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Sample records for coronary computed tomographic

  1. Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women

    DEFF Research Database (Denmark)

    Penagaluri, Ashritha; Higgins, Angela Y; Vavere, Andrea L

    2016-01-01

    BACKGROUND: Coronary computed tomographic angiography (CTA) and myocardial perfusion imaging (CTP) is a validated approach for detection and exclusion of flow-limiting coronary artery disease (CAD), but little data are available on gender-specific performance of these modalities. In this study, w...... REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037....

  2. Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients With Coronary Computed Tomographic Angiography.

    Science.gov (United States)

    Nakanishi, Rine; Baskaran, Lohendran; Gransar, Heidi; Budoff, Matthew J; Achenbach, Stephan; Al-Mallah, Mouaz; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; DeLago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Cury, Ricardo; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Kaufmann, Philipp A; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J; Villines, Todd C; Dunning, Allison; Marques, Hugo; Pontone, Gianluca; Andreini, Daniele; Rubinshtein, Ronen; Bax, Jeroen; Jones, Erica; Hindoyan, Niree; Gomez, Millie; Lin, Fay Y; Min, James K; Berman, Daniel S

    2017-08-01

    Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17 181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent ≥64-detector row coronary computed tomographic angiography, we identified 14 803 patients without known coronary artery disease. Of these, 1434 hypertensive patients were matched to 1434 patients without hypertension. Major adverse cardiac events risk of hypertension and non-hypertensive patients was evaluated with Cox proportional hazards models. The prognostic associations between hypertension and no-hypertension with increasing degree of coronary stenosis severity (nonobstructive or obstructive ≥50%) and extent of coronary artery disease (segment involvement score of 1-5, >5) was also assessed. Hypertension patients less commonly had no coronary atherosclerosis and more commonly had nonobstructive and 1-, 2-, and 3-vessel disease than the no-hypertension group. During a mean follow-up of 5.2±1.2 years, 180 patients experienced cardiac events, with 104 (2.0%) occurring in the hypertension group and 76 (1.5%) occurring in the no-hypertension group (hazard ratios, 1.4; 95% confidence intervals, 1.0-1.9). Compared with no-hypertension patients without coronary atherosclerosis, hypertension patients with no coronary atherosclerosis and obstructive coronary disease tended to have higher risk of cardiac events. Similar trends were observed with respect to extent of coronary artery disease. Compared with no-hypertension patients, hypertensive patients have increased presence, extent, and severity of coronary atherosclerosis and tend to have an increase in major adverse cardiac events. © 2017 American Heart Association, Inc.

  3. Subclinical coronary atherosclerosis identified by coronary computed tomographic angiography in asymptomatic morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Peter A. McCullough

    2010-09-01

    Full Text Available Obesity is a common public health problem and obese individuals in particular have a disproportionate incidence of acute coronary events. This study was undertaken to identify coronary artery lesions as well as associated clinical features, risk factors and demographics in patients with a body mass index (BMI >40 kg/m2 without known coronary artery disease (CAD. Morbidly obese subjects were prospectively recruited to undergo coronary computed tomographic angiography (CCTA using a dual-source computed tomography (CT system. CAD was defined as the presence of any atherosclerotic lesion in any one coronary artery segment. The presence, location, and severity of atherosclerosis were related to patient characteristics. Forty-one patients (28 women, mean age, 50.4±10.0 years, mean BMI, 43.8±4.8 kg/m2 served as the study population. Of these, 25 patients (61% had at least one coronary stenosis. All but 2 patients within the CAD cohort had coronary artery calcium (CAC scores >0, and most plaques identified (75.4% were non-calcified. There was a predilection of calcified and non-calcified atherosclerosis involving the left anterior descending (LAD coronary artery compared with other coronary segments. Univariate predictors of CAD included older age, dyslipidemia, and diabetes. In this preliminary study of young morbidly obese patients, CCTA detected a high prevalence of calcified and non-calcified CAD, although the later predominated.

  4. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    NARCIS (Netherlands)

    J.K. Min (James); T.M. LaBounty (Troy); M. Gomez (Millie); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); A.M. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); P.A. Kaufmann (Philipp); Y-J. Kim (Yong-Jin); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); D.S. Berman (Daniel)

    2014-01-01

    textabstractBackground: Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic indiv

  5. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    NARCIS (Netherlands)

    J.K. Min (James); T.M. LaBounty (Troy); M. Gomez (Millie); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); A.M. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); P.A. Kaufmann (Philipp); Y-J. Kim (Yong-Jin); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); D.S. Berman (Daniel)

    2014-01-01

    textabstractBackground: Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic indiv

  6. Correlation between coronary computed tomographic angiography and fractional flow reserve

    DEFF Research Database (Denmark)

    Kristensen, Thomas Skaarup; Engstrøm, Thomas; Kelbæk, Henning

    2010-01-01

    Coronary CT angiography (CCTA) has become an important modality to evaluate the presence of coronary artery disease. Coronary artery stenosis of intermediate severity remains a therapeutic dilemma. Measurement of fractional flow reserve (FFR) during coronary angiography is the most established...... technique to determine the hemodynamic severity of a coronary artery lesion. The aim of this study was to compare CCTA with FFR....

  7. Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: Results from the multicenter CONFIRM registry

    NARCIS (Netherlands)

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

    2015-01-01

    textabstractObjective: This study sought to determine the correlation between baseline cardiac medications and cardiovascular outcomes in patients with obstructive coronary artery disease (CAD) diagnosed by coronary computed tomographic angiography (CCTA). Methods: 1637 patients (mean age 64.8±10.2

  8. Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: Results from the multicenter CONFIRM registry

    NARCIS (Netherlands)

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

    2015-01-01

    textabstractObjective: This study sought to determine the correlation between baseline cardiac medications and cardiovascular outcomes in patients with obstructive coronary artery disease (CAD) diagnosed by coronary computed tomographic angiography (CCTA). Methods: 1637 patients (mean age 64.8±10.2

  9. Coronary dominance and prognosis in patients undergoing coronary computed tomographic angiography: Results from the CONFIRM (COronary CTAngiography EvaluatioN for Clinical Outcomes: An InteRnational Multicenter) registry

    NARCIS (Netherlands)

    C. Gebhard (Catherine); T.A. Fuchs (Tobias A.); J. Stehli (Julia); H. Gransar (Heidi); D.S. Berman (Daniel S.); M.J. Budoff (Matthew); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); M. Gomez (Millie); M. Hadamitzky (Martin); J. Hausleiter (Jörg); N. Hindoyan (Niree); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); A.M. Dunning (Allison M.); J.K. Min (James); P.A. Kaufmann (Philipp)

    2015-01-01

    textabstractAims: Coronary computed tomographic angiography (CCTA) has become an important tool for non-invasive diagnosis of coronary artery disease (CAD). Coronary dominance can be assessed by CCTA; however, the predictive value of coronary dominance is controversially discussed. The aim of this s

  10. Coronary dominance and prognosis in patients undergoing coronary computed tomographic angiography: Results from the CONFIRM (COronary CTAngiography EvaluatioN for Clinical Outcomes: An InteRnational Multicenter) registry

    NARCIS (Netherlands)

    C. Gebhard (Catherine); T.A. Fuchs (Tobias A.); J. Stehli (Julia); H. Gransar (Heidi); D.S. Berman (Daniel S.); M.J. Budoff (Matthew); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); M. Gomez (Millie); M. Hadamitzky (Martin); J. Hausleiter (Jörg); N. Hindoyan (Niree); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); A.M. Dunning (Allison M.); J.K. Min (James); P.A. Kaufmann (Philipp)

    2015-01-01

    textabstractAims: Coronary computed tomographic angiography (CCTA) has become an important tool for non-invasive diagnosis of coronary artery disease (CAD). Coronary dominance can be assessed by CCTA; however, the predictive value of coronary dominance is controversially discussed. The aim of this s

  11. Coronary computer tomographic angiography for preoperative risk stratification in patients undergoing liver transplantation

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    Jodocy, Daniel, E-mail: daniel.jodocy@klinikum-minden.de [Department of Internal Medicine III (Cardiology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria); Abbrederis, Susanne, E-mail: susanne.abbrederis@uki.at [Department of Internal Medicine II (Gastroenterology and Hepatology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria); Graziadei, Ivo W., E-mail: ivo.graziadei@i-med.ac.at [Department of Internal Medicine II (Gastroenterology and Hepatology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria); Vogel, Wolfgang, E-mail: wolfgang.vogel@uki.at [Department of Internal Medicine II (Gastroenterology and Hepatology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria); Pachinger, Otmar, E-mail: otmar.pachinger@uki.at [Department of Internal Medicine III (Cardiology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria); Feuchtner, Gudrun M., E-mail: gudrun.feuchtner@i-med.ac.at [Department of Radiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria); Jaschke, Werner, E-mail: werner.jaschke@i-med.ac.at [Department of Radiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria); Friedrich, Guy, E-mail: guy.friedrich@uki.at [Department of Internal Medicine III (Cardiology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck (Austria)

    2012-09-15

    The assessment of the cardiovascular risk profile in patients with end-stage liver disease is essential prior to liver transplantation (LT) as cardiovascular diseases are major causes of morbidity and mortality in the posttransplant course. The aim of this study was to evaluate the accuracy of a 64-slice coronary computed tomographic angiography (CTA) and coronary calcium scoring (CCS) to predict the postoperative cardiovascular risk of patients assessed for LT. In this single center, observational study we included 54 consecutive patients who were assessed for LT and consequently transplanted. Twenty-four patients (44%) presented with a high CCS above 300 and/or a significant stenosis (>50% percent narrowing due to stenotic plaques) and were further referred to coronary angiography. Three of these patients had a more than 70% LAD stenosis with subsequent angioplasty (n = 1) or conservative therapy (n = 2). The other patients showed only diffuse CAD without significant stenosis. The remaining 30 patients with normal CTA findings were listed for LT without further tests. None of the 54 patients developed cardiovascular events peri- and postoperatively. This study indicated that CTA combined with CCS is a useful non-invasive imaging technique for pre-LT assessment of coronary artery disease and safe tool in the risk assessment of peri- and postoperative cardiovascular events in patients undergoing LT.

  12. Comparison of usefulness of exercise testing versus coronary computed tomographic angiography for evaluation of patients suspected of having coronary artery disease

    DEFF Research Database (Denmark)

    Ovrehus, Kristian A; Jensen, Jesper K; Mickley, Hans;

    2010-01-01

    In patients suspected of having coronary artery disease (CAD), we compared the diagnostic sensitivity and specificity of exercise testing using ST-segment changes alone and ST-segment changes, angina pectoris, and hemodynamic variables compared to coronary computed tomographic angiography (CTA...... performance of CTA for the detection and exclusion of significant CAD might favor CTA as the first-line diagnostic test in patients suspected of having CAD....

  13. Dual-source computed tomographic coronary angiography: image quality and stenosis diagnosis in patients with high heart rates.

    Science.gov (United States)

    Zheng, Minwen; Li, Jiayi; Xu, Jian; Chen, Kang; Zhao, Hongliang; Huan, Yi

    2009-01-01

    We sought to evaluate prospectively the effects of heart rate and heart-rate variability on dual-source computed tomographic coronary image quality in patients whose heart rates were high, and to determine retrospectively the accuracy of dual-source computed tomographic diagnosis of coronary artery stenosis in the same patients.We compared image quality and diagnostic accuracy in 40 patients whose heart rates exceeded 70 beats/min with the same data in 40 patients whose heart rates were 70 beats/min or slower. In both groups, we analyzed 1,133 coronary arterial segments. Five hundred forty-five segments (97.7%) in low-heart-rate patients and 539 segments (93.7%) in high-heart-rate patients were of diagnostic image quality. We considered P coronary artery, nor were any significant differences found between the groups in the accurate diagnosis of angiographically significant stenosis.Calcification was the chief factor that affected diagnostic accuracy. In high-heart-rate patients, heart-rate variability was significantly related to the diagnostic image quality of all segments (P = 0.001) and of the left circumflex coronary artery (P = 0.016). Heart-rate variability of more than 5 beats/min most strongly contributed to an inability to evaluate segments in both groups. When heart rates rose, the optimal reconstruction window shifted from diastole to systole.The image quality of dual-source computed tomographic coronary angiography at high heart rates enables sufficient diagnosis of stenosis, although variability of heart rates significantly deteriorates image quality.

  14. Radiation dose to patients and image quality evaluation from coronary 256-slice computed tomographic angiography

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    Chen, Liang-Kuang [Department of Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan (China); College of Medicine, Fu Jen Catholic University, Taiwan (China); Department of Radiological Technology, Yuan Pei University, Taiwan (China); Wu, Tung-Hsin [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 155 Li-Nong St., Section 2, Taipei 112, Taiwan (China); Yang, Ching-Ching [Department of Radiological Technology, Tzu Chi College of Technology, Hualien, Taiwan (China); Tsai, Chia-Jung [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 155 Li-Nong St., Section 2, Taipei 112, Taiwan (China); Lee, Jason J.S., E-mail: jslee@ym.edu.t [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 155 Li-Nong St., Section 2, Taipei 112, Taiwan (China)

    2010-07-21

    The aim of this study is to assess radiation dose and the corresponding image quality from suggested CT protocols which depends on different mean heart rate and high heart rate variability by using 256-slice CT. Fifty consecutive patients referred for a cardiac CT examination were included in this study. All coronary computed tomographic angiography (CCTA) examinations were performed on a 256-slice CT scanner with one of five different protocols: retrospective ECG-gating (RGH) with full dose exposure in all R-R intervals (protocol A), RGH of 30-80% pulsing window with tube current modulation (B), RGH of 78{+-}5% pulsing window with tube current modulation (C), prospective ECG-triggering (PGT) of 78% R-R interval with 5% padding window (D) and PGT of 78% R-R interval without padding window (E). Radiation dose parameters and image quality scoring were determined and compared. In this study, no significant differences were found in comparison on image quality of the five different protocols. Protocol A obtained the highest radiation dose comparing with those of protocols B, C, D and E by a factor of 1.6, 2.4, 2.5 and 4.3, respectively (p<0.001), which were ranged between 2.7 and 11.8 mSv. The PGT could significantly reduce radiation dose delivered to patients, as compared to the RGH. However, the use of PGT has limitations and is only good in assessing cases with lower mean heart rate and stable heart rate variability. With higher mean heart rate and high heart rate variability circumstances, the RGH within 30-80% of R-R interval pulsing window is suggested as a feasible technique for assessing diagnostic performance.

  15. 16-Detector row computed tomographic coronary angiography in patients undergoing evaluation for aortic valve replacement: comparison with catheter angiography

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    Manghat, N.E.; Morgan-Hughes, G.J.; Broadley, A.J.; Undy, M.B.; Wright, D.; Marshall, A.J.; Roobottom, C.A

    2006-09-15

    Aim: To evaluate the diagnostic accuracy of 16-detector row computed tomography (CT) in assessing haemodynamically significant coronary artery stenoses in patients under evaluation for aortic stenosis pre-aortic valve replacement. Subjects and methods: Forty consecutive patients under evaluation for severe aortic stenosis and listed for cardiac catheterization before potential aortic valve replacement underwent coronary artery calcium (CAC) scoring and retrospective electrocardiogram (ECG)-gated multi-detector row computed tomographic coronary angiography (MDCTA) using a GE Lightspeed 16-detector row CT within 1 month of invasive coronary angiography (ICA) for comparative purposes. All 13 major coronary artery segments of the American Heart Association model were evaluated for the presence of {>=}50% stenosis and compared to the reference standard. Data were analysed on a segment-by-segment basis and also in 'whole patient' terms. Results: A total of 412/450 segments from 35 patients were suitable for analysis. The overall accuracy of MDCTA for detection of segments with {>=}50% stenosis was high, with a sensitivity of 81.3%, specificity 95.0%, positive predictive value (PPV) 57.8%, and negative predictive value (NPV) 98.4%. On a 'whole-patient' basis, 100% (19/19) of patients with significant coronary disease were correctly identified and there were no false-negatives. Excluding patients with CAC >1000 from the analysis improved the accuracy of MDCTA to: sensitivity 90%, specificity 98.1%, PPV 60%, NPV 99.7%. Conclusion: Non-invasive 16-detector row MDCTA accurately excludes significant coronary disease in patients with severe aortic stenosis undergoing evaluation before aortic valve replacement and in whom ICA can therefore be avoided. Its segment-by-segment accuracy is improved further if CAC > 1000 is used as a gatekeeper to MDCTA.

  16. Computed tomographic angiography or conventional coronary angiography in therapeutic decision-making

    NARCIS (Netherlands)

    Piers, Lieuwe H.; Dikkers, Riksta; Willems, Tineke P.; de Smet, Bart J. G. L.; Oudkerk, Matthijs; Zijlstra, Felix; Tio, Rene A.

    2008-01-01

    To evaluate non-invasive angiography using dual-source computed tomography (CT) for the determination of the most appropriate therapeutic strategy in patients with suspected coronary artery disease (CAD). CT angiography (Dual Source CT, Somatom Definition, Siemens Medical Systems, Forchheim, Germany

  17. Clinical implementation of an emergency department coronary computed tomographic angiography protocol for triage of patients with suspected acute coronary syndrome.

    Science.gov (United States)

    Ghoshhajra, Brian B; Takx, Richard A P; Staziaki, Pedro V; Vadvala, Harshna; Kim, Phillip; Neilan, Tomas G; Meyersohn, Nandini M; Bittner, Daniel; Janjua, Sumbal A; Mayrhofer, Thomas; Greenwald, Jeffrey L; Truong, Quyhn A; Abbara, Suhny; Brown, David F M; Januzzi, James L; Francis, Sanjeev; Nagurney, John T; Hoffmann, Udo

    2017-07-01

    To evaluate the efficiency and safety of emergency department (ED) coronary computed tomography angiography (CTA) during a 3-year clinical experience. Single-center registry of coronary CTA in consecutive ED patients with suspicion of acute coronary syndrome (ACS). The primary outcome was efficiency of coronary CTA defined as the length of hospitalization. Secondary endpoints of safety were defined as the rate of downstream testing, normalcy rates of invasive coronary angiography (ICA), absence of missed ACS, and major adverse cardiac events (MACE) during follow-up, and index radiation exposure. One thousand twenty two consecutive patients were referred for clinical coronary CTA with suspicion of ACS. Overall, median time to discharge home was 10.5 (5.7-24.1) hours. Patient disposition was 42.7 % direct discharge from the ED, 43.2 % discharge from emergency unit, and 14.1 % hospital admission. ACS rate during index hospitalization was 9.1 %. One hundred ninety two patients underwent additional diagnostic imaging and 77 underwent ICA. The positive predictive value of CTA compared to ICA was 78.9 % (95 %-CI 68.1-87.5 %). Median CT radiation exposure was 4.0 (2.5-5.8) mSv. No ACS was missed; MACE at follow-up after negative CTA was 0.2 %. Coronary CTA in an experienced tertiary care setting allows for efficient and safe management of patients with suspicion for ACS. • ED Coronary CTA using advanced systems is associated with low radiation exposure. • Negative coronary CTA is associated with low rates of MACE. • CTA in ED patients enables short median time to discharge home. • CTA strategy is characterized by few downstream tests including unnecessary ICA.

  18. Low-density lipoprotein and noncalcified coronary plaque composition in patients with newly diagnosed coronary artery disease on computed tomographic angiography.

    Science.gov (United States)

    Cheng, Victor Y; Wolak, Arik; Gutstein, Ariel; Gransar, Heidi; Wong, Nathan D; Dey, Damini; Thomson, Louise E J; Hayes, Sean W; Friedman, John D; Slomka, Piotr J; Berman, Daniel S

    2010-03-15

    We sought to determine significant relations between atherogenic lipoproteins and the contribution of calcified plaque (CP), mixed plaque (MP), and noncalcified plaque (NCP) to the total plaque (TP) burden in patients without previous coronary artery disease. From 823 adult patients without previously established coronary artery disease (52% receiving statin therapy, 34% asymptomatic) but with visible coronary plaque on coronary computed tomographic angiography, we obtained segmental CP, MP, NCP, and TP counts from contrast-enhanced, electrocardiographic-gated computed tomography. Multivariate linear regression analysis was used to determine the associations of clinical factors and lipoprotein levels to CP, MP, and NCP counts and CP/TP, MP/TP, and NCP/TP count ratios. Age, male gender, diabetes, smoking, and statin therapy were significantly associated with the CP count (p NCP counts (all p values NCP/TP ratios, including an inverse association with CP/TP (p = 0.008) and a positive association with MP/TP (p = 0.032). Analyses using non-high-density lipoprotein cholesterol in place of LDL cholesterol yielded similar results. In conclusion, among the traditional clinical factors used to estimate cardiovascular event risk, LDL cholesterol is associated with an increased MP and NCP burden and is the sole variable that independently predicted relative predominance of CP, MP, and NCP, suggesting a potentially important role for lipoprotein levels in modulating the type of detectable coronary arterial plaque.

  19. 256-Slice coronary computed tomographic angiography in patients with atrial fibrillation: optimal reconstruction phase and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Seitaro; Yuki, Hideaki; Kidoh, Masafumi; Utsunomiya, Daisuke; Nakaura, Takeshi; Namimoto, Tomohiro; Yamashita, Yasuyuki [Kumamoto University, Department of Diagnostic Radiology, Faculty of Life Sciences, Chuou-ku, Kumamoto (Japan); Honda, Keiichi; Yoshimura, Akira; Katahira, Kazuhiro [Kumamoto Chuo Hospital, Department of Diagnostic Radiology, Minami-ku, Kumamoto (Japan); Noda, Katsuo; Oshima, Shuichi [Kumamoto Chuo Hospital, Department of Cardiology, Minami-ku, Kumamoto (Japan)

    2016-01-15

    To assess the optimal reconstruction phase and the image quality of coronary computed tomographic angiography (CCTA) in patients with atrial fibrillation (AF). We performed CCTA in 60 patients with AF and 60 controls with sinus rhythm. The images were reconstructed in multiple phases in all parts of the cardiac cycle, and the optimal reconstruction phase with the fewest motion artefacts was identified. The coronary artery segments were visually evaluated to investigate their assessability. In 46 (76.7 %) patients, the optimal reconstruction phase was end-diastole, whereas in 6 (10.0 %) patients it was end-systole or mid-diastole, and in 2 (3.3 %) patients it was another cardiac phase. In 53 (88.3 %) of the controls, the optimal reconstruction phase was mid-diastole, whereas it was end-systole in 4 (6.7 %), and in 3 (5.0 %) it was another cardiac phase. There was a significant difference between patients with AF and the controls in the optimal phase (p < 0.01) but not in the visual image quality score (p = 0.06). The optimal reconstruction phase in most patients with AF was the end-diastolic phase. The end-systolic phase tended to be optimal in AF patients with higher average heart rates. (orig.)

