic

  13. Multi-detector CT perfusion

    Directory of Open Access Journals (Sweden)

    Ashraf M. Enite

    2016-09-01

    Conclusion: CTP is a promising non-invasive technique assessing the efficacy, predicting early response to local treatment therapies and monitoring tumor recurrence. It assesses the degree of post therapy tumor perfusion especially the degree of arterialization.

  14. Region-Based 4D Tomographic Image Reconstruction: Application to Cardiac X-ray CT

    NARCIS (Netherlands)

    Eyndhoven, G. Van; Batenburg, K.J.; Sijbers, J.

    2015-01-01

    X-ray computed tomography (CT) is a powerful tool for noninvasive cardiac imaging. However, radiation dose is a major issue. In this paper, we propose an iterative reconstruction method that reduces the radiation dose without compromising image quality. This is achieved by exploiting prior knowledge

  15. Time-resolved cardiac cone beam CT using an interventional C-arm system

    NARCIS (Netherlands)

    Schomberg, H.

    2012-01-01

    It is both desirable and challenging to make interventional C-arm systems fit for cardiac cone beam CT. A number of methods towards thisgoal have been proposed, some of which even attempt to generate 4Dimages of the beating heart. A promising candidate of this type, proposed earlier by this author,

  16. Quantification of Global Left Ventricular Function: Comparison of Multidetector Computed Tomography and Magnetic Resonance Imaging. A Meta-analysis and Review of the Current Literature

    Energy Technology Data Exchange (ETDEWEB)

    Vleuten, P.A. van der; Willems, T.P.; Goette, M.J.; Tio, R.A.; Greuter, M.J.; Zijlstra, F.; Oudkerk, M. [Univ. Medical Centre Groningen (Netherlands). Depts. of Cardiology and Radiology

    2006-12-15

    Cardiac morbidity and mortality are closely related to cardiac volumes and global left ventricular (LV) function, expressed as left ventricular ejection fraction. Accurate assessment of these parameters is required for the prediction of prognosis in individual patients as well as in entire cohorts. The current standard of reference for left ventricular function is analysis by short-axis magnetic resonance imaging. In recent years, major extensive technological improvements have been achieved in computed tomography. The most marked development has been the introduction of the multidetector CT (MDCT), which has significantly improved temporal and spatial resolutions. In order to assess the current status of MDCT for analysis of LV function, the current available literature on this subject was reviewed. The data presented in this review indicate that the global left ventricular functional parameters measured by contemporary multi-detector row systems combined with adequate reconstruction algorithms and post-processing tools show a narrow diagnostic window and are interchangeable with those obtained by MRI.

  17. Subcutaneous Tissue Thickness is an Independent Predictor of Image Noise in Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Staniak, Henrique Lane; Sharovsky, Rodolfo [Hospital Universitário - Universidade de São Paulo, São Paulo, SP (Brazil); Pereira, Alexandre Costa [Hospital das Clínicas - Universidade de São Paulo, São Paulo, SP (Brazil); Castro, Cláudio Campi de; Benseñor, Isabela M.; Lotufo, Paulo A. [Hospital Universitário - Universidade de São Paulo, São Paulo, SP (Brazil); Faculdade de Medicina - Universidade de São Paulo, São Paulo, SP (Brazil); Bittencourt, Márcio Sommer, E-mail: msbittencourt@mail.harvard.edu [Hospital Universitário - Universidade de São Paulo, São Paulo, SP (Brazil)

    2014-01-15

    Few data on the definition of simple robust parameters to predict image noise in cardiac computed tomography (CT) exist. To evaluate the value of a simple measure of subcutaneous tissue as a predictor of image noise in cardiac CT. 86 patients underwent prospective ECG-gated coronary computed tomographic angiography (CTA) and coronary calcium scoring (CAC) with 120 kV and 150 mA. The image quality was objectively measured by the image noise in the aorta in the cardiac CTA, and low noise was defined as noise < 30HU. The chest anteroposterior diameter and lateral width, the image noise in the aorta and the skin-sternum (SS) thickness were measured as predictors of cardiac CTA noise. The association of the predictors and image noise was performed by using Pearson correlation. The mean radiation dose was 3.5 ± 1.5 mSv. The mean image noise in CT was 36.3 ± 8.5 HU, and the mean image noise in non-contrast scan was 17.7 ± 4.4 HU. All predictors were independently associated with cardiac CTA noise. The best predictors were SS thickness, with a correlation of 0.70 (p < 0.001), and noise in the non-contrast images, with a correlation of 0.73 (p < 0.001). When evaluating the ability to predict low image noise, the areas under the ROC curve for the non-contrast noise and for the SS thickness were 0.837 and 0.864, respectively. Both SS thickness and CAC noise are simple accurate predictors of cardiac CTA image noise. Those parameters can be incorporated in standard CT protocols to adequately adjust radiation exposure.

  18. First pass cable artefact correction for cardiac C-arm CT imaging.

    Science.gov (United States)

    Haase, C; Schäfer, D; Kim, M; Chen, S J; Carroll, J D; Eshuis, P; Dössel, O; Grass, M

    2014-07-21

    Cardiac C-arm CT imaging delivers a tomographic region-of-interest reconstruction of the patient's heart during image guided catheter interventions. Due to the limited size of the flat detector a volume image is reconstructed, which is truncated in the cone-beam (along the patient axis) and the fan-beam (in the transaxial plane) direction. To practically address this local tomography problem correction methods, like projection extension, are available for first pass image reconstruction. For second pass correction methods, like metal artefact reduction, alternative correction schemes are required when the field of view is limited to a region-of-interest of the patient. In classical CT imaging metal artefacts are corrected by metal identification in a first volume reconstruction and generation of a corrected projection data set followed by a second reconstruction. This approach fails when the metal structures are located outside the reconstruction field of view. When a C-arm CT is performed during a cardiac intervention pacing leads and other cables are frequently positioned on the patients skin, which results in propagating streak artefacts in the reconstruction volume. A first pass approach to reduce this type of artefact is introduced and evaluated here. It makes use of the fact that the projected position of objects outside the reconstruction volume changes with the projection perspective. It is shown that projection based identification, tracking and removal of high contrast structures like cables, only detected in a subset of the projections, delivers a more consistent reconstruction volume with reduced artefact level. The method is quantitatively evaluated based on 50 simulations using cardiac CT data sets with variable cable positioning. These data sets are forward projected using a C-arm CT system geometry and generate artefacts comparable to those observed in clinical cardiac C-arm CT acquisitions. A C-arm CT simulation of every cardiac CT data set without

  19. Dynamic CT perfusion measurement in a cardiac phantom.

    Science.gov (United States)

    Ziemer, Benjamin P; Hubbard, Logan; Lipinski, Jerry; Molloi, Sabee

    2015-10-01

    Widespread clinical implementation of dynamic CT myocardial perfusion has been hampered by its limited accuracy and high radiation dose. The purpose of this study was to evaluate the accuracy and radiation dose reduction of a dynamic CT myocardial perfusion technique based on first pass analysis (FPA). To test the FPA technique, a pulsatile pump was used to generate known perfusion rates in a range of 0.96-2.49 mL/min/g. All the known perfusion rates were determined using an ultrasonic flow probe and the known mass of the perfusion volume. FPA and maximum slope model (MSM) perfusion rates were measured using volume scans acquired from a 320-slice CT scanner, and then compared to the known perfusion rates. The measured perfusion using FPA (P(FPA)), with two volume scans, and the maximum slope model (P(MSM)) were related to known perfusion (P(K)) by P(FPA) = 0.91P(K) + 0.06 (r = 0.98) and P(MSM) = 0.25P(K) - 0.02 (r = 0.96), respectively. The standard error of estimate for the FPA technique, using two volume scans, and the MSM was 0.14 and 0.30 mL/min/g, respectively. The estimated radiation dose required for the FPA technique with two volume scans and the MSM was 2.6 and 11.7-17.5 mSv, respectively. Therefore, the FPA technique can yield accurate perfusion measurements using as few as two volume scans, corresponding to approximately a factor of four reductions in radiation dose as compared with the currently available MSM. In conclusion, the results of the study indicate that the FPA technique can make accurate dynamic CT perfusion measurements over a range of clinically relevant perfusion rates, while substantially reducing radiation dose, as compared to currently available dynamic CT perfusion techniques.

  20. Canadian Association of Radiologists: consensus guidelines and standards for cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dennie, C.J. [Dept. of Diagnostic Imaging, The Ottawa Hospital, Civic Campus, Ottawa, Ontario (Canada)], E-mail: cdennie@toh.on.ca; Leipsic, J. [Dept. of Radiology, Div. of Cardiology, Univ. of British Columbia and St Paul' s Hospital, Vancouver, British Columbia (Canada); Brydie, A. [Dept. of Radiology, Dalhousie Univ. and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia (Canada)

    2009-02-15

    Invasive coronary angiography remains the gold standard for imaging of the coronary arteries. Because of poor temporal and spatial resolution, noninvasive imaging of the heart using computed tomography (CT) had remained a challenge until the recent past. Since 1999, and the advent of 4-detector electrocardiogram (ECG)-gated CT, there have been rapid technical developments in CT technology and postprocessing tools, thus enabling an accurate noninvasive assessment of cardiac anatomy including the coronary arteries as well as cardiac function. Today, this relatively new technique increasingly is being requested and performed on a routine basis. Although guidelines and standards for the performance of cardiac CT (CCT) have been published by other societies outside of Canada [1-5], the Canadian Association of Radiologists recognizes that Canadian radiologists play a leading and pivotal role in the safe and proper implementation of CCT throughout the country, as well as in the training and continuing medical education of physicians performing and interpreting CCT studies. This comprehensive article reviews the current evidence for CCT to date and outlines the standards for the implementation of a CCT program. Based on the review of the current literature and on expert opinion, recommendations regarding indications and contraindications for CCT also are provided. (author)

  1. Reduction of blooming artifacts in cardiac CT images by blind deconvolution and anisotropic diffusion filtering

    Science.gov (United States)

    Castillo-Amor, Angélica M.; Navarro-Navia, Cristian A.; Cadena-Bonfanti, Alberto J.; Contreras-Ortiz, Sonia H.

    2015-12-01

    Even though CT is an imaging technique that offers high quality images, limitations on its spatial resolution cause blurring in small objects with high contrast. This phenomenon is known as blooming artifact and affects cardiac images with small calcifications and stents. This paper describes an approach to reduce the blooming artifact and improve resolution in cardiac images using blind deconvolution and anisotropic diffusion filtering. Deconvolution increases resolution but reduces signal-to-noise ratio, and the anisotropic diffusion filter counteracts this effect without affecting the edges in the image.

  2. Evaluation of respiratory and cardiac motion correction schemes in dual gated PET/CT cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lamare, F., E-mail: frederic.lamare@chu-bordeaux.fr; Fernandez, P. [Univ. Bordeaux, INCIA, UMR 5287, F-33400 Talence (France); CNRS, INCIA, UMR 5287, F-33400 Talence (France); Service de Médecine Nucléaire, Hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux (France); Le Maitre, A.; Visvikis, D. [INSERM, UMR1101, LaTIM, Université de Bretagne Occidentale, 29609 Brest (France); Dawood, M.; Schäfers, K. P. [European Institute for Molecular Imaging, University of Münster, Mendelstr. 11, 48149 Münster (Germany); Rimoldi, O. E. [Vita-Salute University and Scientific Institute San Raffaele, Milan, Italy and CNR Istituto di Bioimmagini e Fisiologia Molecolare, Milan (Italy)

    2014-07-15

    Purpose: Cardiac imaging suffers from both respiratory and cardiac motion. One of the proposed solutions involves double gated acquisitions. Although such an approach may lead to both respiratory and cardiac motion compensation there are issues associated with (a) the combination of data from cardiac and respiratory motion bins, and (b) poor statistical quality images as a result of using only part of the acquired data. The main objective of this work was to evaluate different schemes of combining binned data in order to identify the best strategy to reconstruct motion free cardiac images from dual gated positron emission tomography (PET) acquisitions. Methods: A digital phantom study as well as seven human studies were used in this evaluation. PET data were acquired in list mode (LM). A real-time position management system and an electrocardiogram device were used to provide the respiratory and cardiac motion triggers registered within the LM file. Acquired data were subsequently binned considering four and six cardiac gates, or the diastole only in combination with eight respiratory amplitude gates. PET images were corrected for attenuation, but no randoms nor scatter corrections were included. Reconstructed images from each of the bins considered above were subsequently used in combination with an affine or an elastic registration algorithm to derive transformation parameters allowing the combination of all acquired data in a particular position in the cardiac and respiratory cycles. Images were assessed in terms of signal-to-noise ratio (SNR), contrast, image profile, coefficient-of-variation (COV), and relative difference of the recovered activity concentration. Results: Regardless of the considered motion compensation strategy, the nonrigid motion model performed better than the affine model, leading to higher SNR and contrast combined with a lower COV. Nevertheless, when compensating for respiration only, no statistically significant differences were

  3. Performance comparison between static and dynamic cardiac CT on perfusion quantitation and patient classification tasks

    Science.gov (United States)

    Bindschadler, Michael; Modgil, Dimple; Branch, Kelley R.; La Riviere, Patrick J.; Alessio, Adam M.

    2015-03-01

    Cardiac CT acquisitions for perfusion assessment can be performed in a dynamic or static mode. In this simulation study, we evaluate the relative classification and quantification performance of these modes for assessing myocardial blood flow (MBF). In the dynamic method, a series of low dose cardiac CT acquisitions yields data on contrast bolus dynamics over time; these data are fit with a model to give a quantitative MBF estimate. In the static method, a single CT acquisition is obtained, and the relative CT numbers in the myocardium are used to infer perfusion states. The static method does not directly yield a quantitative estimate of MBF, but these estimates can be roughly approximated by introducing assumed linear relationships between CT number and MBF, consistent with the ways such images are typically visually interpreted. Data obtained by either method may be used for a variety of clinical tasks, including 1) stratifying patients into differing categories of ischemia and 2) using the quantitative MBF estimate directly to evaluate ischemic disease severity. Through simulations, we evaluate the performance on each of these tasks. The dynamic method has very low bias in MBF estimates, making it particularly suitable for quantitative estimation. At matched radiation dose levels, ROC analysis demonstrated that the static method, with its high bias but generally lower variance, has superior performance in stratifying patients, especially for larger patients.

  4. 4D micro-CT for cardiac and perfusion applications with view under sampling

    Science.gov (United States)

    Badea, Cristian T.; Johnston, Samuel M.; Qi, Yi; Johnson, G. Allan

    2011-06-01

    Micro-CT is commonly used in preclinical studies to provide anatomical information. There is growing interest in obtaining functional measurements from 4D micro-CT. We report here strategies for 4D micro-CT with a focus on two applications: (i) cardiac imaging based on retrospective gating and (ii) pulmonary perfusion using multiple contrast injections/rotations paradigm. A dual source micro-CT system is used for image acquisition with a sampling rate of 20 projections per second. The cardiac micro-CT protocol involves the use of a liposomal blood pool contrast agent. Fast scanning of free breathing mice is achieved using retrospective gating. The ECG and respiratory signals are used to sort projections into ten cardiac phases. The pulmonary perfusion protocol uses a conventional contrast agent (Isovue 370) delivered by a micro-injector in four injections separated by 2 min intervals to allow for clearance. Each injection is synchronized with the rotation of the animal, and each of the four rotations is started with an angular offset of 22.5 from the starting angle of the previous rotation. Both cardiac and perfusion protocols result in an irregular angular distribution of projections that causes significant streaking artifacts in reconstructions when using traditional filtered backprojection (FBP) algorithms. The reconstruction involves the use of the point spread function of the micro-CT system for each time point, and the analysis of the distribution of the reconstructed data in the Fourier domain. This enables us to correct for angular inconsistencies via deconvolution and identify regions where data is missing. The missing regions are filled with data from a high quality but temporally averaged prior image reconstructed with all available projections. Simulations indicate that deconvolution successfully removes the streaking artifacts while preserving temporal information. 4D cardiac micro-CT in a mouse was performed with adequate image quality at isotropic

  5. Constrain static target kinetic iterative image reconstruction for 4D cardiac CT imaging

    Science.gov (United States)

    Alessio, Adam M.; La Riviere, Patrick J.

    2011-03-01

    Iterative image reconstruction offers improved signal to noise properties for CT imaging. A primary challenge with iterative methods is the substantial computation time. This computation time is even more prohibitive in 4D imaging applications, such as cardiac gated or dynamic acquisition sequences. In this work, we propose only updating the time-varying elements of a 4D image sequence while constraining the static elements to be fixed or slowly varying in time. We test the method with simulations of 4D acquisitions based on measured cardiac patient data from a) a retrospective cardiac-gated CT acquisition and b) a dynamic perfusion CT acquisition. We target the kinetic elements with one of two methods: 1) position a circular ROI on the heart, assuming area outside ROI is essentially static throughout imaging time; and 2) select varying elements from the coefficient of variation image formed from fast analytic reconstruction of all time frames. Targeted kinetic elements are updated with each iteration, while static elements remain fixed at initial image values formed from the reconstruction of data from all time frames. Results confirm that the computation time is proportional to the number of targeted elements; our simulations suggest that 3 times reductions in reconstruction time. The images reconstructed with the proposed method have matched mean square error with full 4D reconstruction. The proposed method is amenable to most optimization algorithms and offers the potential for significant computation improvements, which could be traded off for more sophisticated system models or penalty terms.

  6. 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.

  7. Improvement Techniques and Experiment Research of Multi-detector of Multi-slice CT%对多层CT的多排探测器的改进技术及实验研究

    Institute of Scientific and Technical Information of China (English)

    苏重清; 刘东红; 杨立国; 乔驰; 陶行成; 崔力元; 郑伟; 郭媛媛

    2013-01-01

    Objective To design a new kind of multidetector for multi-slice CT, so as to decrease X-ray dosage and increase resolution. Methods Laid additional detectors under the detectors of CT, to obtain new X-ray energy and new resolution data through the upper detectors and make various images with original detector data. Results Laid a layer of X-ray attenuation material on the present detectors of CT as the first layer detector and regarded the present detector as the second layer detector in the design to scan, the second layer detector data is testified available. Conclusion Through simulating tests on present CT scanner, the design is testified to be feasible.%目的 设计一种新型多层CT机的多排探测器,降低X线剂量和提高分辨率.方法在CT探测器下面再加探测器,接收穿透上层探测器的X线获得能量与分辨率不同的额外数据,和原来探测器数据做各种形式的叠加成像.结果在现有CT探测器上加X线衰减层模拟第1层探测器而视现有CT探测器为本设计的第2层探测器扫描,证明了第2层探测器的数据可用.结论通过在现有CT上的模拟实验,证明此设计是可行的.

  8. Feasibility of epicardial adipose tissue quantification in non-ECG-gated low-radiation-dose CT: comparison with prospectively ECG-gated cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Simon-Yarza, Isabel; Viteri-Ramirez, Guillermo; Saiz-Mendiguren, Ramon; Slon-Roblero, Pedro J.; Paramo, Maria [Dept. of Radiology, Clinica Univ. de Navarra, Pamplona (Spain); Bastarrika, Gorka [Dept. of Radiology, Clinica Univ. de Navarra, Pamplona (Spain); Cardiac Imaging Unit, Clinica Univ. de Navarra, Pamplona (Spain)], e-mail: bastarrika@unav.es

    2012-06-15

    Background: Epicardial adipose tissue (EAT) is an important indicator of cardiovascular risk. This parameter is generally assessed on ECG-gated computed tomography (CT) images. Purpose: To evaluate feasibility and reliability of EAT quantification on non-gated thoracic low-radiation-dose CT examinations with respect to prospectively ECG-gated cardiac CT acquisition. Material and Methods: Sixty consecutive asymptomatic smokers (47 men; mean age 64 {+-} 9.8 years) underwent low-dose CT of the chest and prospectively ECG-gated cardiac CT acquisitions (64-slice dual-source CT). The two examinations were reconstructed with the same range, field of view, slice thickness, and convolution algorithm. Two independent observers blindly quantified EAT volume using commercially available software. Data were compared with paired sample Student t-test, concordance correlation coefficients (CCC), and Bland-Altman plots. Results: No statistically significant difference was observed for EAT volume quantification with low-dose-CT (141.7 {+-} 58.3 mL) with respect to ECG-gated CT (142.7 {+-} 57.9 mL). Estimation of CCC showed almost perfect concordance between the two techniques for EAT-volume assessment (CCC, 0.99; mean difference, 0.98 {+-} 5.1 mL). Inter-observer agreement for EAT volume estimation was CCC: 0.96 for low-dose-CT examinations and 0.95 for ECG-gated CT. Conclusion: Non-gated low-dose CT allows quantifying EAT with almost the same concordance and reliability as using dedicated prospectively ECG-gated cardiac CT acquisition protocols.

  9. Spiral CT of Non-Graft Post Cardiac Surgery Complications: A Pictorial Essay

    Directory of Open Access Journals (Sweden)

    S. Shirani

    2010-06-01

    Full Text Available Spiral CT is a rapidly growing method for noninvasive visualization of post-operative complications, including post-operative complications in CABG (coronary artery bypass graft. In the recent years, several different, yet more efficient types have been introduced with progressive improvement in the diagnostic accuracy in the detection of post-operative complications. The introduction of 64-slice technology, which allows high resolution as well as reconstructed images, has resulted in further progress in the diagnostic process. This kind of diagnostic equipment will spread rapidly in the world. Although studies with large numbers of patients regarding spiral CT as a routine diagnostic method have not been reported, there is great need for it all over the world. In this article, we intend to review the spiral CT findings of non-graft complications in patients after cardiac surgery.

  10. Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC)

    DEFF Research Database (Denmark)

    Flotats, Albert; Gutberlet, Matthias; Knuuti, Juhani

    2011-01-01

    . However, hybrid cardiac imaging has also generated controversy with regard to which patients should undergo such integrated examination for clinical effectiveness and minimization of costs and radiation dose, and if software-based fusion of images obtained separately would be a useful alternative....... The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients...

  11. Multidetector CT: a new gold standard in the diagnosis of pulmonary embolism? State of the art and diagnostic algorithms; La TC multitettore: il nuovo gold standard nella diagnosi di embolia polmonare? Stato dell'arte e algoritmi diagnostici

    Energy Technology Data Exchange (ETDEWEB)

    Russo, Vincenzo; Piva, Tommaso; Lovato, Luigi; Fattori, Rossella; Gavelli, Giampaolo [Policlinico S. Orsola, Bologna (Italy). Dipartimento di Radiologia Radiologia III

    2005-02-01

    Purpose: From the early 90s, spiral CT technology has considerably changed the diagnostic capability of Pulmonary Embolism (PE), giving a direct vision of intravascular thrombi. Further technological progress has straightened its diagnostic impact leading to an essential role in clinical practice. The advent of Multi-Detector CT (MDCT) has subsequently increased the reliability of this technique to the point of undermining the role of pulmonary angiography as the gold standard and occupying a central position in diagnostic algorithms. The aim of this paper is to appraise this evolution by means of a meta-analysis of the relevant literature from 1995 to 2004. Results: The review of the literature showed the sensitivity and specificity of CT to have increased from 37-94% and 91-100% (single detector CT) to 87-94% and 94-100% (4-channel multidetector CT), especially thanks to the possibility of depicting subsegmental clots, with an interobserver agreement of 0.63-0.94 (k). Conclusions: CT is one of the most reliable and effective methods in the diagnosis is PE, with the advantage of being extremely fast and providing alternative diagnoses. Recent improvements in MDCT technology confers the highest value of diagnostic accuracy with respect to other imaging modalities such as scintigraphy, angiography, MRI, D-dimer essay and Doppler US. [Italian] Scopo: Dall'inizio degli anni '90, la tecnologia TC spirale (TCS) ha cambiato notevolmente la capacita' diagnostica di Embolia Polmonare (EP), fornendo una visione diretta dei trombi endoluminali. Successivi progressi tecnologici hanno fortificato il suo impatto diagnostico a tal punto che questa metodica e' ora essenziale nella pratica clinica. L'avvento della TC Multi-Detettore (TCMD) ha aumentato di conseguenza l'affidabilita' di questa tecnica fino a tal punto da scalzare l'angiopneumografia dal ruolo di Gold Standard ed occupare una posizione cantrale negli algoritmi diagnostici

  12. Image registration and analysis for quantitative myocardial perfusion: application to dynamic circular cardiac CT

    Science.gov (United States)

    Isola, A. A.; Schmitt, H.; van Stevendaal, U.; Begemann, P. G.; Coulon, P.; Boussel, L.; Grass, M.

    2011-09-01

    Large area detector computed tomography systems with fast rotating gantries enable volumetric dynamic cardiac perfusion studies. Prospectively, ECG-triggered acquisitions limit the data acquisition to a predefined cardiac phase and thereby reduce x-ray dose and limit motion artefacts. Even in the case of highly accurate prospective triggering and stable heart rate, spatial misalignment of the cardiac volumes acquired and reconstructed per cardiac cycle may occur due to small motion pattern variations from cycle to cycle. These misalignments reduce the accuracy of the quantitative analysis of myocardial perfusion parameters on a per voxel basis. An image-based solution to this problem is elastic 3D image registration of dynamic volume sequences with variable contrast, as it is introduced in this contribution. After circular cone-beam CT reconstruction of cardiac volumes covering large areas of the myocardial tissue, the complete series is aligned with respect to a chosen reference volume. The results of the registration process and the perfusion analysis with and without registration are evaluated quantitatively in this paper. The spatial alignment leads to improved quantification of myocardial perfusion for three different pig data sets.

  13. Image registration and analysis for quantitative myocardial perfusion: application to dynamic circular cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Isola, A A [Philips Research Laboratories, X-ray Imaging Systems Department, Weisshausstrasse 2, D-52066 Aachen (Germany); Schmitt, H; Van Stevendaal, U; Grass, M [Philips Research Laboratories, Sector Digital Imaging, Roentgenstrasse 24-26, D-22335 Hamburg (Germany); Begemann, P G [Department of Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg (Germany); Coulon, P [Philips Healthcare France, 33 rue de Verdun, F-92150 Suresnes Cedex (France); Boussel, L, E-mail: Alfonso.Isola@Philips.com [Department of Radiology, Louis Pradel Hospital, CREATIS, UMR CNRS 5515, INSERM U630, Lyon (France)

    2011-09-21

    Large area detector computed tomography systems with fast rotating gantries enable volumetric dynamic cardiac perfusion studies. Prospectively, ECG-triggered acquisitions limit the data acquisition to a predefined cardiac phase and thereby reduce x-ray dose and limit motion artefacts. Even in the case of highly accurate prospective triggering and stable heart rate, spatial misalignment of the cardiac volumes acquired and reconstructed per cardiac cycle may occur due to small motion pattern variations from cycle to cycle. These misalignments reduce the accuracy of the quantitative analysis of myocardial perfusion parameters on a per voxel basis. An image-based solution to this problem is elastic 3D image registration of dynamic volume sequences with variable contrast, as it is introduced in this contribution. After circular cone-beam CT reconstruction of cardiac volumes covering large areas of the myocardial tissue, the complete series is aligned with respect to a chosen reference volume. The results of the registration process and the perfusion analysis with and without registration are evaluated quantitatively in this paper. The spatial alignment leads to improved quantification of myocardial perfusion for three different pig data sets.

  14. Fully automated intrinsic respiratory and cardiac gating for small animal CT

    Energy Technology Data Exchange (ETDEWEB)

    Kuntz, J; Baeuerle, T; Semmler, W; Bartling, S H [Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Dinkel, J [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Zwick, S [Department of Diagnostic Radiology, Medical Physics, Freiburg University (Germany); Grasruck, M [Siemens Healthcare, Forchheim (Germany); Kiessling, F [Chair of Experimental Molecular Imaging, RWTH-Aachen University, Medical Faculty, Aachen (Germany); Gupta, R [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)], E-mail: j.kuntz@dkfz.de

    2010-04-07

    A fully automated, intrinsic gating algorithm for small animal cone-beam CT is described and evaluated. A parameter representing the organ motion, derived from the raw projection images, is used for both cardiac and respiratory gating. The proposed algorithm makes it possible to reconstruct motion-corrected still images as well as to generate four-dimensional (4D) datasets representing the cardiac and pulmonary anatomy of free-breathing animals without the use of electrocardiogram (ECG) or respiratory sensors. Variation analysis of projections from several rotations is used to place a region of interest (ROI) on the diaphragm. The ROI is cranially extended to include the heart. The centre of mass (COM) variation within this ROI, the filtered frequency response and the local maxima are used to derive a binary motion-gating parameter for phase-sensitive gated reconstruction. This algorithm was implemented on a flat-panel-based cone-beam CT scanner and evaluated using a moving phantom and animal scans (seven rats and eight mice). Volumes were determined using a semiautomatic segmentation. In all cases robust gating signals could be obtained. The maximum volume error in phantom studies was less than 6%. By utilizing extrinsic gating via externally placed cardiac and respiratory sensors, the functional parameters (e.g. cardiac ejection fraction) and image quality were equivalent to this current gold standard. This algorithm obviates the necessity of both gating hardware and user interaction. The simplicity of the proposed algorithm enables adoption in a wide range of small animal cone-beam CT scanners.

  15. 64排螺旋CT灌注成像对前列腺癌的诊断价值研究%Study on Diagnostic Value of 64 - multidetector Spiral CT Perfusion Imaging in Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    殷少龙; 许庆森; 赵春龙; 武迎军; 冯庆韬

    2012-01-01

    目的 探讨64排螺旋CT灌注成像对前列腺癌(PCa)的诊断价值. 方法 选择2006年8月-2010年5月张家口市第一医院确诊的前列腺癌患者62例,另选择正常前列腺15例为对照组.两组均行64排螺旋CT灌注成像技术检查,对比两组灌注参数之间的差异. 结果 对照组正常前列腺中央带和周围带的CT灌注参数比较,中央带明显高于周围带(P<0.05).正常对照组(周围带)和PCa组的CT灌注参数比较,PCa组的BF、BV、PS明显高于对照组(周围带)(P<0.05),MTT、TTP值明显小于对照组(周围带)(P<0.05).对照组TDC曲线呈缓升-平台型,PCa组TDC曲线呈速升-缓降型. 结论 64排螺旋CT灌注成像对PCa具有重要的诊断价值,其中BF、PS、TTP对PCa的评价意义最大,能更准确反映肿瘤的血管生成,可以作为临床诊断PCa的有效普查方法.%Objective To explore the value of 54 - multidetector spiral CT perfusion imaging in diagnosis of prostate carcinoma (PCa). Methods Sixty- two patients with PCa confirmed by the First Hospital of Zhangjiakou City from August 2006 to May 2010 were selected as PCa group, and another 15 healthy individuals were served as the control group. 64 - multidetector spiral CT perfusion imaging was performed on all objects of the study. The differences in the perfusion parameters of the two groups, including mean blood flow (BF), blood volume (BV), time to peak (TTP), mean transit time (MTT), capillary permeability - surface (PS), time-density curve (TDC) were documented and compared. Results In the control group, the perfusion parameters of the central zone were significantly higher than those in the peripheral zone (P < 0.05). Compared with the perfusion parameters of the peripheral zone of the control group, BF, BV and PS of Pca group were significantly higher than those in the control group (P<0.05), while TTP and MTT were significantly less than those in the control group (P< 0.05). Time - density curve of the

  16. Survey regarding the clinical practice of cardiac CT in Germany. Indications, scanning technique and reporting

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Marc H.; Hamm, B.; Dewey, M. [Inst. fuer Radiologie, Charite - Universitaetsmedizin Berlin (Germany)

    2009-12-15

    Purpose: to obtain an overview of the current clinical practice of cardiac computed tomography (CT) in Germany. Materials and methods: a 30-item question-naire was mailed to 149 providers of cardiac CT in Germany. The items asked about indications, scanning technique and reporting, data storage, and cost of the examination. Results: overall 45 questionnaires could be analyzed (30%). The majority of centers (76%, 34 of 45 centers) used CT scanners of the latest generation (at least 64 rows). The most common appropriate indications were exclusion of coronary artery disease (91%, 41/45), coronary anomalies (80%, 36/45), and follow-up after coronary artery bypass grafting (53%, 24/45). Each center examined on average 243 {+-} 310 patients in 2007 and the number of centers performing cardiac CT increased significantly in 2007 (p = 0.035) compared with the preceding year. Most used sublingual nitroglycerin (84%, 38/45; median of 2 sprays = 0.8 mg) and/or a beta blocker (86%, 39/44; median of 5 mg IV, median heart rate threshold: 70 beats/min). Many providers used ECG-triggered tube current modulation (65%, 29/44) and/or adjusted the tube current to the body mass index or body weight (63%, 28/44). A median slice thickness of 0.75 mm with a 0.5 mm increment and a 20 cm field-of-view was most commonly used. Source images in orthogonal planes (96%, 43/45), curved MPRs (93%, 42/45), and thin-slice MIPs (69%, 31/45) were used most frequently for interpretation. Extracardiac structures were also evaluated by 84% of the centers (38/45). The mean examination time was 16.2 min and reporting took an average of 28.8 min. (orig.)

  17. High-concentration contrast media in neurological multidetector-row CT applications: implications for improved patient management in neurology and neurosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Schramm, Peter [University of Heidelberg Medical Center, Department of Neuroradiology, Heidelberg (Germany)

    2007-07-15

    Dynamic CT scanning after intravenous injection of iodine contrast medium (CM) was proposed in the very early days of CT. The goal was to characterize tissue by extracting information from the temporal course of enhancement. In the early 1980s, modeling algorithms were already described in the literature for the quantitative calculation of cerebral blood flow (CBF). However, cerebral applications suffered from the insufficient temporal resolution available at that time and the central nervous system was already seen primarily as an MRI domain. The renaissance of dynamic CT in neurological applications came in the middle of the 1990s with the introduction of thrombolytic therapy in acute stroke. With CT being the primary imaging modality, getting additional hemodynamic information from the same device without having to move the patient appeared attractive. Multimodal CT protocols allow a comprehensive diagnosis of the emergency stroke patient in less than 15 minutes by combining nonenhanced CT (NECT), perfusion CT (PCT) and CT angiography (CTA). Dynamic PCT can also render important information in patients with intraaxial brain tumors, allowing differentiation not only between lymphoma and glioma but also between low-grade and high-grade glioma by quantifying local cerebral blood volume (CBV) and permeability of the blood-brain barrier (BBB). Hoever, even if a shorter imaging time permits a reduction in volume of CM, adequate total iodine levels must be preserved for dynamic CT applications. Increased concentrations of iodine are therefore helpful to obtain adequate total iodine levels for imaging. (orig.)

  18. Randomized controlled trial of relaxation music to reduce heart rate in patients undergoing cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Ming Yen [University of Toronto, Department of Medical Imaging, Toronto General Hospital, Toronto, ON (Canada); The University of Hong Kong, Queen Mary Hospital, Department of Diagnostic Radiology, Hong Kong (China); Karimzad, Yasser; Menezes, Ravi J.; Wintersperger, Bernd J.; Li, Qin; Forero, Julian; Paul, Narinder S.; Nguyen, Elsie T. [University of Toronto, Department of Medical Imaging, Toronto General Hospital, Toronto, ON (Canada)

    2016-10-15

    To evaluate the heart rate lowering effect of relaxation music in patients undergoing coronary CT angiography (CCTA), pulmonary vein CT (PVCT) and coronary calcium score CT (CCS). Patients were randomised to a control group (i.e. standard of care protocol) or to a relaxation music group (ie. standard of care protocol with music). The groups were compared for heart rate, radiation dose, image quality and dose of IV metoprolol. Both groups completed State-Trait Anxiety Inventory anxiety questionnaires to assess patient experience. One hundred and ninety-seven patients were recruited (61.9 % males); mean age 56y (19-86 y); 127 CCTA, 17 PVCT, 53 CCS. No significant difference in heart rate, radiation dose, image quality, metoprolol dose and anxiety scores. 86 % of patients enjoyed the music. 90 % of patients in the music group expressed a strong preference to have music for future examinations. The patient cohort demonstrated low anxiety levels prior to CT. Relaxation music in CCTA, PVCT and CCS does not reduce heart rate or IV metoprolol use. Patients showed low levels of anxiety indicating that anxiolytics may not have a significant role in lowering heart rate. Music can be used in cardiac CT to improve patient experience. (orig.)

  19. Measurement of four chambers' volumes and ventricular masses by cardiac CT examination

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Motomasa; Naito, Hiroaki; Ohta, Mitsushige; Kozuka, Takahiro; Kito, Yoshitsugu (National Cardiovascular Center, Suita, Osaka (Japan))

    1983-09-01

    Using cardiac computed tomography (CT), the ''mean'' volume of each cardiac chamber and both ventricular masses were calculated from summation of a sliced volume by ungated scans obtained using rapid sequential scanning covering the whole heart. 1. Estimation of a normal value of each chamber's volume was attempted in 20 patients with ischemic heart disease and with normal heart function. The ''mean'' volume of the right atrium (RAMV), right ventricle (RVMV), and left atrium (LAMV) was 22.3 +- 6.5, 40.3 +- 6.5 and 28.7 +- 8.2ml/m/sup 2/, respectively. 2. In 54 patients with valvular heart diseases, each chamber's volume obrained by CT was compared with the grade of tricuspid regurgitation (TR) estimated by ultrasonic Doppler technique or the grade of mitral regurgitation (MR) by left ventriculography (LVG). The RAMV (234 +- 119 ml/m/sup 2/) and the RVMV (101 +- 39 ml/m/sup 2/) were markedly increased in patients with severe TR (grade 3 to 4) (p<0.01). The LAMV (487 +- 231 ml/m/sup 2/) was also increased in patients with severe mitral regurgitation (grade 3 to 4) (p<0.01). 3. In 46 patients with valvular heart diseases, the LVMV by CT was well correlated with end-diastolic volume (EDV) obtained by LVG (r=0.92), and the LVEDVs by ECG gated CT and by LVG showed a fairly good correlation (r=0.95). 4. CT examination was performed before and after surgery in 17 patients with MR or TR for evaluation of the change of chamber volumes. The mean reduction ratio (MRR) of the RAMV after tricuspid annuloplasty, the LVMV after mitral valve plasty, and the LAMV after left atrial plication was 44%, 41%, and 60%, respectively.

  20. Feasibility of determining myocardial transient ischemic dilation from cardiac CT by automated stress/rest registration

    Science.gov (United States)

    Woo, Jonghye; Slomka, Piotr J.; Nakazato, Ryo; Tamarappoo, Balaji K.; Min, James K.; Germano, Guido; Berman, Daniel S.; Dey, Damini

    2012-02-01

    Transient ischemic dilation (TID) of the left ventricle measured by myocardial perfusion Single Photon Emission Computed Tomography (SPECT) and defined as a the ratio of stress myocardial blood volume to rest myocardial blood volume has been shown to be highly specific for detection of severe coronary artery disease. This work investigates automated quantification of TID from cardiac Computed Tomography (CT) perfusion images. To date, TID has not been computed from CT. Previous studies to compute TID have assumed accurate segmentation of the left ventricle and performed subsequent analysis of volume change mainly on static or less often on gated myocardial perfusion SPECT. This, however, may limit the accuracy of TID due to potential errors from segmentation, perfusion defects or volume measurement from both images. In this study, we propose to use registration methods to determine TID from cardiac CT scans where deformation field within the structure of interest is used to measure the local volume change between stress and rest. Promising results have been demonstrated with 7 datasets, showing the potential of this approach as a comparative method for measuring TID.

  1. Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT : an anthropomorphic phantom study

    NARCIS (Netherlands)

    Xie, X.; Zhao, Yingru; Snijder, R.A.; van Ooijen, P.M.; de Jong, P.A.; Oudkerk, M.; de Bock, G.H.; Vliegenthart, R.; Greuter, M.J.

    2013-01-01

    To assess the sensitivity of detection and accuracy of volumetry by manual and semi-automated quantification of artificial pulmonary nodules in an anthropomorphic thoracic phantom on low-dose CT. Fifteen artificial spherical nodules (diameter 3, 5, 8, 10 and 12 mm; CT densities -800, -630 and +100 H

  2. Influence of technical parameters on epicardial fat volume quantification at cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Bucher, Andreas M. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt (Germany); Joseph Schoepf, U., E-mail: schoepf@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Krazinski, Aleksander W.; Silverman, Justin; Spearman, James V. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); De Cecco, Carlo N. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza” – Polo Pontino, Latina (Italy); Meinel, Felix G. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich (Germany); Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt (Germany); Geyer, Lucas L. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich (Germany)

    2015-06-15

    Highlights: • Upper threshold levels and contrast enhancement influence epicardial fat volumetry. • Cardiac cycle does not significantly influence epicardial fat volumetry. • Adjustments of upper threshold can lead to comparable volumetry results. - Abstract: Objectives: To systematically analyze the influence of technical parameters on quantification of epicardial fat volume (EATV) at cardiac CT. Methods: 153 routine cardiac CT data sets were analyzed using three-dimensional pericardial border delineation. Three image series were reconstructed per patient: (a) CTA{sub D}: coronary CT angiography (CTA), diastolic phase; (b) CTA{sub S}: coronary CTA, systolic phase; (c) CaSc{sub D}: non-contrast CT, diastolic phase. EATV was calculated using three different upper thresholds (−15HU, −30HU, −45HU). Repeated measures ANOVA, Spearman's rho, and Bland Altman plots were used. Results: Mean EATV differed between all three image series at a −30HU threshold (CTA{sub D} 87.2 ± 38.5 ml, CTA{sub S} 90.9 ± 37.7 ml, CaSc{sub D} 130.7 ± 49.5 ml, P < 0.001). EATV of diastolic and systolic CTA reconstructions did not differ significantly (P = 0.225). Mean EATV for contrast enhanced CTA at a −15HU threshold (CTA{sub D15} 102.4 ± 43.6 ml, CTA{sub S15} 105.3 ± 42.3 ml) could be approximated most closely by non-contrast CT at −45HU threshold (CaSc{sub D45} 105.3 ± 40.8 ml). The correlation was excellent: CTA{sub S15}–CTA{sub D15}, rho = 0.943; CTA{sub D15}–CaSc{sub D45}, rho = 0.905; CTA{sub S15}–CaSc{sub D45}, rho = 0.924; each P < 0.001). Bias values from Bland Altman Analysis were: CTA{sub S15}–CTA{sub D15}, 4.9%; CTA{sub D15}–CaSc{sub D45}, −4.3%; CTA{sub S15}–CaSc{sub D45}, 0.6%. Conclusions: Measured EATV can differ substantially between contrast enhanced and non-contrast CT studies, which can be reconciled by threshold modification. Heart cycle phase does not significantly influence EATV measurements.

  3. Estudio del oído con TC Multidetector de 64 canales 64 - Detector CT findings in the study of the ear

    Directory of Open Access Journals (Sweden)

    María Lourdes Mallo

    2010-12-01

    Full Text Available El oído es una estructura anatómica compleja. Su estudio y comprensión resultan un reto diario para el radiólogo, siendo la tomografía computada una herramienta esencial para su estudio. La tomografía computada convencional con cortes finos en planos axiales y coronales permite una buena visualización de las diferentes estructuras. Sin embargo, se necesitan tiempos prolongados para su realización y posicionamientos incómodos o intolerables para muchos pacientes. Además la visualización de algunas de sus estructuras es limitada. La tomografía axial computada multidetector de 64 canales a nuestro medio permite optimizar el estudio de la compleja y pequeña anatomía del oído. La realización de adquisiciones volumétricas con cortes de 0,5 mm, con reconstrucciones multiplanares en los tres planos básicos, en planos curvos y reconstrucciones tridimensionales, hacen posible la visualización detallada de las estructuras en escasos segundos y en condiciones cómodas para el paciente. Nuestro propósito en este artículo es demostrar la utilidad de las reconstrucciones, particularmente en planos oblicuos, para identificar y analizar los diferentes reparos anatómicos del oído y alcanzar la visualización óptima de la anatomía relevante del hueso temporal.The ear is a complex anatomic structure. Its study and understanding represent a constant challenge for the radiologist. As a consequence the computed tomography becomes an essential tool for its examination. Conventional tomographic examination with both axial and coronal reconstruction of the image allows a satisfactory visualization of the different structures. However, the study requires long periods of time for its acquisition and uncomfortable or intolerable positions for the patients. Moreover, the characterization of some structures of the ear becomes limited. Sixty-four slice multidetector computed tomography allows the optimal study of the small and complex ear anatomy

  4. Automatic intrinsic cardiac and respiratory gating from cone-beam CT scans of the thorax region

    Science.gov (United States)

    Hahn, Andreas; Sauppe, Sebastian; Lell, Michael; Kachelrieß, Marc

    2016-03-01

    We present a new algorithm that allows for raw data-based automated cardiac and respiratory intrinsic gating in cone-beam CT scans. It can be summarized in three steps: First, a median filter is applied to an initially reconstructed volume. The forward projection of this volume contains less motion information and is subtracted from the original projections. This results in new raw data that contain only moving and not static anatomy like bones, that would otherwise impede the cardiac or respiratory signal acquisition. All further steps are applied to these modified raw data. Second, the raw data are cropped to a region of interest (ROI). The ROI in the raw data is determined by the forward projection of a binary volume of interest (VOI) that includes the diaphragm for respiratory gating and most of the edge of the heart for cardiac gating. Third, the mean gray value in this ROI is calculated for every projection and the respiratory/cardiac signal is acquired using a bandpass filter. Steps two and three are carried out simultaneously for 64 or 1440 overlapping VOI inside the body for the respiratory or cardiac signal respectively. The signals acquired from each ROI are compared and the most consistent one is chosen as the desired cardiac or respiratory motion signal. Consistency is assessed by the standard deviation of the time between two maxima. The robustness and efficiency of the method is evaluated using simulated and measured patient data by computing the standard deviation of the mean signal difference between the ground truth and the intrinsic signal.

  5. Cardiac CT and MRI guide surgery in impending left ventricular rupture after acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Shah Ashish S

    2009-08-01

    Full Text Available Abstract We report the case of a 67 year-old patient who presented with worsening chest pain and shortness of breath, four days post acute myocardial infarction. Contrast enhanced computed tomography of the chest ruled out a pulmonary embolus but revealed an unexpected small subepicardial aneurysm (SEA in the lateral left ventricular wall which was confirmed on cardiac magnetic resonance imaging. Intraoperative palpation of the left lateral wall was guided by the cardiac MRI and CT findings and confirmed the presence of focally thinned and weakened myocardium, covered by epicardial fat. An aneurysmorrhaphy was subsequently performed in addition to coronary bypass surgery and a mitral valve repair. The patient was discharged home on post operative day eight in good condition and is feeling well 2 years after surgery.

  6. 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.

  7. Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis in nonstented coronary arteries.

    Science.gov (United States)

    Kefer, Joelle M; Coche, Emmanuel; Vanoverschelde, Jean-Louis J; Gerber, Bernhard L

    2007-01-01

    The purpose of this study was to assess the diagnostic accuracy of 16-slice multidetector-row computed tomography (MDCT) for detecting in-stent restenosis. Fifty patients with 69 previously implanted coronary stents underwent 16-slice MDCT before quantitative coronary angiography (QCA). Diagnostic accuracy of MDCT for detection of in-stent restenosis defined as >50% lumen diameter stenosis (DS) in stented and nonstented coronary segments >1.5-mm diameter was computed using QCA as reference. According to QCA, 18/69 (25%) stented segments had restenosis. In addition, 33/518 (6.4%) nonstented segments had >50% DS. In-stent restenosis was correctly identified on MDCT images in 12/18 stents, and absence of restenosis was correctly identified in 50/51 stents. Stenosis in native coronary arteries was correctly identified in 22/33 segments and correctly excluded in 482/485 segments. Thus, sensitivity (67% vs 67% p=1.0), specificity (98% vs 99%, p=0.96) and overall diagnostic accuracy (90% vs 97%, p=0.68) was similarly high for detecting in-stent restenosis as for detecting stenosis in nonstented coronary segments. MDCT has similarly high diagnostic accuracy for detecting in-stent restenosis as for detecting coronary artery disease in nonstented segments. This suggests that MDCT could be clinically useful for identification of restenosis in patients after coronary stenting.

  8. Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis in nonstented coronary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kefer, Joelle M.; Vanoverschelde, Jean-Louis J.; Gerber, Bernhard L. [Cliniques Universitaires St. Luc UCL, Department of Cardiology, Brussels (Belgium); Coche, Emmanuel [Cliniques Universitaires St. Luc UCL, Department of Radiology, Brussels (Belgium)

    2007-01-15

    The purpose of this study was to assess the diagnostic accuracy of 16-slice multidetector-row computed tomography (MDCT) for detecting in-stent restenosis. Fifty patients with 69 previously implanted coronary stents underwent 16-slice MDCT before quantitative coronary angiography (QCA). Diagnostic accuracy of MDCT for detection of in-stent restenosis defined as >50% lumen diameter stenosis (DS) in stented and nonstented coronary segments >1.5-mm diameter was computed using QCA as reference. According to QCA, 18/69 (25%) stented segments had restenosis. In addition, 33/518 (6.4%) nonstented segments had >50% DS. In-stent restenosis was correctly identified on MDCT images in 12/18 stents, and absence of restenosis was correctly identified in 50/51 stents. Stenosis in native coronary arteries was correctly identified in 22/33 segments and correctly excluded in 482/485 segments. Thus, sensitivity (67% vs 67% p=1.0), specificity (98% vs 99%, p=0.96) and overall diagnostic accuracy (90% vs 97%, p=0.68) was similarly high for detecting in-stent restenosis as for detecting stenosis in nonstented coronary segments. MDCT has similarly high diagnostic accuracy for detecting in-stent restenosis as for detecting coronary artery disease in nonstented segments. This suggests that MDCT could be clinically useful for identification of restenosis in patients after coronary stenting. (orig.)

  9. Three-dimensional volume-rendered multidetector CT imaging of the posterior inferior pancreaticoduodenal artery: its anatomy and role in diagnosing extrapancreatic perineural invasion

    Science.gov (United States)

    Giacomini, Craig; Brooke Jeffrey, R.; Willmann, Juergen K.; Olcott, Eric

    2013-01-01

    Abstract Extrapancreatic perineural spread in pancreatic adenocarcinoma contributes to poor outcomes, as it is known to be a major contributor to positive surgical margins and disease recurrence. However, current staging classifications have not yet taken extrapancreatic perineural spread into account. Four pathways of extrapancreatic perineural spread have been described that conveniently follow small defined arterial pathways. Small field of view three-dimensional (3D) volume-rendered multidetector computed tomography (MDCT) images allow visualization of small peripancreatic vessels and thus perineural invasion that may be associated with them. One such vessel, the posterior inferior pancreaticoduodenal artery (PIPDA), serves as a surrogate for extrapancreatic perineural spread by pancreatic adenocarcinoma arising in the uncinate process. This pictorial review presents the normal and variant anatomy of the PIPDA with 3D volume-rendered MDCT imaging, and emphasizes its role as a vascular landmark for the diagnosis of extrapancreatic perineural invasion from uncinate adenocarcinomas. Familiarity with the anatomy of PIPDA will allow accurate detection of extrapancreatic perineural spread by pancreatic adenocarcinoma involving the uncinate process, and may potentially have important staging implications as neoadjuvant therapy improves. PMID:24434918

  10. Renal safety in pediatric imaging: randomized, double-blind phase IV clinical trial of iobitridol 300 versus iodixanol 270 in multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Zo' o, Martin; Dosseur, Patrick Le [CHU Charles Nicolle, Radiology Department, Rouen (France); Hoermann, Marcus; Balassy, Csilla [AKH, Radiology Department, Vienna (Austria); Brunelle, Francis [Necker Hospital, Radiopediatry Department, Paris (France); Azoulay, Robin [Robert Debre Hospital, Radiopediatry Department, Paris (France); Pariente, Daniele [Kremlin-Bicetre Hospital, Radiopediatry Department, Kremlin-Bicetre (France); Panuel, Michel [Nord Hospital, Medical Imaging Department, Marseille (France)

    2011-11-15

    It is debated whether iso-osmolar and low-osmolar contrast media are associated with different incidences of contrast medium-induced nephropathy (CIN) in patients with renal insufficiency. To compare the incidence of CIN in children undergoing contrast-enhanced multidetector computer tomography (MDCT) with intravenous injection of low-osmolar (iobitridol, Xenetix {sup registered} 300) or an iso-osmolar (iodixanol, Visipaque {sup registered} 270) iodinated contrast medium. One hundred forty-six children with normal renal function were included in this multicenter trial and underwent contrast-enhanced MDCT. The primary endpoint was the relative change in creatinine clearance from 48 h pre- to 72 h postcontrast medium administration using a noninferiority analysis in the intent-to-treat (ITT, n = 128) and per protocol (n = 68) populations. Secondary endpoints were incidence of CIN, global image quality, diagnostic efficacy and clinical safety. In the ITT population, the noninferiority of iobitridol over iodixanol was demonstrated. CIN incidence was 4.8% (three cases) with iobitridol and 10.6% (seven cases) with iodixanol (not significant). No statistically significant differences were observed for the secondary endpoints. Comparable satisfactory safety profiles were confirmed for both contrast media, with no significant difference in the incidence of CIN in children with normal renal function. (orig.)