  20. Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

    Institute of Scientific and Technical Information of China (English)

    Wen-Ying Jin; Xiu-Juan Zhao; Hong Chen

    2016-01-01

    Background:Multislice computed tomography (MSCT) coronary angiography (CAG) is a noninvasive technique with a reported high diagnostic accuracy for coronary artery disease (CAD).Women,more frequently than men,are known to develop atypical angina symptoms.The purpose of this study was to investigate whether the diagnostic accuracy of MSCT in women with atypical presentation differs from that in men.Methods:We enrolled 396 in-hospital patients (141 women and 255 men) with suspected or proven CAD who successively underwent both MSCT and invasive CAG.CAD was defined as any coronary stenosis of≥50% on conventional invasive CAG,which was used as the reference standard.The patients were divided into typical and atypical groups based on their symptoms of angina pectoris.The diagnostic accuracy of MSCT,including its sensitivity,specificity,negative predictive value,and positive predictive value (PPV),was calculated to determine the usefulness of MSCT in assessing stenoses.The diagnostic performance of MSCT was also assessed by constructing receiver operating characteristic (ROC) curves.Results:The PPV (91% vs.97%,x2 =5.705,P < 0.05) and diagnostic accuracy (87% vs.93%,x2 =5.093,P < 0.05) of MSCT in detecting CAD were lower in women than in men.Atypical presentation was an independent influencing factor on the diagnostic accuracy of MSCT in women (odds ratio =4.94,95% confidence intervals:1.16-20.92,Walds =4.69,P < 0.05).Compared with those in the atypical group,women with typical angina pectoris had higher PPV (98% vs.74%,x2 =17.283.P < 0.001),diagnostic accuracy (93% vs.72%,x2 =9.571,P < 0.001),and area under the ROC curve (0.91 vs.0.64,Z =2.690,P < 0.01) in MSCT diagnosis.Conclusions:Although MSCT is a reliable diagnostic modality for the exclusion of significant coronary artery stenoses in all patients,gender and atypical symptoms might have some influence on its diagnostic accuracy.

  1. Effect of beta blockade on single photon emission computed tomographic (SPECT) thallium-201 images in patients with coronary disease

    Energy Technology Data Exchange (ETDEWEB)

    Narahara, K.A.; Thompson, C.J.; Hazen, J.F.; Brizendine, M.; Mena, I.

    1989-05-01

    We evaluated the effect of beta blockers on thallium-201 (Tl-201) single photon emission computed tomographic (SPECT) imaging in 12 patients with coronary disease using an automated computer algorithm. Maximal exercise heart rate and blood pressure were reduced and exercise time was increased with beta blockers. Estimated stress defect size decreased from 47 +/- 36.3 gm during placebo treatment to 32 +/- 27.1 gm during beta blocker therapy (-32%; p less than 0.01). The placebo treatment redistribution defect was estimated to be 28 +/- 29.8 gm. It fell to 15 +/- 23.3 gm with beta blockade (-46%; p less than 0.005). All patients had a stress Tl-201 defect during placebo treatment and eight had redistribution defects consistent with residual scar. During beta blocker therapy, 2 of 12 patients had normal stress-redistribution studies and only five patients had redistribution defects. Beta blockade can reduce exercise and redistribution Tl-201 SPECT defect size significantly while simultaneously increasing exercise time and reducing angina. Beta blockers may unmask or may eliminate evidence of redistribution. Tl-201 SPECT imaging may be useful in defining the reduction in ischemia produced by cardiac drugs.

  2. Effects of Cardiac Medications for Patients With Obstructive Coronary Artery Disease by Coronary Computed Tomographic Angiography: Results from the Multicenter CONFIRM Registry

    Science.gov (United States)

    Schulman-Marcus, Joshua; Hartaigh, Bríain ó; Giambrone, Ashley E; Gransar, Heidi; Valenti, Valentina; Berman, Daniel S.; Budoff, Matthew J.; Achenbach, Stephan; Al-Mallah, Mouaz; Andreini, Daniele; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J. W.; Cury, Ricardo; Delago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Feuchtner, Gudrun; Kim, Yong-Jin; Kaufmann, Philipp A.; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Pontone, Gianluca; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Dunning, Allison; Min, James K

    2014-01-01

    Objective This study sought to determine the correlation between baseline cardiac medications and cardiovascular outcomes in patients with obstructive coronary artery disease (CAD) diagnosed by coronary computed tomographic angiography (CCTA). Methods 1637 patients (mean age 64.8 ± 10.2 years, 69.6% male) with obstructive CAD from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry were followed over the course of three years. Obstructive CAD was defined as a >50% stenosis in an epicardial vessel. Medications analyzed included statins, aspirin, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs). Using Cox proportional-hazards models, we calculated the hazard ratio (HR) with 95% confidence intervals (95% CIs) for incident major adverse cardiovascular events (MACE), defined as death, acute coronary syndrome, or myocardial infarction. Results At the time of CCTA, 59%, 54%, 40%, and 46% of patients were using statins, aspirin, beta-blockers, and ACE inhibitors or ARBs, respectively. Statins were associated with a 43% (95% CI = 0.38-0.87, p=0.008) lower adjusted risk of MACE. Following adjustment, aspirin, beta-blockers, ACE inhibitors and ARBs did not attenuate the risk of MACE. When restricted to patients with multivessel obstructive CAD, only statins were associated with lower risk of MACE. Conclusion In patients with obstructive CAD by CCTA, the baseline use of statins was associated with improved clinical outcomes. Other cardiac medications—including aspirin, beta-blockers, ACE inhibitors, and ARBs—were not associated with reduced risk of MACE. PMID:25479800

  3. Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

    Directory of Open Access Journals (Sweden)

    Wen-Ying Jin

    2016-01-01

    Conclusions: Although MSCT is a reliable diagnostic modality for the exclusion of significant coronary artery stenoses in all patients, gender and atypical symptoms might have some influence on its diagnostic accuracy.

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

    Directory of Open Access Journals (Sweden)

    Danny Lee

    2015-09-01

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

  5. Incremental prognostic value of coronary computed tomographic angiography high-risk plaque characteristics in newly symptomatic patients.

    Science.gov (United States)

    Fujimoto, Shinichiro; Kondo, Takeshi; Takamura, Kazuhisa; Baber, Usman; Shinozaki, Tomohiro; Nishizaki, Yuji; Kawaguchi, Yuko; Matsumori, Rie; Hiki, Makoto; Miyauchi, Katsumi; Daida, Hiroyuki; Hecht, Harvey; Stone, Gregg W; Narula, Jagat

    2016-06-01

    The incremental prognostic value of the plaque features in coronary computed tomographic angiography (CTA) has not been well assessed. This study was designed to determine whether CTA high-risk plaques have prognostic value incremental to the Framingham risk score (FRS) and the severity of luminal obstruction. A total of 628 newly symptomatic patients without known coronary artery disease underwent CTA. They were followed for a median of 677 days during which there were 26 cardiac events, including cardiac death, acute myocardial infarction, and hospitalization for unstable angina. Incremental prognostic value of adding plaque characteristics to the number of diseased vessels and the FRS was evaluated using 3 Cox models and net reclassification indexes. The discrimination index was significantly increased by adding the number of diseased vessels to the FRS (change in c-statistic from 65.8% to 78.6%, p=0.028) but not significantly by further adding plaque characteristics (change in c-statistic from 78.6% to 80.0%, p=0.812). However, improved model-fitting by adding plaque characteristics into the linear combination with risk score and the number of diseased vessels (p=0.007 from likelihood ratio test) and the lowest value of Akaike's information criteria of that model indicated that plaque characteristics improved both predictive accuracy and discrimination perspective. More subjects reclassified by plaque characteristics were moved to directions consistent with their subsequent cardiac event status than in an inconsistent direction. Evaluation of CTA plaque characteristics may provide incremental prognostic value to the number of diseased vessels and the FRS. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. Comprehensive coronary risk determination in primary prevention: an imaging and clinical based definition combining computed tomographic coronary artery calcium score and national cholesterol education program risk score.

    Science.gov (United States)

    Nasir, Khurram; Vasamreddy, Chandra; Blumenthal, Roger S; Rumberger, John A

    2006-06-16

    Cardiovascular disease (CVD) is the leading cause of mortality and a major cause of morbidity. Coronary heart disease (CHD) accounts for nearly half of all CVD deaths. Currently estimation of risk in primary prevention is based on the Framingham risk equations, which inputs traditional risk factors and is helpful in predicting the development of CHD in asymptomatic individuals. However many individuals suffer events in the absence of established risk factors for atherosclerosis and broad based population risk estimations may have little precision when applied to a given individual. To meet the challenge of CHD risk assessment, several tools have been developed to identify atherosclerotic disease in its preclinical stages. This paper aims to incorporate information from coronary artery calcification (CAC) scoring from a computed tomographic "heartscan" (using Electron Beam Tomography (EBT) as the validated prototype) along with current Framingham risk profiling in order to refine risk on an absolute scale by combining imaging and clinical data to affect a more comprehensive calculation of absolute risk in a given individual. For CAC scores above the 75th percentile but or =55 years, women> or =65 years) a CAC = 0 will result in an age point score corresponding to the age-group whose median CAC score is zero i.e., 40-44 years for men and 55-59 years for women. The utilization of CAC scores allows the inclusion of sub-clinical disease definition into the context of modifiable risk factors as well as identifies high-risk individuals requiring aggressive treatment.

  7. Experimental computer tomograph

    Directory of Open Access Journals (Sweden)

    Heinemann D.

    2015-09-01

    Full Text Available The computed tomography is one of the most important medical instruments, allowing the non-invasive visualization of cross sections which are free from superpositions. Since 2000 an experimental computer tomo-graph of the third generation for the purpose of education and research was set up and further developed. Besides the mechanical construction design reconstruction algorithms, including certain corrections of the measured data were developed and implemented. In 2013 iterative reconstruction methods were investigated and implemented for advanced reconstructions and dose reduction using various ray tracing algorithms. The new reconstruction technique leads to improvements in image quality and low dose reconstructions.

  8. Comparison of three-dimensional volume-targeted thin-slab FIESTA magnetic resonance angiography and 64-multidetector computed tomographic angiography for the identification of proximal coronary stenosis.

    Science.gov (United States)

    Cheng, Liuquan; Ma, Lin; Schoenhagen, Paul; Ye, Huiyi; Lou, Xin; Gao, Yuangui; Zhao, Xihai; Wang, Xinjiang; Dong, Wei

    2013-09-10

    Based on recent clinical data, an imaging strategy of identifying proximal coronary disease allows further management decisions in patients with stable angina pectoris. We aimed to compare diagnostic accuracy of non-contrast fast steady-state (FIESTA) magnetic resonance angiography (MRA) with 64-multidetector computed tomographic angiography (CTA), using conventional coronary angiography (CA) as the reference standard. Thirty patients with suspected coronary artery disease consented to participate in an institutional review board-approved protocol. Coronary MRA was performed at 1.5 T using a respiratory navigator and electrocardiogram-gated three-dimensional FIESTA pulse sequence. CTA images were acquired using a 64-multidetector computed tomographic scanner, using beta blockade to reduce the heart rate to less than 70 bpm. Coronary luminal stenosis >50% was identified. Plaques were classified as non-calcified, mixed, or calcified on CTA, and as high-, intermediate-, or low-signal on FIESTA MRA. Compared to CA, the sensitivity, specificity, and overall accuracy for detection of >50% proximal coronary stenoses were 83.0%, 86.9%, and 86.1% for MRA and 85.1%, 87.2%, and 86.8% for CTA, respectively. For the 24 calcified stenoses, MRA corrected 16 segments that overestimated on CTA and MRA had an accuracy of 75% in evaluating calcified plaques. High-resolution three-dimensional FIESTA MRA and CTA have a similar accuracy in detecting proximal coronary stenosis. The clinical impact of identification of proximal disease in patients with stable CAD needs to be examined in future studies. Copyright © 2012. Published by Elsevier Ireland Ltd.

  9. Computed tomographic coronary angiography for patients with heart failure (CTA-HF): a randomized controlled trial (IMAGE HF Project 1-C).

    Science.gov (United States)

    Chow, Benjamin J W; Green, Rachel E; Coyle, Doug; Laine, Mika; Hanninen, Helena; Leskinen, Hanna; Rajda, Miroslav; Larose, Eric; Hartikainen, Juha; Hedman, Marja; Mielniczuk, Lisa; O'Meara, Eileen; deKemp, Robert A; Klein, Ran; Paterson, Ian; White, James A; Yla-Herttuala, Seppo; Leber, Alex; Tandon, Vikas; Lee, Ting; Al-Hesayen, Abdul; Hessian, Renee; Dowsley, Taylor; Kass, Malek; Kelly, Cathy; Garrard, Linda; Tardif, Jean-Claude; Knuuti, Juhani; Beanlands, Rob S; Wells, George A

    2013-12-26

    The prevalence of heart failure (HF) is rising in industrialized and developing countries. Though invasive coronary angiography (ICA) remains the gold standard for anatomical assessment of coronary artery disease in HF patients, alternatives are being sought. Computed tomographic coronary angiography (CTA) has emerged as an accurate non-invasive diagnostic tool for coronary artery disease (CAD) and has been demonstrated to have prognostic value. Whether or not CTA can be used in HF patients is unknown. Acknowledging the aging population, the growing prevalence of HF and the increasing financial burden of healthcare, we need to identify non-invasive diagnostic tests that are available, safe, accurate and cost-effective. The proposed study aims to provide insight into the efficacy of CTA in HF patients. A multicenter randomized controlled trial will enroll 250 HF patients requiring coronary anatomical definition. Enrolled patients will be randomized to either CTA or ICA (n = 125 per group) as the first test to define coronary anatomy. The primary outcomes will be collected to determine downstream resource utilization. Secondary outcomes will include the composite clinical events and major adverse cardiac events. In addition, the accuracy of CTA for detecting coronary anatomy and obstruction will be assessed in patients who subsequently undergo both CTA and ICA. It is expected that CTA will be a more cost-effective strategy for diagnosis: yielding similar outcomes with fewer procedural risks and improved resource utilization. ClinicalTrials.gov, NCT01283659. Team grant #CIF 99470.

  10. Impact of Clinical Guideline Recommendations on the Application of Coronary Computed Tomographic Angiography in Patients with Suspected Stable Coronary Artery Disease

    Science.gov (United States)

    Zhou, Jia; Yang, Jun-Jie; Yang, Xia; Chen, Zhi-Ye; He, Bai; Du, Luo-Shan; Chen, Yun-Dai

    2016-01-01

    Background: Coronary computed tomographic angiography (CCTA) has been widely used in patients who are at intermediate risk for having stable coronary artery disease (SCAD), and 2013 European Society of Cardiology Guidelines on the Management of SCAD (2013G) recommended the appropriate application of CCTA. However, 2013G has not been subjected to systematic analyses for subsequent impact on clinical practice. Methods: A total of 5320 patients suspected with SCAD were enrolled and scheduled for CCTA from March 2013 to September 2014. For each patient, pretest probability of SCAD was calculated according to updated Diamond-Forrester model (UDFM). Appropriate CCTA or appropriate stress test was determined as described in the 2013G. A generalized estimating equation model was used to determine the trends in the half-monthly rate of appropriate CCTA. Results: Overall, only 61.37% of patients received appropriate CCTA, and there was insignificant change over time (P = 0.8701). The application of CCTA in patients who should have had a stress test accounted for most of the inappropriate CCTA before (22.29%) or after (19.98%) the publication of the 2013G. In all patients or any subgroup, no significant change in the adjusted half-monthly rate of appropriate CCTA was found after the publication of the 2013G (odds ratio, 1.002; 95% confidence interval, 0.982–1.021; P = 0.8678). Conclusions: These findings suggest that the 2013G have not, to date, been fully incorporated into clinical practice, and the clinical utilization of CCTA remains unreasonable to some extent. PMID:26830982

  11. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

    Science.gov (United States)

    Min, James K.; Labounty, Troy M.; Gomez, Millie J.; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor; Chinnaiyan, Kavitha M.; Chow, Benjamin; Cury, Ricardo; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Jorg; Kaufmann, Philipp; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Berman, Daniel S.

    2015-01-01

    Background Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic individuals beyond clinical risk factors and coronary artery calcium scoring (CACS) remains unexplored. Methods From a prospective 12-center international registry of 27,125 individuals undergoing CCTA, we identified 400 asymptomatic diabetic individuals without known CAD. Coronary stenosis by CCTA was graded as 0%, 1–49%, 50–69%, and ≥70%. CAD was judged on a per-patient, per-vessel and per-segment basis as maximal stenosis severity, number of vessels with ≥50% stenosis, and coronary segments weighted for stenosis severity (segment stenosis score), respectively. We assessed major adverse cardiovascular events (MACE) – inclusive of mortality, nonfatal myocardial infarction (MI), and late target vessel revascularization ≥90 days (REV) – and evaluated the incremental utility of CCTA for risk prediction, discrimination and reclassification. Results Mean age was 60.4 ± 9.9 years; 65.0% were male. At a mean follow-up 2.4 ± 1.1 years, 33 MACE occurred (13 deaths, 8 MI, 12 REV) [8.25%; annualized rate 3.4%]. By univariate analysis, per-patient maximal stenosis [hazards ratio (HR) 2.24 per stenosis grade, 95% confidence interval (CI) 1.61–3.10, p < 0.001], increasing numbers of obstructive vessels (HR 2.30 per vessel, 95% CI 1.75–3.03, p < 0.001) and segment stenosis score (HR 1.14 per segment, 95% CI 1.09–1.19, p < 0.001) were associated with increased MACE. After adjustment for CAD risk factors and CACS, maximal stenosis (HR 1.80 per grade, 95% CI 1.18–2.75, p = 0.006), number of obstructive vessels (HR 1.85 per vessel, 95% CI 1.29–2.65, p < 0.001) and segment stenosis score (HR 1.11 per segment, 95% CI 1.05–1.18, p < 0.001) were associated with increased risk of

  12. Assessment of the relationship between stenosis severity and distribution of coronary artery stenoses on multislice computed tomographic angiography and myocardial ischemia detected by single photon emission computed tomography

    Science.gov (United States)

    Tamarappoo, Balaji K.; Gutstein, Ariel; Cheng, Victor Y.; Nakazato, Ryo; Gransar, Heidi; Dey, Damini; Thomson, Louise E. J.; Hayes, Sean W.; Friedman, John D.; Germano, Guido; Slomka, Piotr J.

    2010-01-01

    Background The relationship between luminal stenosis measured by coronary CT angiography (CCTA) and severity of stress-induced ischemia seen on single photon emission computed tomographic myocardial perfusion imaging (SPECT-MPI) is not clearly defined. We sought to evaluate the relationship between stenosis severity assessed by CCTA and ischemia on SPECT-MPI. Methods and Results ECG-gated CCTA (64 slice dual source CT) and SPECT-MPI were performed within 6 months in 292 patients (ages 26-91, 73% male) with no prior history of coronary artery disease. Maximal coronary luminal narrowing, graded as 0, ≥25%, 50%, 70%, or 90% visual diameter reduction, was consensually assessed by two expert readers. Perfusion defect on SPECT-MPI was assessed by computer-assisted visual interpretation by an expert reader using the standard 17 segment, 5 point-scoring model (stress perfusion defect of ≥5% = abnormal). By SPECT-MPI, abnormal perfusion was seen in 46/292 patients. With increasing stenosis severity, positive predictive value (PPV) increased (42%, 51%, and 74%, P = .01) and negative predictive value was relatively unchanged (97%, 95%, and 91%) in detecting perfusion abnormalities on SPECT-MPI. In a receiver operator curve analysis, stenosis of 50% and 70% were equally effective in differentiating between the presence and absence of ischemia. In a multivariate analysis that included stenosis severity, multivessel disease, plaque composition, and presence of serial stenoses in a coronary artery, the strongest predictors of ischemia were stenosis of 50-89%, odds ratio (OR) 7.31, P = .001, stenosis ≥90%, OR 34.05, P = .0001, and serial stenosis ≥50% OR of 3.55, P = .006. Conclusions The PPV of CCTA for ischemia by SPECT-MPI rises as stenosis severity increases. Luminal stenosis ≥90% on CCTA strongly predicts ischemia, while stenosis strongly predicts the absence of ischemia. Serial stenosis of ≥50% in a vessel may offer incremental value in addition to

  13. 2010年冠状动脉CT血管造影专家共识解读%Interpretation of 2010 Expert Consensus Document on Coronary Computed Tomographic Angiography

    Institute of Scientific and Technical Information of China (English)

    刘斌; 赵世华

    2011-01-01

    专家共识旨在陈述冠状动脉CT血管造影(coronary computed tomographic angiography,CCTA)对于疑似或确诊冠状动脉疾病的临床应用现状.鉴于目前还没有足够的循证医学证据确立CCTA的临床实践指南,故该共识未提供CCTA应用的明确推荐意见.共识的内容旨在根据业已出版的同行评议文献并经专家委员会讨论,总结出CCTA目前在临床应用中的长处和短处.因此既不是一个全面的综述,也不是对CCTA技术进行指导,并且也没有专门陈述CCTA检查的适应证.因为有关心脏CT和磁共振成像的适应证标准以及冠状动脉钙化CT检测的临床意义此前业已发表.%Thia document presents an expert consensus overview of the current and emerging clinical uses of coronary CTA in patients with suspected or known coronary anery disease ( CAD ) . The intention of this document is to summarize the strengths and weaknesses of current clinical uses of coronary CTA as reflected in the published peer-reviewed literature and as interpreted by the writing committee. The document is not intended primarily as either a comprehensive literature review or as an instruction guide for those interested in performing or interpreting coronary computed tomoWaphy ( CT) angiograms. The document also does not offer specific staLements ratjng the appropriateness of various potential clinical uses of coronary CTA , as this has been dealt with in the ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 Appropnateness Critena for Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging. Finally, this document does not address the evaluation of coronary calcium using CT, except as it pertains to CTA studies in patients with suspected or known CAD, since this topic has also been covered in the ACCF/AHA 2007 Clinical Expert Consensus Document on Coronary Artery Calcium Scoring by Computed Tomography in Global Cardiovascular Risk Assessment and in Evaluation of Patients With Chest Pain.