  11. Assessing Cardiac Injury in Mice With Dual Energy-MicroCT, 4D-MicroCT, and MicroSPECT Imaging After Partial Heart Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang-Lung; Min, Hooney [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Befera, Nicholas; Clark, Darin; Qi, Yi [Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States); Das, Shiva [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Johnson, G. Allan; Badea, Cristian T. [Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States); Kirsch, David G., E-mail: david.kirsch@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina (United States)

    2014-03-01

    Purpose: To develop a mouse model of cardiac injury after partial heart irradiation (PHI) and to test whether dual energy (DE)-microCT and 4-dimensional (4D)-microCT can be used to assess cardiac injury after PHI to complement myocardial perfusion imaging using micro-single photon emission computed tomography (SPECT). Methods and Materials: To study cardiac injury from tangent field irradiation in mice, we used a small-field biological irradiator to deliver a single dose of 12 Gy x-rays to approximately one-third of the left ventricle (LV) of Tie2Cre; p53{sup FL/+} and Tie2Cre; p53{sup FL/−} mice, where 1 or both alleles of p53 are deleted in endothelial cells. Four and 8 weeks after irradiation, mice were injected with gold and iodinated nanoparticle-based contrast agents, and imaged with DE-microCT and 4D-microCT to evaluate myocardial vascular permeability and cardiac function, respectively. Additionally, the same mice were imaged with microSPECT to assess myocardial perfusion. Results: After PHI with tangent fields, DE-microCT scans showed a time-dependent increase in accumulation of gold nanoparticles (AuNp) in the myocardium of Tie2Cre; p53{sup FL/−} mice. In Tie2Cre; p53{sup FL/−} mice, extravasation of AuNp was observed within the irradiated LV, whereas in the myocardium of Tie2Cre; p53{sup FL/+} mice, AuNp were restricted to blood vessels. In addition, data from DE-microCT and microSPECT showed a linear correlation (R{sup 2} = 0.97) between the fraction of the LV that accumulated AuNp and the fraction of LV with a perfusion defect. Furthermore, 4D-microCT scans demonstrated that PHI caused a markedly decreased ejection fraction, and higher end-diastolic and end-systolic volumes, to develop in Tie2Cre; p53{sup FL/−} mice, which were associated with compensatory cardiac hypertrophy of the heart that was not irradiated. Conclusions: Our results show that DE-microCT and 4D-microCT with nanoparticle-based contrast agents are novel imaging approaches

  12. The effects of gantry tilt on breast dose and image noise in cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Hoppe, Michael E.; Gandhi, Diksha; Schmidt, Taly Gilat [Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin 53233 (United States); Stevens, Grant M. [GE Healthcare, Waukesha, Wisconsin 53188 (United States); Foley, W. Dennis [Department of Radiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin 53226 (United States)

    2013-12-15

    Purpose: This study investigated the effects of tilted-gantry acquisition on image noise and glandular breast dose in females during cardiac computed tomography (CT) scans. Reducing the dose to glandular breast tissue is important due to its high radiosensitivity and limited diagnostic significance in cardiac CT scans.Methods: Tilted-gantry acquisition was investigated through computer simulations and experimental measurements. Upon IRB approval, eight voxelized phantoms were constructed from previously acquired cardiac CT datasets. Monte Carlo simulations quantified the dose deposited in glandular breast tissue over a range of tilt angles. The effects of tilted-gantry acquisition on breast dose were measured on a clinical CT scanner (CT750HD, GE Healthcare) using an anthropomorphic phantom with MOSFET dosimeters in the breast regions. In both simulations and experiments, scans were performed at gantry tilt angles of 0°–30°, in 5° increments. The percent change in breast dose was calculated relative to the nontilted scan for all tilt angles. The percent change in noise standard deviation due to gantry tilt was calculated in all reconstructed simulated and experimental images.Results: Tilting the gantry reduced the breast dose in all simulated and experimental phantoms, with generally greater dose reduction at increased gantry tilts. For example, at 30° gantry tilt, the dosimeters located in the superior, middle, and inferior breast regions measured dose reductions of 74%, 61%, and 9%, respectively. The simulations estimated 0%–30% total breast dose reduction across the eight phantoms and range of tilt angles. However, tilted-gantry acquisition also increased the noise standard deviation in the simulated phantoms by 2%–50% due to increased pathlength through the iodine-filled heart. The experimental phantom, which did not contain iodine in the blood, demonstrated decreased breast dose and decreased noise at all gantry tilt angles.Conclusions: Tilting the

  13. Is it possible that this patient is asymptomatic? The role of multidetector ct angiography in detection of ulcerated plaques in patients with asymptomatic carotid stenosis: Case report

    Directory of Open Access Journals (Sweden)

    Tanasković Slobodan

    2015-01-01

    Full Text Available Introduction. Although intervention in patients with symptomatic carotid disease is generally accepted as beneficial, the management of asymptomatic disease is still controversial. We wanted to introduce and discuss treatment options in a patient with asymptomatic carotid stenosis and high embolic potential lesions of common and internal carotid artery detected by multidetector computed tomography (MDCT. Case Outline. A 78-year-old female patient was admitted to our institution for diagnostics and surgical treatment of asymptomatic high-grade carotid stenosis. Upon admission, color duplex ultrasonography of the carotid arteries revealed the left common carotid artery (CCA stenosis of 50% and the ipsilateral internal carotid artery (ICA stenosis of 60%, while the right CCA was narrowed by 60% and the ipsilateral ICA by 80%. Because of the left subclavian artery (LSA occlusion, also described by ultrasonography, MDCT angiography was performed to assess arterial morphology for possible angioplasty. In addition to LSA occlusion, MDCT angiography surprisingly revealed significant left CCA (>80% and ICA (>70% narrowing by ulcerated plaques with high embolic potential. Surgical treatment of the left CCA and ICA was indicated and Dacron® tubular graft interposition was performed. The postoperative course was uneventful and the patient was discharged from the Institute on the third postoperative day. After the six-month follow-up the patient was doing well with well-preserved graft patency. Conclusion. Although color duplex ultrasonography is reliable and safe imaging modality in carotid stenosis diagnosis, MDCT angiography plays a significant role in patients with asymptomatic carotid stenosis since plaques with high embolic potential could be detected, which, if left untreated, could have severe neurological ischemic consequences. [Projekat Ministarstva nauke Republike Srbije, br. 41002

  14. Improving Low-dose Cardiac CT Images based on 3D Sparse Representation

    Science.gov (United States)

    Shi, Luyao; Hu, Yining; Chen, Yang; Yin, Xindao; Shu, Huazhong; Luo, Limin; Coatrieux, Jean-Louis

    2016-03-01

    Cardiac computed tomography (CCT) is a reliable and accurate tool for diagnosis of coronary artery diseases and is also frequently used in surgery guidance. Low-dose scans should be considered in order to alleviate the harm to patients caused by X-ray radiation. However, low dose CT (LDCT) images tend to be degraded by quantum noise and streak artifacts. In order to improve the cardiac LDCT image quality, a 3D sparse representation-based processing (3D SR) is proposed by exploiting the sparsity and regularity of 3D anatomical features in CCT. The proposed method was evaluated by a clinical study of 14 patients. The performance of the proposed method was compared to the 2D spares representation-based processing (2D SR) and the state-of-the-art noise reduction algorithm BM4D. The visual assessment, quantitative assessment and qualitative assessment results show that the proposed approach can lead to effective noise/artifact suppression and detail preservation. Compared to the other two tested methods, 3D SR method can obtain results with image quality most close to the reference standard dose CT (SDCT) images.

  15. Myocardial Extracellular Volume Fraction with Dual-Energy Equilibrium Contrast-enhanced Cardiac CT in Nonischemic Cardiomyopathy: A Prospective Comparison with Cardiac MR Imaging.

    Science.gov (United States)

    Lee, Hye-Jeong; Im, Dong Jin; Youn, Jong-Chan; Chang, Suyon; Suh, Young Joo; Hong, Yoo Jin; Kim, Young Jin; Hur, Jin; Choi, Byoung Wook

    2016-07-01

    Purpose To evaluate the feasibility of equilibrium contrast material-enhanced dual-energy cardiac computed tomography (CT) to determine extracellular volume fraction (ECV) in nonischemic cardiomyopathy (CMP) compared with magnetic resonance (MR) imaging. Materials and Methods This study was approved by the institutional review board; informed consent was obtained. Seven healthy subjects and 23 patients (six with hypertrophic CMP, nine with dilated CMP, four with amyloidosis, and four with sarcoidosis) (mean age ± standard deviation, 57.33 years ± 14.82; 19 male participants [63.3%]) were prospectively enrolled. Twelve minutes after contrast material injection (1.8 mL/kg at 3 mL/sec), dual-energy cardiac CT was performed. ECV was measured by two observers independently. Hematocrit levels were compared between healthy subjects and patients with the Mann-Whitney U test. In per-subject analysis, interobserver agreement for CT was assessed with the intraclass correlation coefficient (ICC), and intertest agreement between MR imaging and CT was assessed with Bland-Altman analysis. In per-segment analysis, Student t tests in the linear mixed model were used to compare ECV on CT images between healthy subjects and patients. Results Hematocrit level was 43.44% ± 1.80 for healthy subjects and 41.23% ± 5.61 for patients with MR imaging (P = .16) and 43.50% ± 1.92 for healthy subjects and 41.35% ± 5.92 for patients with CT (P = .15). For observer 1 in per-subject analysis, ECV was 34.18% ± 8.98 for MR imaging and 34.48% ± 8.97 for CT. For observer 2, myocardial ECV was 34.42% ± 9.03 for MR imaging and 33.98% ± 9.05 for CT. Interobserver agreement for ECV at CT was excellent (ICC = 0.987). Bland-Altman analysis between MR imaging and CT showed a small bias (-0.06%), with 95% limits of agreement of -1.19 and 1.79. Compared with healthy subjects, patients with hypertrophic CMP, dilated CMP, amyloidosis, and sarcoidosis had significantly higher myocardial ECV at dual

  16. Multidetector computed tomography pulmonary angiography in childhood acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Chun Xiang; Zhang, Long Jiang; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Department of Pediatrics, Charleston, SC (United States); Chowdhury, Shahryar M. [Medical University of South Carolina, Department of Pediatrics, Charleston, SC (United States); Fox, Mary A. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2015-09-15

    Pulmonary embolism is a life-threatening condition affecting people of all ages. Multidetector row CT pulmonary angiography has improved the imaging of pulmonary embolism in both adults and children and is now regarded as the routine modality for detection of pulmonary embolism. Advanced CT pulmonary angiography techniques developed in recent years, such as dual-energy CT, have been applied as a one-stop modality for pulmonary embolism diagnosis in children, as they can simultaneously provide anatomical and functional information. We discuss CT pulmonary angiography techniques, common and uncommon findings of pulmonary embolism in both conventional and dual-energy CT pulmonary angiography, and radiation dose considerations. (orig.)

  17. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Tom Anthony; Arthurs, Owen John; Calder, Alistair Duncan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); Muthialu, Nagarajan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Cardiothoracic surgery, London (United Kingdom)

    2014-02-15

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects (''rib gaps''). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia. (orig.)

  18. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation.

    Science.gov (United States)

    Watson, Tom Anthony; Arthurs, Owen John; Muthialu, Nagarajan; Calder, Alistair Duncan

    2014-02-01

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects ("rib gaps"). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia.

  19. Performance of automated software in the assessment of segmental left ventricular function in cardiac CT: Comparison with cardiac magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Rui [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); Meinel, Felix G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Ludwig-Maximilians-University Hospital, Institute for Clinical Radiology, Munich (Germany); Schoepf, U.J. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Canstein, Christian [Siemens Medical Solutions USA, Malvern, PA (United States); Spearman, James V. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); De Cecco, Carlo N. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' , Departments of Radiological Sciences, Oncology and Pathology, Latina (Italy)

    2015-12-15

    To evaluate the accuracy, reliability and time saving potential of a novel cardiac CT (CCT)-based, automated software for the assessment of segmental left ventricular function compared to visual and manual quantitative assessment of CCT and cardiac magnetic resonance (CMR). Forty-seven patients with suspected or known coronary artery disease (CAD) were enrolled in the study. Wall thickening was calculated. Segmental LV wall motion was automatically calculated and shown as a colour-coded polar map. Processing time for each method was recorded. Mean wall thickness in both systolic and diastolic phases on polar map, CCT, and CMR was 9.2 ± 0.1 mm and 14.9 ± 0.2 mm, 8.9 ± 0.1 mm and 14.5 ± 0.1 mm, 8.3 ± 0.1 mm and 13.6 ± 0.1 mm, respectively. Mean wall thickening was 68.4 ± 1.5 %, 64.8 ± 1.4 % and 67.1 ± 1.4 %, respectively. Agreement for the assessment of LV wall motion between CCT, CMR and polar maps was good. Bland-Altman plots and ICC indicated good agreement between CCT, CMR and automated polar maps of the diastolic and systolic segmental wall thickness and thickening. The processing time using polar map was significantly decreased compared with CCT and CMR. Automated evaluation of segmental LV function with polar maps provides similar measurements to manual CCT and CMR evaluation, albeit with substantially reduced analysis time. (orig.)

  20. Low radiation dose protocol in cardiac CT with 100 kVp: usefulness of display preset optimization.

    Science.gov (United States)

    Nakaura, Takeshi; Kidoh, Masafumi; Sakaino, Naritsugu; Nakamura, Shota; Nozaki, Toshimitsu; Izumi, Akari; Harada, Kazunori; Yamashita, Yasuyuki

    2013-08-01

    To evaluate the radiation dose and image quality of 100 kVp cardiac CT, and the effects of display setting optimization. We randomly assigned 100 patients undergoing cardiac CT to one of following two protocols. Fifty patients underwent our conventional protocol with 120 kVp, and the other 50 patients underwent our low radiation dose protocol with 100 kVp. We compared effective dose (ED); CT number, image noise, and contrast noise ratio (CNR) of ascending aorta at 120 and 100 kVp protocol. We also performed quantitative analysis and qualitative analysis for bitmap image of 120, 100 kVp, and display preset optimization for 100 kVp images. The estimated ED was 48 % lower with the 100 kVp protocol than the 120 kVp protocol (2.8 vs. 5.5 mSv, p protocol (18.5 ± 3.6 vs. 18.6 ± 3.8, p = 0.84). Display preset optimization significantly improved image quality of 100 kVp cardiac CT, and there is no significant difference in qualitative analysis and quantitative analysis between 100 kVp scan with optimized display preset and 120 kVp scan (p > 0.05). The 100 kVp scanning with optimized display preset offers almost same image quality at cardiac CT of thin adults under 48 % decreased radiation dose.

  1. Denoising of 4D cardiac micro-CT data using median-centric bilateral filtration

    Science.gov (United States)

    Clark, D.; Johnson, G. A.; Badea, C. T.

    2012-02-01

    Bilateral filtration has proven an effective tool for denoising CT data. The classic filter uses Gaussian domain and range weighting functions in 2D. More recently, other distributions have yielded more accurate results in specific applications, and the bilateral filtration framework has been extended to higher dimensions. In this study, brute-force optimization is employed to evaluate the use of several alternative distributions for both domain and range weighting: Andrew's Sine Wave, El Fallah Ford, Gaussian, Flat, Lorentzian, Huber's Minimax, Tukey's Bi-weight, and Cosine. Two variations on the classic bilateral filter, which use median filtration to reduce bias in range weights, are also investigated: median-centric and hybrid bilateral filtration. Using the 4D MOBY mouse phantom reconstructed with noise (stdev. ~ 65 HU), hybrid bilateral filtration, a combination of the classic and median-centric filters, with Flat domain and range weighting is shown to provide optimal denoising results (PSNRs: 31.69, classic; 31.58 median-centric; 32.25, hybrid). To validate these phantom studies, the optimal filters are also applied to in vivo, 4D cardiac micro-CT data acquired in the mouse. In a constant region of the left ventricle, hybrid bilateral filtration with Flat domain and range weighting is shown to provide optimal smoothing (stdev: original, 72.2 HU; classic, 20.3 HU; median-centric, 24.1 HU; hybrid, 15.9 HU). While the optimal results were obtained using 4D filtration, the 3D hybrid filter is ultimately recommended for denoising 4D cardiac micro-CT data, because it is more computationally tractable and less prone to artifacts (MOBY PSNR: 32.05; left ventricle stdev: 20.5 HU).

  2. Split-bolus single-phase cardiac multidetector computed tomography for reliable detection of left atrial thrombus. Comparison to transesophageal echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Staab, W.; Zwaka, P.A.; Sohns, J.M.; Schwarz, A.; Lotz, J. [University Medical Center Goettingen Univ. (Germany). Inst. for Diagnostic and Interventional Radiology; Sohns, C.; Vollmann, D.; Zabel, M.; Hasenfuss, G. [Goettingen Univ. (Germany). Dept. of Cardiology and Pneumology; Schneider, S. [Goettingen Univ. (Germany). Dept. of Medical Statistics

    2014-11-15

    Evaluation of a new cardiac MDCT protocol using a split-bolus contrast injection protocol and single MDCT scan for reliable diagnosis of LA/LAA thrombi in comparison to TEE, optimizing radiation exposure and use of contrast agent. A total of 182 consecutive patients with drug refractory AF scheduled for PVI (62.6% male, mean age: 64.1 ± 10.2 years) underwent routine diagnostic work including TEE and cardiac MDCT for the evaluation of LA/LAA anatomy and thrombus formation between November 2010 and March 2012. Contrast media injection was split into a pre-bolus of 30 ml and main bolus of 70 ml iodinated contrast agent separated by a short time delay. In this study, split-bolus cardiac MDCT identified 14 of 182 patients with filling defects of the LA/LAA. In all of these 14 patients, abnormalities were found in TEE. All 5 of the 14 patients with thrombus formation in cardiac MDCT were confirmed by TEE. MDCT was 100% accurate for thrombus, with strong but not perfect overall results for SEC equivalent on MDCT.

  3. Automatic cable artifact removal for cardiac C-arm CT imaging

    Science.gov (United States)

    Haase, C.; Schäfer, D.; Kim, M.; Chen, S. J.; Carroll, J.; Eshuis, P.; Dössel, O.; Grass, M.

    2014-03-01

    Cardiac C-arm computed tomography (CT) imaging using interventional C-arm systems can be applied in various areas of interventional cardiology ranging from structural heart disease and electrophysiology interventions to valve procedures in hybrid operating rooms. In contrast to conventional CT systems, the reconstruction field of view (FOV) of C-arm systems is limited to a region of interest in cone-beam (along the patient axis) and fan-beam (in the transaxial plane) direction. Hence, highly X-ray opaque objects (e.g. cables from the interventional setup) outside the reconstruction field of view, yield streak artifacts in the reconstruction volume. To decrease the impact of these streaks a cable tracking approach on the 2D projection sequences with subsequent interpolation is applied. The proposed approach uses the fact that the projected position of objects outside the reconstruction volume depends strongly on the projection perspective. By tracking candidate points over multiple projections only objects outside the reconstruction volume are segmented in the projections. The method is quantitatively evaluated based on 30 simulated CT data sets. The 3D root mean square deviation to a reference image could be reduced for all cases by an average of 50 % (min 16 %, max 76 %). Image quality improvement is shown for clinical whole heart data sets acquired on an interventional C-arm system.

  4. Novel phase-based noise reduction strategy for quantification of left ventricular function and mass assessment by cardiac CT: Comparison with cardiac magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Wai, Bryan, E-mail: bwai@partners.org [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Thai, Wai-ee [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Brown, Heather [Qi Imaging, Redwood City, California (United States); Truong, Quynh A. [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2013-08-15

    Background: Tube current modulation in retrospective ECG gated cardiac computed tomography (CT) results in increased image noise and may reduce the accuracy of left ventricular (LV) ejection fraction (EF) and mass assessment. Objective: To examine the effects of a novel CT phase-based noise reduction (NR) algorithm on LV EF and mass quantification as compared to cardiac magnetic resonance (CMR). Methods: In 40 subjects, we compared the LV EF and mass between CT and CMR. In a subset of 24 subjects with tube current modulated CT, the effect of phase-based noise reduction strategies on contrast-to-noise ratio (CNR) and the assessment of LV EF and mass was compared to CMR. Results: There was excellent correlation between CT and CMR for EF (r = 0.94) and mass (r = 0.97). As compared to CMR, the limits of agreement improved with increasing strength of NR strategy. There was a systematic underestimation of LV mass by CT compared to CMR with no NR (−10.3 ± 10.1 g) and low NR (−10.3 ± 12.5 g), but was attenuated with high NR (−0.5 ± 8.3 g). Studies without NR had lower CNR compared to low and high NR at both the ES phase and ED phase (all p < 0.01). Conclusions: A high NR strategy on tube current modulated functional cardiac CT improves correlation of EF compared to CMR and reduces variability of EF and mass evaluation by increasing the CNR. In an effort to reduce radiation dose with tube current modulation, this strategy provides better image quality when LV function and mass quantification is needed.

  5. Automatic coronary artery calcium scoring in cardiac CT angiography using paired convolutional neural networks.

    Science.gov (United States)

    Wolterink, Jelmer M; Leiner, Tim; de Vos, Bob D; van Hamersvelt, Robbert W; Viergever, Max A; Išgum, Ivana

    2016-12-01

    The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular events. CAC is clinically quantified in cardiac calcium scoring CT (CSCT), but it has been shown that cardiac CT angiography (CCTA) may also be used for this purpose. We present a method for automatic CAC quantification in CCTA. This method uses supervised learning to directly identify and quantify CAC without a need for coronary artery extraction commonly used in existing methods. The study included cardiac CT exams of 250 patients for whom both a CCTA and a CSCT scan were available. To restrict the volume-of-interest for analysis, a bounding box around the heart is automatically determined. The bounding box detection algorithm employs a combination of three ConvNets, where each detects the heart in a different orthogonal plane (axial, sagittal, coronal). These ConvNets were trained using 50 cardiac CT exams. In the remaining 200 exams, a reference standard for CAC was defined in CSCT and CCTA. Out of these, 100 CCTA scans were used for training, and the remaining 100 for evaluation of a voxel classification method for CAC identification. The method uses ConvPairs, pairs of convolutional neural networks (ConvNets). The first ConvNet in a pair identifies voxels likely to be CAC, thereby discarding the majority of non-CAC-like voxels such as lung and fatty tissue. The identified CAC-like voxels are further classified by the second ConvNet in the pair, which distinguishes between CAC and CAC-like negatives. Given the different task of each ConvNet, they share their architecture, but not their weights. Input patches are either 2.5D or 3D. The ConvNets are purely convolutional, i.e. no pooling layers are present and fully connected layers are implemented as convolutions, thereby allowing efficient voxel classification. The performance of individual 2.5D and 3D ConvPairs with input sizes of 15 and 25 voxels, as well as the performance of ensembles of these Conv

  6. Flat-panel volume CT: fundamental principles, technology, and applications.

    Science.gov (United States)

    Gupta, Rajiv; Cheung, Arnold C; Bartling, Soenke H; Lisauskas, Jennifer; Grasruck, Michael; Leidecker, Christianne; Schmidt, Bernhard; Flohr, Thomas; Brady, Thomas J

    2008-01-01

    Flat-panel volume computed tomography (CT) systems have an innovative design that allows coverage of a large volume per rotation, fluoroscopic and dynamic imaging, and high spatial resolution that permits visualization of complex human anatomy such as fine temporal bone structures and trabecular bone architecture. In simple terms, flat-panel volume CT scanners can be thought of as conventional multidetector CT scanners in which the detector rows have been replaced by an area detector. The flat-panel detector has wide z-axis coverage that enables imaging of entire organs in one axial acquisition. Its fluoroscopic and angiographic capabilities are useful for intraoperative and vascular applications. Furthermore, the high-volume coverage and continuous rotation of the detector may enable depiction of dynamic processes such as coronary blood flow and whole-brain perfusion. Other applications in which flat-panel volume CT may play a role include small-animal imaging, nondestructive testing in animal survival surgeries, and tissue-engineering experiments. Such versatility has led some to predict that flat-panel volume CT will gain importance in interventional and intraoperative applications, especially in specialties such as cardiac imaging, interventional neuroradiology, orthopedics, and otolaryngology. However, the contrast resolution of flat-panel volume CT is slightly inferior to that of multidetector CT, a higher radiation dose is needed to achieve a comparable signal-to-noise ratio, and a slower scintillator results in a longer scanning time.

  7. Multiplanar reformat and volume rendering of a multidetector CT scan for path planning a fluoroscopic procedure on Gasserian ganglion block - a preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, Jun; Ishifuro, Minoru; Fukuda, Hiroshi; Akiyama, Yuji; Ito, Katsuhide

    2005-02-01

    In the treatment of trigeminal neuralgia, Gasserian block under fluoroscopical guidance may be difficult because of anatomic variability, and difficulty in identification of the foramen ovale. We introduce how to use three-dimensional CT in the preprocedural planning. We determine the skull-rotation angle in which the foramen ovale is best visualized, the relationship (distance, angle) between the virtual puncture point and anatomical landmarks, and the distance between the virtual puncture point and the foramen.

  8. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    OpenAIRE

    Rozie, S.; de Weert, T. T.; de Monyé, C.; Homburg, P. J.; Tanghe, H L J; Dippel, D W J; van der Lugt, A

    2009-01-01

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic a...

  9. Color-coded perfused blood volume imaging using multidetector CT: initial results of whole-brain perfusion analysis in acute cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kloska, Stephan P.; Fischer, Tobias; Fischbach, Roman; Heindel, Walter [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Nabavi, Darius G.; Dittrich, Ralf; Ringelstein, E.B. [University of Muenster, Department of Neurology, Muenster (Germany); Ditt, Hendrik; Klotz, Ernst [Siemens AG, Medical Solutions, Forchheim (Germany)

    2007-09-15

    Computed tomography (CT) is still the primary imaging modality following acute stroke. To evaluate a prototype of software for the calculation of color-coded whole-brain perfused blood volume (PBV) images from CT angiography (CTA) and nonenhanced CT (NECT) scans, we studied 14 patients with suspected acute ischemia of the anterior cerebral circulation. PBV calculations were performed retrospectively. The detection rate of ischemic changes in the PBV images was compared with NECT. The volume of ischemic changes in PBV was correlated with the infarct volume on follow-up examination taking potential vessel recanalization into account. PBV demonstrated ischemic changes in 12/12 patients with proven infarction and was superior to NECT (8/12) in the detection of early ischemia. Moreover, PBV demonstrated the best correlation coefficient with the follow-up infarct volume (Pearson's R = 0.957; P = 0.003) for patients with proven recanalization of initially occluded cerebral arteries. In summary, PBV appears to be more accurate in the detection of early infarction compared to NECT and mainly visualizes the irreversibly damaged ischemic tissue. (orig.)

  10. Value of multi-detector CT angiography in Takayasu arteritis%多排螺旋CT对多发性大动脉炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    陈海雄; 胡秋根; 李景雷

    2014-01-01

    目的 探讨多排螺旋CT(MDCT)在多发性大动脉炎中的诊断价值。方法 回顾性分析32 例经临床确诊为大动脉炎患者的MDCT 资料及实验室检查,图像后处理方法包括多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现(VR),实验室检查主要包括红细胞沉降率(ESR)和C 反应蛋白(CRP)。结果 按照Lupi-Herrea 分类法,Ⅰ型10 例,Ⅱ型9 例,Ⅲ型8 例,Ⅳ型5 例;共累及血管134 支,狭窄- 阻塞型112 支;扩张型8 支;混合型14 支。受累血管管壁最大厚度范围为1.3~8.6 mm(平均3.65±1.58),活动期管壁最大厚度约2.7~8.6 mm(平均5.24±1.59),明显大于非活动期1.3~6.0 mm (平均2.93±0.92)(P<0.05)。增强扫描活动期管壁强化8 例(80.0%),非活动期管壁轻度强化2 例(9.0%),非活动期管壁钙化 7 例(31.8%)。结论 MDCT 能准确判断多发性大动脉炎的分型、分期及病变范围,可作为其首选检查方法。%ObjectiveTo investigate the clinical value of multi-detector computed tomography(MDCT)in the diagnosis of Takayasu's arteritis.Methods MDCT, erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels of 32 patients with Takayasu’s arteritis were analyzed retrospectively. Image processing included multi-planar reformation(MPR), maximum intensity projection (MIP), and volume rendering reconstruction(VR).Results The patients were classified Lupi-Herrea type I(10), type II(9), type III(8) and type IV(5). Of 134 abnormal vessels, 112 were stenotic or occlusive, 8 were dilated and 14 were mixed. The vessel wall thickness was 1.3-8.6 mm(average 3.65±1.58 mm)with significantly(P<0.05)thicker walls in the active phase(2.7-8.6 mm)than that in the resting phase(1.3-6.0 mm). There was heterogeneous contrast enhancement of the vessel walls in the active phase(80.0%), mild enhancement(9.0%)and calcification (31.8%)in the resting

  11. [The effect of the severity of congenital pectus excavatum on the cardiac morphology in children: evaluation with multislice helical CT].

    Science.gov (United States)

    Lu, Tao; Deng, Kaihong

    2013-12-01

    This paper is aimed to evaluate the CT manifestation of congenital pectus excavatum and its effect on the cardiac morphology. CT features of 34 children with pectus excavatum were retrospectively reviewed. The Haller index (HI), CT depression index (CTDI), cardiac rotation angle (CRA), pulmonary vein angle (PVA), cardiac compression index (CCI) and cardiac asymmetry index (CAI) were measured from the images on the PACS system. The relationships among these indexes were evaluated. The HI was 4.12 +/- 1.48, the CTDI was 2.39+/- 0.70, CRA was (53.52 +/- 7.68) degrees, PVA was (66.51 +/- 11.02) degrees, CCI was 2.43 +/- 0.95, and CAI was 1.55 +/- 0.56. There was statistical significance of CCI and CAI between children with severe or slight pectus excavatum. The HI and CTDI were positively related with CCI and CAI respectively, whereas there was no statistical significance of CRA and PVA between children with severe or slight pectus excavatum. There was no statistical significance of HI, CTDI, CRA, PVA, CCI and CAI among different age groups. The morphological change of the heart compressed in children with pectus excavatum can be accurately evaluated by multislice helical CT.

  12. A registration based approach for 4D cardiac micro-CT using combined prospective and retrospective gating

    Science.gov (United States)

    Badea, Cristian T.; Schreibmann, Eduard; Fox, Tim

    2008-01-01

    Recent advances in murine cardiac studies with three-dimensional cone beam micro-computed tomography (CT) have used either prospective or retrospective gating technique. While prospective gating ensures the best image quality and the highest resolution, it involves longer sampling times and higher radiation dose. Sampling is faster and the radiation dose can be reduced with retrospective gating but the image quality is affected by the limited number of projections with an irregular angular distribution which complicate the reconstruction process, causing significant streaking artifacts. This work involves both prospective and retrospective gating in sampling. Deformable registration is used between a high quality image set acquired with prospective gating with the multiple data sets during the cardiac cycle obtained using retrospective gating. Tests were conducted on a four-dimensional (4D) cardiac mouse phantom and after optimization, the method was applied to in vivo cardiac micro-CT data. Results indicate that, by using our method, the sampling time can be reduced by a factor of 2.5 and the radiation dose can be reduced 35% compared to the prospective sampling while the image quality can be maintained. In conclusion, we proposed a novel solution to 4D cine cardiac micro-CT based on a combined prospective with retrospective gating in sampling and deformable registration post reconstruction that mixed the advantages of both strategies. PMID:18491508

  13. Left ventricle endocardium segmentation for cardiac CT volumes using an optimal smooth surface

    Science.gov (United States)

    Zheng, Yefeng; Georgescu, Bogdan; Vega-Higuera, Fernando; Comaniciu, Dorin

    2009-02-01

    We recently proposed a robust heart chamber segmentation approach based on marginal space learning. In this paper, we focus on improving the LV endocardium segmentation accuracy by searching for an optimal smooth mesh that tightly encloses the whole blood pool. The refinement procedure is formulated as an optimization problem: maximizing the surface smoothness under the tightness constraint. The formulation is a convex quadratic programming problem, therefore has a unique global optimum and can be solved efficiently. Our approach has been validated on the largest cardiac CT dataset (457 volumes from 186 patients) ever reported. Compared to our previous work, it reduces the mean point-to-mesh error from 1.13 mm to 0.84 mm (22% improvement). Additionally, the system has been extensively tested on a dataset with 2000+ volumes without any major failure.

  14. A framework of whole heart extracellular volume fraction estimation for low dose cardiac CT images

    Science.gov (United States)

    Chen, Xinjian; Summers, Ronald M.; Nacif, Marcelo Souto; Liu, Songtao; Bluemke, David A.; Yao, Jianhua

    2012-02-01

    Cardiac magnetic resonance imaging (CMRI) has been well validated and allows quantification of myocardial fibrosis in comparison to overall mass of the myocardium. Unfortunately, CMRI is relatively expensive and is contraindicated in patients with intracardiac devices. Cardiac CT (CCT) is widely available and has been validated for detection of scar and myocardial stress/rest perfusion. In this paper, we sought to evaluate the potential of low dose CCT for the measurement of myocardial whole heart extracellular volume (ECV) fraction. A novel framework was proposed for CCT whole heart ECV estimation, which consists of three main steps. First, a shape constrained graph cut (GC) method was proposed for myocardium and blood pool segmentation for post-contrast image. Second, the symmetric Demons deformable registrations method was applied to register pre-contrast to post-contrast images. Finally, the whole heart ECV value was computed. The proposed method was tested on 7 clinical low dose CCT datasets with pre-contrast and post-contrast images. The preliminary results demonstrated the feasibility and efficiency of the proposed method.

  15. Detection of intramyocardial fatty components in patients with cardiac disease by ultrafast X-ray CT

    Energy Technology Data Exchange (ETDEWEB)

    Kaminaga, T. [Div. of Tracer Kinetics, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Naito, H. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Takamiya, M. [Dept. of Radiology, National Cardiovascular Center, Suita, Osaka (Japan)

    1994-10-01

    To investigate intramyocardial fatty components as regards their distribution, frequency by disorder and cause, 331 patients with cardiac disease were examined with ultrafast X-ray CT (UFCT). The patient group consisted of 139 cases of myocardial infarction and angina, 27 cases of Kawasaki disease, 28 cases of hypertrophic cardiomyopathy (HCM), 22 cases of dilated cardiomyopathy (DCM), 3 cases of arrhythmogenic right ventricular dysplasia (ARVD), 40 cases of valvular disease, 33 cases of left ventricular hypertrophy due to hypertension, 17 cases of arrhythmia, 10 cases of cardiac sarcoidosis, 6 cases of myocarditis and 6 cases of congenital anomaly. Intramyocardial fatty components were detected in 15 patients (5 myocardial infarction, 2 Kawasaki disease, 3 HCM, 4 DCM, 1 ARVD). In patients with myocardial infarction, Kawasaki disease or DCM, the segments with fatty components agreed well with the segments with asynergy in left ventriculography and/or the segments with perfusion defects in thallium myocardial scintigraphy. The frequency of intramyocardial fatty components in each disease was initially determined as follows: 6% in myocardial infarction, 7% in Kawasaki disease, 11% in HCM and 18% in DCM. Ischaemic myocardial damage can induce intramyocardial fatty components in patients with myocardial infarction, Kawasaki disease or DCM. (orig.)

  16. Beam hardening and motion artifacts in cardiac CT: evaluation and iterative correction method

    Science.gov (United States)

    Shen, Zeyang; Lee, Okkyun; Taguchi, Katsuyuki

    2016-03-01

    For myocardial perfusion CT exams, beam hardening (BH) artifacts may degrade the accuracy of myocardial perfusion defect detection. Meanwhile, cardiac motion may make BH process inconsistent, which makes conventional BH correction (BHC) methods ineffective. The aims of this study were to assess the severity of BH artifacts and motion artifacts and propose a projection-based iterative BHC method which has a potential to handle the motion-induced inconsistency better than conventional methods. In this study, four sets of forward projection data were first acquired using both cylindrical phantoms and cardiac images as objects: (1) with monochromatic x-rays without motion; (2) with polychromatic x-rays without motion; (3) with monochromatic x-rays with motion; and (4) with polychromatic x-rays with motion. From each dataset, images were reconstructed using filtered back projection; for datasets 2 and 4, one of the following BHC methods was also performed: (A) no BHC; (B) BHC that concerns water only; and (C) BHC that takes both water and iodine into account, which is an iterative method we developed in this work. Biases of images were quantified by the mean absolute difference (MAD). The MAD of images with BH artifacts alone (dataset 2, without BHC) was comparable or larger than that of images with motion artifacts alone (dataset 3): In the study of cardiac image, BH artifacts account for over 80% of the total artifacts. The use of BHC was effective: with dataset 4, MAD values were 170 HU with no BHC, 54 HU with water BHC, and 42 HU with the proposed BHC. Qualitative improvements in image quality were also noticeable in reconstructed images.

  17. Current role of cardiac and extra-cardiac pathologies in clinically indicated cardiac computed tomography with emphasis on status before pulmonary vein isolation

    Energy Technology Data Exchange (ETDEWEB)

    Sohns, J.M.; Lotz, J. [Goettingen University Medical Center (Germany). Inst. for Diagnostic and Interventional Radiology; German Center for Cardiovascular Research (DZHK), Goettingen (Germany); Menke, J.; Staab, W.; Fasshauer, M.; Kowallick, J.T.; Zwaka, P.A.; Schwarz, A. [Goettingen University Medical Center (Germany). Inst. for Diagnostic and Interventional Radiology; Spiro, J. [Koeln University Hospital (Germany). Radiology; Bergau, L.; Unterberg-Buchwald, C. [Goettingen University Medical Center (Germany). Cardiology and Pneumology

    2014-09-15

    Purpose: The aim of this study was to assess the incidence of cardiac and significant extra-cardiac findings in clinical computed tomography of the heart in patients with atrial fibrillation before pulmonary vein isolation (PVI). Materials and Methods: 224 patients (64 ± 10 years; male 63%) with atrial fibrillation were examined by cardiac 64-slice multidetector CT before PVI. Extra-cardiac findings were classified as 'significant' if they were recommended to additional diagnostics or therapy, and otherwise as 'non-significant'. Additionally, cardiac findings were documented in detail. Results: A total of 724 cardiac findings were identified in 203 patients (91% of patients). Additionally, a total of 619 extra-cardiac findings were identified in 179 patients (80% of patients). Among these extra-cardiac findings 196 (32%) were 'significant', and 423 (68%) were 'non-significant'. In 2 patients (1%) a previously unknown malignancy was detected (esophageal cancer and lung cancer, local stage, no metastasis). 203 additional imaging diagnostics followed to clarify the 'significant' findings (124 additional CT, costs 38,314.69 US dollars). Overall, there were 3.2 cardiac and 2.8 extra-cardiac findings per patient. Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p < 0.05). Conclusion: Cardiac CT scans before PVI should be screened for extracardiac incidental findings that could have important clinical implications for each patient. (orig.)

  18. Anatomical-based partial volume correction for low-dose dedicated cardiac SPECT/CT

    Science.gov (United States)

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-09-01

    Due to the limited spatial resolution, partial volume effect has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods include perturbation geometry transfer matrix (pGTM), pGTM followed by multi-target correction (MTC), pGTM with known concentration in blood pool, the former followed by MTC and our newly proposed methods, which perform the MTC method iteratively, where the mean values in all regions are estimated and updated by the MTC-corrected images each time in the iterative process. The NCAT phantom was simulated for cardiovascular imaging with 99mTc-tetrofosmin, a myocardial perfusion agent, and 99mTc-red blood cell (RBC), a pure intravascular imaging agent. Images were acquired at six different count levels to investigate the performance of PVC methods in both high and low count levels for low-dose applications. We performed two large animal in vivo cardiac imaging experiments following injection of 99mTc-RBC for evaluation of intramyocardial blood volume (IMBV). The simulation results showed our proposed iterative methods provide superior performance than other existing PVC methods in terms of image quality, quantitative accuracy, and reproducibility (standard deviation), particularly for low-count data. The iterative approaches are robust for both 99mTc-tetrofosmin perfusion imaging and 99mTc-RBC imaging of IMBV and blood pool activity even at low count levels. The animal study results indicated the effectiveness of PVC to correct the overestimation of IMBV due to blood pool contamination. In conclusion, the iterative PVC methods can achieve more accurate quantification, particularly for low

  19. Cardiac motion correction based on partial angle reconstructed images in x-ray CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seungeon; Chang, Yongjin; Ra, Jong Beom, E-mail: jbra@kaist.ac.kr [Department of Electrical Engineering, KAIST, Daejeon 305-701 (Korea, Republic of)

    2015-05-15

    Purpose: Cardiac x-ray CT imaging is still challenging due to heart motion, which cannot be ignored even with the current rotation speed of the equipment. In response, many algorithms have been developed to compensate remaining motion artifacts by estimating the motion using projection data or reconstructed images. In these algorithms, accurate motion estimation is critical to the compensated image quality. In addition, since the scan range is directly related to the radiation dose, it is preferable to minimize the scan range in motion estimation. In this paper, the authors propose a novel motion estimation and compensation algorithm using a sinogram with a rotation angle of less than 360°. The algorithm estimates the motion of the whole heart area using two opposite 3D partial angle reconstructed (PAR) images and compensates the motion in the reconstruction process. Methods: A CT system scans the thoracic area including the heart over an angular range of 180° + α + β, where α and β denote the detector fan angle and an additional partial angle, respectively. The obtained cone-beam projection data are converted into cone-parallel geometry via row-wise fan-to-parallel rebinning. Two conjugate 3D PAR images, whose center projection angles are separated by 180°, are then reconstructed with an angular range of β, which is considerably smaller than a short scan range of 180° + α. Although these images include limited view angle artifacts that disturb accurate motion estimation, they have considerably better temporal resolution than a short scan image. Hence, after preprocessing these artifacts, the authors estimate a motion model during a half rotation for a whole field of view via nonrigid registration between the images. Finally, motion-compensated image reconstruction is performed at a target phase by incorporating the estimated motion model. The target phase is selected as that corresponding to a view angle that is orthogonal to the center view angles of

  20. CT of tracheal agenesis

    Energy Technology Data Exchange (ETDEWEB)

    Strouse, Peter J.; Hernandez, Ramiro J. [C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Newman, Beverley [Children' s Hospital of Pittsburgh, PA (United States). Department of Pediatric Radiology; Afshani, Ehsan [Children' s Hospital of Buffalo, NY (United States). Departments of Radiology and Pediatrics; Bommaraju, Mahesh [Women' s and Children' s Hospital of Buffalo, Division of Neonatology, University Pediatrics Associates, Buffalo, NY (United States)

    2006-09-15

    Tracheal agenesis is a rare and usually lethal anomaly. In the past, opaque contrast medium was injected via the esophagus to demonstrate the anatomy. To demonstrate the utility of helical and multidetector CT in delineating the aberrant anatomy in newborns with tracheal agenesis. Four newborns with tracheal agenesis were identified from three institutions. Imaging studies and medical records were reviewed. Each child was imaged with chest radiography. One child was imaged on a single-detector helical CT scanner and the other three on multidetector scanners. Helical and multidetector CT with 2D and 3D reconstructions clearly delineated the aberrant tracheobronchial and esophageal anatomy in each infant. Minimum intensity projection reformatted CT images were particularly helpful. One infant each had type I and type II tracheal agenesis. Two infants had type III tracheal agenesis. All four infants died. CT is a useful tool for delineating the aberrant anatomy of newborns with tracheal agenesis and thus helps in making rational clinical decisions. (orig.)

  1. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  2. Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: impact on surgical procedure

    Energy Technology Data Exchange (ETDEWEB)

    Frericks, Bernd B.J. [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); University of Berlin, Department of Radiology, Berlin (Germany); Charite - University Medicine Berlin, Department of Radiology and Nuclear Medicine, Berlin (Germany); Kirchhoff, Timm D.; Shin, Hoen-Oh; Stamm, Georg; Merkesdal, Sonja; Abe, Takehiko; Galanski, Michael [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Schenk, Andrea; Peitgen, Heinz-Otto [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); MeVis - Center for Medical Diagnostic Systems and Visualization, Bremen (Germany); Klempnauer, Juergen [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Nashan, Bjoern [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Dalhousie University, Multi Organ Transplant Program, Halifax, Nova Scotia (Canada)

    2006-12-15

    The purpose was to assess the volumes of the different hepatic territories and especially the drainage of the right paramedian sector in adult living donor liver transplantation (ALDLT). CT was performed in 40 potential donors of whom 28 underwent partial living donation. Data sets of all potential donors were postprocessed using dedicated software for segmentation, volumetric analysis and visualization of liver territories. During an initial period, volumes and shapes of liver parts were calculated based on the individual portal venous perfusion areas. After partial hepatic congestion occurring in three grafts, drainage territories with special regard to MHV tributaries from the right paramedian sector, and the IRHV were calculated additionally. Results were visualized three-dimensionally and compared to the intraoperative findings. Calculated graft volumes based on hepatic venous drainage and graft weights correlated significantly (r=0.86,P<0.001). Mean virtual graft volume was 930 ml and drained as follows: RHV: 680 ml, IRHV: 170 ml (n=11); segment 5 MHV tributaries: 100 ml (n=16); segment 8 MHV tributaries: 110 ml (n=20). When present, the mean aberrant venous drainage fraction of the right liver lobe was 28%. The evaluated protocol allowed a reliable calculation of the hepatic venous draining areas and led to a change in the hepatic venous reconstruction strategy at our institution. (orig.)

  3. 多排螺旋CT 诊断小网膜囊病变的价值%Diagnostic value of multi-detector CT for abnormalities in lesser omental bursa

    Institute of Scientific and Technical Information of China (English)

    成峰; 吴凯宏; 李孝虎

    2011-01-01

    目的 探讨小网膜囊正常解剖及病变的多排螺旋CT(MDCT)表现,评价小网膜囊病变的CT 诊断价值.方法 对24 例小网膜囊病变进行上腹部CT 平扫及三期增强扫描检查,均经手术病理证实.结果 小网膜囊病变中:原发肿瘤6 例(神经鞘瘤2 例,平滑肌瘤1 例,血管瘤1 例,脂肪肉瘤1 例,淋巴瘤1 例),CT 表现为小网膜囊内边界清晰肿块.邻近脏器的良、恶性肿瘤8 例(胰头癌4 例,肝左叶肝细胞癌2 例,胃间质瘤2 例),CT 表现为小网膜囊肿块与邻近相应肿瘤边界不清.转移性肿瘤2 例.结核1 例,CT 表现多个病灶融合,内见钙化.积液(腹水漏出液、炎性渗出液、脓液、血液、胆汁、淋巴液)6 例;假性囊肿1 例;CT 均表现为小网膜囊内液性密度灶.结论 多排螺旋CT对小网膜囊病变具有重要的诊断价值.%Objective To investigate the normal CT anatomy and diagnostic value of CT for abnormalities of lesser omental bursa. Methods Twenty-four patients with 6 primary neoplasms (2 neurinomas, 1 leiomyoma, 1 cavernous hemangioma, 1 liposarcoma, 1 lymphoma), 8 local spread from adjacent benign or malignant neoplasms (4 carcinomas of head of pancreas, 2 left hepatic tumors, 2 gastrointestinal stromal tumors of the stomach), 2 metastatic tumors, 1 tuberculosis, 6 fluid collections (transudate ascites, inflammatory infiltrate, pus, blood, bile, lymph), lpseudocyst were enrolled in the study. All of the lesions were confirmed by operation and pathology. The pre- and post-contrast abdominal CT scans were reviewed. Results The borders of the 6 primary neoplasms were well-defined on CT whereas the 8 benign or malignant neoplasms originating from adjacent structures were contiguous with the primary tumors. CT showed multiple aggregated lesions on 2 patients with metastases and 1 patient with tuberculosis. The 6 fluid collections and lpseudocyst displayed fluid density within lesser omental bursa on CT. Conclusion CT is valuable in

  4. Transcatheter Mitral Paravalvular Leak Closure Facilitated by Preprocedural Cardiac CT for Simulation of Fluoroscopic Anatomy and Paravalvular Defect Localization.

    Science.gov (United States)

    Korsholm, Kasper; Mortensen, Ulrik; Jensen, Jesper Møller; Piazza, Nicolo; Thériault-Lauzier, Pascal; Nielsen-Kudsk, Jens Erik

    2017-02-01

    Paravalvular leakage (PVL) occurs in 6%-15% of cases after surgical heart valve replacement. A percutaneous approach is increasingly used to close PVLs as an alternative to repeat surgery. Computed tomography (CT) can be used for simulation of fluoroscopic cardiac anatomy. This technique allows preprocedural definition of optimal C-arm angulations and PVL localization in reference to fluoroscopic views. It is very helpful for guidewire crossing of the PVL and positioning of the closure device. We report a case with the first use of dedicated software for fluoroscopic simulation (FluoroCT) in transcatheter mitral PVL closure.

  5. Value of multi-detector spiral CT angiography in the assessment of coronary artery elasticity%多层螺旋CT血管成像在冠状动脉弹性研究中的价值

    Institute of Scientific and Technical Information of China (English)

    许开元; 肖丹丹; 何祥发; 贾艳莲; 高芳琴; 张雪林

    2015-01-01

    Objective To study the efficacy of multi-detector spiral CT angiography (CTA) for evaluating coronary artery elasticity. Methods CTA was performed on 133 patients from August 2010 to April 2013..Diameter changes of 412 segment of coronary arteries in the systolic and diastolic phases were measured by CTA and digital subtraction angiography (DSA)..Coronary artery elastic parameters and elasticity index (ERI) were analyzed and correlated with DSA results. Results The ERI was positively correlated with remodeling on DSA (P0) in 46 coronary artery segments,.no significant remodeling (ERI=0) in 32 segments,.and negative remodeling (ERI<0) in 71 segments. Conclusion Multi-slice CTA can reflect the elasticity of coronary vessel walls. Compared with the results of DSA , coronary artery elasticity index correlates with the remodeling of coronary artery plaques and allows assessment of plaque instability.%目的:评价多层螺旋CT血管成像在冠状动脉弹性重塑中的价值。方法选取2010年8月~2013年4月本院行冠状动脉 CT 血管成像检查及冠脉 DSA 检查患者资料共133例,通过测量冠状动脉412节段在收缩期、舒张期的动脉管径变化,并与DSA对照,分析冠状动脉斑块处血管弹性,计算冠状动脉弹性重塑指数,并分析冠状动脉弹性重塑指数与DSA结果的相关性。结果冠状动脉弹性重塑指数(ERI)与DSA结果呈正相关,(P<0.05, r=0.402)。斑块处冠状动脉弹性正性重塑(ERI>0)46节段,无明显重塑者(ERI=0)32节段,负性重塑者(ERI<0)71节段。结论多层螺旋 CT 血管成像可较好反映正常冠状动脉血管壁弹性。与冠状动脉DSA结果相比,斑块处冠状动脉弹性重塑指数可反映斑块处冠状动脉弹性重塑情况,评价斑块稳定性。

  6. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... the best way to see if treatment is working or if a finding is stable or changed over time. top of page What are the benefits vs. risks? Benefits Using a multidetector CT unit ...

  7. Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT.

    Directory of Open Access Journals (Sweden)

    Damian Craiem

    Full Text Available BACKGROUND: The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC can be assessed from computed tomography (CT scans, originally aimed at coronary artery calcium (CAC assessment. CAC screening improves cardiovascular risk prediction, beyond standard risk assessment, whereas TAC performance remains controversial. However, the curvilinear portion of the thoracic aorta (TA, that includes the aortic arch, is systematically excluded from TAC analysis. We investigated the prevalence and spatial distribution of TAC all along the TA, to see how those segments that remain invisible in standard TA evaluation were affected. METHODS AND RESULTS: A total of 970 patients (77% men underwent extended non-contrast cardiac CT scans including the aortic arch. An automated algorithm was designed to extract the vessel centerline and to estimate the vessel diameter in perpendicular planes. Then, calcifications were quantified using the Agatston score and associated with the corresponding thoracic aorta segment. The aortic arch and the proximal descending aorta, "invisible" in routine CAC screening, appeared as two vulnerable sites concentrating 60% of almost 11000 calcifications. The aortic arch was the most affected segment per cm length. Using the extended measurement method, TAC prevalence doubled from 31% to 64%, meaning that 52% of patients would escape detection with a standard scan. In a stratified analysis for CAC and/or TAC assessment, 111 subjects (46% women were exclusively identified with the enlarged scan. CONCLUSIONS: Calcium screening in the TA revealed that the aortic arch and the proximal descending aorta, hidden in standard TA evaluations, concentrated most of the calcifications. Middle-aged women were more prone to have calcifications in those hidden portions and became candidates for reclassification.

  8. Image artefact propagation in motion estimation and reconstruction in interventional cardiac C-arm CT.

    Science.gov (United States)

    Müller, K; Maier, A K; Schwemmer, C; Lauritsch, G; De Buck, S; Wielandts, J-Y; Hornegger, J; Fahrig, R

    2014-06-21

    The acquisition of data for cardiac imaging using a C-arm computed tomography system requires several seconds and multiple heartbeats. Hence, incorporation of motion correction in the reconstruction step may improve the resulting image quality. Cardiac motion can be estimated by deformable three-dimensional (3D)/3D registration performed on initial 3D images of different heart phases. This motion information can be used for a motion-compensated reconstruction allowing the use of all acquired data for image reconstruction. However, the result of the registration procedure and hence the estimated deformations are influenced by the quality of the initial 3D images. In this paper, the sensitivity of the 3D/3D registration step to the image quality of the initial images is studied. Different reconstruction algorithms are evaluated for a recently proposed cardiac C-arm CT acquisition protocol. The initial 3D images are all based on retrospective electrocardiogram (ECG)-gated data. ECG-gating of data from a single C-arm rotation provides only a few projections per heart phase for image reconstruction. This view sparsity leads to prominent streak artefacts and a poor signal to noise ratio. Five different initial image reconstructions are evaluated: (1) cone beam filtered-backprojection (FDK), (2) cone beam filtered-backprojection and an additional bilateral filter (FFDK), (3) removal of the shadow of dense objects (catheter, pacing electrode, etc) before reconstruction with a cone beam filtered-backprojection (cathFDK), (4) removal of the shadow of dense objects before reconstruction with a cone beam filtered-backprojection and a bilateral filter (cathFFDK). The last method (5) is an iterative few-view reconstruction (FV), the prior image constrained compressed sensing combined with the improved total variation algorithm. All reconstructions are investigated with respect to the final motion-compensated reconstruction quality. The algorithms were tested on a mathematical

  9. 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

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

    Directory of Open Access Journals (Sweden)

    M. Motevalli

    2007-05-01

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

  11. Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves

    NARCIS (Netherlands)

    Habets, Jesse; van den Brink, Renee B. A.; Uijlings, Ruben; Spijkerboer, Anje M.; Mali, Willem P. Th. M.; Chamuleau, Steven A. J.; Budde, Ricardo P. J.

    2012-01-01

    Objectives Patients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT. Methods ECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of p

  12. Investigation of saddle trajectories for cardiac CT imaging in cone-beam geometry

    Energy Technology Data Exchange (ETDEWEB)

    Pack, Jed D [Department of Radiology, University of Utah, Salt Lake City, UT 84112 (United States); Noo, Frederic [Department of Radiology, University of Utah, Salt Lake City, UT 84112 (United States); Kudo, H [Department of Computer Science, Graduate School of Systems and Information Engineering, University of Tsukuba (Japan)

    2004-06-07

    This paper investigates cone-beam tomography for a wide class of x-ray source trajectories called saddles. In particular, a mathematical analysis of the number of intersections between a saddle and an arbitrary plane is given. This analysis demonstrates that axially truncated cone-beam projections acquired along a saddle can be used for exact reconstruction at any point in a large volume. The reconstruction can be achieved either using a new algorithm presented herein or using a formula recently introduced by Katsevich (2003 Int. J. Math. Math. Sci. 21 1305-21). The shape of the reconstructed volume and the properties of saddles make saddles attractive for cardiac imaging. Three examples of saddles are presented with a discussion of implementation on devices similar to modern C-arm systems and multislice CT scanners. Reconstruction with one of these saddles has been tested using computer-simulated data, with and without truncation. The imaged phantom for the truncated data is a FORBILD head phantom (representing the heart) that has been modified and embedded inside the FORBILD thorax phantom. The non-truncated data were generated by excluding the thorax. The reconstructed images demonstrate the accuracy of the mathematical results.

  13. A framework of whole heart extracellular volume fraction estimation for low-dose cardiac CT images.

    Science.gov (United States)

    Chen, Xinjian; Nacif, Marcelo S; Liu, Songtao; Sibley, Christopher; Summers, Ronald M; Bluemke, David A; Yao, Jianhua

    2012-09-01

    Cardiac CT (CCT) is widely available and has been validated for the detection of focal myocardial scar using a delayed enhancement technique in this paper. CCT, however, has not been previously evaluated for quantification of diffuse myocardial fibrosis. In our investigation, we sought to evaluate the potential of low-dose CCT for the measurement of myocardial whole heart extracellular volume (ECV) fraction. ECV is altered under conditions of increased myocardial fibrosis. A framework consisting of three main steps was proposed for CCT whole heart ECV estimation. First, a shape-constrained graph cut (GC) method was proposed for myocardium and blood pool segmentation on postcontrast image. Second, the symmetric demons deformable registration method was applied to register precontrast to postcontrast images. So the correspondences between the voxels from precontrast to postcontrast images were established. Finally, the whole heart ECV value was computed. The proposed method was tested on 20 clinical low-dose CCT datasets with precontrast and postcontrast images. The preliminary results demonstrated the feasibility and efficiency of the proposed method.