  14. Advanced computed tomographic anatomical and morphometric plaque analysis for prediction of fractional flow reserve in intermediate coronary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Opolski, Maksymilian P., E-mail: opolski.mp@gmail.com [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Kepka, Cezary, E-mail: c.kepka@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Achenbach, Stephan, E-mail: stephan.achenbach@uk-erlangen.de [Department of Internal Medicine 2 (Cardiology), University of Erlangen, Erlangen (Germany); Pregowski, Jerzy, E-mail: jerzypregowski74@gmail.com [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Kruk, Mariusz, E-mail: mariuszkruk2000@yahoo.com [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Staruch, Adam D., E-mail: adstarman@gmail.com [Medical University of Warsaw, Warsaw (Poland); Kadziela, Jacek, E-mail: j.kadziela@ikard.pl [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Ruzyllo, Witold, E-mail: w.ruzyllo@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Witkowski, Adam, E-mail: witkowski@hbz.pl [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland)

    2014-01-15

    Objective: To determine the application of advanced coronary computed tomography angiography (CCTA) plaque analysis for predicting invasive fractional flow reserve (FFR) in intermediate coronary lesions. Methods: Sixty-one patients with 71 single intermediate coronary lesions (≥50–80% stenosis) on CCTA prospectively underwent coronary angiography and FFR. Advanced anatomical and morphometric plaque analysis was performed based on CCTA data set to determine optimal criteria for significant flow impairment. A significant stenosis was defined as FFR ≤ 0.80. Results: FFR averaged 0.85 ± 0.09, and 19 lesions (27%) were functionally significant. FFR correlated with minimum lumen area (MLA) (r = 0.456, p < 0.001), minimum lumen diameter (MLD) (r = 0.326, p = 0.006), reference lumen diameter (RLD) (r = 0.245, p = 0.039), plaque burden (r = −0.313, p = 0.008), lumen area stenosis (r = −0.305, p = 0.01), lesion length (r = −0.692, p < 0.001), and plaque volume (r = −0.668, p < 0.001). There was no relationship between FFR and CCTA morphometric plaque parameters. By multivariate analysis the independent predictors of FFR were lesion length (beta = −0.581, p < 0.001), MLA (beta = 0.360, p = 0.041), and RLD (beta = −0.255, p = 0.036). The optimal cutoffs for lesion length, MLA, MLD, RLD, and lumen area stenosis were >18.5 mm, ≤3.0 mm{sup 2}, ≤2.1 mm, ≤3.2 mm, and >69%, respectively (max. sensitivity: 100% for MLA, max. specificity: 79% for lumen area stenosis). Conclusions: CCTA predictors for FFR support the mathematical relationship between stenosis pressure drop and coronary flow. CCTA could prove to be a useful rule-out test for significant hemodynamic effects of intermediate coronary stenoses.

  15. Reproducibility of coronary plaque detection and characterization using low radiation dose coronary computed tomographic angiography in patients with intermediate likelihood of coronary artery disease (ReSCAN study)

    DEFF Research Database (Denmark)

    Ovrehus, Kristian Altern; Marwan, Mohamed; Bøtker, Hans Erik

    2012-01-01

    The purpose of this study is to evaluate the interscan, interobserver and intraobserver agreement for coronary plaque detection, and characterization using low radiation dose high-pitch spiral acquisition coronary CT angiography (CTA). Two experienced observers independently evaluated coronary CTA......-values 0.57-0.85), and 67-84% (0.31-0.67) for non-calcified plaques on a patient level. No significant difference was observed in mean interscan or interobserver SIS. Mean (95% CI) intraobserver SIS difference was -0.88 (-1.25; -0.51), P Low radiation dose...... datasets from 50 consecutive patients undergoing two 128-slice dual source CT scans within 12 days. Mean (±SD) estimated radiation exposure was 1.5 ± 0.2 mSv per scan. Observers recorded the presence and characterization of coronary plaques as non-calcified or calcified. A "segment involvement score" (SIS...

  16. What Have We Learned from CONFIRM? Prognostic Implications from a Prospective Multicenter International Observational Cohort Study of Consecutive Patients Undergoing Coronary Computed Tomographic Angiography

    Science.gov (United States)

    Otaki, Yuka; Arsanjani, Reza; Gransar, Heidi; Cheng, Victor Y.; Dey, Damini; Labounty, Troy; Lin, Fay Y.; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J. W.; Delago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Kaufmann, Philipp; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Dunning, Allison; Cury, Ricardo C.; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Berman, Daniel S.; Min, James K.

    2014-01-01

    Coronary computed tomographic angiography (CCTA) employing CT scanners of 64-detector rows or greater represents a novel noninvasive method for detection of coronary artery disease (CAD), providing excellent diagnostic information when compared to invasive angiography. In addition to its high diagnostic performance, prior studies have shown that CCTA can provide important prognostic information, although these prior studies have been generally limited to small cohorts at single centers. The Coronary CT Angiography EvaluatioN For clinical Outcomes: An InterRnational Multicenter Registry, or CONFIRM, is a large, prospective, multinational, dynamic observational cohort study of patients undergoing CCTA. This registry currently represents more than 32,000 consecutive adults suspected of having CAD who underwent ≥ 64–detector row CCTA at 12 centers in 6 countries between 2005 and 2009. Based on its large sample size and adequate statistical power, the data derived from CONFIRM registry has and will continue to provide key answers to many important topics regarding CCTA. Based on its multisite international national design, the results derived from CONFIRM should be considered as more generalizable than prior smaller single-center studies. This article summarizes the current status of several studies from CONFIRM registry. PMID:22689072

  17. Current but not past smoking increases the risk of cardiac events: Insights from coronary computed tomographic angiography

    NARCIS (Netherlands)

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

    2015-01-01

    textabstractAims We evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA). Methods and results We evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588

  18. Current but not past smoking increases the risk of cardiac events: Insights from coronary computed tomographic angiography

    NARCIS (Netherlands)

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

    2015-01-01

    textabstractAims We evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA). Methods and results We evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588

  19. Computed tomographic findings of trichuriasis

    Institute of Scientific and Technical Information of China (English)

    Naime Tokmak; Zafer Koc; Serife Ulusan; Ismail Soner Koltas; Nebil Bal

    2006-01-01

    In this report, we present computed tomographic findings of colonic trichuriasis. The patient was a 75-year-old man who complained of abdominal pain, and weight loss.Diagnosis was achieved by colonoscopic biopsy. Abdominal computed tomography showed irregular and nodular thickening of the wall of the cecum and ascending colon.Although these findings are nonspecific, they may be one of the findings of trichuriasis. These findings, confirmed by pathologic analysis of the biopsied tissue and KatoKatz parasitological stool flotation technique, revealed adult Trichuris. To our knowledge, this is the first report of colonic trichuriasis indicated by computed tomography.

  20. Radiation and contrast agent doses reductions by using 80-kV tube voltage in coronary computed tomographic angiography: A comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Jian-xin [Department of Radiology, Wuhan 161th Hospital, Wuhan (China); Wang, Yi-min, E-mail: wym6669@yahoo.com.cn [Department of Radiology, Wuhan 161th Hospital, Wuhan (China); Lu, Jin-guo [Department of Cardiology, Asia Heart Hospital, Wuhan (China); Zhang, Yu; Wang, Peng; Yang, Cheng [Department of Radiology, Wuhan 161th Hospital, Wuhan (China)

    2014-02-15

    Objective: To investigate the effects of 80-kilovoltage (kV) tube voltage coronary computed tomographic angiography (CCTA) with a reduced amount of contrast agent on qualitative and quantitative image quality parameters and on radiation dose in patients with a body mass index (BMI) <23.0 kg/m{sup 2}. Methods: One hundred and twenty consecutive patients with a BMI <23.0 kg/m{sup 2} and a low calcium load undergoing retrospective electrocardiogram (ECG)-gated dual-source CCTA were randomized into two groups [standard-tube voltage (120-kV) vs. low-tube voltage (80-kV)]. The injection flow rate of contrast agent (350 mg I/mL) was adjusted to body weight of each patient (4.5–5.5 mL/s in the 120-kV group and 2.8–3.8 mL/s in the 80-kV group). Radiation and contrast agent doses were evaluated. Quantitative image quality parameters and figure of merit (FOM) of coronary artery were evaluated. Each coronary segment was evaluated for image quality on a 4-point scale. Results: Compared with the 120-kV group, effective dose and amount of contrast agent in the 80-kV group were decreased by 57.8% and 30.5% (effective dose:2.7 ± 0.5vs. 6.4 ± 1.3 mSv; amount of contrast agent:57.1 ± 3.2 vs. 82.1 ± 6.1 mL; both p < 0.0001), respectively. Image noise was 22.7 ± 2.1 HU for 120-kV images and 33.2 ± 5.2 HU for 80-kV images (p < 0.0001). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the proximal right coronary artery (RCA) and left main coronary artery (LMA) were all lower in 80-kV than 120-kV images (SNR in the proximal RCA: 16.5 ± 1.8 vs. 19.4 ± 2.8; SNR in the LMA: 16.3 ± 2.0 vs.19.6 ± 2.7; CNR in the proximal RCA: 19.4 ± 2.3 vs.22.9 ± 3.0; CNR in the LMA: 18.8 ± 2.4 vs. 22.7 ± 2.9; all p < 0.0001). FOM were all significantly higher in 80-kV than 120-kV images (proximal RCA: 146.7 ± 45.1 vs. 93.4 ± 32.0; LMA: 139.1 ± 47.2 vs. 91.6 ± 31.1; all p < 0.0001). There was no significant difference in image quality score between the two groups (3.3 ± 0

  1. Differences in episode-based care costs for multidetector computed tomographic coronary angiography versus myocardial perfusion imaging for the diagnosis of coronary artery disease.

    Science.gov (United States)

    Min, James K; Robinson, Matthew; Shaw, Leslee J; Lin, Fay; Legorreta, Antonio P; Gilmore, Amanda

    2008-01-01

    Multidetector computed tomography (MDCT) is a novel method for diagnosis and prognosis of coronary artery disease (CAD). The opportunity costs that favour MDCT over other CAD diagnostic methods is currently unknown. This study used an episodes of care cost model based on epidemiologic and economic data evaluating individuals without known CAD undergoing MDCT or myocardial perfusion scintigraphy (MPS). It was a multicenter retrospective database review of medical and pharmacy-related claims linked by episodes of care from 2002 to 2005. CAD-related episodes of care costs were examined 1-year downstream for patients after initial MDCT that were matched to patients who underwent MPS. After adjustment for patient factors, 1-year total CAD-related episodes of care costs for MDCT were 16.4% lower than MPS, by an average of $682 (95% confidence interval $14, $1,350) per patient. While costs per CAD-related episode were similar between MDCT and MPS groups ($4,284 vs. $4,277, p=0.08). Patients without known CAD who undergo MDCT as an initial diagnostic test, compared to MPS, incurred fewer CAD-related episodes of care and lower overall CAD-related costs.

  2. Current but not past smoking increases the risk of cardiac events: insights from coronary computed tomographic angiography

    Science.gov (United States)

    Nakanishi, Rine; Berman, Daniel S.; Budoff, Matthew J.; Gransar, Heidi; Achenbach, Stephan; Al-Mallah, Mouaz; Andreini, Daniele; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor Y.; Chinnaiyan, Kavitha; Chow, Benjamin J.W.; Cury, Ricardo; Delago, Augustin; Hadamitzky, Martin; Hausleiter, Jörg; Feuchtner, Gudrun; Kim, Yong-Jin; Kaufmann, Philipp A.; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Pontone, Gianluca; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Dunning, Allison; Min, James K.

    2015-01-01

    Aims We evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA). Methods and results We evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588 current smokers; 2183 past smokers who quit ≥3 months before CCTA; and 5685 never smokers). By risk-adjusted Cox proportional-hazards models, we related smoking status to MACE (all-cause death or non-fatal myocardial infarction). We further performed 1:1:1 propensity matching for 1000 in each group evaluate event risk among individuals with similar age, gender, CAD risk factors, and symptom presentation. During a mean follow-up of 2.8 ± 1.9 years, 297 MACE occurred. Compared with never smokers, current and past smokers had greater atherosclerotic burden including extent of plaque defined as segments with any plaque (2.1 ± 2.8 vs. 2.6 ± 3.2 vs. 3.1 ± 3.3, P < 0.0001) and prevalence of obstructive CAD [1-vessel disease (VD): 10.6% vs. 14.9% vs. 15.2%, P < 0.001; 2-VD: 4.4% vs. 6.1% vs. 6.2%, P = 0.001; 3-VD: 3.1% vs. 5.2% vs. 4.3%, P < 0.001]. Compared with never smokers, current smokers experienced higher MACE risk [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.4–2.6, P < 0.001], while past smokers did not (HR 1.2, 95% CI 0.8–1.6, P = 0.35). Among matched individuals, current smokers had higher MACE risk (HR 2.6, 95% CI 1.6–4.2, P < 0.001), while past smokers did not (HR 1.3, 95% CI 0.7–2.4, P = 0.39). Similar findings were observed for risk of all-cause death. Conclusion Among patients without known CAD undergoing CCTA, current and past smokers had increased burden of atherosclerosis compared with never smokers; however, risk of MACE was heightened only in current smokers. PMID:25666322

  3. Computed Tomographic Evaluation of Mandibular Ameloblastoma

    Directory of Open Access Journals (Sweden)

    N Eswar

    2003-01-01

    Five interesting cases of mandibular ameloblastoma are presented here, each case showing different histological pattern and corresponding computer tomographic appearance. Also an attempt is made to establish CT pattern in these histological varieties of ameloblastoma.

  4. High Energy Computed Tomographic Inspection of Munitions

    Science.gov (United States)

    2016-11-01

    UNCLASSIFIED UNCLASSIFIED AD-E403 815 Technical Report AREIS-TR-16006 HIGH ENERGY COMPUTED TOMOGRAPHIC INSPECTION OF MUNITIONS...REPORT DATE (DD-MM-YYYY) November 2016 2. REPORT TYPE Final 3. DATES COVERED (From – To) 4. TITLE AND SUBTITLE HIGH ENERGY COMPUTED...otherwise be accomplished by other nondestructive testing methods. 15. SUBJECT TERMS Radiography High energy Computed tomography (CT

  5. Radiation dose in neurological computed tomographic scanning

    Energy Technology Data Exchange (ETDEWEB)

    Whitmore, R.C.; Bushong, S.C.; Archer, B.A.; Glaze, S.A.

    1979-07-01

    Patient dose and dose distribution during neurologicl computed tomography examinations were determined with five different computed tomography scanners. Maximum intracranial doses ranged from 1.17 to 2.67 rads. Doses to the lens of the eye ranged from 0.23 to 2.81 rads. These levels are considered and compared with patient doses reported for other computed tomography studies and for conventional tomographic examinations. In general, patient dose during computer tomographic examinations is less than one quarter of that during conventional tomography of the head.

  6. Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFRCT: outcome and resource impacts study

    Science.gov (United States)

    Douglas, Pamela S.; Pontone, Gianluca; Hlatky, Mark A.; Patel, Manesh R.; Norgaard, Bjarne L.; Byrne, Robert A.; Curzen, Nick; Purcell, Ian; Gutberlet, Matthias; Rioufol, Gilles; Hink, Ulrich; Schuchlenz, Herwig Walter; Feuchtner, Gudrun; Gilard, Martine; Andreini, Daniele; Jensen, Jesper M.; Hadamitzky, Martin; Chiswell, Karen; Cyr, Derek; Wilk, Alan; Wang, Furong; Rogers, Campbell; De Bruyne, Bernard

    2015-01-01

    Aims In symptomatic patients with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) improves patient selection for invasive coronary angiography (ICA) compared with functional testing. The impact of measuring fractional flow reserve by CTA (FFRCT) is unknown. Methods and results At 11 sites, 584 patients with new onset chest pain were prospectively assigned to receive either usual testing (n = 287) or CTA/FFRCT (n = 297). Test interpretation and care decisions were made by the clinical care team. The primary endpoint was the percentage of those with planned ICA in whom no significant obstructive CAD (no stenosis ≥50% by core laboratory quantitative analysis or invasive FFR < 0.80) was found at ICA within 90 days. Secondary endpoints including death, myocardial infarction, and unplanned revascularization were independently and blindly adjudicated. Subjects averaged 61 ± 11 years of age, 40% were female, and the mean pre-test probability of obstructive CAD was 49 ± 17%. Among those with intended ICA (FFRCT-guided = 193; usual care = 187), no obstructive CAD was found at ICA in 24 (12%) in the CTA/FFRCT arm and 137 (73%) in the usual care arm (risk difference 61%, 95% confidence interval 53–69, P< 0.0001), with similar mean cumulative radiation exposure (9.9 vs. 9.4 mSv, P = 0.20). Invasive coronary angiography was cancelled in 61% after receiving CTA/FFRCT results. Among those with intended non-invasive testing, the rates of finding no obstructive CAD at ICA were 13% (CTA/FFRCT) and 6% (usual care; P = 0.95). Clinical event rates within 90 days were low in usual care and CTA/FFRCT arms. Conclusions Computed tomographic angiography/fractional flow reserve by CTA was a feasible and safe alternative to ICA and was associated with a significantly lower rate of invasive angiography showing no obstructive CAD. PMID:26330417

  7. All-cause mortality benefit of coronary revascularization vs. medical therapy in patients without known coronary artery disease undergoing coronary computed tomographic angiography: results from CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry)

    Science.gov (United States)

    Min, James K.; Berman, Daniel S.; Dunning, Allison; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor; Chinnaiyan, Kavitha; Chow, Benjamin J.W.; Cury, Ricardo; Delago, Augustin; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Joerg; Kaufmann, Philipp; Karlsberg, Ronald P.; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Plank, Fabian; Raff, Gilbert; Villines, Todd; Labounty, Troy M.; Shaw, Leslee J.

    2012-01-01

    Aims To date, the therapeutic benefit of revascularization vs. medical therapy for stable individuals undergoing invasive coronary angiography (ICA) based upon coronary computed tomographic angiography (CCTA) findings has not been examined. Methods and results We examined 15 223 patients without known coronary artery disease (CAD) undergoing CCTA from eight sites and six countries who were followed for median 2.1 years (interquartile range 1.4–3.3 years) for an endpoint of all-cause mortality. Obstructive CAD by CCTA was defined as a ≥50% luminal diameter stenosis in a major coronary artery. Patients were categorized as having high-risk CAD vs. non-high-risk CAD, with the former including patients with at least obstructive two-vessel CAD with proximal left anterior descending artery involvement, three-vessel CAD, and left main CAD. Death occurred in 185 (1.2%) patients. Patients were categorized into two treatment groups: revascularization (n = 1103; 2.2% mortality) and medical therapy (n = 14 120, 1.1% mortality). To account for non-randomized referral to revascularization, we created a propensity score developed by logistic regression to identify variables that influenced the decision to refer to revascularization. Within this model (C index 0.92, χ2 = 1248, P < 0.0001), obstructive CAD was the most influential factor for referral, followed by an interaction of obstructive CAD with pre-test likelihood of CAD (P = 0.0344). Within CCTA CAD groups, rates of revascularization increased from 3.8% for non-high-risk CAD to 51.2% high-risk CAD. In multivariable models, when compared with medical therapy, revascularization was associated with a survival advantage for patients with high-risk CAD [hazards ratio (HR) 0.38, 95% confidence interval 0.18–0.83], with no difference in survival for patients with non-high-risk CAD (HR 3.24, 95% CI 0.76–13.89) (P-value for interaction = 0.03). Conclusion In an intermediate-term follow-up, coronary revascularization is

  8. Rationale and design of the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry: A comprehensive exploration of plaque progression and its impact on clinical outcomes from a multicenter serial coronary computed tomographic angiography study.

    Science.gov (United States)

    Lee, Sang-Eun; Chang, Hyuk-Jae; Rizvi, Asim; Hadamitzky, Martin; Kim, Yong-Jin; Conte, Edoardo; Andreini, Daniele; Pontone, Gianluca; Volpato, Valentina; Budoff, Matthew J; Gottlieb, Ilan; Lee, Byoung Kwon; Chun, Eun Ju; Cademartiri, Filippo; Maffei, Erica; Marques, Hugo; Leipsic, Jonathon A; Shin, Sanghoon; Choi, Jung Hyun; Chung, Namsik; Min, James K

    2016-12-01

    The natural history of coronary artery disease (CAD) in patients with low-to-intermediate risk is not well characterized. Although earlier invasive serial studies have documented the progression of atherosclerotic burden, most were focused on high-risk patients only. The PARADIGM registry is a large, prospective, multinational dynamic observational registry of patients undergoing serial coronary computed tomographic angiography (CCTA). The primary aim of PARADIGM is to characterize the natural history of CAD in relation to clinical and laboratory data. The PARADIGM registry (ClinicalTrials.govNCT02803411) comprises ≥2,000 consecutive patients across 9 cluster sites in 7 countries. PARADIGM sites were chosen on the basis of adequate CCTA volume, site CCTA proficiency, local demographic characteristics, and medical facilities to ensure a broad-based sample of patients. Patients referred for clinically indicated CCTA will be followed up and enrolled if they had a second CCTA scan. Patients will also be followed up beyond serial CCTA performance to identify adverse CAD events that include cardiac and noncardiac death, myocardial infarction, unstable angina, target vessel revascularization, and CAD-related hospitalization. The results derived from the PARADIGM registry are anticipated to add incremental insight into the changes in CCTA findings in accordance with the progression or regression of CAD that confer prognostic value beyond demographic and clinical characteristics. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Computed tomographic appearances of sternocostoclavicular hyperostosis

    Energy Technology Data Exchange (ETDEWEB)

    Chigira, Masaki; Shimizu, Toru (Gunma Univ. (Japan). Dept. of Orthopaedic Surgery)

    1989-08-01

    Computed tomographical analysis of sternocostoclavicular hyperostosis was performed in 27 patients. In the earliest stage hyperostosis occurred around the cartilaginous portion of the first ribs. The sternoclavicular joint space was preserved even in the late stage III of the disorder. It is also suggested that perichondritis and periostitis play important roles in the etiology of this disorder. (orig./GDG).