  14. Multidetector CT and DSA research of beagle′s celiac artery anatomy%比格犬腹腔动脉解剖的多层螺旋 CT和 DSA 研究

    Institute of Scientific and Technical Information of China (English)

    迪里木拉提·巴吾冬; 巴哈提·哈立亚; 别克木拉提·马合木提; 赵建卿

    2013-01-01

    Objective To assess the anatomical features of beagle′s celiac artery by multidetector CT angi-ography (MDCTA) and digital subtraction angiography (DSA) .Methods 15 adult beagles were examined by multidetector CT (MDCT ) .Celiac artery was catheterized via a superficial branch access of femoral ar-tery and performed selective angiography .Results MDCT and angiography were performed successfully in all animals ,with a success rate of 100% (15/15) .Beagle′s celiac artery anatomy is very similar to the hu-man′s .Similarities between the beagle′s and human celiac artery anatomy revealed by MSCT and DSA in-clude:(1) The celiac artery arises from the aorta at the same level ;(2) After arising from the anterior wall of the aorta ,the celiac artery runs forwardly and gives branches ;(3) Although Left gastric artery ari-ses from the proximal splenic artery in beagle ,it is still a branch of the celiac artery ,therefore ,three branches of celiac artery ,the hepatic artery ,splenic artery and left gastric artery were the same with hu-man′s .The differences are :(1) Left gastric artery arise from the proximal splenic artery ;(2) Gastroduo-denal artery arise at the liver hilar .The proper hepatic artery is very short or absent .In 3 dogs ,right he-patic artery rises before the gastroduodenal artery (20% ) .Conclusion The study confirms anatomical similarity between the beagle′s celiac artery and the human celiac artery .It has broad application prospects in animal interventional studies of the liver ,spleen ,pancreas ,stomach and other organs .%目的:采用多层螺旋CT血管造影(MDCTA)和数字减影血管造影(DSA)评价比格犬腹腔动脉及其主要分支的解剖学特点。方法成年比格犬15只,分别进行多层螺旋C T (M DC T )检查和在直视下行经股动脉浅表分支选择性腹腔动脉插管及DSA造影术,观察腹腔干其主要分支的起源和走行并测量直径和长度。结果15只比格犬15条股动脉

  15. Diagnostic value of appendicolith in appendicitis with multi-detector CT%阑尾石多排螺旋CT征象诊断阑尾炎的价值

    Institute of Scientific and Technical Information of China (English)

    戚乐; 向军益; 戴平丰; 丁建平

    2012-01-01

    Objective To investigate the diagnostic value of appendicolith in appendicitis with multi-detector CT. Methods MDCT findings of 87 cases of appendicitis and 55 cases of non-appendicitis confirmed by surgery and clinical follow-up were retrospectively analysed. The relationship between appendicolith and appendicitis was statistically analysed. Results The appendicolith sign in MDCT was positive in 43 cases(33 cases of appendicitis and 10 cases of non-appendicitis). The appendicolith sign was not of significant difference on CT images in differential diagnosis for appendicitis and non-appendicitis, including pathologically classified (P>0. 05). The accuracy was 54. 9% , the sensitivity was 37. 9% , and the specificity was 81. 8% in diagnosing appendicititis with appendicolith sign. Obstructive appendicolith sign in 12 cases (short diameter>5 mm, located in the appendix proximal) was more seen in appendicitis group,but could identify pathologically classified(P>0. 05). The extraluminal appendicolith sign in 5 cases was seen only in gangrenous appendicitis (P<0. 05). Conclusion Obstructive appendicolith sign is helpful in diagnosis of appendicitis, and extraluminal appendicolith sign has high specificity in diagnosis of gangrenous appendicitis.%目的 探讨阑尾石MDCT征象诊断阑尾炎的价值.方法 回顾分析经手术和临床随访证实的87例阑尾炎和55例非阑尾炎患者的MDCT影像表现.统计分析阑尾石征象与阑尾炎的关系.结果 阑尾石征象阳性43例(阑尾炎患者33例,非阑尾炎患者10例),诊断阑尾炎的准确性、敏感性和特异性分别为54.9%、37.9%和81.8%,在阑尾炎组和非阑尾炎组中出现的概率无显著差异性,亦不能鉴别阑尾炎的病理分型(P>0.05).12例梗阻性阑尾石征象(短径≥5 mm,位于阑尾近端)多见于阑尾炎组,但不能鉴别阑尾炎病理分型(P>0.05).5例腔外阑尾石征象仅见于坏疽性阑尾炎(P<0.05).结论 梗阻性阑尾石征象有助于

  16. Hereditary haemorrhagic telangiectasia: study of hepatic vascular alterations with multi-detector row helical CT and reconstruction programs; Telangiectasia emorragica ereditaria: TC multidetettore multifasica e programmi di ricostruzione nello studio delle alterazioni vascolari epatiche

    Energy Technology Data Exchange (ETDEWEB)

    Memeo, Maurizio; Stabile Ianora, Amato Antonio; Scaldapane, Arnaldo; Rotondo, Antonio; Angelelli, Giuseppe [Policlinico Universitario, Bari (Italy). DiMIMP Sezione di Diagnostica per Immagini; Suppressa, Patrizia; Cirulli, Anna; Sabba' , Carlo [Policlinico Universitario, Bari (Italy). Centro Interdipartimentale per lo studio dell' HHT

    2005-02-01

    Purpose: To evaluate hepatic alterations in patients affected by Hereditary Haemorrhagic Telangiectasia (HHT) by using multidetector row helical CT (MDCT) and new reconstruction programs. Materials and methods: An MDCT multiphasic study of the liver was performed in 105 consecutive patients: 89 considered to be affected by HHT and 16 with suspicion of disease alone. The scan delay was determined by using a test bolus of contrast material. The CT examination was performed with a triphasic technique (double arterial phase and portal venous phase). multiplanar and angiographic reconstructions were then obtained, and the images checked for the presence of shunts, hepatic perfusion disorders, vascular lesions (telangiectasis and large confluent vascular masses), indirect signs of portal hypertension, and anatomical vascular variants. Results: Hepatic vascular alterations were found in 78/105 cases (67/89) patients affected by HHT and 11/16 patients with clinical suspicion alone). Therefore HHT diagnosis was excluded in 5 patients. 78/100 (78%) patients with HHT had intrahepatic vascular alterations: arterioportal shunts in 40/78 (51.2%) arteriosystemic shunts in 16/78 (20.5%) and both shunt types in 22/78 (28.3%). Intraparenchymal perfusion disorders were found in 46/78 (58.9%) patients. Telangiectasis were recognised in 50/78 (64.1%) patients. Large confluent vascular masses (LCVMs) were identified in 20/78 (25.6%) patients. indirect signs of portal hypertension were found in 46/78 (58.9%) cases. Variant hepatic arterial anatomy was present in 38/100 cases (38%). Conclusions: Multiphasic MDCT and the new reconstruction programs enable the identification and characterisation of the complex vascular alterations typical of HHT. [Italian] Scopo: Valutare le alterazioni epatiche nei pazienti affetti da Telangiectasia Emorraica Ereditaria (TEE) utilizzando una TC multidetettore (TCMD) ed in nuovi programmi di ricostruzione. Materiale e metodi: E' stato eseguito uno

  17. Venous thromboembolic disease. CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, L. R. [Medical College of Wisconsin, Pulmonary Medicine and Intensive Care, Dept. of Diagnostic Radiology, Milwaukee, WI (United States)

    2001-12-01

    Helical and multidetector CT has proven to be a valuable imaging modality for both pulmonary embolism and deep venous thrombosis. This paper will review the sensitivity and specificity of CT and discuss diagnostic algorithms utilizing CT and more established imaging technologies.

  18. Multidetector CT of hepatic artery pathologies.

    Science.gov (United States)

    Karaosmanoglu, D; Erol, B; Karcaaltincaba, M

    2012-01-01

    The hepatic artery can be involved by a variety of pathology and diseases.Today MDCT enables high quality imaging of the hepatic artery using axial, MIP and volume rendered images. We illustrate MDCT findings of anatomical variations, aneurysm, dilatation, dissection, arteriovenous fistula, thrombosis and stenosis. Aneurysms can be saccular, fusiform and multiple and may develop due to atherosclerosis, vasculitis, trauma and biopsy. Dilatation of hepatic artery can be seen in portal hypertension, Osler-Weber-Rendu disease and hemangiomatosis. Hepatic artery can be occluded after trauma and transplantation. Dissection develops due to atherosclerosis, Marfan and Ehler Danlos syndromes and during pregnancy. Arteriovenous fistula can be congenital and acquired. We conclude that various hepatic artery pathologies can be confidently diagnosed by MDCT.

  19. Watermarked cardiac CT image segmentation using deformable models and the Hermite transform

    Science.gov (United States)

    Gomez-Coronel, Sandra L.; Moya-Albor, Ernesto; Escalante-Ramírez, Boris; Brieva, Jorge

    2015-01-01

    Medical image watermarking is an open area for research and is a solution for the protection of copyright and intellectual property. One of the main challenges of this problem is that the marked images should not differ perceptually from the original images allowing a correct diagnosis and authentication. Furthermore, we also aim at obtaining watermarked images with very little numerical distortion so that computer vision tasks such as segmentation of important anatomical structures do not be impaired or affected. We propose a preliminary watermarking application in cardiac CT images based on a perceptive approach that includes a brightness model to generate a perceptive mask and identify the image regions where the watermark detection becomes a difficult task for the human eye. We propose a normalization scheme of the image in order to improve robustness against geometric attacks. We follow a spread spectrum technique to insert an alphanumeric code, such as patient's information, within the watermark. The watermark scheme is based on the Hermite transform as a bio-inspired image representation model. In order to evaluate the numerical integrity of the image data after watermarking, we perform a segmentation task based on deformable models. The segmentation technique is based on a vector-value level sets method such that, given a curve in a specific image, and subject to some constraints, the curve can evolve in order to detect objects. In order to stimulate the curve evolution we introduce simultaneously some image features like the gray level and the steered Hermite coefficients as texture descriptors. Segmentation performance was assessed by means of the Dice index and the Hausdorff distance. We tested different mark sizes and different insertion schemes on images that were later segmented either automatic or manual by physicians.

  20. 多排螺旋CT在气管、支气管异物临床诊断中的价值%Diagnostic Value of Multidetector Spiral CT for Foreign Bodies in Trachea and Bronchus of Children

    Institute of Scientific and Technical Information of China (English)

    赵银霞; 王晓东; 陆彪; 郭宏庆

    2011-01-01

    Objective To explore the diagnostic value of multidetector spiral CT (MDCT) for foreign bodies in trachea and bronchus of children. Methods The clinical and MDCT manifestations of 97 children with highly suspected tracheobronchial foreign body were analyzed retrospectively. MDCT scan and bronchoscopy were performed in all the patients, and the post - processing reconstruction included multiple planar reconstruction ( MPR ), CT virtual bronchoscopy (CTVB), shaded surface display (SSD) and minimum intensity projection (MinlP).Results The clinical symptoms of tracheobronchial foreign bodies in children were generally atypical, and the common symptoms were various degrees of wheezing, coughing and recurrent lung infection. Of all the 97 cases, the foreign bodies were mainly opaque plant ones,and mostly were located in the bronchus lobaris and below the segmental bronchus,the left or right main bronchus. In 89 eases, foreign bodies were found directly by MDCT reconstruction, and the complications such as obstructive pneumonia, emphysema, atelectasis and mediastinal emphysema caused by foreign bodies were also shown. In 4 cases, MDCT only showed emphysema on one side and patchy pulmonary inflammation, while the foreign bodies which were not found by MDCT were removed by bronchoscopy. In another 4 cases, foreign bodies in the bronchial lumen showed on MDCT disappeared under bronchoscopy, among which two turned to be thick sputum. After anti - inflammatory treatment, lung inflammation and clinical symptoms disappeared in these patients. Bronchoscopy was performed under the guidance of CT imaging results, and the foreign bodies were removed successfully in 93 cases. The accuracy of MDCT in the diagnosis of tracheobronchial foreign body in children was 95.9%. Conclusions MDCT has great value in the diagnosis of tracheobronchial foreign body in children, but the clinical history and physical signs of the patients should also be considered.%目的 探讨多排螺旋CT(MDCT)

  1. A novel method for incorporating respiratory-matched attenuation correction in the motion correction of cardiac PET-CT studies

    Science.gov (United States)

    McQuaid, Sarah J.; Lambrou, Tryphon; Hutton, Brian F.

    2011-05-01

    Mismatches between PET and CT datasets due to respiratory effects can lead to artefactual perfusion defects. To overcome this, we have proposed a method of aligning a single CT with each frame of a gated PET study in a semi-automatic manner, incorporating a statistical shape model of the diaphragm and a rigid registration of the heart. This ensures that the structures that could influence the appearance of the reconstructed cardiac activity are correctly matched between emission and transmission datasets. When tested on two patient studies, it was found in both cases that attenuation correction using the proposed technique resulted in PET images that were closer to the gold standard of attenuation correction with a gated CT, compared with scenarios where only heart matching was considered (and not the diaphragm) or where no transformation was performed (i.e. where a single CT frame was used to attenuation-correct all PET frames). These preliminary results suggest that diaphragm matching between PET and CT improves the quantitative accuracy of reconstructed PET images and that the proposed method of using a statistical shape model to describe the diaphragm shape and motion, in combination with a rigid registration to determine respiratory-induced heart motion, is a feasible method of achieving this.

  2. Quantification of myocardial delayed enhancement and wall thickness in hypertrophic cardiomyopathy: Multidetector computed tomography versus magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Lei [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd Beijing (China); Ma, Xiaohai, E-mail: maxi8238@gmail.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd Beijing (China); Feuchtner, Gudrun Maria [Department of Radiology II, Innsbruck Medical University, Innsbruck (Austria); Zhang, Chen; Fan, Zhanming [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd Beijing (China)

    2014-10-15

    Objectives: To evaluate the accuracy of multidetector computed tomography (MDCT) in assessing myocardial delayed enhancement and left ventricle wall thickness in hypertrophic cardiomyopathy (HCM) compared with cardiac magnetic resonance (CMR) as the reference standard. Materials and methods: Eighty consecutive patients (59 male; 53.2 ± 13.0 years) were examined with MDCT, followed by CMR 1 day later. Cardiac CT angiography and a delayed CT were performed. CMR was performed according to a standardized protocol. Left ventricle wall thickness and positions of myocardial delayed enhancement were identified in both CMR and CT images according to the American Heart Association left ventricle 17-segment model. Myocardial delayed enhancement was characterized as “dense” (areas with clear defined borders) or “diffuse” and then quantified using both techniques. Results: Left ventricle wall thickness determined by MDCT was significantly correlated with CMR (R = 0.88, P < 0.01). Compared with CMR, MDCT accurately diagnosed 74 of 78 (94.9%) patients and 1243 of 1326 (93.7%) segments. For dense myocardial delayed enhancement, MDCT significantly correlated with CMR (R = 0.88, P < 0.01) and slightly underestimated myocardial delayed enhancement (mean, −3.85%; lower and upper limits of agreement, −13.40% and 5.70%, respectively). Conclusions: MDCT provides reliable quantification of myocardial delayed enhancement and evaluation of left ventricle wall thickness and has a good correlation with CMR in patients with HCM when a comprehensive cardiac CT protocol is used and can be applied for intervention planning.

  3. Correlation of CT-based regional cardiac function (SQUEEZ) with myocardial strain calculated from tagged MRI: an experimental study.

    Science.gov (United States)

    Pourmorteza, Amir; Chen, Marcus Y; van der Pals, Jesper; Arai, Andrew E; McVeigh, Elliot R

    2016-05-01

    The objective of this study was to investigate the correlation between local myocardial function estimates from CT and myocardial strain from tagged MRI in the same heart. Accurate detection of regional myocardial dysfunction can be an important finding in the diagnosis of functionally significant coronary artery disease. Tagged MRI is currently a reference standard for noninvasive regional myocardial function analysis; however, it has practical drawbacks. We have developed a CT imaging protocol and automated image analysis algorithm for estimating regional cardiac function from a few heartbeats. This method tracks the motion of the left ventricular (LV) endocardial surface to produce local function maps: we call the method Stretch Quantification of Endocardial Engraved Zones (SQUEEZ). Myocardial infarction was created by ligation of the left anterior descending coronary artery for 2 h followed by reperfusion in canine models. Tagged and cine MRI scans were performed during the reperfusion phase and first-pass contrast enhanced CT scans were acquired. The average delay between the CT and MRI scans was myocardial strain (Ecc) was calculated from the tagged MRI data. The agreement between peak systolic Ecc and SQUEEZ was investigated in 162 segments in the 9 hearts. Linear regression and Bland-Altman analysis was used to assess the correlation between the two metrics of local LV function. The results show good agreement between SQUEEZ and Ecc: (r = 0.71, slope = 0.78, p function. The good agreement between the estimates of local myocardial function obtained from CT SQUEEZ and tagged MRI provides encouragement to investigate the use of SQUEEZ for measuring regional cardiac function at a low clinical dose in humans.

  4. Prospective-gated cardiac micro-CT imaging of free-breathing mice using carbon nanotube field emission x-ray

    Energy Technology Data Exchange (ETDEWEB)

    Cao Guohua; Burk, Laurel M.; Lee, Yueh Z.; Calderon-Colon, Xiomara; Sultana, Shabana; Lu Jianping; Zhou, Otto [Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599 and Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Curriculum in Applied Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599 (United States) and Curriculum in Applied Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Curriculum in Applied Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina 27599 (United States) and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599 (United States)

    2010-10-15

    Purpose: Carbon nanotube (CNT) based field emission x-ray source technology has recently been investigated for diagnostic imaging applications because of its attractive characteristics including electronic programmability, fast switching, distributed source, and multiplexing. The purpose of this article is to demonstrate the potential of this technology for high-resolution prospective-gated cardiac micro-CT imaging. Methods: A dynamic cone-beam micro-CT scanner was constructed using a rotating gantry, a stationary mouse bed, a flat-panel detector, and a sealed CNT based microfocus x-ray source. The compact single-beam CNT x-ray source was operated at 50 KVp and 2 mA anode current with 100 {mu}mx100 {mu}m effective focal spot size. Using an intravenously administered iodinated blood-pool contrast agent, prospective cardiac and respiratory-gated micro-CT images of beating mouse hearts were obtained from ten anesthetized free-breathing mice in their natural position. Four-dimensional cardiac images were also obtained by gating the image acquisition to different phases in the cardiac cycle. Results: High-resolution CT images of beating mouse hearts were obtained at 15 ms temporal resolution and 6.2 lp/mm spatial resolution at 10% of system MTF. The images were reconstructed at 76 {mu}m isotropic voxel size. The data acquisition time for two cardiac phases was 44{+-}9 min. The CT values observed within the ventricles and the ventricle wall were 455{+-}49 and 120{+-}48 HU, respectively. The entrance dose for the acquisition of a single phase of the cardiac cycle was 0.10 Gy. Conclusions: A high-resolution dynamic micro-CT scanner was developed from a compact CNT microfocus x-ray source and its feasibility for prospective-gated cardiac micro-CT imaging of free-breathing mice under their natural position was demonstrated.

  5. 自发性腹腔干夹层的 MSCT 血管成像表现%Imaging manifestations of spontaneous celiac artery trunk dissection with multi-detector CT angiography

    Institute of Scientific and Technical Information of China (English)

    宁辉; 张龙江

    2015-01-01

    Objective:To summarize the multi-detector CT angiography (MDCTA)manifestations of spontaneous ce-liac artery trunk dissection.Methods:The clinical and MDCTA manifestations of 14 patients with spontaneous celiac artery trunk dissection were retrospectively analyzed.Results:Of the 14 patients,10 patients (71.4%,10/14)had spontaneous ce-liac artery trunk dissection,4 patients (28.6%,4/14)had both celiac artery trunk and superior mesenteric artery dissec-tion.Intimal plaque,orifice of dissection,true and false lumen were displayed in all involved 14 celiac artery trunk and 4 su-perior mesenteric artery dissections.Three dissected arteries were associated with thrombosis,2 dissected arteries with mu-ral calcification,2 dissected arteries with adjacent hematoma,and 1 with splenic infarct.Of the 14 celiac artery trunk dissec-tion,6 associated with aneurymal protrusion,and all 4 superior mesenteric artery dissection had aneurysmal protrusion asso-ciated.Two patients had celiac artery Digital Subtraction Angiography performed,the manifestations were similar to that of MSCT angiography.Intra-stent thrombosis was found in one patient underwent stent implantation.Conclusion:MDCT angi-ography can detect the pathology of celiac artery trunk dissection sensitively,which might used as the first choice modality for the diagnosis and follow up of this disease entity.%目的:总结自发性腹腔干夹层的 MSCT 血管成像表现。方法:回顾性分析14例自发性腹腔干夹层患者的临床及 MSCT 血管成像表现。结果:14例患者中自发性腹腔干夹层10例(71.4%,10/14),腹腔干和肠系膜上动脉夹层4例(28.6%,4/14)。14条腹腔干血管和4条肠系膜上动脉夹层均显示了内膜片、破口及真假腔,3条血管夹层合并血栓,2条夹层血管合并钙化,2例患者合并周围血肿,1例合并脾梗死。14条腹腔干夹层中6条血管夹层伴有动脉瘤样突起,4条肠系膜上动脉夹层

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

  7. Low radiation dose non-contrast cardiac CT: is it of value in the evaluation of mechanical aortic valve

    Energy Technology Data Exchange (ETDEWEB)

    Bazeed, Mohamed Fayez (Dept. of Diagnostic Radiology, Faculty of Medicine, Mansoura Univ. (Egypt)), email: m_bazeed@yahoo.com; Moselhy, Mohamed Saleh (Cardiology Dept. Faculty of Medicine, Suez Canal Univ. (Egypt)); Rezk, Ahmad Ibrahim (Dept. of Cardiac Surgery, Faculty of Medicine, Aim Shams Univ. (Egypt)); Al-Murayeh, Mushabab Ayedh (Dept. of Cardiac Services, Armed Forces Hospitals Southern Region (Saudi Arabia))

    2012-05-15

    Background: Prosthetic bileaflet mechanical valve function has been traditionally evaluated using echocardiography and fluoroscopy. Multidetector computed tomography (MDCT) is a novel technique for cardiac evaluation. Purpose: To evaluate bileaflet mechanical aortic valves using a low-milliampere (mA), non-contrast MDCT protocol with a limited scan range. Material and Methods: Forty patients with a bileaflet mechanical aortic valve were evaluated using a non-contrast, low-mA, ECG-gated 64 MDCT protocol with a limited scan range. MDCT findings of opening and closing valve angles were correlated to fluoroscopy and echocardiography. Also, the valve visibility was evaluated on MDCT and fluoroscopy according to a 3-point grading scale. Results: The visualization score with the MDCT was significantly superior to the fluoroscopy (3 vs. 2.7). A strong correlation was noted between the opening (r = 0.82) and closing (r = 0.96) valve angles with MDCT and fluoroscopy without a statistically significant difference (P = 0.31 and 0.16, respectively). The mean effective radiation dose of the suggested protocol was 4 +- 0.5 mSv. Five valves were evaluated using transesophageal echocardiography because the valves were difficult to evaluate with transthoracic echocardiography, and all of these valves were evaluated optimally with MDCT. A high-pressure gradient was noted in nine valves, and the MDCT showed that seven of these valves inadequately opened, and two valves opened well, which resulted in patient valve mismatch. Incomplete valve closure was noted in five valves, and the echocardiography showed significant transvalvular regurgitation in all five valves. Conclusion: MDCT can provide a precise measurement of valve function and can potentially evaluate high-pressure gradients and transvalvular regurgitation

  8. Abdominal manifestations of polyarteritis nodosa demonstrated with CT

    Energy Technology Data Exchange (ETDEWEB)

    Adaletli, Ibrahim; Ozpeynirci, Yigit; Kurugoglu, Sebuh [Istanbul University, Department of Radiology, Cerrahpasa Medical School, Istanbul (Turkey); Sever, Lale; Arisoy, Nil [Istanbul University, Department of Pediatric Nephrology, Istanbul (Turkey)

    2010-05-15

    We report a rare case of polyarteritis nodosa (PAN) presenting in childhood. The child had multiple visceral aneurysms and later developed ascending colitis and jejunitis. The diagnosis was established with multidetector CT and CT angiography. (orig.)

  9. Hemobilia in a child due to right hepatic artery pseudoaneurysm: Multidetector-row computed tomography demonstration

    Directory of Open Access Journals (Sweden)

    Nisar A Wani

    2011-01-01

    Full Text Available We present a case of a 12-year-old boy who developed upper gastrointestinal bleeding in the form of hematemesis and melena 1 month after blunt trauma to liver. Computed tomography (CT angiography with multidetector-row CT demonstrated pseudoaneurysm of right hepatic artery related to old liver laceration to be the cause of the bleeding. Pseudoaneurysm was resected using the roadmap provided by CT angiography findings.

  10. Five-dimensional motion compensation for respiratory and cardiac motion with cone-beam CT of the thorax region

    Science.gov (United States)

    Sauppe, Sebastian; Hahn, Andreas; Brehm, Marcus; Paysan, Pascal; Seghers, Dieter; Kachelrieß, Marc

    2016-03-01

    We propose an adapted method of our previously published five-dimensional (5D) motion compensation (MoCo) algorithm1, developed for micro-CT imaging of small animals, to provide for the first time motion artifact-free 5D cone-beam CT (CBCT) images from a conventional flat detector-based CBCT scan of clinical patients. Image quality of retrospectively respiratory- and cardiac-gated volumes from flat detector CBCT scans is deteriorated by severe sparse projection artifacts. These artifacts further complicate motion estimation, as it is required for MoCo image reconstruction. For high quality 5D CBCT images at the same x-ray dose and the same number of projections as todays 3D CBCT we developed a double MoCo approach based on motion vector fields (MVFs) for respiratory and cardiac motion. In a first step our already published four-dimensional (4D) artifact-specific cyclic motion-compensation (acMoCo) approach is applied to compensate for the respiratory patient motion. With this information a cyclic phase-gated deformable heart registration algorithm is applied to the respiratory motion-compensated 4D CBCT data, thus resulting in cardiac MVFs. We apply these MVFs on double-gated images and thereby respiratory and cardiac motion-compensated 5D CBCT images are obtained. Our 5D MoCo approach processing patient data acquired with the TrueBeam 4D CBCT system (Varian Medical Systems). Our double MoCo approach turned out to be very efficient and removed nearly all streak artifacts due to making use of 100% of the projection data for each reconstructed frame. The 5D MoCo patient data show fine details and no motion blurring, even in regions close to the heart where motion is fastest.