  10. E-learn Computed Tomographic Angiography

    DEFF Research Database (Denmark)

    Havsteen, Inger; Christensen, Anders; Nielsen, Jens K

    2012-01-01

    BACKGROUND: Computed tomographic angiography (CTA) is widely available in emergency rooms to assess acute stroke patients. To standardize readings and educate new readers, we developed a 3-step e-learning tool based on the test-teach-retest methodology in 2 acute stroke scenarios: vascular...

  11. Computed tomographic colonography:Hope or hype?

    Institute of Scientific and Technical Information of China (English)

    Otto; Schiueh-Tzang; Lin

    2010-01-01

    Computed tomographic colonography (CTC) is a promising emerging technology for imaging of the colon. This concise review discusses the currently available data on CTC technique,test characteristics,acceptance,safety,cost-effectiveness,follow-up strategy,and extracolonic findings. In summary,CTC technique is still evolving,and further research is needed to clarify the role of automated colonic insufflation,smooth-muscle relaxants,intravenous and oral contrast,soft-ware rendering,and patient positioning. Curr...

  12. SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI).

    Science.gov (United States)

    Abbara, Suhny; Blanke, Philipp; Maroules, Christopher D; Cheezum, Michael; Choi, Andrew D; Han, B Kelly; Marwan, Mohamed; Naoum, Chris; Norgaard, Bjarne L; Rubinshtein, Ronen; Schoenhagen, Paul; Villines, Todd; Leipsic, Jonathon

    In response to recent technological advancements in acquisition techniques as well as a growing body of evidence regarding the optimal performance of coronary computed tomography angiography (coronary CTA), the Society of Cardiovascular Computed Tomography Guidelines Committee has produced this update to its previously established 2009 "Guidelines for the Performance of Coronary CTA" (1). The purpose of this document is to provide standards meant to ensure reliable practice methods and quality outcomes based on the best available data in order to improve the diagnostic care of patients. Society of Cardiovascular Computed Tomography Guidelines for the Interpretation is published separately (2). The Society of Cardiovascular Computed Tomography Guidelines Committee ensures compliance with all existing standards for the declaration of conflict of interest by all authors and reviewers for the purpose ofclarity and transparency.

  13. Computed tomographic findings in acute infantile hemiplegia

    Energy Technology Data Exchange (ETDEWEB)

    Hisanaga, M.; Utsumi, S.; Kyoi, K.; Gega, A.; Tanikake, T. (Nara Medical Univ., Kashihara (Japan))

    1981-06-01

    The clinical and computed tomographic findings in four cases of acute infantile hemiplegia that were followed for over ten years are described. The most impressive and common findings in four cases are as follows: 1) Unilateral loss of cerebral volume with displacement of the midline structures to the affected side. 2) Unilateral thicked calvarium and dilated frontal and ethmoid sinus and mastoid air cells on affected side. 3) A dilated lateral ventricle in the affected hemisphere. The recognition of these calvarial changes should indicate that the cerebral abnormalities are the result of an atrophic and hypoplastic process that began in early life.

  14. Cranial computed tomographic abnormalities in leptomeningeal metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y.Y.; Glass, J.P.; Geoffray, A.; Wallace, S.

    1984-11-01

    Sixty-four (57.6%) of 111 cancer patients with cerebrospinal fluid cytology positive for malignant cells had cranial computed tomographic (CT) scans within 2 weeks before or after a lumbar puncture. Twenty-two (34.3%) of the 64 had abnormal CT findings indicative of leptomeningeal metastasis. Thirteen (59.6%) of these 22 patients had associated parenchymal metastases. Recognition of leptomeningeal disease may alter the management of patients with parenchymal metastases. Communicating hydrocephalus in cancer patients should be considered to be related to leptomeningeal metastasis until proven otherwise.

  15. Computer tomographic investigation of ancient Egyptian mummies

    Energy Technology Data Exchange (ETDEWEB)

    Huebner, K.H.; Pahl, W.M.

    1981-08-01

    Radiological and computer tomographic examinations of Egyptian mummies have been carried out at the Institute of Anthropology and Human Genetics from 1975 to 1978. These have demonstrated the value of CT in medical archaeology. It enables one to study the soft tissues, the skin (if bandaged), the muscles and any organs retained in situ for magical or religious reason. Measurements of attenuation values indicate the materials which were used for mummifying the skin and organs. Characteristic examples are described and the early results of these examinations are discussed.

  16. Computed tomographic anatomy of the equine foot.

    Science.gov (United States)

    Claerhoudt, S; Bergman, E H J; Saunders, J H

    2014-10-01

    This study describes a detailed computed tomographic reference of the normal equine foot. Ten forefeet of five adult cadavers, without evidence of orthopaedic disease, were used. Computed tomography (CT) was performed on all feet. Two-millimetre thick transverse slices were obtained, and sagittal and dorsal planes were reformatted. The CT images were matched with the corresponding anatomic slices. The phalanges and the distal sesamoid bone showed excellent detail. The extensor and flexor tendons (including their attachments) could be clearly evaluated. The collateral (sesamoidean) ligaments could be readily located, but were difficult to delineate at their proximal attachment. The distal digital annular ligament could only be distinguished from the deep digital flexor tendon proximal to the distal sesamoid bone, and its proximal attachment could be identified, but not its distal insertion. Small ligaments (impar ligament, chondrosesamoidean, chondrocoronal and chondrocompedal ligaments, axial and abaxial palmar ligaments of the proximal inter-phalangeal joint) were seen with difficulty and not at all slices. The joint capsules could not be delineated from the surrounding soft tissue structures. The lateral and medial proprius palmar digital artery and vein could be visualized occasionally on some slices. The ungular cartilages, corium and hoof wall layering were seen. The nerves, the articular and fibrocartilage of the distal sesamoid bone and the chondroungular ligament could not be assessed. Computed tomography of the equine foot can be of great value when results of radiography and ultrasonography are inconclusive. Images obtained in this study may serve as reference for CT of the equine foot.

  17. Computed tomographic findings of cerebral paragonimiasis

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Nak Kwan; Nam, Kyung Jin; Park, Churl Min; Eun, Chung Kie; Lee, Sun Wha [Kyung Hee Unversity Hospital, Seoul (Korea, Republic of)

    1983-03-15

    Paragonimiasis is widely distributed in Far East and Southeast Asia, particularly in Korea. The central nervous system is the most frequent location for paragonimiasis outside the lungs. We analyzed the computed tomographic findings of 17 cases which were diagnosed pathologically and clinically as cerebral paragonimiasis. The results were as follows: 1. The ratio of male to female was 10 : 7 and about 88% of cases were under the age of 40 years. 2. The common locations of cerebral paragonimiasis were the occipital (12 cases) and temporal (11 cases) lobes. 3. Precontrast CT findings of cerebral paragonimiasis were low density with calcifications in 6 cases, low and isodensities in 4 cases, mixed densities in 3 cases, only low density in 2 cases and only calcification in 2 cases. Hydrocephalus (7 cases), mass effect (6 cases), atrophic change (6 cases) and cyst formation (3 cases) were associated. 4. The shape of calcifications in CT scan were soap-bubble or ring in 6 cases, nodular or oval in 6 cases, stipple in 4 cases and amorphous conglomerated in 2 cases. 5. The contrast -enhanced 8 cases were 5 ring or rim like, 2 nodular and 1 irregular enhancements, while 9 cases were not enhanced.

  18. Computed tomographic findings of intracerebral cysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jin Kyo; Lee, Sun Wha; Kim, Ho Kyun; Ahn, Chi Yul [School of Medicine, Kyung-Hee University, Seoul (Korea, Republic of)

    1980-12-15

    Cysticercosis is a parasitic disease in which man serves as the intermediate host of Taenia Solium, the pork tapeworm. The computed tomographic findings of 25 cases of intracerebral cysticercosis proven by pathologic and/or clinical findings during past 2 years were analysed. The results were as follows; 1. The sex was 19 males and 6 females, and 56 percent of the patients were seen in fourth and fifth decades. The most common symptom was epilepsy (72%). 2. The C. T. findings in precontrast study were varied; such as ill defined low density (48%), cystic low density (20%), dilated ventricles (20%), ill defined low density with isodense nodule (18%), cystic low density with isodense mural nodule (12%) and calcification (8%). 3. The areas of involvement were 20 cases (80%) of parenchymal form, 3 cases (12%) of ventricular form and 2 cases (8%) of mixed form. 4. The contrast-enhanced 13 cases were 5 nodular, 5 ring or rim-like and 3 mixed type enhancements, while 12 cases were not enhanced. 5. C.T. scan demonstrated more precise location and extents of cerebral cysticercosis, especially in parenchymal form. It was considered to be important in determination of surgical feasibility and its approach.

  19. Computed tomographic findings in orbital Mucor

    Energy Technology Data Exchange (ETDEWEB)

    Greenberg, M.R.; Lippman, S.M.; Grinnell, V.S.; Colman, M.F.; Edwards, J.E. Jr.

    1985-07-01

    Mucormycosis is an increasingly important infection in immunocompromised patients; knowledge regarding the variability of its clinical manifestations is expanding steadily. The infection is of paranasal sinus origin and may involve the orbit secondarily via freely communicating foramina and venous channels. Death often ensues when the infection spreads either into the cavernous sinus or the central nervous system. Early diagnosis of rhinocerebral mucormycosis is crucial for a successful outcome. Computed tomographic (CT) scanning is used to visualize many intraorbital pathologic abnormalities. The patient discussed in this paper had extensive orbital Mucor that appeared minimal on a CT scan. This inability of the scan to reflect the severity of infection prompted a review of the literature describing the use of CT scans for detecting this potentially fatal, opportunistic infection. The search showed that a disparity between scan findings and the severity of the disease is the rule rather than the exception. Recognition of this disparity has significant implications for appropriate diagnosis and management of orbital Mucor.

  20. Computed tomographic findings of cerebral paragonimiasis

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Weon Tae; Jung, Min Ki; Kang, Heoung Keun; Chung, Hyon De [Chonnam University Medicine School, Gwangju (Korea, Republic of)

    1988-10-15

    Authors analyzed the computed tomographic (CT) findings of 19 cases pathologically and clinically proven cerebral paragonimiasis that were performed at Chonnam University Hospital from April 1983 through March 1987. The results were as follows: 1. Male to female ratio was 15:4 and the most prevalent age group was 3rd decade (7 cases). The common symptoms were epileptic seizure (16 cases) and headache (12 cases). 2. The multiplicity of cerebral paragonimiasis was 7 of 19 cases and the distributions of lesion were occipital (11 cases), temporal (6 cases), frontal (5 cases) and parietal (5 cases) lobe. 3. The calcification on CT scan were single (7 cases) or multiple (7 cases) and the shape of calcification were nodular (10 cases), soap babble of ring (8 cases), and stippled (6 cases). The pattern of contrast enhancement were ring (5 cases) or nodular (1 case), and along the basal cistern (1 case with arachnoiditis). 4. 12 out of 13 cases, had long clinical symptoms over 3 years with calcifications, could be analyzed according to Valentine's vascular territory; 6 cases in PCA territory, 3 in MCA and 3 in ACA. 5. CT findings were noted according to the duration of symptoms; 5 cases, had symptoms less than 1 year, showed abscess (5 cases) and arachnoiditis (1 case) with brain edema, mass effect, hydrocephalus and contrast enhancement but no calcification in all. One case, had symptom of 1 year and 2 months, showed partially calcified granulomatous lesion with perifocal edema and contrast enhancement, 13 cases, had symptoms over 3 years, showed multiple calcification with brain atrophy (10 cases), but no contrast enhancement in all cases.

  1. Computer simulations of a low energy proton beam tomograph

    Energy Technology Data Exchange (ETDEWEB)

    Milhoretto, E.; Schelin, H.R.; Setti, J.A.P.; Denyak, V.; Paschuk, S.A.; Basilio, A.C.; Rocha, R.; Ribeiro Junior, S. [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil). Curso de Pos-Graduacao em Engenharia Eletrica e Informatica Industrial (CPGEI)]. E-mails: sergei@utfpr.edu.br; edneymilhoretto@yahoo.com; schelin@cpgei.cefetpr.br; Evseev, I.; Yevseyeva, O. [Universidade Estadual do Rio de Janeiro (UERJ), Nova Friburgo, RJ (Brazil)]. E-mail: evseev@iprj.uerj.br; Lopes, R.T. [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graducao em Engenharia (COPPE). Lab. de Instrumentacao Nuclear]. E-mail: ricardo@lin.ufrj.br; Vinagre Filho, U.M. [Instituto de Energia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2007-07-01

    This work presents the recent development of a low energy proton beam tomograph. The proton tomograph prototype (involving UTFPR, UERJ, UFRJ and IEN/CNEN) has been installed and tested at the cyclotron CV-28 of IEN/CNEN. New computer simulations were performed in order to optimize the performance of the scattered proton beam and its aluminum collimator energy losses. The computer code simulates the tomographic measurements with two aluminum collimators (variable aperture from 0.2 mm to 0.4 mm in diameter and variable thickness from 4 mm to 8 mm), a water phantom and a Si(Li) detector. The analysis of the exit beam energy spectra in comparison with a perfectly collimated proton beam made it possible to achieve the best quality of reconstructed tomographic images of water phantom. (author)

  2. Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    XU Fang-hong; CHEN Wei-jian; YANG Yun-jun; DUAN Yu-xia; FU Feng-li

    2008-01-01

    Objective: To evaluate the application value of multislice computed tomographic perfusion imaging (MSCTPI) and multislice computed tomographic angiography (MSCTA) on traumatic cerebral infarction. Methods: MSCTA was performed on 10 patients who were initiailly diagnosed as traumatic cerebral infarction by normal conventional computed tomography (NCCT), among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection (MIP) and volume rendering (VR) from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow (Rcbf), regional cerebral blood volume (Rcbv), mean transit time (MTT), and time to peak (TTP), acquired by the perfusing analysis software was obtained. Results: Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from steno sis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA. Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA. Conclusion: The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral

  3. Reduction in downstream test utilization following introduction of coronary computed tomography in a cardiology practice

    OpenAIRE

    Karlsberg, Ronald P.; Budoff, Matthew J.; Thomson, Louise E; Friedman, John D.; Berman, Daniel S.

    2010-01-01

    To compare utilization of non-invasive ischemic testing, invasive coronary angiography (ICA), and percutaneous coronary intervention (PCI) procedures before and after introduction of 64-slice multi-detector row coronary computed tomographic angiography (CCTA) in a large urban primary and consultative cardiology practice. We utilized a review of electronic medical records (NotesMD®) and the electronic practice management system (Megawest®) encompassing a 4-year period from 2004 to 2007 to dete...

  4. Computed tomographic findings in penetrating peptic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Madrazo, B.L.; Halpert, R.D.; Sandler, M.A.; Pearlberg, J.L.

    1984-12-01

    Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a convenient diagnosis of this important complication of peptic ulcer disease.

  5. [Multispiral computed tomographic semiotics of laryngeal cancer].

    Science.gov (United States)

    Vasil'ev, P V; Iudin, A L; Sdvizhkov, A M; Kozhanov, L G

    2007-01-01

    Multispiral computed tomography (MSCT) with intravenous bolus contrasting is a currently available method for radiodiagnosis of laryngeal cancer. MSCT is of much higher informative value in estimating the extent of a tumorous lesion than the traditional radiodiagnostic techniques: linear tomography, lateral X-ray study, roentgenoscopy and roentgenography of the laryngopharynx and esophagus with barium meal.

  6. Computed tomographic findings of sellar and parasellar tumors

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Kee Hyun; Kim, Dai Young; Seo, Heung Suk [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1980-12-15

    A total of 42 cases of sellar and parasellar tumors are verified at Seoul National University Hospital from December 1978 through July 1980. They are composed of 25 pituitary adenomas, 5 meningiomas, 4 craniopharyngiomas, 1 astrocytoma, 1 germinoma, 1 teratoma, 1 epidermoid, 1 arachnoid cyst, 1 chondroma, 1 sphenoid mucocele and 1 chronic epidural hematoma. Authors analyzed and described the computed tomographic findings of them.

  7. Lymphadenopathy in celiac disease: computed tomographic observations

    Energy Technology Data Exchange (ETDEWEB)

    Jones, B.; Bayless, T.M.; Fishman, E.K.; Siegelman, S.S.

    1984-06-01

    Lymphadenopathy in patients with celiac disease is generally viewed with alarm due to the association between celiac disease and intestinal lymphoma. Four patients with celiac disease are described in whom significant mesenteric and paraaortic adenopathy was demonstrated by computed tomogrophy (CT). The subsequent clinical course of these patients revealed no evidence of lymphoma. In two patients with longstanding celiac disease and recent relapse, exploratory laparotomy revealed reactive hyperplasia in the enlarged glands; in one patient this was associated with intestinal ulceration, and in the other no underlying pathology was found. Follow-up CT scans in both these patients demonstrated regression of the findings with clinical improvement. In the other two patients, CT was performed as part of the initial evaluation.

  8. Computed tomographical evaluation of diabetic nephropathy

    Energy Technology Data Exchange (ETDEWEB)

    Ubara, Yoshifumi; Hara, Shigeko; Arizono, Kenji; Katori, Hideyuki; Yamada, Akira; Mimura, Nobuhide [Toranomon Hospital, Tokyo (Japan). Kidney Center; Hagura, Ryoko

    1996-06-01

    Diabetic nephropathy can be regarded mainly as a type of microangiopathy, but is a disease that may also include aspects of macroangiopathy. This is especially true of renal disease in non-insulin dependent diabetes mellitus (NIDDM), which is characterized not only by diabetic glomerulosclerosis, but also by atherosclerosis. We performed morphological studies on the kidney, using computed tomography (CT), focusing on such points as: abdominal aortic calcifications at the level of kidney, calcifications in the renal artery, and wedge-shaped defects on the renal surface. We noted that these findings became more prominent in NIDDM patients during end-stage renal failure than during normal renal function, and were significantly more common in those two NIDDM groups than in age-matched nondiabetic patients without hypertension, hyperlipidemia or gout. NIDDM patients exhibited these features more frequently than IDDM patients. (author)

  9. Computer Aided Interpretation Approach for Optical Tomographic Images

    CERN Document Server

    Klose, Christian D; Netz, Uwe; Beuthan, Juergen; Hielscher, Andreas H

    2010-01-01

    A computer-aided interpretation approach is proposed to detect rheumatic arthritis (RA) of human finger joints in optical tomographic images. The image interpretation method employs a multi-variate signal detection analysis aided by a machine learning classification algorithm, called Self-Organizing Mapping (SOM). Unlike in previous studies, this allows for combining multiple physical image parameters, such as minimum and maximum values of the absorption coefficient for identifying affected and not affected joints. Classification performances obtained by the proposed method were evaluated in terms of sensitivity, specificity, Youden index, and mutual information. Different methods (i.e., clinical diagnostics, ultrasound imaging, magnet resonance imaging and inspection of optical tomographic images), were used as "ground truth"-benchmarks to determine the performance of image interpretations. Using data from 100 finger joints, findings suggest that some parameter combinations lead to higher sensitivities while...

  10. Technical innovation: Multidimensional computerized software enabled subtraction computed tomographic angiography.

    Science.gov (United States)

    Bhatia, Mona; Rosset, Antoine; Platon, Alexandra; Didier, Dominique; Becker, Christoph D; Poletti, Pierre-Alexandre

    2010-01-01

    Computed tomographic angiography (CTA) is a frequent noninvasive alternative to digital subtraction angiography. We previously reported the development of a new subtraction software to overcome limitations of adjacent bone and calcification in CT angiographic subtraction. Our aim was to further develop and improve this fast and automated computerized software, universally available for free use and compatible with most CT scanners, thus enabling better delineation of vascular structures, artifact reduction, and shorter reading times with potential clinical benefits. This computer-based free software will be available as an open source in the next release of OsiriX at the Web site http://www.osirix-viewer.com.

  11. ULTRASOUND AND COMPUTED TOMOGRAPHIC DIAGNOSIS OF OPTIC NERVE TUMORS

    Directory of Open Access Journals (Sweden)

    S. V. Saakyan

    2012-01-01

    Full Text Available A comprehensive examination was made in 93 patients, including 18 children, with tumors of the optic nerve (ON. Duplex ultrasound scanning was performed in 39 patients, of them there were 11 patients with ON gliomas and 28 with ON meningiomas. The specific computed tomographic and echographic signs of ON glioma and meningiomas were detected. The studies have shown that duplex ultrasound scanning and structural computed tomography of orbital sockets are highly informative complementary imaging procedures for ON tumors, which permits one to make their correct diagnosis, to specify surgical volume, and to plan adequate treatment.