  11. Quantitative assessment of left ventricular function with dual-source CT in comparison to cardiac magnetic resonance imaging: initial findings

    Energy Technology Data Exchange (ETDEWEB)

    Busch, S.; Johnson, T.R.C.; Wintersperger, B.J.; Minaifar, N.; Bhargava, A.; Rist, C.; Reiser, M.F.; Becker, C.; Nikolaou, K. [University of Munich, Department of Clinical Radiology, Munich (Germany)

    2008-03-15

    Cardiac magnetic resonance imaging and echocardiography are currently regarded as standard modalities for the quantification of left ventricular volumes and ejection fraction. With the recent introduction of dual-source computedtomography (DSCT), the increased temporal resolution of 83 ms should also improve the assessment of cardiac function in CT. The aim of this study was to evaluate the accuracy of DSCT in the assessment of left ventricular functional parameters with cardiac magnetic resonance imaging (MRI) as standard of reference. Fifteen patients (two female, 13 male; mean age 50.8 {+-} 19.2 years) underwent CT and MRI examinations on a DSCT (Somatom Definition; Siemens Medical Solutions, Forchheim, Germany) and a 3.0-Tesla MR scanner (Magnetom Trio; Siemens Medical Solutions), respectively. Multiphase axial CT images were analysed with a semiautomatic region growing algorithms (Syngo Circulation; Siemens Medical Solutions) by two independent blinded observers. In MRI, dynamic cine loops of short axis slices were evaluated with semiautomatic contour detection software (ARGUS; Siemens Medical Solutions) independently by two readers. End-systolic volume (ESV), end-diastolic volume (EDV), ejection fraction (EF) and stroke volume (SV) were determined for both modalities, and correlation coefficient, systematic error, limits of agreement and inter-observer variability were assessed. In DSCT, EDV and ESV were 135.8 {+-} 41.9 ml and 54.9 {+-} 29.6 ml, respectively, compared with 132.1 {+-} 40.8 ml EDV and 57.6 {+-} 27.3 ml ESV in MRI. Thus, EDV was overestimated by 3.7 ml (limits of agreement -46.1/+53.6), while ESV was underestimated by 2.6 ml (-36.6/+31.4). Mean EF was 61.6 {+-} 12.4% in DSCT and 57.9 {+-} 9.0% in MRI, resulting in an overestimation of EF by 3.8% with limits of agreement at -14.7 and +22.2%. Rank correlation rho values were 0.81 for EDV (P = 0.0024), 0.79 for ESV (P = 0.0031) and 0.64 for EF (P = 0.0168). The kappa value of inter

  12. Image Registration and Analysis for Quantitative Myocardial Perfusion: Application to Dynamic Circular Cardiac CT

    NARCIS (Netherlands)

    Isola, A.; Schmitt, H.; Van Stevendaal, U.; Begemann, P.G.C.; Coulon, P.; Boussel, L.; Grass, M.

    2012-01-01

    Large area detector computed tomography systems with fastrotating gantries enable volumetric dynamic cardiac perfusion studies. Prospectively ECG-triggered acquisitions limit the data acquisition to a predefined cardiac phase and thereby reduce X-ray dose andlimit motion artifacts. Even in the case

  13. Prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT scans; Praevalenz und klinische Bedeutung inzidenteller Herzbefunde im nicht EKG-getriggerten Thorax-CT

    Energy Technology Data Exchange (ETDEWEB)

    Quentin, M.; Kroepil, P.; Lanzman, R.S.; Blondin, D.; Miese, F.; Scherer, A. [Heinrich-Heine-Universitaet Duesseldorf, Institut fuer Radiologie, Duesseldorf (Germany); Steiner, S. [Klinikum der Heinrich-Heine-Universitaet Duesseldorf, Klinik fuer Kardiologie, Pneumologie und Angiologie, Duesseldorf (Germany); Choy, G.; Abbara, S. [Massachusetts General Hospital, Harvard Medical School, Cardiovascular Imaging Section, Boston (United States)

    2011-01-15

    The purpose of this study was to evaluate the prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT. Non-ECG-gated chest CT examinations of 300 patients were retrospectively analyzed for incidental cardiac findings. Subsequently, these findings were evaluated for their clinical relevance by a cardiologist. A total of 107 out of 300 examined patients had 174 incidental cardiac findings including coronary calcification (90), aortic/mitral valve calcification (42), iatrogenic changes (23), pericardial effusion (6), dilatation of the heart (4), myocardial changes (3), thrombus in the left ventricle (2), constrictive pericarditis (2) and atrial myxoma (1). Of the cardiac findings 51% were described in the written report and in 53 out of the 107 patients the cardiac findings were unknown. Newly detected incidental findings from 8 patients were rated as clinically significant: pericardial effusion (4), constrictive pericarditis (1), thrombus in the left ventricle (1), atrial myxoma (1) and dilatation of the heart (1). Incidental cardiac findings are frequent in non-ECG-gated chest CT and may have a high clinical relevance. (orig.) [German] Ziel dieser Studie war es, die Praevalenz und klinische Bedeutung inzidenteller Herzbefunde im nicht EKG-getriggerten Thorax-CT ohne primaer kardiale Fragestellung zu evaluieren. Dreihundert nicht EKG-getriggerte Thorax-CT-Untersuchungen wurden retrospektiv bzgl. inzidenteller Herzbefunde analysiert. Die klinische Bedeutung wurde von einem Kardiologen bewertet. Von 300 Patienten hatten 107 insgesamt 174 Herzbefunde: Koronarsklerose (90), Aorten-/Mitralklappenverkalkung (42), iatrogene Veraenderungen (23), Perikarderguss (6), Herzvergroesserung (4), Myokardpathologien (3), Perikardverkalkungen (2), Thrombus im linken Ventrikel (2) und Myxom (1). Im radiologischen Bericht wurden 51% aller Herzbefunde beschrieben. Bei 53 der 107 Patienten mit Herzbefund waren diese klinisch nicht bekannt. Als

  14. Ultra-low dose comprehensive cardiac CT imaging in a patient with acute myocarditis.

    Science.gov (United States)

    Tröbs, Monique; Brand, Michael; Achenbach, Stephan; Marwan, Mohamed

    2014-01-01

    The ability of contrast-enhanced CT to detect "late enhancement" in a fashion similar to magnetic resonance imaging has been previously reported. We report a case of acute myocarditis with coronary CT angiography as well as "late enhancement" imaging with ultra-low effective radiation dose.

  15. New Applications of Cardiac Computed Tomography Dual-Energy, Spectral, and Molecular CT Imaging

    NARCIS (Netherlands)

    Danad, Ibrahim; Fayad, Zahi A.; Willemink, Martin J.; Min, James K.

    2015-01-01

    Computed tomography (CT) has evolved into a powerful diagnostic tool, and it is impossible to imagine current clinical practice without CT imaging. Because of its widespread availability, ease of clinical application, superb sensitivity for the detection of coronary artery disease, and noninvasive n

  16. Assessment of normal left atrial appendage anatomy and function over gender and ages by dynamic cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Boucebci, Samy; Velasco, Stephane; Duboe, Pier-Olivier; Tasu, Jean-Pierre [University of Poitiers, University Hospital, Department of Radiology, Poitiers (France); Pambrun, Thomas [University of Poitiers, University Hospital, Department of Cardiology, Poitiers (France); Ingrand, Pierre [University of Poitiers, University Institute of Public Health, Poitiers (France)

    2016-05-15

    The aim of this study was to evaluate variations in anatomy and function according to age and gender using cardiac computed tomography (CT) in a large prospective cohort of healthy patients. The left atrial appendage (LAA) is considered the most frequent site of intracardiac thrombus formation. However, variations in normal in vivo anatomy and function according to age and gender remain largely unknown. Three-dimensional (3D) cardiac reconstructions of the LAA were performed from CT scans of 193 consecutive patients. Parameters measured included LAA number of lobes, anatomical position of the LAA tip, angulation measured between the proximal and distal portions, minimum (iVol{sub min}) and maximum (iVol{sub max}) volumes indexed to body surface area (BSA), and ejection fraction (LAAEF). Relationship with age was assessed for each parameter. We found that men had longer and wider LAAs. The iVol{sub min} and iVol{sub max} increased by 0.23 and 0.19 ml per decade, respectively, while LAAEF decreased by 2 % per decade in both sexes. Although LAA volumes increase, LAAEF decreases with age in both sexes. (orig.)

  17. Gated cardiac imaging using a continuously rotating CT scanner: clinical evaluation of 91 patients.

    Science.gov (United States)

    Oyama, Y; Uji, T; Hirayama, T; Inada, Y; Ishikawa, T; Fujii, M

    1984-05-01

    To produce electrocardiographically (ECG)-gated computed tomographic (CT) images of the heart, a post-data-acquisition ECG correlation technique was used in which data for missing angular projections are derived from the original scan data to complete 360 angular projections. Improved image quality and clinical usefulness were demonstrated compared with routine nongated CT and two-dimensional echocardiography. Gated CT was better than nongated CT in 26 of 41 positive and three of five negative cases of suspected myocardial infarction, four of 10 positive and one of 12 negative cases of suspected left atrial mass, three of 10 cases with pericardial fluid collection, and three other cases. Compared with echocardiography, CT was of additional value in eight of 10 cases of myocardial infarction, five of nine positive and one of 10 negative cases of suspected left atrial mass, four of 10 positive and one of three negative cases of suspected pericardial fluid collection, and two other cases. The equipment required for CT gating is of low cost, but the examination time is lengthy and less conveniently performed than echocardiography. However, when echocardiography is indecisive or suspected to be falsely negative, gated CT imaging of the heart is recommended.

  18. Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography.

    Science.gov (United States)

    Soukup, Jason W; Drees, Randi; Koenig, Lisa J; Snyder, Christopher J; Hetzel, Scott; Miles, Chanda R; Schwarz, Tobias

    2015-01-01

    The objective of this blinded study was to validate the use of cone beam computed tomography (C) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methylmethacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxillary segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT.

  19. Cardiac imaging with multi-sector data acquisition in volumetric CT: variation of effective temporal resolution and its potential clinical consequences

    Science.gov (United States)

    Tang, Xiangyang; Hsieh, Jiang; Taha, Basel H.; Vass, Melissa L.; Seamans, John L.; Okerlund, Darin R.

    2009-02-01

    With increasing longitudinal detector dimension available in diagnostic volumetric CT, step-and-shoot scan is becoming popular for cardiac imaging. In comparison to helical scan, step-and-shoot scan decouples patient table movement from cardiac gating/triggering, which facilitates the cardiac imaging via multi-sector data acquisition, as well as the administration of inter-cycle heart beat variation (arrhythmia) and radiation dose efficiency. Ideally, a multi-sector data acquisition can improve temporal resolution at a factor the same as the number of sectors (best scenario). In reality, however, the effective temporal resolution is jointly determined by gantry rotation speed and patient heart beat rate, which may significantly lower than the ideal or no improvement (worst scenario). Hence, it is clinically relevant to investigate the behavior of effective temporal resolution in cardiac imaging with multi-sector data acquisition. In this study, a 5-second cine scan of a porcine heart, which cascades 6 porcine cardiac cycles, is acquired. In addition to theoretical analysis and motion phantom study, the clinical consequences due to the effective temporal resolution variation are evaluated qualitative or quantitatively. By employing a 2-sector image reconstruction strategy, a total of 15 (the permutation of P(6, 2)) cases between the best and worst scenarios are studied, providing informative guidance for the design and optimization of CT cardiac imaging in volumetric CT with multi-sector data acquisition.

  20. Myocardial contrast defect associated with thrombotic coronary occlusion: Pre-autopsy diagnosis of a cardiac death with post-mortem CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon; Cha, Jang Gyu [Dept. of Radiology, Soonchunhyang University Hospital, Bucheon (Korea, Republic of); Park, Hye Jin; Lee, Soo Kyoung; Yang, Kyung Moo [Dept. of Forensic Medicine, National Forensic Service, Wonju (Korea, Republic of)

    2015-10-15

    We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice.

  1. 腕骨脱位的X线平片及40层螺旋CT诊断比较%Diagnostic comparison of X-ray plain film and 40-multidetector CT in dislocation of carpal bones

    Institute of Scientific and Technical Information of China (English)

    于宝江; 曹立福; 骈文婷; 郭健; 宋伟兴; 白振武

    2012-01-01

    Objective To study the imaging manifestations and detecting rates of dislocation of carpal bones on X- ray plain film and 40-multidetector CT (MDCT), to improve the diagnostic accuracy and to reduce the missed diagnosis and misdiagnosis. Materials and Methods The X -ray plain films, MDCT, volume rendering (VR) and multiplanar reconstruction (MPR) of 21 patients with dislocation of carpal bones were retrospectively studied. 19 cases were male and two were female, mean age 31±7 years old (19-45 years). Dislocation was in left side in 14 cases, in right in seven cases. Result Eight cases of lunate dislocation, 13 cases of perilunar dislocation, three cases of simple perilunar dislocation , four cases of perilunar dislocation per navicular bone, One case of perilunar dislocation per navicular and triangular bones, three cases of perilunar dislocation per triangular bones, two cases of perilunar dislocation per styloid process of radius. Among the cases with fracture of other carpal bones, the diagnosis of fractures of radial styloid process and navicular bones were correctly detected on X-ray plain film. But in three cases with fracture of triangular bone, the fractures were indetectable or the original place of the bone fragments were unable to determine on X-ray plain film, but could be correctly detected with MDCT and reconstruct technology. Conclusion Diagnosis of dislocation of carpal bones can be correctly made with X-ray plain film in the most cases. But for the cases with fracture of carpal bones, especially with tiny fracture, X-ray plain film produces high rate of missed diagnosis. MDCT, VR and MPR can accurately show dislocations and fractures in three-dimension having high clinical value.%目的 探讨腕骨脱位X线平片及多层螺旋CT的影像学表现,并对两者的检出情况进行比较,以提高对腕骨脱位的诊断水平,减少漏诊误诊.资料与方法对2006年8月-2009年11月共21例腕骨脱位病人的X线平片、多层螺旋CT薄

  2. Image-based motion estimation for cardiac CT via image registration

    Science.gov (United States)

    Cammin, J.; Taguchi, K.

    2010-03-01

    Images reconstructed from tomographic projection data are subject to motion artifacts from organs that move during the duration of the scan. The effect can be reduced by taking the motion into account in the reconstruction algorithm if an estimate of the deformation exists. This paper presents the estimation of the three-dimensional cardiac motion by registering reconstructed images from cardiac quiet phases as a first step towards motion-compensated cardiac image reconstruction. The non-rigid deformations of the heart are parametrized on a coarse grid on the image volume and are interpolated with cubic b-splines. The optimization problem of finding b-spline coefficients that best describe the observed deformations is ill-posed due to the large number of parameters and the resulting motion vector field is sensitive to the choice of initial parameters. Particularly challenging is the task to capture the twisting motion of the heart. The motion vector field from a dynamic computer phantom of the human heart is used to initialize the transformation parameters for the optimization process with realistic starting values. The results are evaluated by comparing the registered images and the obtained motion vector field to the case when the registration is performed without using prior knowledge about the expected cardiac motion. We find that the registered images are similar for both approaches, but the motion vector field obtained from motion estimation initialized with the phantom describes the cardiac contraction and twisting motion more accurately.

  3. Tomografía Computada Multidetector en el diagnóstico de la pseudocoartación de aorta: Reporte de dos casos y revisión de la literatura Multidetector CT in diagnosis of aortic pseudocoarctation: Two reported cases and revised literature

    Directory of Open Access Journals (Sweden)

    Martín Mela

    2011-06-01

    Full Text Available La pseudocoartación aórtica es una rara anomalía que consiste en una elongación tortuosa con acodadura de la arteria aorta que involucra la región distal del cayado y la porción descendente proximal, típicamente relacionada al sitio de inserción del ligamento arterioso. No suelen existir manifestaciones clínicas asociadas, por lo que el diagnóstico habitualmente es incidental mediante estudios de imágenes. Entre ellos, se destacan la angio Tomografía Computada Multidetector (angio TCMD y la Resonancia Magnética (RM. Se diferencia de la verdadera coartación aórtica por su morfología y por la ausencia de obstrucción hemodinámicamente significativa. En el presente artículo revisamos los aspectos imagenológicos utilizando TCMD en dos pacientes a los cuales se les diagnosticó la pseudocoartación, sin ser ésta la patología sospechada al momento de indicar el estudio. La TCMD permite realizar un diagnóstico apropiado mostrando las características diferenciales con otras anomalías aórticas.The aortic pseudocoarctation is a rare anomaly characterized by a tortuous elongation with kink aorta which compromises the distal portion of the aortic arch and the proximal descending portion, typically related to the insertion site of arterious ligament. Usually, there are no associated symptoms so the diagnosis is generally incidental with imaging such as Multidetector Computed Tomography (MDCT or Magnetic Resonance Imaging (MRI. It differs from the true aortic coarctaction in their morphology and in the absence of hemodynamically significant obstruction. In this paper we review the imagenologic features using MDCT in two patients who were diagnosed with pseudocoartaction, which was not suspected before performing the study. MDCT allows a proper diagnosis showing differential characteristics with other aortic anomalies.

  4. Evaluation of retrospectively ECG-gated 4-row multidetector CT in patients planned for minimal invasive coronary artery bypass grafting; Die EKG-getriggerte 4-Zeilen-Spiral-CT des Herzens in der praeoperativen Bildgebung vor minimalinvasiver koronarer Bypass-Operation

    Energy Technology Data Exchange (ETDEWEB)

    Begemann, P.G.C.; Ittrich, H.; Koops, A.; Adam, G.; Weber, C. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Radiologisches Zentrum, Universitaetsklinikum, Hamburg (Germany); Arnold, M.; Detter, C.; Boehm, D.H.; Reichenspurner, H. [Universitaetsklinikum Hamburg-Eppendorf, Herzzentrum, Herz und Gefaesschirurgie, Hamburg (Germany)

    2005-08-01

    Purpose: Minimal invasive direct coronary artery bypass grafting (MIDCAB) or off-pump coronary artery bypass grafting (OPCAB) on the beating heart with full or mini-sternotomy are becoming more common in coronary bypass surgery of the left anterior descending (LAD). In the decision, which surgical approach (MIDCAB, OPCAB or conventional surgery with cardiopulmonary bypass) will be best used, knowledge of the anatomical field is of major importance. The aim of the study was to evaluate retrospective ECG-gated 4-row multidetector CT (MDCT) in patients planned for MIDCAB as additional imaging to coronary angiography. Material and methods: The study included 25 consecutive patients. MSCT was performed as unenhanced (collimation 4 x 2.5 mm) and contrast-enhanced examination (140-170 ml, 300 mg Iodine/ml, collimation 4 x 1 mm). The evaluation included presence of LAD calcifications, distance of LAD and left internal mammarian artery (LIMA), coursek of LAD and LIMA, the presence or absence of bridging through myocardium or epicardial fat and the presence of pleural fibrosis. The MDCT results were correlated with intra-operative findings. Results: All MDCTs could be assessed with reference to the demands. In 20/25 operations, MDCT had direct influence as to the selection of the surgical approach (11 MIDCAB, 7 OPCAB with mini-sternotomy and 5 with full sternotomy, 2 conventional surgeries). The distance of LAD and LIMA varied from 0.9 to 4.5 cm in MDCT. As to calcifications, 3/25 correlated patients had calcifications and 10 patients had no calcifications in the middle LAD. Seven patients had intraoperative fibrosis of the vessel wall without calcification of the middle LAD, which could not be detected with MDCT. Another 5 patients had single calcified plaques in the middle LAD, 4 of these had a fibrosis of the vessel and 1 had a normal vessel at surgery. In these cases, the anastomosis was done between the calcified plaques. No myocardial bridging was detected by MDCT and

  5. CT measurement of changes in cerebral perfusion in patients with asymptomatic carotid artery stenosis undergoing carotid stenting prior to cardiac surgery: "proof of principle"

    NARCIS (Netherlands)

    Heyden, J. Van der; Waaijer, A.; Wouter, E.S. Van; Neerven, D. van; Sonker, U.; Suttorp, M.J.; Bal, E.T.; Prokop, M.

    2011-01-01

    AIMS: To identify asymptomatic patients with impaired cerebral perfusion using CT perfusion (CTP) technique during staged carotid stenting (CAS) and cardiac surgery. METHODS AND RESULTS: This is a prospective, non-randomised study in 16 neurologically asymptomatic patients designed to analyse cerebr

  6. Influence of statin treatment on coronary atherosclerosis visualised using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Hans [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Klinikum Brandenburg, Department of Cardiology, Angiology, and Pulmonology, Brandenburg an der Havel (Germany); Frieler, Katja [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Medical Statistics, Berlin (Germany); Potsdam Institut fuer Klimaforschung, Potsdam (Germany); Schlattmann, Peter [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Medical Statistics, Berlin (Germany); Hamm, Bernd [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Dewey, Marc [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology (Germany)

    2010-12-15

    Coronary angiography using multidetector computed tomography (MDCT) allows non-invasive assessment of non-calcified, calcified and mixed plaques. Progression of coronary plaques may be influenced by statins. Sixty-three consecutive patients underwent MDCT as a follow-up to their original CT angiography in a retrospective longitudinal study. MDCT was performed by using a voxel size of 0.5 x 0.35 x 0.35 mm{sup 3} at two time points 25 {+-} 3 months apart. Non-calcified, calcified and mixed coronary plaque components were analysed by using volumetric measurement. The influence of statin, low-density lipoprotein (LDL) and risk factors was assessed by using a linear random intercept model for plaque growth. The volumes of non-calcified, calcified and mixed coronary plaques significantly (P < 0.001) increased from baseline (medians/interquartile ranges = 21/15-39, 7/3-20 and 36/16-69 mm{sup 3}) to follow-up (29/17-44, 13/6-29 and 41/20-75 mm{sup 3}). Statins significantly slowed the growth of non-calcified plaques (statin coefficient {beta} = -0.0036, P = 0.01) but did not significantly affect the growth rate of mixed or calcified plaques. The effect of statin treatment on non-calcified plaques remained significant after adjusting for LDL levels and cardiac risk factors. Quantification using MDCT shows that progression of non-calcified coronary plaques may be slowed by statins. (orig.)

  7. Extranodal Rosai-Dorfman Disease Involving the Left Atrium: Cardiac MRI, CT, and PET Scan Findings

    Directory of Open Access Journals (Sweden)

    Vistasp J. Daruwalla

    2015-01-01

    Full Text Available Rosai-Dorfman disease (RDD is a rare entity that usually involves the lymph nodes but extranodal involvements have been seen in numerous cases, although RDD with cardiovascular involvement is extremely rare. We describe a case of a young male who presented with intermittent palpitations and was found to have a left atrium mass. Our case not only emphasizes the rarity of the above lesion but also highlights the importance of modern-day imaging like computed tomography, Cardiac Magnetic Resonance Imaging (CMRI, and PET scan in characterizing such nonspecific lesions and directing appropriate line of treatment. RDD should be considered as one of the differentials even for isolated cardiac lesions.

  8. TU-A-12A-09: Absolute Blood Flow Measurement in a Cardiac Phantom Using Low Dose CT

    Energy Technology Data Exchange (ETDEWEB)

    Ziemer, B; Hubbard, L; Lipinski, J; Molloi, S [University of California, Irvine, CA (United States)

    2014-06-15

    Purpose: To investigate a first pass analysis technique to measure absolute flow from low dose CT images in a cardiac phantom. This technique can be combined with a myocardial mass assignment to yield absolute perfusion using only two volume scans and reduce the radiation dose to the patient. Methods: A four-chamber cardiac phantom and perfusion chamber were constructed from poly-acrylic and connected with tubing to approximate anatomical features. The system was connected to a pulsatile pump, input/output reservoirs and power contrast injector. Flow was varied in the range of 1-2.67 mL/s with the pump operating at 60 beats/min. The system was imaged once a second for 14 seconds with a 320-row scanner (Toshiba Medical Systems) using a contrast-enhanced, prospective-gated cardiac perfusion protocol. Flow was calculated by the following steps: subsequent images of the perfusion volume were subtracted to find the contrast entering the volume; this was normalized by an upstream, known volume region to convert Hounsfield (HU) values to concentration; this was divided by the subtracted images time difference. The technique requires a relatively stable input contrast concentration and no contrast can leave the perfusion volume before the flow measurement is completed. Results: The flow calculated from the images showed an excellent correlation with the known rates. The data was fit to a linear function with slope 1.03, intercept 0.02 and an R{sup 2} value of 0.99. The average root mean square (RMS) error was 0.15 mL/s and the average standard deviation was 0.14 mL/s. The flow rate was stable within 7.7% across the full scan and served to validate model assumptions. Conclusion: Accurate, absolute flow rates were measured from CT images using a conservation of mass model. Measurements can be made using two volume scans which can substantially reduce the radiation dose compared with current dynamic perfusion techniques.

  9. 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.)

  10. Calcifications of the Thoracic Aorta on Extended Non-Contrast-Enhanced Cardiac CT

    OpenAIRE

    Damian Craiem; Gilles Chironi; Casciaro, Mariano E.; Sebastian Graf; Alain Simon

    2014-01-01

    BACKGROUND: The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC) can be assessed from computed tomography (CT) scans, originally aimed at coronary artery calcium (CAC) assessment. CAC screening improves cardiovascular risk prediction, beyond standard risk assessment, whereas TAC performance remains controversial. However, the curvilinear portion of the thoracic aorta (TA), that includes the aorti...

  11. Advanced Gastric Cancer: Differentiation of Borrmann Type IV versus Borrmann Type III by Two-Phased Dynamic Multi-Detector Row CT with Use of the Water Filling Method

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Jung; Yu, Jeong Sik; Lee, Sang Min; Kim, Joo Hee; Chung, Jae Joon; Kim, Ki Whang [Dept. of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kang, Hae Youn [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2013-02-15

    To characterize Borrmann type IV from Borrmann type III advanced gastric cancer (AGC) by two-phased multi-detector row computed tomography (MDCT) using the water filling method. A total of 143 patients (pathologically confirmed Borrmann type III and IV - 100 and 43 patients), who underwent preoperative MDCT, were enrolled. Two radiologists, retrospectively and independently, determined tumor enhancement pattern using a 5-grade scale without clinical information. A weighted kappa test was applied for interobserver variability. The score of tumor enhancement pattern correlated with Borrmann type as determined by Spearman's correlation coefficient. The accuracy of differentiation of Borrmann type using MDCT was determined by receiver operating characteristic curves. Interobserver agreement (weighted kappa = 0.683) was substantial. The tumor enhancement pattern score showed a significant correlation with Borrmann type (reviewer 1, r = 0.591, p < 0.001; reviewer 2, r = 0.616, p < 0.001). The accuracy for differentiation of Borrmann type on MDCT was 0.86 (p < 0.001) in both reviewers. The sensitivity and specificity of the diagnosis of Borrmann type IV were 79% and 82% in reviewer 1, and 88% and 78% in reviewer 2, respectively. Dual-phased MDCT using the water filling method can differentiate between Borrmann type IV and III AGC with high accuracy.

  12. Radiation dose assessment in a 320-detector-row CT scanner used in cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Goma, Carles; Ruiz, Agustin; Jornet, Nuria; Latorre, Artur; Pallerol, Rosa M.; Carrasco, Pablo; Eudaldo, Teresa; Ribas, Montserrat [Servei de Radiofisica i Radioproteccio, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025 Barcelona (Spain)

    2011-03-15

    Purpose: In the present era of cone-beam CT scanners, the use of the standardized CTDI{sub 100} as a surrogate of the idealized CTDI is strongly discouraged and, consequently, so should be the use of the dose-length product (DLP) as an estimate of the total energy imparted to the patient. However, the DLP is still widely used as a reference quantity to normalize the effective dose for a given scan protocol mainly because the CTDI{sub 100} is an easy-to-measure quantity. The aim of this article is therefore to describe a method for radiation dose assessment in large cone-beam single axial scans, which leads to a straightforward estimation of the total energy imparted to the patient. The authors developed a method accessible to all medical physicists and easy to implement in clinical practice in an attempt to update the bridge between CT dosimetry and the estimation of the effective dose. Methods: The authors used commercially available material and a simple mathematical model. The method described herein is based on the dosimetry paradigm introduced by the AAPM Task Group 111. It consists of measuring the dose profiles at the center and the periphery of a long body phantom with a commercial solid-state detector. A weighted dose profile is then calculated from these measurements. To calculate the CT dosimetric quantities analytically, a Gaussian function was fitted to the dose profile data. Furthermore, the Gaussian model has the power to condense the z-axis information of the dose profile in two parameters: The single-scan central dose, f(0), and the width of the profile, {sigma}. To check the energy dependence of the solid-state detector, the authors compared the dose profiles to measurements made with a small volume ion chamber. To validate the overall method, the authors compared the CTDI{sub 100} calculated analytically to the measurement made with a 100 mm pencil ion chamber. Results: For the central and weighted dose profiles, the authors found a good

  13. Comparison of in vivo cone-beam and multidetector computed tomographic scans by three-dimensional merging software.

    Science.gov (United States)

    Rostetter, Claudio; Metzler, Philipp; Schenkel, Jan S; Seifert, Burkhardt; Luebbers, Heinz-Theo

    2015-12-01

    In dentomaxillofacial radiology, cone-beam computed tomography (CT) is used to give fast and high-resolution 3-dimensional images of bone with a low dose of radiation. However, its use for quantitative measurement of bone density based on absolute values (Hounsfield units, HU) as in multidetector CT is still controversial. We know of no in vivo study of 3-dimensional merging software that will reliably match identical bone areas of cone-beam and multidetector CT datasets. We studied 19 multidetector, and 19 cone-beam, CT scans of the skull. The two datasets were fused, corresponding points were identified for measurement, and we compared mean density. We used linear regression to analyse the relation between the two different scanning methods, and studied a total of 4180 measurements. The mean time interval between scans was 5.2 (4.7) months. Mean R(2) over all measurements was 0.63 (range 0.22 - 0.79) with a mean internal consistency (Cronbach's α) of 0.86 (range 0.61 - 0.93). The strongest linearity, seen at the left mastoid, was R(2)=0.79 with high internal consistency (Cronbach's α 0.89), and the weakest was at the left zygomatic bone with R(2)=0.22 and Cronbach's α=0.61. Measurements of bone density based on cone-beam and multidetector CT scans generated in vivo showed high and reproducible internal consistency but poor linearity.