  12. Instantaneous wave-free ratio derived from coronary computed tomography angiography in evaluation of ischemia-causing coronary stenosis

    Science.gov (United States)

    Ma, Yue; Liu, Hui; Hou, Yang; Qiao, Aike; Hou, Yingying; Yang, Qingqing; Guo, Qiyong

    2017-01-01

    Abstract The instantaneous wave-free ratio (iFR) closely related to fractional flow reserve (FFR) is a adenosine-independent physiologic index of coronary stenosis severity. We sought to evaluate whether iFR derived from coronary computed tomographic angiography (iFRCT) can be used as a novel noninvasive method for diagnosis of ischemia-causing coronary stenosis. We retrospectively enrolled 33 patients (47 lesions) with coronary artery disease (CAD) and examined with coronary computed tomographic angiography (CTA), invasive coronary angiography (ICA), and FFR. Patient-specific anatomical model of the coronary artery was built by original resting end-diastolic CTA images. Based on the model and computational fluid dynamics, individual boundary conditions were set to calculate iFRCT as the mean pressure distal to the stenosis divided by the mean aortic pressure during the diastolic wave-free period of rest state. Ischemia was assessed by an FFR of up to 0.8, while anatomically obstructive CAD was defined by a stenosis of at least 50% by ICA. The correlation between iFRCT and FFR was evaluated. The receiver operating characteristic (ROC) curve was used to select the cut-off value of iFRCT for diagnosis of ischemia-causing stenosis. The diagnostic performances of iFRCT, coronary CTA, and iFRCT plus CTA for ischemia-causing stenosis were compared with ROC curve and Delong method. On a per-vessel basis, iFRCT and FFR had linear correlation (r = 0.75, p coronary CTA (AUC = 0.60), iFRCT yielded diagnostic improvement over stenosis assessment with AUC increasing from 0.6 by CTA to 0.87 (P coronary CTA for detection of ischemia-causing coronary stenosis. PMID:28121952

  13. Noninvasive coronary artery angiography using electron beam computed tomography

    Science.gov (United States)

    Rumberger, John A.; Rensing, Benno J.; Reed, Judd E.; Ritman, Erik L.; Sheedy, Patrick F., II

    1996-04-01

    Electron beam computed tomography (EBCT), also known as ultrafast-CT or cine-CT, uses a unique scanning architecture which allows for multiple high spatial resolution electrocardiographic triggered images of the beating heart. A recent study has demonstrated the feasibility of qualitative comparisons between EBCT derived 3D coronary angiograms and invasive angiography. Stenoses of the proximal portions of the left anterior descending and right coronary arteries were readily identified, but description of atherosclerotic narrowing in the left circumflex artery (and distal epicardial disease) was not possible with any degree of confidence. Although these preliminary studies support the notion that this approach has potential, the images overall were suboptimal for clinical application as an adjunct to invasive angiography. Furthermore, these studies did not examine different methods of EBCT scan acquisition, tomographic slice thicknesses, extent of scan overlap, or other segmentation, thresholding, and interpolation algorithms. Our laboratory has initiated investigation of these aspects and limitations of EBCT coronary angiography. Specific areas of research include defining effects of cardiac orientation; defining the effects of tomographic slice thickness and intensity (gradient) versus positional (shaped based) interpolation; and defining applicability of imaging each of the major epicardial coronary arteries for quantitative definition of vessel size, cross-sectional area, taper, and discrete vessel narrowing.

  14. Computed tomographic features of fibrous dysplasia of maxillofacial region

    Energy Technology Data Exchange (ETDEWEB)

    Sontakke, Subodh Arun; Karjodka, Freny R [Nair Hospital Dental College, Mumba (India); Umarji, Hemant R [Government Dental College and Hospital, Mumbai (India)

    2011-03-15

    This study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region. All eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibrous dysplasia was confirmed by histopathological report. All cases showed the ill-defined margins of lesions except in the region where the lesions were extending to cortex of the involved bone. Internal structure of all cases showed ground glass appearance. Four cases of maxillary lesion showed the displacement of maxillary sinus maintaining the shape of maxillary sinus. Two cases showed complete obliteration of maxillary sinus. Displacement of inferior alveolar canal did not follow any typical pattern in any of the cases but was displaced in different directions. The craniofacial type of fibrous dysplasia is as common as fibrous dysplasia of jaw. The margins, extent, internal structure and effect on surrounding structure are well detected on computed tomographic images.

  15. Assessment of coronary artery bypass graft patency by multidetector computed tomography and electron-beam tomography

    NARCIS (Netherlands)

    Piers, LH; Dorgelo, J; Tio, RA; Jessurun, GAJ; Oudkerk, M; Zijlstra, F

    2005-01-01

    This case report describes the use of retrospectively ECG-gated 16-slice multidetector computed tomography (MDCT) and electron-beam tomography (EBT) for assessing bypass graft patency in two patients with recurrent angina after coronary artery bypass graft surgery. The results of each tomographic mo

  16. Computer-aided interpretation approach for optical tomographic images

    Science.gov (United States)

    Klose, Christian D.; Klose, Alexander D.; Netz, Uwe J.; Scheel, Alexander K.; Beuthan, Jürgen; Hielscher, Andreas H.

    2010-11-01

    A computer-aided interpretation approach is proposed to detect rheumatic arthritis (RA) in human finger joints using optical tomographic images. The image interpretation method employs a classification algorithm that makes use of a so-called self-organizing mapping scheme to classify fingers as either affected or unaffected by RA. Unlike in previous studies, this allows for combining multiple image features, such as minimum and maximum values of the absorption coefficient for identifying affected and not affected joints. Classification performances obtained by the proposed method were evaluated in terms of sensitivity, specificity, Youden index, and mutual information. Different methods (i.e., clinical diagnostics, ultrasound imaging, magnet resonance imaging, and inspection of optical tomographic images), were used to produce ground truth benchmarks to determine the performance of image interpretations. Using data from 100 finger joints, findings suggest that some parameter combinations lead to higher sensitivities, while others to higher specificities when compared to single parameter classifications employed in previous studies. Maximum performances are reached when combining the minimum/maximum ratio of the absorption coefficient and image variance. In this case, sensitivities and specificities over 0.9 can be achieved. These values are much higher than values obtained when only single parameter classifications were used, where sensitivities and specificities remained well below 0.8.

  17. Low-dose computed tomographic imaging in orbital trauma

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, A.; Whitehouse, R.W. (Manchester Univ. (United Kingdom). Dept. of Diagnostic Radiology)

    1993-08-01

    The authors review findings in 75 computed tomographic (CT) examinations of 66 patients with orbital trauma who were imaged using a low-radiation-dose CT technique. Imaging was performed using a dynamic scan mode and exposure factors of 120 kVp and 80 mAs resulting in a skin dose of 11 mGy with an effective dose-equivalent of 0.22 mSv. Image quality was diagnostic in all cases and excellent in 73 examinations. Soft-tissue abnormalities within the orbit including muscle adhesions were well demonstrated both on primary axial and reconstructed multiplanar images. The benefits of multiplanar reconstructions are stressed and the contribution of soft-tissue injuries to symptomatic diplopia examined. (author).

  18. Iatrogenic Colonic Perforation due to Computed Tomographic Colonography

    Directory of Open Access Journals (Sweden)

    Takashi Kato

    2015-05-01

    Full Text Available Although the complications of computed tomographic colonography (CTC are very rare, CTC is associated with potential risk of colonic perforation. In the present report we describe two cases of colonic perforation secondary to CTC. In the first case with ascending colonic carcinoma, insertion of a rigid double-balloon catheter caused direct rectal wall perforation. In the second case with obstructive colonic carcinoma, pneumoperitoneum developed due to automated carbon dioxide insufflation. Both patients were asymptomatic after examination and recovered without any complications. Based on the findings of the current cases, we recommend that a soft-tip catheter be used for CTC, and suggest that colonic perforation can occur even with automatic insufflation, depending on patient characteristics.

  19. Intravenous coronary angiography using electron beam computed tomography

    NARCIS (Netherlands)

    Rensing, B J; Bongaerts, A H; van Geuns, R J; van Ooijen, P M; Oudkerk, M; de Feyter, P J

    1999-01-01

    Intravenous coronary angiography with electron beam computed tomography (EBCT) allows for the noninvasive visualisation of coronary arteries. With dedicated computer hardware and software, three-dimensional renderings of the coronary arteries, veins, and other cardiac structures can be constructed f

  20. Current experience with computed tomographic cystography and blunt trauma.

    Science.gov (United States)

    Deck, A J; Shaves, S; Talner, L; Porter, J R

    2001-12-01

    We present our experience with computed tomographic (CT) cystography for the diagnosis of bladder rupture in patients with blunt abdominal and pelvic trauma and compare the results of CT cystography to operative exploration. We identified all blunt trauma patients diagnosed with bladder rupture from January 1992 to September 1998. We also reviewed the radiology computerized information system (RIS) for all CT cystograms performed for the evaluation of blunt trauma during the same time period. The medical records and pertinent radiographs of the patients with bladder rupture who underwent CT cystography as part of their admission evaluation were reviewed. Operative findings were compared to radiographic findings. Altogether, 316 patients had CT cystograms as part of an initial evaluation for blunt trauma. Of these patients, 44 had an ultimate diagnosis of bladder rupture; 42 patients had CT cystograms indicating bladder rupture. A total of 28 patients underwent formal bladder exploration; 23 (82%) had operative findings that exactly (i.e., presence and type of rupture) matched the CT cystogram interpretation. The overall sensitivity and specificity of CT cystography for detection of bladder rupture were 95% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 78% and 99%, respectively. CT cystography provides an expedient evaluation for bladder rupture caused by blunt trauma and has an accuracy comparable to that reported for plain film cystography. We recommend CT cystography over plain film cystography for patients undergoing CT evaluation for other blunt trauma-related injuries.

  1. Adoption of Computed Tomographic Colonography by U.S. Hospitals

    Science.gov (United States)

    McHugh, Megan; Osei-Anto, Awo; Klabunde, Carrie N.; Galen, Barbara A.

    2010-01-01

    Purpose Computed tomographic colonography (CTC) is a new non-invasivetechnology proposed as an option for colorectal cancer screening. The purpose of this study was to identify the percent of U.S. hospitals that offered CTC between 2005 and 2008 and factors that motivated or impeded adoption. Methods We analyzed data on the provision of colorectal cancer screening services by non-federal, general hospitals using the 2005 – 2008 American Hospital Association Annual Surveys. Additionally, in 2009, we conducted exploratory interviews with representatives from radiology departments at nine hospitals – six that provided CTC and three that did not. Results In 2008, 17% of hospitals offered CTC, up from 13% in 2005. Sixty-nine percent of hospitals that offered CTC in 2008 also offered optical colonoscopy services. Factors motivating adoption of CTC included a desire to provide an alternative screening option for frail, elderly patients and patients with a failed optical colonoscopy; long waits for optical colonoscopy; and promising evidence on CTC published in peer-reviewed literature. Lack of reimbursement was a commonly-cited barrier. Conclusion Growth of CTC services at U.S. hospitals occurred even in the absence of Medicare coverage or agreement among national guideline-setting organizations regarding CTC’s use in screening. Almost one-third of hospitals that offer CTC do not offer optical colonoscopy, and may not be prepared to provide adequate follow-up for patients with failed CTCs. PMID:21371666

  2. Computed tomographic characteristics of eosinophilic pulmonary granulomatosis in five dogs.

    Science.gov (United States)

    Fina, Caroline; Vignoli, Massimo; Terragni, Rossella; Rossi, Federica; Wisner, Erik; Saunders, Jimmy H

    2014-01-01

    Canine pulmonary eosinophilic granulomatosis is a rare inflammatory pulmonary disease characterized by formation of eosinophilic granulomas that tend to obliterate the normal pulmonary architecture. The purpose of this retrospective study was to describe the CT characteristics of confirmed idiopathic pulmonary eosinophilic granulomatosis in a group of dogs. Five dogs met inclusion criteria. All patients were young adult dogs of variable breeds. No dog had concurrent occult heartworm disease. Computed tomographic characteristics most commonly included pulmonary masses and nodules of variable size, and lesions were most commonly located in the caudal lung lobes. Four dogs had large pulmonary masses with or without additional nodules and one dog had nodular lesions disseminated throughout the entire lung parenchyma. All large eosinophilic granulomas were smoothly margined, heterogeneous pulmonary masses displaying heterogeneous contrast enhancement. A honeycomb-like enhancement pattern was observed in all but one mass and consisted of multiple hyperattenuating rims delineating central hypoattenuating areas, suggestive of bronchiectatic lung with peripheral enhancing airway walls and fluid-filled, necrotic bronchial lumen. One dog had evidence of tracheobronchial lymphadenopathy. Findings indicated that canine eosinophilic pulmonary granulomatosis should be included as a differential diagnosis for dogs with CT characteristics of multiple pulmonary masses and/or nodules in caudal lung lobes, and a honeycomb-like enhancement pattern in masses after intravenous administration of iodinated contrast medium.

  3. Cerebral computed tomographic angiography scan delay in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Lukosevicius Saulius

    2005-01-01

    Full Text Available CONTEXT: Computed tomographic angiography (CTA is widely applied in the evaluation of cerebral vessels. Contrast enhancement in cerebral CTA without care or test bolus is not always sufficient for high-quality images. AIMS: Evaluation of the possibilities of calculation of scan delay for cerebral CTA in case of subarachnoid hemorrhage (SAH, based on clinical data of a patient and to find out prognostic error of the model. SETTINGS AND DESIGN: Prospective study in Neurosurgery and Radiology departments. MATERIALS AND METHODS: Scan delay in 53 patients suffering an acute SAH was measured employing test bolus technique. Cerebral CTA was performed afterwards. STATISTICAL ANALYSIS USED: SPSS for Windows v.10.1 software package was applied for dispersion analysis, including one-sample Kolmogorov-Smirnov′s test and Levene′s Test of Equality of Error Variances. RESULTS: A statistical model for the prediction of scan delay in SAH was developed. Cerebral CTA scan delay was dependent upon age, neurological status and impact of the latter factors together (P<0.05. The determined mean square error of prognosis of scan delay of the developed model equals 3.3 sec. CONCLUSION: Using our proposed model it is possible to estimate an optimal delay time for CTA in most patients with SAH with a determined error.

  4. Diagnostic accuracy of noninvasive coronary angiography with 320-detector row computed tomography.

    Science.gov (United States)

    Nasis, Arthur; Leung, Michael C; Antonis, Paul R; Cameron, James D; Lehman, Sam J; Hope, Sarah A; Crossett, Marcus P; Troupis, John M; Meredith, Ian T; Seneviratne, Sujith K

    2010-11-15

    We sought to evaluate the diagnostic accuracy of noninvasive coronary angiography using 320-detector row computed tomography, which provides 16-cm craniocaudal coverage in 350 ms and can image the entire coronary tree in a single heartbeat, representing a significant advance from previous-generation scanners. We evaluated 63 consecutive patients who underwent 320-detector row computed tomography and invasive coronary angiography for the investigation of suspected coronary artery disease. Patients with known coronary artery disease were excluded. Computed tomographic (CT) studies were assessed by 2 independent observers blinded to results of invasive coronary angiography. A single observer unaware of CT results assessed invasive coronary angiographic images quantitatively. All available coronary segments were included in the analysis, regardless of size or image quality. Lesions with >50% diameter stenoses were considered significant. Mean heart rate was 63 ± 7 beats/min, with 6 patients (10%) in atrial fibrillation during image acquisition. Thirty-three patients (52%) and 70 of 973 segments (7%) had significant coronary stenoses on invasive coronary angiogram. Seventeen segments (2%) were nondiagnostic on computed tomogram and were assumed to contain significant stenoses on an "intention-to-diagnose" analysis. Sensitivity, specificity, and positive and negative predictive values of computed tomography for detecting significant stenoses were 94%, 87%, 88%, and 93%, respectively, by patient (n = 63), 89%, 95%, 82%, and 97%, respectively, by artery (n = 260), and 87%, 97%, 73%, and 99%, respectively, by segment (n = 973). In conclusion, noninvasive 320-detector row CT coronary angiography provides high diagnostic accuracy across all coronary segments, regardless of size, cardiac rhythm, or image quality.

  5. Cochlear implantation in 53 patients with otosclerosis: demographics, computed tomographic scanning, surgery, and complications.

    NARCIS (Netherlands)

    Rotteveel, L.J.C.; Proops, D.W.; Ramsden, R.T.; Saeed, S.R.; Olphen, A.F. van; Mylanus, E.A.M.

    2004-01-01

    OBJECTIVES: To collect data from a large number of cochlear implant recipients with otosclerosis and to make an assessment of these patients' clinical characteristics, computed tomographic scans, surgical findings, and complications, and to quantify the occurrence of postoperative facial nerve

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

    Institute of Scientific and Technical Information of China (English)

    马国林

    2013-01-01

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

  7. Computed tomographic demonstration of ocular calcification: Correlations with clinical and pathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Hedges, T.R. III; Pozzi-Mucelli, R.; Char, D.H.; Newton, T.H.

    1982-03-01

    The computed tomographic features of calcification in the eye were correlated with clinical and pathological findings in a variety of ophthalmic and systemic disorders. These consisted of ocular neoplasms, trauma and inflammation of the eye, idiopathic ocular lesions, and disorders of calcium metabolism. Computed tomographic documentation of ocular clarification was found to be useful in the differential diagnosis and management of patients with these disorders.

  8. Predictors of incomplete optical colonoscopy using computed tomographic colonography

    Directory of Open Access Journals (Sweden)

    Reetika Sachdeva

    2016-01-01

    Full Text Available Background/Aims: Optical colonoscopy (OC is the primary modality for investigation of colonic pathology. Although there is data on demographic factors for incomplete OC, paucity of data exists for anatomic variables that are associated with an incomplete OC. These anatomic variables can be visualized using computed tomographic colonography (CTC. We aim to retrospectively identify variables associated with incomplete OC using CTC and develop a scoring method to predict the outcome of OC. Patients and Methods: In this case-control study, 70 cases ( with incomplete OC and 70 controls (with complete OC were identified. CTC images of cases and controls were independently reviewed by a single CTC radiologist. Demographic and anatomical parameters were recorded. Data was examined using descriptive linear statistics and multivariate logistic regression model. Results: On analysis, female gender (80% vs 58.6% P = 0.007, prior abdominal/pelvic surgeries (51.4% vs 14.3% P < 0.001, colonic length (187.6 ± 30.0 cm vs 163.8 ± 27.2 cm P < 0.001, and number of flexures (11.4 ± 3.1 vs 8.4 ± 2.9 P < 0.001 increased the risk for incomplete OC. No significant association was observed for increasing age (P = 0.881 and history of severe diverticulosis (P = 0.867 with incomplete OC. A scoring system to predict the outcome of OC is proposed based on CTC findings. Conclusion: Female gender, prior surgery, and increasing colonic length and tortuosity were associated with incomplete OC, whereas increasing age and history of severe diverticulosis were not. These factors may be used in the future to predict those patients who are at risk of incomplete OC.

  9. Anaplastic Thyroid Carcinoma: Computed Tomographic Differentiation from Other Thyroid Masses

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Won; Yoon, Dae Young; Choi, Chul Soon; Chang, Suk Ki; Yun, Eun Joo; Seo, Young Lan; Rho, Young-Soo; Jin Cho, Sung; Kim, Keon Ha (Depts. of Radiology, Otorhinolaryngology, and Pathology, Kangdong Seong-Sim Hospital, Hallym Univ. College of Medicine, Seoul (KR))

    2008-04-15

    Background: Anaplastic thyroid carcinoma is rare but is one of the most aggressive malignancies. Therefore, accurate diagnosis is important in order to provide appropriate therapy. Purpose: To establish useful computed tomographic (CT) criteria for differentiating anaplastic carcinoma from other thyroid masses. Material and Methods: The CT scans of nine patients with anaplastic carcinomas were retrospectively reviewed and compared with those of 32 patients with papillary carcinomas (n = 12) or benign lesions (n = 20) exceeding a maximum diameter of 2.0 cm. Image analysis was performed according to the following CT parameters: size, margin (well defined or ill defined), composition (cystic, mixed, or solid), mean attenuation value, ratio of attenuation of the mass to that of the adjacent muscle (M/m attenuation ratio), necrosis (present or absent), and calcification (stippled, nodular, or absent) of the thyroid mass; and tumor-spreading patterns including the presence of surrounding normal thyroid tissue in the involved lobe, involvement of the contralateral thyroid lobe, extension into the adjacent structures, and cervical lymphadenopathy. Results: Anaplastic carcinomas appeared as large (average 4.6 cm), solid (100%), and ill-defined (88.9%) masses accompanied by necrosis (100%), nodular calcification (44.4%), direct invasion into the adjacent organs (55.6%), and cervical lymph node involvement (77.8%). Tumor necrosis was the most valuable parameter in differentiating anaplastic carcinomas from other thyroid masses. Patient age (>70 years) and low attenuation value on postcontrast scan (attenuation value <100 HU, or M/m attenuation ratio <1.3) are also helpful predictors for anaplastic carcinoma. Conclusion: If a patient is older than 70 years of age and has a large necrotic thyroid mass of low attenuation, anaplastic carcinoma should be included in the differential diagnosis

  10. Computed tomographic features of lymphangioleiomyomatosis: Evaluation in 138 patients

    Energy Technology Data Exchange (ETDEWEB)

    Tobino, Kazunori, E-mail: tobino@juntendo.ac.jp [Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka 820-0018 (Japan); Division of Respiratory Medicine, Juntendo University Faculty of Medicine & Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Johkoh, Takeshi [Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Kurumazuka 3-1, Itami, Hyogo 664-0872 (Japan); Fujimoto, Kiminori [Department of Radiology, Kurume University School of Medicine and Center for Diagnostic Imaging, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka 830-0011 (Japan); Sakai, Fumikazu [Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298 (Japan); Arakawa, Hiroaki [Department of Radiology, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi 321-0293 (Japan); Kurihara, Masatoshi [The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Pneumothorax Center, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Kumasaka, Toshio [The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-Ku, Tokyo 150-0012 (Japan); Koike, Kengo; Takahashi, Kazuhisa [Division of Respiratory Medicine, Juntendo University Faculty of Medicine & Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Seyama, Kuniaki [Division of Respiratory Medicine, Juntendo University Faculty of Medicine & Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan)

    2015-03-15

    Highlights: •In our series, the frequency of pulmonary nodules was higher than in the previous reports. •Our sporadic LAM patients had a lower frequency of renal AML than in that of previous reports. •LAM patients may have a high incidence of renal and hepatic cysts. •LAM cells may originate in the pelvis then spread via the axial lymphatic system. -- Abstract: Purpose: The aim was to characterize the computed tomographic (CT) findings from Japanese patients with lymphangioleiomyomatosis (LAM). Materials and methods: CT scans of the chest, abdomen, and pelvis from 124 patients with sporadic LAM (S-LAM, mean age, 37.4 years) and 14 patients with tuberous sclerosis complex (TSC)-LAM (mean age, 35.6 years) were analyzed. Results: Pulmonary nodules (18.8%) and hepatic angiomyolipoma (AML, 24.3%) were more common in our patients than those in previous reports. Compared with TSC-LAM, S-LAM group had a higher frequency of pulmonary nodules (28.6% vs 32.3%, P < 0.01) and lower frequencies of air-space consolidation (21.4% vs 2.4%, P < 0.01), pneumothorax (28.6% vs 8.1%, P = 0.02), pulmonary hilar lymphadenopathy (14.3% vs 0.8%, P < 0.01), renal AML (85.7% vs 17.4%, P < 0.01), hepatic AML (71.4% vs 17.4%, P < 0.01), and retrocrural lymphadenopathy (14.3% vs 1.4%, P = 0.04). Axial lymphatic abnormalities (i.e., thoracic duct dilatation, lymphadenopathy, and lymphangioleiomyoma) were most common in the pelvis and tended to decrease in incidence with increased distance from the pelvis. Conclusion: The incidence of some CT findings in Japanese patients differed from those in previous reports. Axial lymphatic abnormalities noted here suggest that the origin of LAM cells may be the pelvis.