  14. DNA double-strand breaks as potential indicators for the biological effects of ionising radiation exposure from cardiac CT and conventional coronary angiography: a randomised, controlled study

    Energy Technology Data Exchange (ETDEWEB)

    Geisel, Dominik; Zimmermann, Elke; Rief, Matthias; Greupner, Johannes; Hamm, Bernd [Charite Medical School, Department of Radiology, Berlin (Germany); Laule, Michael; Knebel, Fabian [Charite Medical School, Department of Cardiology, Berlin (Germany); Dewey, Marc [Charite Medical School, Department of Radiology, Berlin (Germany); Charite, Institut fuer Radiologie, Berlin (Germany)

    2012-08-15

    To prospectively compare induced DNA double-strand breaks by cardiac computed tomography (CT) and conventional coronary angiography (CCA). 56 patients with suspected coronary artery disease were randomised to undergo either CCA or cardiac CT. DNA double-strand breaks were assessed in fluorescence microscopy of blood lymphocytes as indicators of the biological effects of radiation exposure. Radiation doses were estimated using dose-length product (DLP) and dose-area product (DAP) with conversion factors for CT and CCA, respectively. On average there were 0.12 {+-} 0.06 induced double-strand breaks per lymphocyte for CT and 0.29 {+-} 0.18 for diagnostic CCA (P < 0.001). This relative biological effect of ionising radiation from CCA was 1.9 times higher (P < 0.001) than the effective dose estimated by conversion factors would have suggested. The correlation between the biological effects and the estimated radiation doses was excellent for CT (r = 0.951, P < 0.001) and moderate to good for CCA (r = 0.862, P < 0.001). One day after radiation, a complete repair of double-strand breaks to background levels was found in both groups. Conversion factors may underestimate the relative biological effects of ionising radiation from CCA. DNA double-strand break assessment may provide a strategy for individualised assessments of radiation. (orig.)

  15. Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

    Energy Technology Data Exchange (ETDEWEB)

    Ghafarian, Pardis [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Aghamiri, S.M.R. [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Ay, Mohammad R. [Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Department of Medical Physics and Biomedical Engineering, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Research Institute for Nuclear Medicine, Tehran (Iran, Islamic Republic of); Rahmim, Arman [Johns Hopkins University, Department of Radiology, Baltimore, MD (United States); Schindler, Thomas H. [Geneva University, Cardiovascular Center, Nuclear Cardiology, Geneva (Switzerland); Ratib, Osman [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland)

    2011-02-15

    Cardiac PET/CT imaging is often performed in patients with pacemakers and implantable cardioverter defibrillator (ICD) leads. However, metallic implants usually produce artefacts on CT images which might propagate to CT-based attenuation-corrected (CTAC) PET images. The impact of metal artefact reduction (MAR) for CTAC of cardiac PET/CT images in the presence of pacemaker, ICD and ECG leads was investigated using both qualitative and quantitative analysis in phantom and clinical studies. The study included 14 patients with various leads undergoing perfusion and viability examinations using dedicated cardiac PET/CT protocols. The PET data were corrected for attenuation using both artefactual CT images and CT images corrected using the MAR algorithm. The severity and magnitude of metallic artefacts arising from these leads were assessed on both linear attenuation coefficient maps ({mu}-maps) and attenuation-corrected PET images. CT and PET emission data were obtained using an anthropomorphic thorax phantom and a dedicated heart phantom made in-house incorporating pacemaker and ICD leads attached at the right ventricle of the heart. Volume of interest-based analysis and regression plots were performed for regions related to the lead locations. Bull's eye view analysis was also performed on PET images corrected for attenuation with and without the MAR algorithm. In clinical studies, the visual assessment of PET images by experienced physicians and quantitative analysis did not reveal erroneous interpretation of the tracer distribution or significant differences when PET images were corrected for attenuation with and without MAR. In phantom studies, the mean differences between tracer uptake obtained without and with MAR were 10.16{+-}2.1% and 6.86{+-}2.1% in the segments of the heart in the vicinity of metallic ICD or pacemaker leads, and were 4.43{+-}0.5% and 2.98{+-}0.5% in segments far from the leads. Although the MAR algorithm was able to effectively improve

  16. Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs. major adverse cardiac events

    Energy Technology Data Exchange (ETDEWEB)

    Schlett, Christopher L. [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg (Germany); Nance, John W. Jr. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); O’Brien, Terrence X. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC (United States); Ebersberger, Ullrich [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Centre Munich-Bogenhausen, Munich (Germany); Headden, Gary F. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Hoffmann, Udo [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Bamberg, Fabian [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Radiology, University of Munich, Grosshadern Campus, and Munich Heart Alliance, Munich (Germany); Department of Radiology, University of Tuebingen (Germany)

    2014-07-15

    Highlights: • Patients developing UAP had overall more atherosclerosis as patients without any events. • Patients developing MACE had only more mixed plaque as those developing UAP. • Different atherosclerotic plaque components by CTA carry different prognostic value. - Abstract: Objective: CT angiography (CTA) has prognostic value in patients. But it is unknown whether differences in atherosclerosis by CTA predict the development of unstable angina pectoris (UAP) vs. major adverse cardiac events (MACE). Methods: We followed patients undergoing CTA as part of their acute chest pain work-up. Primary outcome was the development of UAP or MACE (cardiac death, myocardial infarction, revascularization) during a minimum follow-up of 12-months. CTAs were assessed for extent and composition of coronary plaque and stenosis. Ordinal regression with a 3-level outcome (no events, UAP, MACE) was applied. Results: Among 315 patients, 22 developed UAP and 31 MACE. While UAP patients had higher atherosclerosis burden with respect to all assessed features compared to patients with no events (p ≤ 0.02), only mixed plaque extent was significantly different between UAP and MACE patients (p = 0.02). The odds ratio was 4.55 for being in a higher disease-level comparing patients with low extent to those with no mixed plaque, and 3.02 comparing patients with high to those with low. These findings remained after adjustments for potential confounders. Conclusion: The extent of mixed coronary plaque is different between patients who develop UAP vs. MACE, supporting the hypothesis that it is a more culprit morphology.

  17. MR angiography and determination of the flow reserve after minimal invasive direct coronary artery bypass (MIDCAB) surgery of the left internal mammary arteria in comparison to the multidetector-row CT; MR-Angiographie und Flussreservenbestimmung nach minimalinvasiver direkter Koronararterien-Bypass(MIDCAB)-Operation der linken Arteria mammaria interna im Vergleich zur Mehrzeilen-CT

    Energy Technology Data Exchange (ETDEWEB)

    Stauder, N.I.; Fenchel, M.; Kuettner, A.; Kramer, U.; Claussen, C.D.; Miller, S. [Abt. Radiologische Diagnostik, Universitaetsklinik Tuebingen (Germany); Stauder, H.; Scheule, A.M. [Abt. Thorax-, Herz- und Gefaesschirurgie, Universitaetsklinik Tuebingen (Germany)

    2005-08-01

    Purpose: To evaluate graft patency, flow and flow reserve in patients with minimal invasive direct coronary artery bypass (MIDCAB) of internal mammary artery (IMA) grafts using a combined MR protocol with phase-contrast technique and MR angiography. Material and methods: At a 1.5T Magnetom Sonata (SIEMENS), 19 symptomatic (angina CCS I-III, intermittent thoracic discomfort, scar disorders) patients (59.9{+-}7.9 years old) with 19 left internal mammary artery (LIMA) grafts implanted in minimal invasive technique were examined 6.9{+-}1.5 years post surgery. Contrast enhanced MR angiography (TR 2.5 ms, TE 1 ms, flip angle 20 , spatial resolution 1.4 x 0.9 x 1.0 mm{sup 3}, breath hold technique, no ECG-triggering, 25 ml Gd-DTPA) was performed to assess bypass patency. Phase-contrast flow measurements with retrospective gating (TR 41 msec, TE 3.2 msec, flip angle 30 , spatial resolution 1.1 x 1.1 x 5 mm{sup 3}, temporal resolution 42 msec, venc 90 cm/sec) were applied in the IMA grafts at rest and after stress induction with dipyridamole (0.56 mg/kg/BW). For comparison, graft patency was evaluated by multidetector-row computed tomography (16-row CT). In 9 patients a selective catheter angiography was performed. Results: MIDCAB grafts were occluded in 4/19 patients. In 4 patients the anastomosis to LAD was highly stenotic (>70%) at MDCT (2 experienced investigators in consensus reading). In MRA 9 grafts could be delineated completely including the distal anastomosis to LAD (47%). In 9 patients the distal part could not be evaluated. In patients with patent grafts (MDCT), a significant improvement of graft flow (at rest 75.4{+-}33.3 ml/min; after stress 202.7{+-}49.6; P<0.002) and flow reserve (patent grafts 3.0{+-}1.1; stenotic grafts 1.5{+-}0.2, P<0.02; occluded grafts 0.9{+-}0.2, P<0.01) after stress induction was detected. Diastolic-to-systolic peak velocity ratios (D/S-PVR) at baseline were not significant between patent and stenotic grafts. Mean flow at baseline and

  18. Distant metastases and synchronous second primary tumors in patients with newly diagnosed oropharyngeal and hypopharyngeal carcinomas: evaluation of {sup 18}F-FDG PET and extended-field multi-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Shu-Hang; Ko, Sheung-Fat; Chin, Shu-Chyn [Chang Gung University, Department of Molecular Imaging Center and Diagnostic Radiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan (China); Chan, Sheng-Chieh; Yen, Tzu-Chen [Chang Gung University, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan (China); Liao, Chun-Ta; Huang, Shiang-Fu [Chang Gung University, Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Taoyuan (China); Chang, Joseph Tung-Chieh; Lin, Chin-Yu. [Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China); Wang, Hung-Ming [Chang Gung University, Department of Medical Oncology, Chang Gung Memorial Hospital, Taoyuan (China)

    2008-11-15

    Patients with oropharyngeal or hypopharyngeal squamous cell carcinoma (SCC) have a high risk of having distant metastases or second primary tumors. We prospectively evaluate the clinical usefulness of {sup 18}F-fluoro-2-deoxyglucose positron emission tomography ({sup 18}F-FDG PET), extended-field multi-detector computed tomography (MDCT), and their side-by-side visual correlation for the detection of distant malignancies in these two tumors at presentation. A total of 160 patients with SCC of the oropharynx (n = 74) or hypopharynx (n=86) underwent {sup 18}F-FDG PET and extended-field MDCT to detect distant metastases or second primary tumors. Suspected lesions were investigated by means of biopsy, clinical, or imaging follow-up. Twenty-six (16.3%) of our 160 patients were found to have distant malignancy. Diagnostic yields of {sup 18}F-FDG PET and MDCT were 12.5% and 8.1%, respectively. The sensitivity of {sup 18}F-FDG PET for detection of distant malignancies was 1.5-fold higher than that of MDCT (76.9% vs. 50.0%, P=0.039), while its specificity was slightly lower (94.0% vs. 97.8%, P=0.125). Side-by-side visual correlation of MDCT and {sup 18}F-FDG PET improved the sensitivity and specificity up to 80.8% and 98.5%, respectively, leading to alteration of treatment in 13.1% of patients. A significant difference in survival rates between its positive and negative results was observed. {sup 18}F-FDG PET and extended-field MDCT had acceptable diagnostic yields for detection of distant malignancies in untreated oropharyngeal and hypopharyngeal SCC. {sup 18}F-FDG PET was 1.5-fold more sensitive than MDCT, but had more false-positive findings. Their visual correlation improved the diagnostic accuracy, treatment planning, and prognosis prediction. (orig.)

  19. Cardiac output measured by electrical velocimetry in the CT suite correlates with coronary artery enhancement: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Flinck, Marianne; Graden, Aasa; Milde, Helen; Flinck, Agneta; Hellstroem, Mikael (Dept. of Radiology, Sahlgrenska Univ. Hospital and Sahlgrenska Academy at Goetenborg Univ., Goeteborg (Sweden)); Bjoerk, Jonas (Competence Centre for Clinical Research, Lund Univ. Hospital, Lund (Sweden)); Nyman, Ulf (Dept. of Radiology, Lasarettet Trelleborg, Univ. of Lund, Trelleborg (Sweden)), e-mail: ulf.nyman@skane.se

    2010-10-15

    Background: Cardiac output (CO) is inversely related to vascular contrast medium (CM) enhancement during computed tomography (CT). Impedance cardiography with a new technique, electrical velocimetry (EV), may create opportunities to measure CO pre-examination for adaptation of CM injection parameters. Purpose: To relate COEV measured by radiology staff to aortic attenuation as a measure of coronary artery attenuation during CT coronary angiography (CTCA), and to formulate a tentative statistical model to adapt CM injection parameters to CO. Material and Methods: COEV was measured immediately before 100 kVp CTCA (64-multirow detector) in 27 patients with presumed coronary artery disease. For CTCA, 260 mg I/kg (maximum dosage weight: 80/90 kg for women/men) was injected intravenously during 12 s. Simple linear regression analysis was performed to explore the correlation between aortic attenuation (Hounsfield units, HU) and body weight, the influence of COEV on aortic attenuation adjusted to injected CM dose rate (HU per mg I/kg/s), and to establish a tentative formula on how to adapt CM injection parameters to COEV and desired aortic attenuation. Results: The correlation between aortic attenuation and body weight was weak and non-significant (r=-0.14 after outlier exclusion). A significant negative correlation (r=-0.63) was found between aortic attenuation adjusted to injected CM dose rate (HU per mg I/kg/s) and COEV. The resulting formula, CM dose rate=COEVx(aortic attenuation-240)/55, made it possible to calculate CM volumes and injection rates at various COs and, for example, the present mean aortic attenuation (438 HU), injection time (12 s), CM concentration (320 mg I/ml), and a certain body weight. Conclusion: EV makes it possible to measure CO in the CT suite before vascular examinations. Hence, CM doses may be decreased in low CO states to reduce the risk of CM-induced nephropathy without jeopardizing diagnostic quality and may be increased in high CO states

  20. CT urography

    Energy Technology Data Exchange (ETDEWEB)

    Korobkin, M. [Dept. of Radiology, Univ. of Michigan, Ann Arbor, MI (United States)

    2005-11-15

    With the advent of multidetector row CT scanners, evaluation of the urothelium of the entire urinary tract with high-resolution thin sections during a single breath-hold has become a reality. Multidetector CT urography (MDCTU) is a single examination that allows evaluation of potential urinary tract calculi, renal parenchymal masses, and both benign and malignant urothelial lesions. Initial results with this new technique are encouraging. Current investigations of MDCTU focus on methods to improve opacification and distension of the upper urinary tract - the collecting systems, pelvis, and ureters. The role of abdominal compression, infusion of saline and/or furosemide, and optimal time delay of excretory phase imaging is being explored. Upper tract urothelial malignancies, including small lesions less the 5 mmin diameter, can be detected with high sensitivity. Methods to reduce radiation exposure are being explored, including split-bolus contrast injection techniques that combine nephrographic and excretory phases into a single phase. It is likely that in the near future, radiological evaluation of significant unexplained hematuria or of known or prior urothelial malignancy will consist of a single examination - MDCTU. (orig.)

  1. Advances and perspectives in lung cancer imaging using multidetector row computed tomography.

    Science.gov (United States)

    Coche, Emmanuel

    2012-10-01

    The introduction of multidetector row computed tomography (CT) into clinical practice has revolutionized many aspects of the clinical work-up. Lung cancer imaging has benefited from various breakthroughs in computing technology, with advances in the field of lung cancer detection, tissue characterization, lung cancer staging and response to therapy. Our paper discusses the problems of radiation, image visualization and CT examination comparison. It also reviews the most significant advances in lung cancer imaging and highlights the emerging clinical applications that use state of the art CT technology in the field of lung cancer diagnosis and follow-up.

  2. Clinical impact of 18F-FDG-PET/CT in the extra cardiac work-up of patients with infective endocarditis

    DEFF Research Database (Denmark)

    Asmar, Ali; Ozcan, Cengiz; Diederichsen, Axel C P;

    2014-01-01

    OBJECTIVE: The purpose of this study was to assess the clinical importance of (18)F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE). BACKGROUND: IE is a serious condition with a significant mortality. Besides the degree of valvular involvement, the progno...... lesions of clinical importance in one of seven IE patients and may be a substantial imaging technique for tracing peripheral infectious embolism due to IE. Thus, (18)F-FDG-PET/CT may help to guide adequate therapy and thereby improve the prognosis of patients with IE.......OBJECTIVE: The purpose of this study was to assess the clinical importance of (18)F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE). BACKGROUND: IE is a serious condition with a significant mortality. Besides the degree of valvular involvement......, the prognosis relies crucially on the presence of systemic infectious embolism. METHODS: Seventy-two patients (71% males and mean age 63 ± 17 years) with IE were evaluated with (18)F-FDG-PET/CT in addition to standard work-up including patient history, physical examination, conventional imaging modalities...

  3. Towards real-time 3D US-CT registration on the beating heart for guidance of minimally invasive cardiac interventions

    Science.gov (United States)

    Li, Feng; Lang, Pencilla; Rajchl, Martin; Chen, Elvis C. S.; Guiraudon, Gerard; Peters, Terry M.

    2012-02-01

    Compared to conventional open-heart surgeries, minimally invasive cardiac interventions cause less trauma and sideeffects to patients. However, the direct view of surgical targets and tools is usually not available in minimally invasive procedures, which makes image-guided navigation systems essential. The choice of imaging modalities used in the navigation systems must consider the capability of imaging soft tissues, spatial and temporal resolution, compatibility and flexibility in the OR, and financial cost. In this paper, we propose a new means of guidance for minimally invasive cardiac interventions using 3D real-time ultrasound images to show the intra-operative heart motion together with preoperative CT image(s) employed to demonstrate high-quality 3D anatomical context. We also develop a method to register intra-operative ultrasound and pre-operative CT images in close to real-time. The registration method has two stages. In the first, anatomical features are segmented from the first frame of ultrasound images and the CT image(s). A feature based registration is used to align those features. The result of this is used as an initialization in the second stage, in which a mutual information based registration is used to register every ultrasound frame to the CT image(s). A GPU based implementation is used to accelerate the registration.

  4. Analysis of left atrial respiratory and cardiac motion for cardiac ablation therapy

    Science.gov (United States)

    Rettmann, M. E.; Holmes, D. R.; Johnson, S. B.; Lehmann, H. I.; Robb, R. A.; Packer, D. L.

    2015-03-01

    Cardiac ablation therapy is often guided by models built from preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans. One of the challenges in guiding a procedure from a preoperative model is properly synching the preoperative models with cardiac and respiratory motion through computational motion models. In this paper, we describe a methodology for evaluating cardiac and respiratory motion in the left atrium and pulmonary veins of a beating canine heart. Cardiac catheters were used to place metal clips within and near the pulmonary veins and left atrial appendage under fluoroscopic and ultrasound guidance and a contrast-enhanced, 64-slice multidetector CT scan was collected with the clips in place. Each clip was segmented from the CT scan at each of the five phases of the cardiac cycle at both end-inspiration and end-expiration. The centroid of each segmented clip was computed and used to evaluate both cardiac and respiratory motion of the left atrium. A total of three canine studies were completed, with 4 clips analyzed in the first study, 5 clips in the second study, and 2 clips in the third study. Mean respiratory displacement was 0.2+/-1.8 mm in the medial/lateral direction, 4.7+/-4.4 mm in the anterior/posterior direction (moving anterior on inspiration), and 9.0+/-5.0 mm superior/inferior (moving inferior with inspiration). At end inspiration, the mean left atrial cardiac motion at the clip locations was 1.5+/-1.3 mm in the medial/lateral direction, and 2.1+/-2.0 mm in the anterior/posterior and 1.3+/-1.2 mm superior/inferior directions. At end expiration, the mean left atrial cardiac motion at the clip locations was 2.0+/-1.5mm in the medial/lateral direction, 3.0+/-1.8mm in the anterior/posterior direction, and 1.5+/-1.5 mm in the superior/inferior directions.

  5. Benefit of combining quantitative cardiac CT parameters with troponin I for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Mathias, E-mail: mr.meyer.mathias@gmail.com [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Fink, Christian, E-mail: Christian.Fink@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Roeger, Susanne, E-mail: susanne.roeger@umm.de [1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Apfaltrer, Paul, E-mail: Paul.Apfaltrer@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Haghi, Dariush, E-mail: dariush.haghi@umm.de [1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Kaminski, Wolfgang E., E-mail: wolfgang.kaminski@umm.de [Department of Clinical Chemistry, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Neumaier, Michael, E-mail: michael.neumaier@medma.uni-heidelberg.de [Department of Clinical Chemistry, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Schoenberg, Stefan O., E-mail: Stefan.Schoenberg@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); and others

    2012-11-15

    Objective: To prospectively evaluate the diagnostic accuracy of quantitative cardiac CT parameters alone and in combination with troponin I for the assessment of right ventricular dysfunction (RVD) and adverse clinical events in patients with acute pulmonary embolism (PE). Materials and results: This prospective study had institutional review board approval and was HIPAA compliant. In total 83 patients with confirmed PE underwent echocardiography and troponin I serum level measurements within 24 h. Three established cardiac CT measurements for the assessment of RVD were obtained (RV/LV{sub axial}, RV/LV{sub 4-CH}, and RV/LV{sub volume}). CT measurements and troponin I serum levels were correlated with RVD found on echocardiography and adverse clinical events according to Management Strategies and Prognosis in Pulmonary Embolism Trial-3 (MAPPET-3 criteria. 31 of 83 patients with PE had RVD on echocardiography and 39 of 83 patients had adverse clinical events. A RV/LV{sub volume} ratio > 1.43 showed the highest area under the curve (AUC) (0.65) for the prediction of adverse clinical events when compared to RV/LV{sub axial}, RV/LV{sub 4Ch} and troponin I. The AUC for the detection of RVD of RV/LV{sub axial}, RV/LV{sub 4Ch}, RV/LV{sub volume}, and troponin I were 0.86, 0.86, 0.92, and 0.69, respectively. Combination of RV/LV{sub axial}, RV/LV{sub 4Ch}, RV/LV{sub volume} with troponin I increased the AUC to 0.87, 0.87 and 0.93, respectively. Conclusion: A combination of cardiac CT parameters and troponin I measurements improves the diagnostic accuracy for detecting RVD and predicting adverse clinical events if compared to either test alone.

  6. Comparison between multi-detector row CT angiography and Doppler ultrasound on detecting carotid artery wall thickness%多层螺旋CT与Doppler超声对颈动脉壁层厚度的对比性研究

    Institute of Scientific and Technical Information of China (English)

    赵刚; 查云飞; 王弘; 洪玮; 邱晓明; 王珍; 肖友梅

    2013-01-01

    Objective To explore the relationship and consistency between multi-detector row computed tomography angiography (MDCTA) and color Doppler ultrasound (CD-US) in measuring carotid artery wall thickness (CAWT) and intima-media thickness (IMT). Methods CAWT and IMT of 38 subjects were measured using MDCTA and CD-US, respectively. Linear correlation analysis was performed to analyze the correlation between the results from CAWT and IMT,and Bland-Altman statistics was employed to analyze the consistency between them. Results The IMT value measured by CD-US was (0.85+0.16) mm, and the CAWT value measured by MDCTA was (0.87.± 0.18) mm (P > 0.05), and there was a high degree of correlation between them (correlation coefficient was 0.958,P< 0.01). An excellent consistency between CAWT and IMT was found by Bland-Altman plot, with a bias of 0.026 mm and the limit of consistency from -0.023 to 0.075. Conclusions There were significant correlation and consistency between MDCTA and CD-US in detecting CAWT and IMT. As a more objective and comprehensive new method, MDCTA can replace CD-US in the evaluation of early carotid atherosclerosis.%目的:探讨多层螺旋CT血管造影(MDCTA)和彩色多普勒超声(CD-US)在检测颈总动脉壁厚度(CAWT)和颈总动脉内膜-中层厚度(IMT)中的相关性和一致性.方法:应用MDCTA和CD-US分别对38例受试者颈总动脉的CAWT和IMT进行检测,用Pearson直线相关分析比较CAWT和IMT的相关性,用Bland-Altman分析比较两者的一致性.结果:MDCTA测量的颈总动脉CAWT为(0.87±0.18)mm,CD-US测量的颈总动脉IMT为(0.85±0.16)mm,两者比较无统计学差异,有高度相关性,相关系数为0.958,P<0.01,Bland-Altman分析两者间存在良好一致性,偏倚为0.026 mm,一致性界限为-0.023 ~ 0.075.结论:MDCTA和CD-US在检测颈总动脉CAWT和IMT时存在良好的相关性和一致性,MDCTA可以替代CD-US,作为一种评价颈动脉早期粥样硬化的更加客观全面的新方法.