  11. CT冠状动脉成像对男性吸烟冠心病患者斑块量化特征的评价%Value of quantification of coronary artery disease in male smokers using cardiac computed tomographic angiography

    Institute of Scientific and Technical Information of China (English)

    庞殿申; 迟华群; 张秀英; 王飞飞

    2016-01-01

    Objective:To explore the difference of quantification of coronary artery plaques between smokers and nonsmokers using cardiac computed tomographic angiography (CCTA). Methods:A total of 354 patients including 121 smokers and 233 controls who underwent 64-slice CCTA and confirmed to have coronary plaques were studied. Plaque area,plaque volume,plaque burden,remodeling and ratio of thickness and length were compared between the two groups. Results:There was no difference for age,diabetes mellitus rate,BMI,blood pressure and blood lipid between the two groups. Smokers group had higher plaque area(median:7.03 mm2 vs. 5.81 mm2),plaque volume(28.31 mm3 vs. 13.67 mm3),plaque burden(49.52% vs. 35.34%),remodel-ing index(1.29 vs. 1.08) and ratio of thickness and length(0.35 vs. 0.25). Conclusion:Plaque area,plaque volume,plaque bur-den,remodeling and ratio of thickness and length measured on 64-slice CCTA are higher in smokers than those in nonsmokers.%目的:探讨吸烟者和非吸烟者64排CT冠状动脉成像(coronary CT angiography,CCTA)斑块量化特征的区别。方法:拟诊冠心病行64排CCTA检查且证实有斑块者354例,比较吸烟组121例和非吸烟组233例的冠状动脉粥样硬化斑块的最大横截面积、体积、斑块负荷、重构指数和厚度长度比。结果:2组年龄、体质量指数、糖尿病、高血压、高血脂发病率差异均无统计学意义(均P>0.05)。吸烟组斑块的最大横截面积、体积、斑块负荷、重构指数、厚度长度比分别为(7.03±3.51)mm2、(28.31±14.03)mm3、(49.52±16.07)%、1.29±0.36、0.35±0.13,均显著高于非吸烟组的(5.81±2.43)mm2、(13.67±5.00)mm3、(35.34±10.12)%、1.08±0.27、0.25±0.15(均P<0.05)。结论:64排CT能够有效测量斑块,吸烟患者的斑块体积、面积及斑块负荷、重构指数、厚度长度比均显著大于非吸烟患者。

  12. Coronary Computed Tomography Angiography (CTA)

    Science.gov (United States)

    ... You may also be asked to remove hearing aids and removable dental work. Women will be asked to remove bras ... both diagnosis and treatment in a single session. Patients with a high risk of coronary artery disease and typical symptoms might ...

  13. Computed tomography versus invasive coronary angiography

    DEFF Research Database (Denmark)

    Napp, Adriane E; Haase, Robert; Laule, Michael

    2017-01-01

    OBJECTIVES: More than 3.5 million invasive coronary angiographies (ICA) are performed in Europe annually. Approximately 2 million of these invasive procedures might be reduced by noninvasive tests because no coronary intervention is performed. Computed tomography (CT) is the most accurate noninva...... angiography (ICA) is the reference standard for detection of CAD. • Noninvasive computed tomography angiography excludes CAD with high sensitivity. • CT may effectively reduce the approximately 2 million negative ICAs in Europe. • DISCHARGE addresses this hypothesis in patients with low...

  14. Evaluation of contrast-enhanced computed tomographic colonography in detection of local recurrent colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Yau-Tong You; Chung-Rong Chang Chien; Jeng-Yi Wang; Koon-Kwan Ng; Jinn-Shiun Chen; Reiping Tang; Jy-Ming Chiang; Chien-Yuh Yeh; Pao-Shiu Hsieh

    2006-01-01

    AIM: To evaluate the diagnostic accuracy, sensitivity,specificity of contrast-enhanced computed tomographic colonography in detecting local recurrence of colorectal cancer.METHODS: From January 2000 to December 2004,434 patients after potentially curative resection for invasive colorectal cancer were followed up for a period ranging from 20 to 55 mo. Eighty of the four hundred and thirty-four patients showing strong clinical evidence for recurring colorectal cancer during the last followup were enrolled in this study. Each patient underwent contrast-enhanced computed tomographic colonography and colonoscopy on the same day. Any lesions, biopsies,identified during the colonoscopic examination, immediate complications and the duration of the procedure were recorded. The results of contrast-enhanced computed tomographic colonography were evaluated by comparing to those of colonoscopy, surgical finding, and clinical follow-up.RESULTS: Contrast-enhanced computed tomographic colonography had a sensitivity of 100%, a specificity of 83% and an overall accuracy of 94% in detecting local recurrent colorectal cancer.CONCLUSION: Conventional colonoscopy and contrastenhanced tomographic colonography can complement each other in detecting local recurrence of colorectal cancer.

  15. Spiral computed tomographic imaging related to computerized ultrasonographic images of carotid plaque morphology and histology

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise; Wagner, A; Wiebe, B M;

    2001-01-01

    Echolucency of carotid atherosclerotic plaques, as evaluated by computerized B-mode ultrasonographic images, has been associated with an increased incidence of brain infarcts on cerebral computed tomographic scans. We tested the hypotheses that characterization of carotid plaques on spiral comput...

  16. Spiral computed tomographic imaging related to computerized ultrasonographic images of carotid plaque morphology and histology

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise; Wagner, A; Wiebe, B M

    2001-01-01

    Echolucency of carotid atherosclerotic plaques, as evaluated by computerized B-mode ultrasonographic images, has been associated with an increased incidence of brain infarcts on cerebral computed tomographic scans. We tested the hypotheses that characterization of carotid plaques on spiral comput...

  17. Temporal bone anomalies in the branchio-oto-renal syndrome: detailed computed tomographic and magnetic resonance imaging findings.

    NARCIS (Netherlands)

    Ceruti, S.; Stinckens, C.I.C.; Cremers, C.W.R.J.; Casselman, J.W.

    2002-01-01

    OBJECTIVE: To inventory computed tomographic and magnetic resonance imaging findings in the branchio-oto-renal (BOR) syndrome. STUDY DESIGN: A prospective computed tomographic and magnetic resonance imaging study on a family with the BOR syndrome. SETTING: Department of medical imaging and magnetic

  18. Temporal bone anomalies in the branchio-oto-renal syndrome: detailed computed tomographic and magnetic resonance imaging findings.

    NARCIS (Netherlands)

    Ceruti, S.; Stinckens, C.I.C.; Cremers, C.W.R.J.; Casselman, J.W.

    2002-01-01

    OBJECTIVE: To inventory computed tomographic and magnetic resonance imaging findings in the branchio-oto-renal (BOR) syndrome. STUDY DESIGN: A prospective computed tomographic and magnetic resonance imaging study on a family with the BOR syndrome. SETTING: Department of medical imaging and magnetic

  19. [Hardware-software system for monitoring parameters and characteristics of X-ray computer tomographs under operation conditions].

    Science.gov (United States)

    Blinov, N N; Zelikman, M I; Kruchinin, S A

    2007-01-01

    The results of testing of hardware and software for monitoring parameters (mean number of CT units, noise, field uniformity, high-contrast spatial resolution, layer width, dose) and characteristics (modulation transfer function) of X-ray computer tomographs are presented. The developed hardware and software are used to monitor the stability of X-ray computer tomograph parameters under operation conditions.

  20. Diagnosis of Coronary Heart Disease and Its Risk Equivalents by Coronary Computed Tomographic Angiography Combined with Isotope Myocardial Imaging%冠状动脉CT成像联合同位素心肌显像对冠心病等危症患者的诊断

    Institute of Scientific and Technical Information of China (English)

    李建龙(综述); 张虹(审校)

    2016-01-01

    The diagnosis of coronary CT angiography combined with myocardial perfusion imaging ( MPI) for coronary heart disease,which provides not only anatomical basis but also myocardial perfusion level evi-dence,has already been applied in clinical diagnosis of coronary heart disease ,but it is less used in the early screening for the patients with coronary heart disease risk equivalents .The combination of the two kinds of diagnostic technologies enables more thorough understanding of the coronary vascular lesions by noninvasive detection and provides a strong basis for the early screening , risk stratification , prognosis and treatment of patients with coronary heart disease.%冠状动脉CT联合心肌灌注显像( MPI)对冠状动脉粥样硬化性心脏病(冠心病)的诊断,既有解剖学依据同时也从心肌灌注层面提供证据,在冠心病临床诊断中已有应用。但采用该技术进行冠心病等危症患者冠心病筛查的公开报道较少。冠状动脉CT与MPI相结合可更全面地从无创性检测方面了解冠状动脉血管病变情况,为冠心病患者的早期筛查、危险分层、预后及治疗提供有力的依据。

  1. Parallel computing for simultaneous iterative tomographic imaging by graphics processing units

    Science.gov (United States)

    Bello-Maldonado, Pedro D.; López, Ricardo; Rogers, Colleen; Jin, Yuanwei; Lu, Enyue

    2016-05-01

    In this paper, we address the problem of accelerating inversion algorithms for nonlinear acoustic tomographic imaging by parallel computing on graphics processing units (GPUs). Nonlinear inversion algorithms for tomographic imaging often rely on iterative algorithms for solving an inverse problem, thus computationally intensive. We study the simultaneous iterative reconstruction technique (SIRT) for the multiple-input-multiple-output (MIMO) tomography algorithm which enables parallel computations of the grid points as well as the parallel execution of multiple source excitation. Using graphics processing units (GPUs) and the Compute Unified Device Architecture (CUDA) programming model an overall improvement of 26.33x was achieved when combining both approaches compared with sequential algorithms. Furthermore we propose an adaptive iterative relaxation factor and the use of non-uniform weights to improve the overall convergence of the algorithm. Using these techniques, fast computations can be performed in parallel without the loss of image quality during the reconstruction process.

  2. Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography

    NARCIS (Netherlands)

    Panayi, Georgios; Wieringa, Wouter G.; Alfredsson, Joakim; Carlsson, Jorg; Karlsson, Jan-Erik; Persson, Anders; Engvall, Jan; Pundziute, Gabija; Swahn, Eva

    2016-01-01

    Background: Three to five percent of patients with acute myocardial infarction (AMI) have normal coronary arteries on invasive coronary angiography (ICA). The aim of this study was to assess the presence and characteristics of atherosclerotic plaques on computed tomography coronary angiography

  3. Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lefkowitz, D.M.; Quencer, D.M.

    1982-08-01

    A vacuum facet phenomenon, seen on computed tomography as a lens-shaped lucency within a lumbar facet joint, was observed as a consequence of degenerative spondylolisthesis. The significance of this finding is discussed.

  4. Computer-aided detection of pulmonary embolism in computed tomographic pulmonary angiography (CTPA): Performance evaluation with independent data sets

    OpenAIRE

    Zhou, Chuan; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M.; Chughtai, Aamer; Patel, Smita; Wei, Jun; Cascade, Philip N.; Kazerooni, Ella A.

    2009-01-01

    The authors are developing a computer-aided detection system for pulmonary emboli (PE) in computed tomographic pulmonary angiography (CTPA) scans. The pulmonary vessel tree is extracted using a 3D expectation-maximization segmentation method based on the analysis of eigenvalues of Hessian matrices at multiple scales. A parallel multiprescreening method is applied to the segmented vessels to identify volume of interests (VOIs) that contained suspicious PE. A linear discriminant analysis (LDA) ...

  5. Dynamic enhanced computed tomographic findings of a perirenal capillary hemangioma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Min; Kim, Sang Won; Kim, Hyun Cheol; Yang, Dal Mo; Ryu, Jung Kyu; Lim, Sung Jig [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2016-05-15

    Hemangiomas are benign mesenchymal neoplasms that rarely occur in the kidney and perirenal space. Perirenal hemangiomas can mimic the appearance of exophytic renal cell carcinoma or various retroperitoneal tumors. We report a case of perirenal hemangioma detected by dynamic enhanced computed tomography in a 43-year-old female.

  6. Coronary computed tomographic angiography at low concentration of contrast media and low tube voltage in obese patients%低浓度等渗对比剂联合低管电压在肥胖患者冠状动脉成像中的应用

    Institute of Scientific and Technical Information of China (English)

    潘宇宁; 李爱静; 陈晓敏; 任大卫; 王健; 陈兆乾; 黄求理

    2016-01-01

    目的 探讨100 kV管电压、270 mgl/ml等渗低浓度对比剂联合迭代重建算法在肥胖人群中进行冠状动脉成像(CCTA)应用的可行性.方法 将48例接受CCTA检查、体质量指数(BMI)> 30 kg/m2的患者,按随机数字表法分为对照组和试验组,每组24例.对照组使用370 mgI/ml对比剂,以常规120 kV扫描,采用传统滤过反投影法(FBP)重建图像;试验组使用270 mgI/ml对比剂,以100kV扫描,采用第三代适应性迭代降噪算法(AIDR-3D)重建图像.两名医师对两组图像质量进行双盲法评分,比较观察者评分的一致性.比较两组患者的有效剂量(E)、平均CT值、图像噪声(N)、信噪比(SNR)、对比信噪比(CNR)、图像优良指数(FOM)和图像质量评分,以及两组患者的总碘量、碘注入率和对比剂相关不适感.结果 两组冠状动脉图像质量主观评分差异无统计学意义(P>0.05).两名医师评分的一致性较高(Kappa=0.88,P<0.05).两组图像平均CT值、SNR和CNR差异无统计学意义(P>0.05).试验组的FOM明显高于对照组(k=-9.250、-8.604、-9.158、-5.341,P<0.05).试验组E为(1.61 ±0.41)mSv,较对照组(3.64±1.09) mSv明显降低(t=8.373,P<0.01).试验组总碘量以及碘注入率均低于对照组(t=7.628、8.480,P<0.01).试验组注射对比剂热感和疼痛感的发生率低于对照组(x2=18.70、6.25,P<0.05).结论 在肥胖人群中,使用等渗低浓度对比剂结合低管电压冠状动脉检查可以在不降低图像质量的前提下,大幅度减低辐射剂量和碘摄入量.临床试验注册中国临床试验注册中心,ChiCTR-DPD-15007510.%Objective To explore the feasibility of coronary computed tomographic angiography (CCTA) for obese patients with lower tube voltage (100 kV) and lower contrast media concentration (270 mgI/ml) using iterative reconstruction.Methods A total of 48 patients with body mass index greater than 30 kg/m2 were included and randomly divided into 2 groups according to

  7. V/Q SPECT and computed tomographic pulmonary angiography.

    Science.gov (United States)

    Leblanc, Michel; Paul, Narinder

    2010-11-01

    Planar ventilation and perfusion (V/Q) scintigraphy has been largely displaced by computed tomography pulmonary angiography (CTPA) in recent years for the diagnosis of pulmonary embolism (PE). This change can be attributed to multiple studies that demonstrate CTPA has a reasonable sensitivity and good prognostic value in negative cases, associated with the ability to deliver few indeterminate results and provide an alternate diagnosis in a significant number of patients. However, the technique has significant limitations. The Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) study has shown a sensitivity of 83%, which is not optimal. However, CT technology has greatly progressed since this time, and therefore it is likely that this number has improved. The PIOPED II study has also shown that there may be a problem in positive or negative predictive value when the imaging results are discordant with the clinical probability. Additional concerns include allergies, contrast nephropathy associated with the use of intravenous contrast in patients with impaired creatinine clearance, suboptimal results in pregnant women, and high radiation exposure. In recent years, V/Q single-photon emission computed tomography has emerged as a mature technique for the diagnosis of PE and has been shown to be clearly superior to planar V/Q. The technique has excellent sensitivity for PE and is not associated with most of the limitations of CTPA, although it has its own set of limitations in patients with very severe chronic obstructive pulmonary disease or with a severely abnormal chest x-ray. V/Q single-photon emission computed tomography can be used as the initial modality for PE diagnosis in a wide variety of situations although CTPA remains invaluable in specific scenarios. Copyright © 2010 Elsevier Inc. All rights reserved.

  8. Chronic septic arthritis of the adult hip: Computed tomographic features

    Energy Technology Data Exchange (ETDEWEB)

    Resnik, C.S.; Ammann, A.M.; Walsh, J.W.

    1987-10-01

    Abnormalities on computed tomography (CT) are described in 12 adults in whom septic arthritis of the hip was diagnosed. Presenting symptoms varied, as did CT findings. Soft tissue abnormalities ranged from intra-articular effusion to large abscess formation, and bone changes ranged from minimal erosion of articular surfaces to gross destruction of the proximal femur and acetabulum. CT can be helpful in the evaluation of septic arthritis of the hip because of its superior demonstration of soft tissue detail. An accurate diagnosis can be established in unsuspected cases and can be confirmed when clinical indicators are vague.

  9. Computed tomographic diagnosis of nongastrointestinal foreign bodies in dogs.

    Science.gov (United States)

    Jones, Jeryl C; Ober, Christopher P

    2007-01-01

    Clinical data and computed tomography (CT) studies were reviewed for 13 dogs with confirmed nongastrointestinal foreign bodies. Locations of foreign bodies were the nasal cavity, thoracic wall, retropharyngeal region, and cerebellum. Types of foreign bodies included small plant components, blades of grass, wooden sticks, cloth fibers, and a needle. Foreign bodies in five dogs were not identified on CT, and secondary reactions resembled neoplastic or fungal disease. In eight dogs, foreign bodies were recognized by their shape and/or internal architecture. In two dogs, three-dimensional reformatting helped demonstrate foreign bodies in relation to palpable bony landmarks.

  10. Hybrid computing: CPU+GPU co-processing and its application to tomographic reconstruction.

    Science.gov (United States)

    Agulleiro, J I; Vázquez, F; Garzón, E M; Fernández, J J

    2012-04-01

    Modern computers are equipped with powerful computing engines like multicore processors and GPUs. The 3DEM community has rapidly adapted to this scenario and many software packages now make use of high performance computing techniques to exploit these devices. However, the implementations thus far are purely focused on either GPUs or CPUs. This work presents a hybrid approach that collaboratively combines the GPUs and CPUs available in a computer and applies it to the problem of tomographic reconstruction. Proper orchestration of workload in such a heterogeneous system is an issue. Here we use an on-demand strategy whereby the computing devices request a new piece of work to do when idle. Our hybrid approach thus takes advantage of the whole computing power available in modern computers and further reduces the processing time. This CPU+GPU co-processing can be readily extended to other image processing tasks in 3DEM. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Computed tomographic imaging of the brain of normal neonatal foals

    Directory of Open Access Journals (Sweden)

    L Cabrera

    2015-01-01

    Full Text Available The aim of this study was to provide a more complete description of normal cross-sectional anatomy of the neonatal brain of the foal and associated structures by computed tomography (CT and gross anatomical sections. Using a fourth-generation CT scanner, 2-mm contiguous transverse images were acquired from two neonatal 5-days-old Quarter horse foals. After the study the animals were euthanised for reasons unrelated to head pathology. To assist in the accurate identification of brain and associated structures, transverse CT images were obtained and compared with the corresponding frozen cross-sections of the head. CT images matched well with their corresponding transverse gross sections and provided good differentiation between the bones and the soft tissues of the head. These CT images are intended to be a useful initial anatomic reference in the interpretation for clinical CT imaging studies of the brain and associated structures in live neonatal foals.

  12. Recurrent largngeal nerve paralysis: a laryngographic and computed tomographic study

    Energy Technology Data Exchange (ETDEWEB)

    Agha, F.P.

    1983-07-01

    Vocal cord paralysis is a relatively common entity, usually resulting from a pathologic process of the vagus nerve or its recurrent larynegeal branch. It is rarely caused by intralargngeal lesions. Four teen patients with recurrent laryngeal nerve paralysis (RLNP) were evaluated by laryngography, computed tomography (CT), or both. In the evaluation of the paramedian cord, CT was limited in its ability to differentiate between tumor or RLNP as the cause of the fixed cord, but it yielded more information than laryngography on the structural abnormalities of the larynx and pre-epiglottic and paralaryngeal spaces. Laryngography revealed distinct features of RLNP and is the procedure of choice for evaluation of functional abnormalities of the larynx until further experience with faster CT scanners and dynamic scanning of the larynx is gained.

  13. Computed tomographic appearance of mucormycosis; Computertomographisches Erscheinungsbild der pulmonalen Mukormykose

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Hinrichs, T.; Jacobi, V. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Boehme, A.; Hoelzer, D. [Frankfurt Univ. (Germany). Medizinische Klinik III, Haematologie/Onkologie

    2000-07-01

    Aim: Analysis of the morphological characteristics of pulmonary mucormycosis using computed tomography (CT). Material and methods: Prospective analysis of CT studies in 9 patients out of 19 patients with proven pulmonary mucormycosis. Results: Pulmonary mucormycosis was most frequently found in the upper lobe bilaterally (51% of all nodules). In 22% of the manifestations, the morphological criterion of a 'bird's nest' could be verified in CT, in 37% central necrotic areas were detected. In 37% an open bronchus was diagnosed, in 6% we observed bronchiectases. 43% of all nodules presented with a halo sign. In three patients we found pleural effusions, enlarged mediastinal lymph nodes were diagnosed in one patient. Conclusion: Computed tomography allows an improved diagnosis and therapeutic follow-up in patients suffering from pulmonary mucormycosis. (orig.) [German] Ziel: Analyse der morphologischen Charakteristika der pulmonalen Mukormykose in der Computertomographie. Material und Methodik: Retrospektive Analyse der computertomographischen Untersuchungen bei 9 Patienten aus einem Kollektiv von 19 Patienten mit gesicherter pulmonaler Mukormykose. Ergebnisse: Pulmonale Mukormanifestationen fanden sich bevorzugt im Oberlappen beidseits (51% aller Herde). Bei 22% der Herde konnte das morphologische Zeichen des 'bird's nest' verifiziert werden, bei 37% zeigten sich Einschmelzungen. In 37% der Herde liess sich ein offener Bronchus nachweisen, bei 6% beobachteten wir Bronchiektasen. 43% der Herde wiesen einen 'Halo' auf. Bei drei Patienten lagen Pleuraerguesse vor, eine Lymphknotenvergroesserung (>1 cm) zeigte sich bei einem Patienten. Schlussfolgerung: Die Computertomographie leistet einen wichtigen Beitrag zur Diagnose und Verlaufskontrolle der pulmonalen Mukormykose. (orig.)

  14. Personal Computer System for Automatic Coronary Venous Flow Measurement

    OpenAIRE

    Dew, Robert B.

    1985-01-01

    We developed an automated system based on an IBM PC/XT Personal computer to measure coronary venous blood flow during cardiac catheterization. Flow is determined by a thermodilution technique in which a cold saline solution is infused through a catheter into the coronary venous system. Regional temperature fluctuations sensed by the catheter are used to determine great cardiac vein and coronary sinus blood flow. The computer system replaces manual methods of acquiring and analyzing temperatur...

  15. Prognostic implications of coronary artery calcium in the absence of coronary artery luminal narrowing

    NARCIS (Netherlands)

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

    2017-01-01

    textabstractBackground and aims: Coronary artery calcium (CAC) scoring is a predictor of future adverse clinical events, and a surrogate measure of overall coronary artery plaque burden. Coronary computed tomographic angiography (CCTA) is a contrast-enhanced method that allows for visualization of p

  16. Computer-aided teniae coli detection using height maps from computed tomographic colonography images

    Science.gov (United States)

    Wei, Zhuoshi; Yao, Jianhua; Wang, Shijun; Summers, Ronald M.

    2011-03-01

    Computed tomographic colonography (CTC) is a minimally invasive technique for colonic polyps and cancer screening. Teniae coli are three bands of longitudinal smooth muscle on the colon surface. They are parallel, equally distributed on the colon wall, and form a triple helix structure from the appendix to the sigmoid colon. Because of their characteristics, teniae coli are important anatomical meaningful landmarks on human colon. This paper proposes a novel method for teniae coli detection on CT colonography. We first unfold the three-dimensional (3D) colon using a reversible projection technique and compute the two-dimensional (2D) height map of the unfolded colon. The height map records the elevation of colon surface relative to the unfolding plane, where haustral folds corresponding to high elevation points and teniae to low elevation points. The teniae coli are detected on the height map and then projected back to the 3D colon. Since teniae are located where the haustral folds meet, we break down the problem by first detecting haustral folds. We apply 2D Gabor filter banks to extract fold features. The maximum response of the filter banks is then selected as the feature image. The fold centers are then identified based on piecewise thresholding on the feature image. Connecting the fold centers yields a path of the folds. Teniae coli are finally extracted as lines running between the fold paths. Experiments were carried out on 7 cases. The proposed method yielded a promising result with an average normalized RMSE of 5.66% and standard deviation of 4.79% of the circumference of the colon.

  17. Computed tomographic study in young epileptics in Kashmir, India

    Directory of Open Access Journals (Sweden)

    Mohd Ashraf

    2013-07-01

    Full Text Available Background: Infectious diseases like neurocysticercosis and neurotuberculosis are endemic in Indian subcontinent and are important causes of epilepsy. Epileptic children are prone to have poor school performance, higher levels of anxiety and depression apart from low self esteem. These treatable condition could be easily picked up on neuroimaging like cranial computed tomography (CT scan and treated accordingly at an earliest. Objectives: To assess the role of cranial computed tomography scan in children having epilepsy. Material and Methods: Seventy two children between the age of 1 month and 14 years were prospectively enrolled, who had atleast two unprovoked seizures greater than 24 hours apart, and all those children where seizures result from acute central nervous system insult were meticulously excluded. Diagnosis of epilepsy was based on detailed history, thorough clinical examination, routine laboratory tests with additional specific tests like electroencephalogram (EEG and CT scan brain. Results: Males constituted 62.5% and females 37.5% of our sample (p=0.247. The EEG was abnormal in 68.1% of all subjects, among which EEG was abnormal in 69.8% of generalized seizures, 64.7% in partial seizures and 1% in undetermined seizures. The spectrum of various seizure types in our study was generalized seizures in 73.6%, partial seizures in 23.6% & undetermined seizures in 2.8%. The incidence of these lesions in hospitalized young epileptics was 31.9%, in order of their frequency, it was cerebral atrophy and dilated ventricle (18.8% each; calcifications (15.5%; encephalomalacia and pachygyria (9.4% each; HIE changes, tuberous sclerosis (6.3% each; leucodystrophy, thin corpus callosum, large cisterna magna, granuloma and periventricular leukomalacia (3.1% each. The intracranial structural lesions were present in 22.6% of generalized seizures, 64.7% of partial seizures, none of undetermined seizures (p=0.004. Conclusion: Abnormal cranial CT scan

  18. Computed Tomographic Evaluation of Presumptively Normal Canine Sternal Lymph Nodes.

    Science.gov (United States)

    Iwasaki, Ryota; Mori, Takashi; Ito, Yusuke; Kawabe, Mifumi; Murakmi, Mami; Maruo, Kohji

    The sternal lymph nodes receive drainage from a wide variety of structures in the thoraco-abdominal region. Evaluation of these lymph nodes is essential, especially in cancer patients. Computed tomography (CT) can detect sternal lymph nodes more accurately than radiography or ultrasonography, and the criteria of the sternal lymphadenopathy are unknown. The purpose of this retrospective study was to describe the CT characteristics of the sternal lymph nodes in dogs considered unlikely to have lymphadenopathy. The ratio of the short axis dimension of the sternal lymph nodes to the thickness of the second sternebra was also investigated. At least one sternal lymph node was identified in each of the 152 dogs included in the study. The mean long axis and short axis dimensions were 0.700 cm and 0.368 cm, respectively. The mean ratio of the sternal lymph nodes to the second sternebrae was 0.457, and the 95% prediction interval ranged from 0.317 to 0.596 (almost a fixed value independent of body weight). These findings will be useful when evaluating sternal lymphadenopathy using CT.

  19. Computed tomographic features of afferent loop syndrome: pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Hertz, M. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv (Israel); Paran, H. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Surgery ' A' , Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Osadchy, A. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Gayer, G. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Assaf Harofe Medical Center, Zrifin, Sackler Faculty of Medicine, Tel Aviv (Israel)

    2005-04-15

    This pictorial essay reviews the computed tomography (CT) findings of afferent loop syndrome (ALS) in various pathological conditions to demonstrate the contribution of a common imaging modality-that is, abdominal CT, used nowadays for various abdominal complaints-to the diagnosis of ALS. ALS is caused by obstruction of the duodenum and jejunum proximal to a gastrojejunostomy anastomosis. It is a rare complication after Billroth II subtotal gastrectomy and even more rare after total or subtotal gastrectomy with Roux-en-Y reconstruction. Although currently advanced medical treatment and endoscopic interventions have dramatically decreased the necessity of surgery for peptic ulcer disease, ALS may appear years after previously common operations. Alternatively, the use of surgical resection for early gastric cancer nowadays leads to an increasing rate of malignancy-related ALS. Clinically, ALS may be difficult to diagnose as its presentation may be vague and nonspecific, but it has a characteristic appearance on CT. Clinicians and radiologists should therefore be familiar with this rare complication. Prompt recognition and correct diagnosis of this syndrome and its probable etiology are important as a guide for treatment. This review illustrates the CT features of ALS in various conditions. (author)

  20. Lacunar infarcts in childhood. Clinical and computed tomographic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Chizuko; Eda, Isematsu; Takashima, Sachio; Takeshita, Kenzo (Tottori Univ., Yonago (Japan). School of Medicine); Kanetoh, Yasuko

    1984-09-01

    Nine cases, ranging in age from 6 months to 9 years, were diagnosed as lacunar infarcts on computed tomography (CT). Hemiplegia developed rapidly or gradually in 8 cases. Three of 8 cases had transient ischemic attacks of hemiplegia. Other neurological deficits were dysarthria, aphasia, confusion and coarse tremor. One case was asymptomatic. Each of 8 cases had single lacuna and one case two lacunae on CT. These lacunae were localized in the internal capsule, the putamen or the caudate nucleus. Lacunae involving the internal capsule were associated with contralateral hemiplegia, whereas asymptomatic lacunae did not involve it. Severity of hemiplegia in the acute stage did not correlate with localization or size of lacunae. Moderate neurological sequelae were noticed in 3 cases, mild sequelae in two and none in three. The sequelae were related to the lacunae which involved the lateral lenticulostriate branch zone of the middle cerebral artery or larger areas. Prognosis did not correlate with the mode of onset or the severity of neurological signs in the acute stage. There were 2 cases with the occlusion of the left internal carotid artery or congenital heart disease, but the etiology of lacunae was unknown in the other cases.

  1. [Recurrence paralysis: computed tomographic analysis of intrathoracic findings].

    Science.gov (United States)

    Delorme, S; Knopp, M V; Kauczor, H U; Zuna, I; Trost, U; Haberkorn, U; van Kaick, G

    1992-09-01

    The long and singular course of the inferior (recurrent) laryngeal nerve makes it very vulnerable to infiltration by tumors of various locations. In particular, mediastinal and pulmonary lesions must be considered in the case of left vocal chord palsy. Recurrent nerve paralysis caused by a tumor indicates advanced disease. We retrospectively reviewed the computed tomography (CT) findings in 29 patients with bronchogenic carcinoma or mediastinal tumors and recurrent nerve paralysis with respect to the site, size and extent of the tumor and the lymph node status. The review revealed a marked predominance of left upper lobe tumors with extensive lymph node metastases to the anterior mediastinum and the aortopulmonary window. The extent of mediastinal involvement exceeded the average involvement in a control group of 30 randomly selected patients with bronchogenic carcinoma at the time of presentation. In all patients CT demonstrated tumor tissue which could have caused the paralysis at one or more sites along the anatomical course of the recurrent nerve. In most cases the tumor was located at the aortic arch. The left paratracheal region, right paratracheal region and right pulmonary apex were affected in one case each. We conclude that in patients with cancer, CT is a suitable method for localizing a recurrent nerve lesion.

  2. Vertebrobasilar system computed tomographic angiography in central vertigo.

    Science.gov (United States)

    Paşaoğlu, Lale

    2017-03-01

    The incidence of vertigo in the population is 20% to 30% and one-fourth of the cases are related to central causes. The aim of this study was to evaluate computed tomography angiography (CTA) findings of the vertebrobasilar system in central vertigo without stroke.CTA and magnetic resonance images of patients with vertigo were retrospectively evaluated. One hundred twenty-nine patients suspected of having central vertigo according to history, physical examination, and otological and neurological tests without signs of infarction on diffusion-weighted magnetic resonance imaging were included in the study. The control group included 120 patients with similar vascular disease risk factors but without vertigo. Vertebral and basilar artery diameters, hypoplasias, exit-site variations of vertebral artery, vertebrobasilar tortuosity, and stenosis of ≥50% detected on CTA were recorded for all patients. Independent-samples t test was used in variables with normal distribution, and Mann-Whitney U test in non-normal distribution. The difference of categorical variable distribution according to groups was analyzed with χ and/or Fisher exact test.Vertebral artery hypoplasia and ≥50% stenosis were seen more often in the vertigo group (P = 0.000, vertigo patients had ≥50% stenosis, 54 (69.2%) had stenosis at V1 segment, 9 (11.5%) at V2 segment, 2 (2.5%) at V3 segment, and 13 (16.6%) at V4 segment. Both vertigo and control groups had similar basilar artery hypoplasia and ≥50% stenosis rates (P = 0.800, >0.05).CTA may be helpful to clarify the association between abnormal CTA findings of vertebral arteries and central vertigo.This article reveals the opportunity to diagnose posterior circulation abnormalities causing central vertigo with a feasible method such as CTA.

  3. Accuracy of the typical computed tomographic appearances of fibrosing alveolitis.

    Science.gov (United States)

    Tung, K T; Wells, A U; Rubens, M B; Kirk, J M; du Bois, R M; Hansell, D M

    1993-01-01

    BACKGROUND--Open lung biopsy is often performed to confirm the diagnosis in patients with suspected fibrosing alveolitis. The superior sensitivity and specificity of high resolution computed tomography (CT) over chest radiography in various diffuse lung diseases suggest that the characteristic appearance of fibrosing alveolitis on high resolution CT might render biopsy confirmation unnecessary. METHODS--The chest radiographs and high resolution CT scans of 86 patients (41 with fibrosing alveolitis and 45 with various other diffuse lung diseases) were examined individually and independently by two observers. No clinical information was given and the observers gave a level of confidence when the diagnosis was thought to be fibrosing alveolitis. RESULTS--The observers correctly and confidently discriminated between fibrosing alveolitis and other diffuse lung diseases on high resolution CT with an accuracy of 88% and on chest radiography with an accuracy of 76%. The false negative rate for fibrosing alveolitis diminished from 29% on chest radiography to 11% on high resolution CT. The false positive rate on chest radiography was 19% and on high resolution CT 13%; the false positive diagnoses on CT were the result of a few conditions (extrinsic allergic alveolitis, sarcoidosis, cryptogenic organising pneumonia, and pulmonary eosinophilia) which mimicked some of the CT features of fibrosing alveolitis. The superficial similarity of the CT patterns of these conditions are discussed. CONCLUSIONS--High resolution CT is superior to chest radiography in establishing the diagnosis of fibrosing alveolitis and the typical CT appearances are virtually pathognomonic. The diagnostic advantages of CT over chest radiography should further reduce the need for open lung biopsy in this condition. Images PMID:8135910

  4. Novel computed tomographic chest metrics to detect pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Li Chin-Shang

    2011-03-01

    Full Text Available Abstract Background Early diagnosis of pulmonary hypertension (PH can potentially improve survival and quality of life. Detecting PH using echocardiography is often insensitive in subjects with lung fibrosis or hyperinflation. Right heart catheterization (RHC for the diagnosis of PH adds risk and expense due to its invasive nature. Pre-defined measurements utilizing computed tomography (CT of the chest may be an alternative non-invasive method of detecting PH. Methods This study retrospectively reviewed 101 acutely hospitalized inpatients with heterogeneous diagnoses, who consecutively underwent CT chest and RHC during the same admission. Two separate teams, each consisting of a radiologist and pulmonologist, blinded to clinical and RHC data, individually reviewed the chest CT's. Results Multiple regression analyses controlling for age, sex, ascending aortic diameter, body surface area, thoracic diameter and pulmonary wedge pressure showed that a main pulmonary artery (PA diameter ≥29 mm (odds ratio (OR = 4.8, right descending PA diameter ≥19 mm (OR = 7.0, true right descending PA diameter ≥ 16 mm (OR = 4.1, true left descending PA diameter ≥ 21 mm (OR = 15.5, right ventricular (RV free wall ≥ 6 mm (OR = 30.5, RV wall/left ventricular (LV wall ratio ≥0.32 (OR = 8.8, RV/LV lumen ratio ≥1.28 (OR = 28.8, main PA/ascending aorta ratio ≥0.84 (OR = 6.0 and main PA/descending aorta ratio ≥ 1.29 (OR = 5.7 were significant predictors of PH in this population of hospitalized patients. Conclusion This combination of easily measured CT-based metrics may, upon confirmatory studies, aid in the non-invasive detection of PH and hence in the determination of RHC candidacy in acutely hospitalized patients.

  5. Computed tomographic evaluation of the portal vein in the hepatomas

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1986-10-15

    Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

  6. Computed tomographic evaluation of head diseases in the horse: 15 cases.

    Science.gov (United States)

    Tietje, S; Becker, M; Böckenhoff, G

    1996-03-01

    The rapid development of software and technology now allows a large amount of diagnostic information to be obtained from a computed tomographic examination. This imaging technique can also be usefully applied to the horse, given appropriate premises and a custom built table for accurate positioning. Computed tomography of the skull has considerable advantages over other techniques, as structures are viewed without superimposition. Fifteen cases are used to demonstrate how through high image quality (precise detail, reduction in artefacts) and objective measurement of density, various pathological changes can be analysed and exact diagnoses achieved. In particular, short measurement and examination times allow preoperative imaging under general anaesthesia giving significant information to assist subsequent surgery.

  7. Computed tomographic findings of the pediatric abdominal masses

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Seong Ku; Kim, Ok Bae; Suh, Soo Jhi [School of Medicine, Keimyung University, Daegu (Korea, Republic of)

    1985-08-15

    Although the ultrasonography is a useful imaging modality for evaluation of abdominal mass in an infant and child, computed tomography has more advantages over the ultrasonography in assessing anatomic detail, precise extent of tumor and differential diagnostic accuracy. The authors analyzed CT features of 85 cases of pathologically or clinically proven pediatric abdominal mass for recent 4.5 years at Keimyung University Dongsan Hospital. The results were as follows: 1. The most common site was kidney (36 cases: 42.4%), followed by nonrenal retroperitoneal masses (23 cases: 27.1%), hepatobiliary masses (15 cases: 17.6%), gastrointestinal masses (9 cases: 10.6%), and genital mass (2 cases: 2.3%) in order of frequency. 2. Hydronephrosis (17 cases: 20%) and Wilms' tumor (17 cases: 20%) were most common and splenomegaly (8 cases: 9.4%), neuroblastoma (5 cases: 5.9%), teratoma (4 cases: 4.7%), rhabdomyosarcoma (4 cases: 4.7%) were descending order of frequency. 3. The male to female ratio was 2:1, but female was predominant in teratoma, choledochal cyst and genital masses. Twenty three cases (27.1%) were under the age of one year. 4. The diagnosis of hydronephrosis, assessment of its severity and localization of exact level of obstruction were easy with CT examination. 5. Characteristic CT features of Wilms' tumor were round or oval shaped, smooth marginated, large intrarenal mass with displaced or obstructed calyces, pseudocapsule and crescent sign; there were no evidence of retroperitoneal lymph node or contiguous extension, retrocrural lymph node enlargement, prevertebral midline extension, or encasement of the aorta. 6. Typical CT findings of the neuroblastoma were irregular shaped and marginated extrarenal mass with calcification frequently, accompanied by retroperitoneal lymph node or contiguous extension, retrocrural lymph node enlargement, prevertebral midline extension and encasement of the aorta; there were no evidence of pseudocapsule or crescent

  8. Contrast media administration in coronary computed tomography angiography. A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Mihl, Casper; Kok, Madeleine; Wildberger, Joachim E.; Das, Marco [Maastricht Univ. Medical Center (Netherlands). CARIM School for Cardiovascular Diseases; Maastricht Univ. Medical Center (Netherlands). Radiology; Maas, Monique; Lobbes, Marc B.I. [Maastricht Univ. Medical Center (Netherlands). Radiology; Turek, Jakub; Seehofnerova, Anna [Maastricht Univ. Medical Center (Netherlands). CARIM School for Cardiovascular Diseases; Leijenaar, Ralph T.H. [GROW School for Oncology and Developmental Biology, Maastricht (Netherlands). Radiation Oncology (MAASTRO)

    2017-04-15

    Various different injection parameters influence enhancement of the coronary arteries. There is no consensus in the literature regarding the optimal contrast media (CM) injection protocol. The aim of this study is to provide an update on the effect of different CM injection parameters on the coronary attenuation in coronary computed tomographic angiography (CCTA). Studies published between January 2001 and May 2014 identified by Pubmed, Embase and MEDLINE were evaluated. Using predefined inclusion criteria and a data extraction form, the content of each eligible study was assessed. Initially, 2551 potential studies were identified. After applying our criteria, 36 studies were found to be eligible. Studies were systematically assessed for quality based on the validated Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-II checklist. Extracted data proved to be heterogeneous and often incomplete. The injection protocol and outcome of the included publications were very diverse and results are difficult to compare. Based on the extracted data, it remains unclear which of the injection parameters is the most important determinant for adequate attenuation. It is likely that one parameter which combines multiple parameters (e.g. IDR) will be the most suitable determinant of coronary attenuation in CCTA protocols. Research should be directed towards determining the influence of different injection parameters and defining individualized optimal IDRs tailored to patient-related factors (ideally in large randomized trials). Key points: This systematic review provides insight into decisive factors on coronary attenuation. Different and contradicting outcomes are reported on coronary attenuation in CCTA. One parameter combining multiple parameters (IDR) is likely decisive in coronary attenuation. Research should aim at defining individualized optimal IDRs tailored to individual factors. Future directions should be tailored towards the influence of different injection

  9. Time-Dependent Computed Tomographic Perfusion Thresholds for Patients With Acute Ischemic Stroke.

    Science.gov (United States)

    d'Esterre, Christopher D; Boesen, Mari E; Ahn, Seong Hwan; Pordeli, Pooneh; Najm, Mohamed; Minhas, Priyanka; Davari, Paniz; Fainardi, Enrico; Rubiera, Marta; Khaw, Alexander V; Zini, Andrea; Frayne, Richard; Hill, Michael D; Demchuk, Andrew M; Sajobi, Tolulope T; Forkert, Nils D; Goyal, Mayank; Lee, Ting Y; Menon, Bijoy K

    2015-12-01

    Among patients with acute ischemic stroke, we determine computed tomographic perfusion (CTP) thresholds associated with follow-up infarction at different stroke onset-to-CTP and CTP-to-reperfusion times. Acute ischemic stroke patients with occlusion on computed tomographic angiography were acutely imaged with CTP. Noncontrast computed tomography and magnectic resonance diffusion-weighted imaging between 24 and 48 hours were used to delineate follow-up infarction. Reperfusion was assessed on conventional angiogram or 4-hour repeat computed tomographic angiography. Tmax, cerebral blood flow, and cerebral blood volume derived from delay-insensitive CTP postprocessing were analyzed using receiver-operator characteristic curves to derive optimal thresholds for combined patient data (pooled analysis) and individual patients (patient-level analysis) based on time from stroke onset-to-CTP and CTP-to-reperfusion. One-way ANOVA and locally weighted scatterplot smoothing regression was used to test whether the derived optimal CTP thresholds were different by time. One hundred and thirty-two patients were included. Tmax thresholds of >16.2 and >15.8 s and absolute cerebral blood flow thresholds of stroke onset-to-CTP time and the optimal CTP thresholds for all parameters based on discrete or continuous time analysis (P>0.05). A statistically significant relationship existed between CTP-to-reperfusion time and the optimal thresholds for cerebral blood flow (P<0.001; r=0.59 and 0.77 for gray and white matter, respectively) and Tmax (P<0.001; r=-0.68 and -0.60 for gray and white matter, respectively) parameters. Optimal CTP thresholds associated with follow-up infarction depend on time from imaging to reperfusion. © 2015 American Heart Association, Inc.