  7. The Value of Multi-detector row CT in Gastroenteropathy and Application of Contrast Agents%MDCT在胃肠道检查中的价值及对比剂的应用

    Institute of Scientific and Technical Information of China (English)

    鲁桂青; 陈克敏; 刘林祥

    2007-01-01

    胃肠道疾患在过去以传统的检查方法 (主要为消化道钡剂透视及纤维内窥镜)为主,随着多层螺旋CT(multi-detector row CT,MDCT)的快速发展以及各种不同腔内对比剂的研究与应用,CT对胃肠道的检查价值显著提高。

  8. Experimental study about the effect of different scan parameters and post-processing methods of multi-detector CT on metallic artifacts%多排螺旋 CT 不同扫描参数及图像后处理方式对金属伪影的影响

    Institute of Scientific and Technical Information of China (English)

    储斌; 邹月芬; 王传兵

    2015-01-01

    目的:探讨多排螺旋 CT(MDCT)扫描参数及图像后处理方式对金属植入物伪影的影响,以期获得最佳方案减少金属伪影。方法制作钛合金钢板水模,将其置入 MDCT 下通过调节不同参数进行扫描(包括管电压、管电流、螺距、焦点),然后测定所得图像伪影面积大小并评价其相关性;对常规扫描参数下获得的15例椎体内固定术后患者图像进行后处理,分别使用常规方式和优化方式重建,包括多平面重建(MPR)、调节窗宽窗位及容积再现技术(VRT),然后评价图像质量。结果不同管电压、螺距、焦点下,伪影面积差异有统计学意义,随着管电压升高,伪影面积逐渐减小;随着螺距减小,伪影面积逐渐减小;使用小焦点扫描较大焦点伪影面积小;不同管电流下,伪影面积差异无统计学意义。图像后处理时骨窗重建选择软组织算法(Kernel B40f)、观察时选择窗位600 HU、窗宽2000 HU 及 VRT 三维重建可减少金属伪影。结论选择适当的 MDCT 扫描参数及图像后处理方式可以减少金属伪影,提高图像质量,有助于影像诊断。%Objective To explore the effect of multi-detector computed tomography (MDCT)scan parameters and imaging post-processing methods on metallic artifacts,so as to achieve the perfection in reduction of artifacts caused by metallic implants.Methods Water phantom with titanium alloy steel plate was scanned under MDCT with alternating scan parameters including tube voltage, tube current,pitch and focal spot.The areas of image artifacts were measured and correlated with the scan parameters.Another 1 5 postoperative patients with vertebral implantation scaned with the conventional scan parameters were also included in the study.Ima-ging post-processing including multi-planar reconstruction (MPR),window width and level adjustment,and volume rendering tech-nique (VRT)was performed by using optimized and

  9. Role of {sup 18}F-FDG PET/CT in the diagnosis of infective endocarditis in patients with an implanted cardiac device: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Graziosi, Maddalena; Lorenzini, Massimiliano; Diemberger, Igor; Pasquale, Ferdinando; Ziacchi, Matteo; Biffi, Mauro; Martignani, Cristian; Boriani, Giuseppe; Rapezzi, Claudio [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Cardiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Bologna (Italy); Nanni, Cristina; Bonfiglioli, Rachele; Fanti, Stefano [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Nuclear Medicine Unit, Department of Experimental, Diagnostic and Specialty Medicine, Bologna (Italy); Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Infectious Diseases Unit, Department of Medical and Surgical Sciences, Bologna (Italy)

    2014-08-15

    Infective endocarditis (IE) is widely underdiagnosed or diagnosed after a major delay. The diagnosis is currently based on the modified DUKE criteria, where the only validated imaging technique is echocardiography, and remains challenging especially in patients with an implantable cardiac device. The aim of this study was to assess the incremental diagnostic role of {sup 18}F-FDG PET/CT in patients with an implanted cardiac device and suspected IE. We prospectively analysed 27 consecutive patients with an implantable device evaluated for suspected device-related IE between January 2011 and June 2013. The diagnostic probability of IE was defined at presentation according to the modified DUKE criteria. PET/CT was performed as soon as possible following the clinical suspicion of IE. Patients then underwent medical or surgical treatment based on the overall clinical evaluation. During follow-up, we considered: lead cultures in patients who underwent extraction, direct inspection and lead cultures in those who underwent surgery, and a clinical/instrumental reevaluation after at least 6 months in patients who received antimicrobial treatment or had an alternative diagnosis and were not treated for IE. After the follow-up period, the diagnosis was systematically reviewed by the multidisciplinary team using the modified DUKE criteria and considering the new findings. Among the ten patients with a positive PET/CT scan, seven received a final diagnosis of ''definite IE'', one of ''possible IE'' and two of ''IE rejected''. Among the 17 patients with a negative PET/CT scan, four were false-negative and received a final diagnosis of definite IE. These patients underwent PET/CT after having started antibiotic therapy (≥48 h) or had a technically suboptimal examination. In patients with a cardiac device, PET/CT increases the diagnostic accuracy of the modified Duke criteria for IE, particularly in the subset of

  10. ASSESSMENT OF EFFECTIVE DOSE FROM CONE BEAM CT IMAGING IN SPECT/CT EXAMINATION IN COMPARISON WITH OTHER MODALITIES.

    Science.gov (United States)

    Tonkopi, Elena; Ross, Andrew A

    2016-12-01

    The aim of this study was to assess radiation dose from the cone beam computed tomography (CBCT) component of single photon emission tomography/computed tomography (SPECT/CT) examinations and to compare it with the radiopharmaceutical related dose as well as dose from multidetector computed tomography (MDCT). Effective dose (ED) from computed tomography (CT) was estimated using dose-length product values and anatomy-specific conversion factors. The contribution from the SPECT component was evaluated using ED per unit administered activity for the radiopharmaceuticals listed in the International Commission on Radiological Protection Publications 80 and 106. With the exception of cardiac studies (0.11 mSv), the CBCT dose (3.96-6.04 mSv) was similar to that from the radiopharmaceutical accounting for 29-56 % of the total ED from the examination. In comparison with MDCT examinations, the CBCT dose was 48 and 42 % lower for abdomen/pelvis and chest/abdomen/pelvis scans, respectively, while in the chest the CBCT scan resulted in higher dose (23 %). Radiation dose from the CT component should be taken into consideration when evaluating total SPECT/CT patient dose.

  11. Multidetector computed tomographic and magnetic resonance enterography in children: state of the art.

    Science.gov (United States)

    Hammer, Matthew R; Podberesky, Daniel J; Dillman, Jonathan R

    2013-07-01

    Advanced multidetector computed tomographic and magnetic resonance imaging techniques (CT and MR enterography, respectively), designed to provide detailed images of the bowel and mesentery, can be successfully performed in children of all ages, frequently without sedation. Cross-sectional enterography allows for noninvasive diagnosis, detection of various disease-related complications and extraintestinal manifestations, and monitoring of bowel-wall inflammation in pediatric inflammatory bowel disease (IBD). This article provides a contemporary review of CT and MR enterography in the pediatric population, including up-to-date techniques and clinical applications. A range of bowel abnormalities is illustrated, with an emphasis on IBD and its many abdominopelvic manifestations.

  12. 多层螺旋CT血管成像在脾动脉瘤中的应用价值%Application value of multidetector CT angiography in splenic artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    孙建梅

    2016-01-01

    目的:研究CT血管成像(CTA)检出的脾动脉瘤的特征。方法2013年1月至2015年11月共32例患者被诊断为脾动脉瘤,回顾性分析检出脾动脉瘤的分布及CT表现。结果32例患者共发现35个脾动脉瘤,30例为单发脾动脉瘤(94%,30/32),位于脾动脉近脾门处28例(93%,28/30),中段2例(7%,2/30);2例(6%,2/32)为多发动脉瘤,其中1例2个动脉瘤,位于脾动脉近段和中段;1例3个动脉瘤,分别位于脾动脉近段、中段和远端近脾门处。35个脾动脉瘤中,囊性动脉瘤占97%,平均最大径为16±6 mm;13个动脉瘤合并瘤壁钙化(37%,13/35),5个合并瘤内血栓形成(14%,5/35)。结论脾动脉瘤最常位于脾动脉近脾门处,多表现为单发囊型瘤样扩张,可伴有壁钙化和血栓形成。 CTA可作为脾动脉瘤术前诊断和随访检查的重要手段。%Objective To investigate the distribution and features of splenic artery aneurysms detected in CT angiography. Methods Splenic artery aneurysms were diagnosed in 32 patients from Jan. 2013 to Nov. 2015. Distri-bution and CT findings were retrospectively analyzed. Results Thirty five aneurysms were detected in 32 patients, solitary aneurysm was found in 30 patients (94%, 30/32). Twenty eight aneurysms were located in distal segment (93%, 28/30), middle segment in 2 patients (7%, 2/30). Two patients (6%, 2/32) had multiple aneurysms. One patient had two aneurysms located in the proximal and middle segment of splenic artery. One patient had three aneurysms lo-cated in the proximal, middle and distal segment of splenic artery. Of 35 splenic aneurysms, cystic aneurysms ac-counted for 97%with the mean diameter of 16±6 mm. Thirteen aneurysms (37%,13/35) had mural calcification and 5 aneurysms (14%, 5/35) with thrombosis formation. Conclusion Splenic aneurysms mostly localized in the distal seg-ment of splenic artery, most of which are solitary and

  13. Value of Multidetector Computed Tomography in Evaluation of Thoracic Venous Abnormalities among Pediatrics with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Dalia F Elbeih*, Mervat M El-Gohary *, Naglaa H Shebrya*,Mohammed A Saleh

    2013-04-01

    Full Text Available Introduction: Venous anomalies of the thorax can involve systemic or pulmonary veins and range from isolated incidental findings to components of more complex anomalies, most often congenital heart disease (CHD. Although echocardiography and catheter directed cardiac angiography are generally accepted as the primary imaging techniques for evaluation of CHD, CT and MRI are important complementary diagnostic tools. Multi-detector computed tomography (MDCT with its increasing availability and utility is now becoming a further method of imaging CHD. In light of its widespread availability, MDCT and 3D imaging are increasingly considered as a viable “one-stop shop” for preoperative imaging evaluation of cardiovascular structures in selected pediatric patients.Aim of the work: The aim of this work is to evaluate the role of MDCT in visualization of the thoracic venous system in pediatrics with congenital heart disease, show prevalence and types of venous anomalies and to compare this data with echocardiographic findings.Methods: The studied group included 30 cases referred to us by pediatric cardiologists to be examined by MSCT angiography of the heart and thoracic vessels. All the patients were known cases of congenital heart disease and underwent echocardiography. They were referred to answer specific anatomic question raised by inconclusive echocardiography, to assess suspected systemic and suspected pulmonary venous anomalies. All patients were subjected to full history taking, clinical examination and MDCT examination with CT lightspeed VCT XT 64-detectors row scanner (General Electric, Medical Systems, Milwaukee, Wisconsin, USA.Results: CTA findings had 77.8 % concordance with echocardiographic findings regarding SVC anomalies, 66.7 % concordance with echocardiography regarding IVC anomalies and 90 % concordance regarding pulmonary venous anomalies.Conclusion: Low dose protocol CTA is a promising method that complementary to Echocardioraphy

  14. Accuracy of whole-body low-dose multidetector CT (WBLDCT) versus skeletal survey in the detection of myelomatous lesions, and correlation of disease distribution with whole-body MRI (WBMRI)

    Energy Technology Data Exchange (ETDEWEB)

    Gleeson, T.G. [Mater Misericordiae University Hospital, Department of Radiology and Diagnostic Imaging, Dublin 7 (Ireland)]|[St Paul' s Hospital, Radiology Department, Vancouver, BC (Canada); Moriarty, J.; Shortt, C.P.; O' Connell, M.; Eustace, S.J. [Mater Misericordiae University Hospital, Department of Radiology and Diagnostic Imaging, Dublin 7 (Ireland); Gleeson, J.P. [University of Limerick, Department of Applied Mathemathics and Statistics, Limerick (Ireland); Fitzpatrick, P. [University College Dublin, UCD School of Public Health and Population Science, Dublin 2 (Ireland); Byrne, B. [Mater Misericordiae University Hospital, Department of Medical Physics, Dublin 7 (Ireland); McHugh, J.; O' Gorman, P. [Mater Misericordiae University Hospital, Department of Haematology, Dublin 7 (Ireland)

    2009-03-15

    The aim of the study is to assess the feasibility of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of multiple myeloma and compare to skeletal survey (SS), using bone marrow biopsy and whole-body magnetic resonance imaging (WBMRI; where available) as gold standard. Patients referred over an 18-month period for investigation of suspected multiple myeloma or restaging of myeloma were randomized to undergo one of two WBLDCT protocols using high kVp, low mAs technique (140 kVp, 14 mAs; or 140 kVp, 25 mAs). Recent WBMRI scans were reviewed in 23 cases. Each imaging modality was assessed by two radiologists in consensus and scored from 0-3 (0= normal, 1=1-4 lesions, 2=5-20 lesions, 3{>=}20 lesions/diffuse disease) in ten anatomical areas. Overall stage of disease, image quality score, and the degree of confidence of diagnosis were recorded. Diagnostic accuracy of skeletal survey and WBLDCT were determined using a gold standard of bone marrow biopsy and distribution of disease was compared to WBMRI. Thirty-nine patients were evaluated. WBLDCT identified more osteolytic lesions than skeletal survey with a greater degree of diagnostic confidence and led to restaging in 18 instances (16 upstaged, two downstaged). In those with recent WBMRI, distribution of disease on WBLDCT showed superior correlation with WBMRI when compared with SS. Overall reader impression of stage on WBLDCT showed significant correlation with WBMRI ({kappa}=0.454, p<0.05). WBLDCT provided complementary information to WBMRI in nine patients with normal marrow signal following treatment response, but which were shown to have diffuse residual cortical abnormalities on CT. WBLDCT at effective doses lower than previously reported, is superior to SS at detecting osteolytic lesions and at determining overall stage of multiple myeloma, and provides complementary information to WBMRI. (orig.)

  15. The value of multidetector row CT in evaluating left renal vein anatomy in living renal transplantation donors%多层螺旋CT在活体肾移植术前左肾静脉解剖评估中的价值

    Institute of Scientific and Technical Information of China (English)

    陶舒敏; 张喆; 吉秋; 孔祥; 张龙江

    2016-01-01

    Objective To discuss the left renal vein anatomy at multi-detector row CT and the implications for living renal transplantation.Methods The left renal vein anatomy and the branches in79 living renal transplantation donors who underwent contrast-enhanced CT angiography were analyzed retrospectively in this study. Maximum intensity projection, curve planar reformation and volume renderings were used for displaying the left renal vein anatomy. Anomalies of left renal vein and branches were recorded and classified.Results Left renal veins were all visualized on late arterial and venous phase CT images in all subjects. There were one case of circumaortic renal vein(n=1) and one case of left inferior vena cava(n=1).0 or1 adrenal vein,0 to2 lumbar veins and0 to 2 gonadal veins were found in each donor.Conclusion Among the left renal vein branches, the number of lumbar vein varied more frequently,multiple gonadal veins were detected in some subjects. Left renal vein branches should be handled carefully to avoid massive haemorrhage in left nephrectomy.%目的:探讨左肾静脉解剖变异及其属支在多层螺旋CT中的表现及其对活体肾移植的意义。方法回顾性分析79例行多层螺旋CT增强的肾移植供者左肾静脉的解剖结构及汇入左肾静脉的属支情况。采用最大密度投影、曲面重组和容积再现后处理技术,总结左肾静脉解剖变异及属支情况并分类讨论。结果多层螺旋CT动脉晚期和静脉期图像均显示左肾静脉主干,发现环主动脉左肾静脉解剖变异1例,左侧下腔静脉1例。每例供者发现肾上腺静脉0~1根,腰静脉0~2根,生殖静脉0~2根。结论左肾静脉属支中,腰静脉数目变异较多,生殖静脉肾有时会出现多根。在左肾切除术中要仔细处理静脉属支,避免大出血的发生。

  16. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-15

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

  18. Instrumentation for multi-detector arrays

    Indian Academy of Sciences (India)

    R K Bhowmik

    2001-07-01

    The new generation of detector arrays require complex instrumentation and data acquisition system to ensure increased reliability of operation, high degree of integration, software control and faster data handling capability. The main features of some of the existing multi-detector arrays like MSU 4 array, Gammasphere and Eurogam are summarized. The instrumentation for the proposed INGA array in India is discussed.

  19. Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note

    Energy Technology Data Exchange (ETDEWEB)

    Feuchtner, Gudrun [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Innsbruck Medical University, Department of Radiology II, Innsbruck (Austria); Goetti, Robert; Marincek, Borut; Alkadhi, Hatem; Leschka, Sebastian [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Plass, Andre; Wieser, Monika [University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland); Baumueller, Stephan; Stolzmann, Paul; Scheffel, Hans [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland)

    2010-09-15

    To describe prospective ECG-triggered dual-source CT dual-step pulsing (pECG{sub dual-step}) for evaluation of coronary arteries and cardiac function. Fifty-one consecutive patients pre- or post-cardiovascular surgery were examined with adaptive sequential tube current modulated (pECG{sub dual-step}) 128-slice dual-source CT without heart rate control (main padding window: 40% RR interval >65 bpm/70% RR interval <65 bpm). Image quality of coronary arteries was graded (4-point scale), and cardiac function was evaluated. Mean HR was 68 bpm. Thirty-seven patients were in stable sinus rhythm (SR); 14 had arrhythmia. Image quality of coronary arteries was diagnostic in 804/816 (98%) of segments. The number of non-diagnostic segments was higher in patients with arrhythmia as compared to those in SR (4% vs. 0.5%; p = 0.01), and there were fewer segments with excellent image quality (79% vs. 94%; p < 0.001) and more segments with impaired image quality (p < 0.001 and p = 0.002). Global and regional LV function could be evaluated in 41 (80%) and 47 (92%) patients, and valvular function in 48 (94%). In 11/14 of patients with arrhythmia, the second step switched to full mAs, increasing radiation exposure to 8.6 mAs (p < 0.001). The average radiation dose was 3.8 mSv (range, 1.7-7.9) in patients in SR. pECG{sub dual-step}128-slice DSCT is feasible for the evaluation of coronary arteries and cardiac function without heart rate control in patients in stable sinus rhythm at a low radiation dose. (orig.)

  20. Cardiac C-arm CT: 4D non-model based heart motion estimation and its application

    Science.gov (United States)

    Prümmer, M.; Fahrig, R.; Wigström, L.; Boese, J.; Lauritsch, G.; Strobel, N.; Hornegger, J.

    2007-03-01

    The combination of real-time fluoroscopy and 3D cardiac imaging on the same C-arm system is a promising technique that might improve therapy planning, guiding, and monitoring in the interventional suite. In principal, to reconstruct a 3D image of the beating heart at a particular cardiac phase, a complete set of X-ray projection data representing that phase is required. One approximate approach is the retrospectively ECG-gated FDK reconstruction (RG-FDK). From the acquired data set of N s multiple C-arm sweeps, those projection images which are acquired closest in time to the desired cardiac phase are retrospectively selected. However, this approach uses only 1/ N s of the obtained data. Our goal is to utilize data from other cardiac phases as well. In order to minimize blurring and motion artifacts, cardiac motion has to be compensated for, which can be achieved using a temporally dependent spatial 3D warping of the filtered-backprojections. In this work we investigate the computation of the 4D heart motion based on prior reconstructions of several cardiac phases using RG-FDK. A 4D motion estimation framework is presented using standard fast non-rigid registration. A smooth 4D motion vector field (MVF) represents the relative deformation compared to a reference cardiac phase. A 4D deformation regridding by adaptive supersampling allows selecting any reference phase independently of the set of phases used in the RG-FDK for a motion corrected reconstruction. Initial promising results from in vivo experiments are shown. The subjects individual 4D cardiac MVF could be computed from only three RG-FDK image volumes. In addition, all acquired projection data were motion corrected and subsequently used for image reconstruction to improve the signal-to-noise ratio compared to RG-FDK.

  1. Ascending aorta measurements as assessed by ECG-gated multi-detector computed tomography: a pilot study to establish normative values for transcatheter therapies

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Tri-Linh C.; Rizzo, Elena [University Hospital Lausanne (CHUV), Department of Radiology, Lausanne (Switzerland); Huber, Christoph H.; Segesser, Ludwig K. von [University Hospital Lausanne (CHUV), Department of Cardiovascular Surgery, Lausanne (Switzerland); Dehmeshki, Jashmid [Kingston University, Digital Imaging Research Centre, Faculty of Computing, Information Systems and Mathematics, London (United Kingdom); Qanadli, Salah D. [University Hospital Lausanne (CHUV), Department of Radiology, Lausanne (Switzerland)]|[BH-07, Centre Hospitalier Universitaire Vaudois, Service de Radiodiagnostic et de Radiologie interventionnelle, Lausanne (Switzerland)

    2009-03-15

    The aim of this study was to provide an insight into normative values of the ascending aorta in regards to novel endovascular procedures using ECG-gated multi-detector CT angiography. Seventy-seven adult patients without ascending aortic abnormalities were evaluated. Measurements at relevant levels of the aortic root and ascending aorta were obtained. Diameter variations of the ascending aorta during cardiac cycle were also considered. Mean diameters (mm) were as follows: LV outflow tract 20.3{+-}3.4, coronary sinus 34.2{+-}4.1, sino-tubular junction 29.7{+-}3.4 and mid ascending aorta 32.7{+-}3.8 with coefficients of variation (CV) ranging from 12 to 17%. Mean distances (mm) were: from the plane passing through the proximal insertions of the aortic valve cusps to the right brachio-cephalic artery (BCA) 92.6{+-}11.8, from the plane passing through the proximal insertions of the aortic valve cusps to the proximal coronary ostium 12.1{+-}3.7, and between both coronary ostia 7.2{+-}3.1, minimal arc of the ascending aorta from left coronary ostium to right BCA 52.9{+-}9.5, and the fibrous continuity between the aortic valve and the anterior leaflet of the mitral valve 14.6{+-}3.3, CV 13-43%. Mean aortic valve area was 582.0{+-}131.9 mm{sup 2}. The variation of the antero-posterior and transverse diameters of the ascending aorta during the cardiac cycle were 8.4% and 7.3%, respectively. Results showed large inter-individual variations in diameters and distances but with limited intra-individual variations during the cardiac cycle. A personalized approach for planning endovascular devices must be considered. (orig.)

  2. Imaging of cardiac perfusion of free-breathing small animals using dynamic phase-correlated micro-CT

    Energy Technology Data Exchange (ETDEWEB)

    Sawall, Stefan; Kuntz, Jan; Socher, Michaela; Knaup, Michael; Hess, Andreas; Bartling, Soenke; Kachelriess, Marc [Institute of Medical Physics, Friedrich-Alexander-University (FAU) Erlangen-Nuernberg, 91052 Erlangen, Germany and Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Animal Laboratory Services Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Institute of Medical Physics, Friedrich-Alexander-University (FAU) Erlangen-Nuernberg, 91052 Erlangen (Germany); Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-University (FAU) Erlangen-Nuernberg, 91052 Erlangen (Germany); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Institute of Medical Physics, Friedrich-Alexander-University (FAU) Erlangen-Nuernberg, 91052 Erlangen, Germany and Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2012-12-15

    Purpose:Mouse models of cardiac diseases have proven to be a valuable tool in preclinical research. The high cardiac and respiratory rates of free breathing mice prohibit conventional in vivo cardiac perfusion studies using computed tomography even if gating methods are applied. This makes a sacrification of the animals unavoidable and only allows for the application of ex vivo methods. Methods: To overcome this issue the authors propose a low dose scan protocol and an associated reconstruction algorithm that allows for in vivo imaging of cardiac perfusion and associated processes that are retrospectively synchronized to the respiratory and cardiac motion of the animal. The scan protocol consists of repetitive injections of contrast media within several consecutive scans while the ECG, respiratory motion, and timestamp of contrast injection are recorded and synchronized to the acquired projections. The iterative reconstruction algorithm employs a six-dimensional edge-preserving filter to provide low-noise, motion artifact-free images of the animal examined using the authors' low dose scan protocol. Results: The reconstructions obtained show that the complete temporal bolus evolution can be visualized and quantified in any desired combination of cardiac and respiratory phase including reperfusion phases. The proposed reconstruction method thereby keeps the administered radiation dose at a minimum and thus reduces metabolic inference to the animal allowing for longitudinal studies. Conclusions: The authors' low dose scan protocol and phase-correlated dynamic reconstruction algorithm allow for an easy and effective way to visualize phase-correlated perfusion processes in routine laboratory studies using free-breathing mice.

  3. {sup 18}F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Graziosi, Maddalena; Rapezzi, Claudio [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Cardiology, Bologna (Italy); Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Infective Diseases, Bologna (Italy); Ferretti, Alice; Rubello, Domenico [Azienda Ospedaliera S. Maria della Misericordia, Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Rovigo (Italy)

    2013-08-15

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of {sup 18}F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent {sup 18}F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  4. Normal values for renal parenchymal volume and kidney length as measured by non-enhanced multidetector spiral computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Fei; Wu, Xiao Hou (Dept. of Urology, The First Affiliated Hospital of Chongqing Medical Univ., Chongqing (China)), email: wuxiaohou@yahoo.com; Yang, Mei (Inst. of Neuroscience, Chongqing Medical Univ., Chongqing (China)); Luo, Chun Li (Dept. of Laboratory Medicine, Chongqing Medical Univ., Chongqing (China)); Pang, Hua (Dept. of Radiology, The First Affiliated Hospital of Chongqing Medical Univ., Chongqing (China))

    2011-07-15

    Background: Renal parenchymal volume (RPV) is considered an important index for clinical decisions. However, normal values have not been established, which hinders the clinical application of RPV. Purpose: To test the accuracy and reproducibility of RPV and to investigate the normal values of RPV and kidney length as measured by non-enhanced multidetector computed tomography (CT). Material and Methods: An animal model study was performed to test the accuracy and repeatability of RPV measured by CT. RPV of porcine kidneys was measured by water displacement (actual values) and non-enhanced multidetector CT. Individual RPV and kidney length were measured by non-enhanced CT in patients with no clinical history of renal disease (n 722). Patient height, age, weight, body surface area (BSA), and body mass index (BMI) were assessed before each patient's CT examination was performed. Results: RPV obtained by the CT method was within 2% of the RPV determined by the water displacement method. The normal values of RPV (M +- 1.96 standard deviation [SD]) were 145.72 +- 54.37 mL for men and 132.46 +- 41.94 mL for women. The normal values of kidney length (M +- 1.96 SD) were 10.27 +- 1.98 cm for men and 9.93 +- 1.58 cm for women. RPV did not significantly correlate with BSA or weight in women, but correlated significantly with height and age in both men and women. Of the assessed factors age, weight, height, BSA, and BMI, age, and height were the independent factors that best reflected RPV, in both men and women. Conclusion: The present animal study results showed that non-enhanced multidetector CT findings accurately reflect the RPV. The subsequent study performed in humans showed that the RPV of the presently sampled Chinese population was lower than the commonly quoted reference values obtained from Western populations

  5. Double Chooz Improved Multi-Detector Measurements

    CERN Document Server

    CERN. Geneva

    2016-01-01

    The Double Chooz experiment (DC) is a reactor neutrino oscillation experiment running at Chooz nuclear power plant (2 reactors) in France. In 2011, DC first reported indication of non-zero θ13 with the far detector (FD) located at the maximum of oscillation effects (i.e. disappearance), thus challenging the CHOOZ non-observation limit. A robust observation of θ13 followed in 2012 by the Daya Bay experiments with multiple detector configurations. Since 2015 DC runs in a multi-detector configuration making thus the impact of several otherwise dominating systematics reduce strongly. DC’s unique almost "iso-flux" site, allows the near detector (ND) to become a direct accurate non-oscillation reference to the FD. Our first multi-detector results at MORIOND-2016 showed an intriguing deviation of θ13 with respect to the world average. We will address this issue in this seminar. The combined "reactor-θ13" measurement is expected to ...

  6. Extrapleural Inner Thoracic Wall Lesions: Multidetector CT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Soo; Kim, Young Tong; Jou, Sung Shik [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of)

    2010-06-15

    The extrapleural space is external to the parietal pleura in the thorax. The structures within and adjacent to this region include the fat pad, endothoracic fascia, intercostal muscles, connective tissue, nerves, vessels, and ribs. Further, the space is divided into the inner and outer thoracic wall by the innermost intercostal muscle. Extrapleural lesions in the inner thoracic wall are classified as air-containing lesions, fat-containing lesions, and soft tissue-containing lesions according on their main component. Air-containing lesions include extrapleural air from direct chest trauma and extrapleural extension from pneumomediastinum. Prominent extrapleural fat is seen in decreased lung volume conditions, and can also be seen in normal individuals. Soft tissue-containing lesions include extrapleural extensions from a pleural or chest wall infection as well as tumors and extrapleural hematoma. We classify extrapleural lesions in the inner thoracic wall and illustrate their imaging findings

  7. Multiparametric multidetector computed tomography scanning on suspicion of hyperacute ischemic stroke: validating a standardized protocol

    Directory of Open Access Journals (Sweden)

    Felipe Torres Pacheco

    2013-06-01

    Full Text Available Multidetector computed tomography (MDCT scanning has enabled the early diagnosis of hyperacute brain ischemia. We aimed at validating a standardized protocol to read and report MDCT techniques in a series of adult patients. The inter-observer agreement among the trained examiners was tested, and their results were compared with a standard reading. No false positives were observed, and an almost perfect agreement (Kappa>0.81 was documented when the CT angiography (CTA and cerebral perfusion CT (CPCT map data were added to the noncontrast CT (NCCT analysis. The inter-observer agreement was higher for highly trained readers, corroborating the need for sp