  10. Experimental Actinobacillus pleuropneumoniae challenge in swine: comparison of computed tomographic and radiographic findings during disease.

    Science.gov (United States)

    Brauer, Carsten; Hennig-Pauka, Isabel; Hoeltig, Doris; Buettner, Falk F R; Beyerbach, Martin; Gasse, Hagen; Gerlach, Gerald-F; Waldmann, Karl-H

    2012-04-30

    In pigs, diseases of the respiratory tract like pleuropneumonia due to Actinobacillus pleuropneumoniae (App) infection have led to high economic losses for decades. Further research on disease pathogenesis, pathogen-host-interactions and new prophylactic and therapeutic approaches are needed. In most studies, a large number of experimental animals are required to assess lung alterations at different stages of the disease. In order to reduce the required number of animals but nevertheless gather information on the nature and extent of lung alterations in living pigs, a computed tomographic scoring system for quantifying gross pathological findings was developed. In this study, five healthy pigs served as control animals while 24 pigs were infected with App, the causative agent of pleuropneumonia in pigs, in an established model for respiratory tract disease. Computed tomographic (CT) findings during the course of App challenge were verified by radiological imaging, clinical, serological, gross pathology and histological examinations. Findings from clinical examinations and both CT and radiological imaging, were recorded on day 7 and day 21 after challenge. Clinical signs after experimental App challenge were indicative of acute to chronic disease. Lung CT findings of infected pigs comprised ground-glass opacities and consolidation. On day 7 and 21 the clinical scores significantly correlated with the scores of both imaging techniques. At day 21, significant correlations were found between clinical scores, CT scores and lung lesion scores. In 19 out of 22 challenged pigs the determined disease grades (not affected, slightly affected, moderately affected, severely affected) from CT and gross pathological examination were in accordance. Disease classification by radiography and gross pathology agreed in 11 out of 24 pigs. High-resolution, high-contrast CT examination with no overlapping of organs is superior to radiography in the assessment of pneumonic lung lesions

  11. Automating the segmentation of medical images for the production of voxel tomographic computational models.

    Science.gov (United States)

    Caon, M; Mohyla, J

    2001-12-01

    Radiation dosimetry for the diagnostic medical imaging procedures performed on humans requires anatomically accurate, computational models. These may be constructed from medical images as voxel-based tomographic models. However, they are time consuming to produce and as a consequence, there are few available. This paper discusses the emergence of semi-automatic segmentation techniques and describes an application (iRAD) written in Microsoft Visual Basic that allows the bitmap of a medical image to be segmented interactively and semi-automatically while displayed in Microsoft Excel. iRAD will decrease the time required to construct voxel models.

  12. 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.

  13. Computed tomographic mammography. Diagnosis of mammographically and clinically occult carcinoma of the breast.

    Science.gov (United States)

    Sibala, J L; Chang, C H; Lin, F; Jewell, W R

    1981-01-01

    If breast cancer can be detected early, while it is still localized and before it can be palpated, the prognosis for cure is excellent. Heretofore, conventional mammography has been the only means available to detect cancer at such an early stage. Two cases of minimal breast carcinoma measuring less than 5 mm in diameter have been detected and correctly diagnosed using computed tomographic mammography (CT/M). Both cases occurred in fatty breasts and were clinically and mammographically occult. These cases demonstrate the value of CT/M in the diagnosis of minimal breast carcinoma that would have been missed otherwise.

  14. Fractional flow reserve derived from coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Eftekhari, Ashkan; Min, James; Achenbach, Stephan

    2016-01-01

    AIMS: Fractional flow reserve (FFR) derived from coronary computed tomography (FFRCT) has high diagnostic performance in stable coronary artery disease (CAD). The diagnostic performance of FFRCT in patients with hypertension (HTN) and diabetes (DM), who are at risk of microvascular impairment, is...

  15. Coronary artery fly-through using electron beam computed tomography

    NARCIS (Netherlands)

    van Ooijen, P M; Oudkerk, M; van Geuns, R J; Rensing, B J; de Feyter, P J

    2000-01-01

    BACKGROUND: Virtual reality techniques have recently been introduced into clinical medicine. This study examines the possibility of coronary artery fly-through using a dataset obtained by noninvasive coronary angiography with contrast-enhanced electron-beam computed tomography. METHODS AND RESULTS:

  16. Coronary Artery Fly-Through Using Electron Beam Computed Tomography

    NARCIS (Netherlands)

    P.M.A. van Ooijen (Peter); M. Oudkerk (Matthijs); R.J.M. van Geuns (Robert Jan); B.J.W.M. Rensing (Benno); P.J. de Feyter (Pim)

    2000-01-01

    textabstractBACKGROUND: Virtual reality techniques have recently been introduced into clinical medicine. This study examines the possibility of coronary artery fly-through using a dataset obtained by noninvasive coronary angiography with contrast-enhanced electron-beam computed tom

  17. Hybrid computing: CPU+GPU co-processing and its application to tomographic reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Agulleiro, J.I.; Vazquez, F.; Garzon, E.M. [Supercomputing and Algorithms Group, Associated Unit CSIC-UAL, University of Almeria, 04120 Almeria (Spain); Fernandez, J.J., E-mail: JJ.Fernandez@csic.es [National Centre for Biotechnology, National Research Council (CNB-CSIC), Campus UAM, C/Darwin 3, Cantoblanco, 28049 Madrid (Spain)

    2012-04-15

    Modern computers are equipped with powerful computing engines like multicore processors and GPUs. The 3DEM community has rapidly adapted to this scenario and many software packages now make use of high performance computing techniques to exploit these devices. However, the implementations thus far are purely focused on either GPUs or CPUs. This work presents a hybrid approach that collaboratively combines the GPUs and CPUs available in a computer and applies it to the problem of tomographic reconstruction. Proper orchestration of workload in such a heterogeneous system is an issue. Here we use an on-demand strategy whereby the computing devices request a new piece of work to do when idle. Our hybrid approach thus takes advantage of the whole computing power available in modern computers and further reduces the processing time. This CPU+GPU co-processing can be readily extended to other image processing tasks in 3DEM. -- Highlights: Black-Right-Pointing-Pointer Hybrid computing allows full exploitation of the power (CPU+GPU) in a computer. Black-Right-Pointing-Pointer Proper orchestration of workload is managed by an on-demand strategy. Black-Right-Pointing-Pointer Total number of threads running in the system should be limited to the number of CPUs.

  18. Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Bøtker, Hans Erik; Sørensen, Henrik T

    2016-01-01

    AIMS: To examine the 3.5 year prognosis of stable coronary artery disease (CAD) as assessed by coronary computed tomography angiography (CCTA) in real-world clinical practice, overall and within subgroups of patients according to age, sex, and comorbidity. METHODS AND RESULTS: This cohort study i......, and comorbidity. CONCLUSION: Coronary artery disease determined by CCTA in real-world practice predicts the 3.5 year composite risk of late revascularization, myocardial infarction, and all-cause death across different groups of age, sex, or comorbidity burden.......AIMS: To examine the 3.5 year prognosis of stable coronary artery disease (CAD) as assessed by coronary computed tomography angiography (CCTA) in real-world clinical practice, overall and within subgroups of patients according to age, sex, and comorbidity. METHODS AND RESULTS: This cohort study...

  19. Predictors of internal mammary vessel diameter: A computed tomographic angiography-assisted anatomic analysis.

    Science.gov (United States)

    Cook, Julia A; Tholpady, Sunil S; Momeni, Arash; Chu, Michael W

    2016-10-01

    The internal mammary vessels are the most common recipient vessels in free flap breast reconstruction. The literature on internal mammary vascular anatomy is limited by small sample sizes, cadaveric studies, or intraoperative changes. The purpose of this study is to analyze internal mammary anatomy using computed tomographic angiography. A retrospective review of 110 consecutive computed tomographic angiography studies of female patients was performed. Measurements of vessel caliber, distance of internal mammary vessels to sternum, location of internal mammary vein bifurcation, intercostal space height, and chest width were analyzed. Patient demographics and comorbidities were reviewed. The right internal mammary artery and vein were larger than the left in all intercostal spaces (p = 0.02 and p breast reconstruction. On average, the internal mammary vein bifurcates at the third intercostal space; patients with larger chest widths and body mass index had larger caliber internal mammary vessels, and 25% of patients had third intercostal space <1.5 cm and, thus, may not be suitable candidates for rib-sparing techniques.

  20. An Human-Computer Interactive Augmented Reality System for Coronary Artery Diagnosis Planning and Training.

    Science.gov (United States)

    Li, Qiming; Huang, Chen; Lv, Shengqing; Li, Zeyu; Chen, Yimin; Ma, Lizhuang

    2017-09-02

    In order to let the doctor carry on the coronary artery diagnosis and preoperative planning in a more intuitive and more natural way, and to improve the training effect for interns, an augmented reality system for coronary artery diagnosis planning and training (ARS-CADPT) is designed and realized in this paper. At first, a 3D reconstruction algorithm based on computed tomographic (CT) images is proposed to model the coronary artery vessels (CAV). Secondly, the algorithms of static gesture recognition and dynamic gesture spotting and recognition are presented to realize the real-time and friendly human-computer interaction (HCI), which is the characteristic of ARS-CADPT. Thirdly, a Sort-First parallel rendering and splicing display subsystem is developed, which greatly expands the capacity of student users. The experimental results show that, with the use of ARS-CADPT, the reconstruction accuracy of CAV model is high, the HCI is natural and fluent, and the visual effect is good. In a word, the system fully meets the application requirement.

  1. Association of Coronary Perivascular Adipose Tissue Inflammation and Drug-Eluting Stent-Induced Coronary Hyperconstricting Responses in Pigs: (18)F-Fluorodeoxyglucose Positron Emission Tomography Imaging Study.

    Science.gov (United States)

    Ohyama, Kazuma; Matsumoto, Yasuharu; Amamizu, Hirokazu; Uzuka, Hironori; Nishimiya, Kensuke; Morosawa, Susumu; Hirano, Michinori; Watabe, Hiroshi; Funaki, Yoshihito; Miyata, Satoshi; Takahashi, Jun; Ito, Kenta; Shimokawa, Hiroaki

    2017-09-01

    Although coronary perivascular adipose tissue (PVAT) may play important roles as a source of inflammation, the association of coronary PVAT inflammation and coronary hyperconstricting responses remains to be examined. We addressed this important issue in a porcine model of coronary hyperconstricting responses after drug-eluting stent implantation with (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomographic imaging. An everolimus-eluting stent (EES) was randomly implanted in pigs into the left anterior descending or the left circumflex coronary artery while nonstented coronary artery was used as a control. After 1 month, coronary vasoconstricting responses to intracoronary serotonin (10 and 100 μg/kg) were examined by coronary angiography in vivo, followed by in vivo and ex vivo (18)F-FDG positron emission tomographic/computed tomographic imaging. Coronary vasoconstricting responses to serotonin were significantly enhanced at the EES edges compared with the control site (Pinflammation. © 2017 American Heart Association, Inc.

  2. Microwave Tomographic Imaging of Cerebrovascular Accidents by Using High-Performance Computing

    CERN Document Server

    Tournier, P -H; Bonazzoli, M; de Buhan, M; Darbas, M; Dolean, V; Hecht, F; Jolivet, P; Kanfoud, I El; Migliaccio, C; Nataf, F; Pichot, C; Semenov, S

    2016-01-01

    The motivation of this work is the detection of cerebrovascular accidents by microwave tomographic imaging. This requires the solution of an inverse problem relying on a minimization algorithm (for example, gradient-based), where successive iterations consist in repeated solutions of a direct problem. The reconstruction algorithm is extremely computationally intensive and makes use of efficient parallel algorithms and high-performance computing. The feasibility of this type of imaging is conditioned on one hand by an accurate reconstruction of the material properties of the propagation medium and on the other hand by a considerable reduction in simulation time. Fulfilling these two requirements will enable a very rapid and accurate diagnosis. From the mathematical and numerical point of view, this means solving Maxwell's equations in time-harmonic regime by appropriate domain decomposition methods, which are naturally adapted to parallel architectures.

  3. Construction of computer tomographic phantoms and their application in radiology and radiation protection

    Energy Technology Data Exchange (ETDEWEB)

    Zankl, M.; Veit, R.; Williams, G.; Schneider, K.; Fendel, H.; Petoussi, N.; Drexler, G.

    1988-05-01

    In order to assess human organ doses for risk estimates under natural and man made radiation exposure conditions, human phantoms have to be used. As an improvement to the mathematical anthropomorphic phantoms, a new family of phantoms is proposed, constructed from Computer Tomographic (CT) data. A technique is developed which allows any physical phantom to be converted into computer files to be used for several applications. The new human phantoms present advantages towards the location and shape of the organs, in particular the hard bone and bone marrow. The CT phantoms were used to construct three dimensional images of high resolution; some examples are given and their potential is discussed. The use of CT phantoms is also demonstrated to assess accurately the proportion of bone marrow in the skeleton. Finally, the use of CT phantoms for Monte Carlo (MC) calculations of doses resulting from various photon exposures in radiology and radiation protection is discussed.

  4. Non-Hodgkin lymphoma: computed tomographic demonstration of unusual extranodal involvement

    Energy Technology Data Exchange (ETDEWEB)

    Glazer, H.S.; Lee, J.K.T.; Balfe, D.M.; Mauro, M.A.; Griffith, R.; Sagel, S.S.

    1983-10-01

    With the advent of computed tomography, lymphomatous involvement of sites other than lymph nodes is being seen with increasing frequency. Review of computed tomographic scans in 400 patients with newly diagnosed or recurrent non-Hodgkin lymphoma revealed 37 patients to have involvement of 56 unusual sites below the diaphragm: psoas/iliacus muscle (16 patients), kidney (13 patients), pancreas (5 patients), adrenal (4 patients), skin/subcutaneous tissue (4 patients), abdominal wall musculature (4 patients), peritoneum (4 patients), omentum (3 patients), and female reproductive tract (3 patients). These were mostly seen in patients with lymphomas of diffuse architecture, especially diffuse histiocytic lymphoma. Concomitant retroperitoneal and/or mesenteric adenopathy was very common; extraodal involvement was rarely the only site of initial or recurrent lymphoma.

  5. Non-Hodgkin lymphoma: computed tomographic demonstration of unusual extranodal involvement.

    Science.gov (United States)

    Glazer, H S; Lee, J K; Balfe, D M; Mauro, M A; Griffith, R; Sagel, S S

    1983-10-01

    With the advent of computed tomography, lymphomatous involvement of sites other than lymph nodes is being seen with increasing frequency. Review of computed tomographic scans in 400 patients with newly diagnosed or recurrent non-Hodgkin lymphoma revealed 37 patients to have involvement of 56 unusual sites below the diaphragm: psoas/iliacus muscle (16 patients), kidney (13 patients), pancreas (5 patients), adrenal (4 patients), skin/subcutaneous tissue (4 patients), abdominal wall musculature (4 patients), peritoneum (4 patients), omentum (3 patients), and female reproductive tract (3 patients). These were mostly seen in patients with lymphomas of diffuse architecture, especially diffuse histiocytic lymphoma. Concomitant retroperitoneal and/or mesenteric adenopathy was very common; extranodal involvement was rarely the only site of initial or recurrent lymphoma.

  6. Experimental Actinobacillus pleuropneumoniae challenge in swine: Comparison of computed tomographic and radiographic findings during disease

    Directory of Open Access Journals (Sweden)

    Brauer Carsten

    2012-04-01

    Full Text Available Abstract Background In pigs, diseases of the respiratory tract like pleuropneumonia due to Actinobacillus pleuropneumoniae (App infection have led to high economic losses for decades. Further research on disease pathogenesis, pathogen-host-interactions and new prophylactic and therapeutic approaches are needed. In most studies, a large number of experimental animals are required to assess lung alterations at different stages of the disease. In order to reduce the required number of animals but nevertheless gather information on the nature and extent of lung alterations in living pigs, a computed tomographic scoring system for quantifying gross pathological findings was developed. In this study, five healthy pigs served as control animals while 24 pigs were infected with App, the causative agent of pleuropneumonia in pigs, in an established model for respiratory tract disease. Results Computed tomographic (CT findings during the course of App challenge were verified by radiological imaging, clinical, serological, gross pathology and histological examinations. Findings from clinical examinations and both CT and radiological imaging, were recorded on day 7 and day 21 after challenge. Clinical signs after experimental App challenge were indicative of acute to chronic disease. Lung CT findings of infected pigs comprised ground-glass opacities and consolidation. On day 7 and 21 the clinical scores significantly correlated with the scores of both imaging techniques. At day 21, significant correlations were found between clinical scores, CT scores and lung lesion scores. In 19 out of 22 challenged pigs the determined disease grades (not affected, slightly affected, moderately affected, severely affected from CT and gross pathological examination were in accordance. Disease classification by radiography and gross pathology agreed in 11 out of 24 pigs. Conclusions High-resolution, high-contrast CT examination with no overlapping of organs is superior to

  7. Coronary Computed Tomography Angiography Derived Fractional Flow Reserve and Plaque Stress

    DEFF Research Database (Denmark)

    Nørgaard, Bjarne Linde; Leipsic, Jonathon; Koo, Bon-Kwon;

    2016-01-01

    Fractional flow reserve (FFR) measured during invasive coronary angiography is an independent prognosticator in patients with coronary artery disease and the gold standard for decision making in coronary revascularization. The integration of computational fluid dynamics and quantitative anatomic...

  8. Influence of Adaptive Statistical Iterative Reconstruction on coronary plaque analysis in coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Precht, Helle; Kitslaar, Pieter H; Broersen, Alexander

    2016-01-01

    PURPOSE: The purpose of this study was to study the effect of iterative reconstruction (IR) software on quantitative plaque measurements in coronary computed tomography angiography (CCTA). METHODS: Thirty patients with a three clinical risk factors for coronary artery disease (CAD) had one CCTA...... performed. Images were reconstructed using FBP, 30% and 60% adaptive statistical IR (ASIR). Coronary plaque analysis was performed as per patient and per vessel (LM, LAD, CX and RCA) measurements. Lumen and vessel volumes and plaque burden measurements were based on automatic detected contours in each...

  9. Optical tomographic detection of rheumatoid arthritis with computer-aided classification schemes

    Science.gov (United States)

    Klose, Christian D.; Klose, Alexander D.; Netz, Uwe; Beuthan, Jürgen; Hielscher, Andreas H.

    2009-02-01

    A recent research study has shown that combining multiple parameters, drawn from optical tomographic images, leads to better classification results to identifying human finger joints that are affected or not affected by rheumatic arthritis RA. Building up on the research findings of the previous study, this article presents an advanced computer-aided classification approach for interpreting optical image data to detect RA in finger joints. Additional data are used including, for example, maximum and minimum values of the absorption coefficient as well as their ratios and image variances. Classification performances obtained by the proposed method were evaluated in terms of sensitivity, specificity, Youden index and area under the curve AUC. Results were compared to different benchmarks ("gold standard"): magnet resonance, ultrasound and clinical evaluation. Maximum accuracies (AUC=0.88) were reached when combining minimum/maximum-ratios and image variances and using ultrasound as gold standard.

  10. Ultrasonographic and computed tomographic findings of hemorrhagic cholecystitis; report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bum Soo; Byun, Jae Young; Shinn, Kyung Sub [Catholic Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Jong Woo [Kangnung Dongin Hospital, Kangnung (Korea, Republic of)

    1996-01-01

    Hemorrhagic cholecystitis(HC) is a rare complication of gallbladder(GB) disease characterized by mucosal and intraluminal hemorrhage of the GB. We report ultrasonographic(US) and computed tomographic(CT) findings of two cases of HC. Hemorrhagic fluid filled in the inflamed GB lumen was initially seen as homogeneous hyperdense and hyperattenuated lesion on both US and CT, respectively. As resolution of the hematoma and gangrenous change of the GB wall progress, US showed inhomogeneous mixed echogenic lesion in the GB having partially indistinct border, mimicking an invasive mass. At this stage, CT still showed homogeneous hyperdense hematoma and a small amount of fluid in the GB, without evidence of contrast enhancement.

  11. Evaluation of myocardial bridging by coronary computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Marcio Vinicius Lins; Rabelo, Daniel Rocha; Siqueira, Maria Helena Albernaz, E-mail: marciovlbarros@uol.com.br [Hospital Mater Dei, Belo Horizonte, MG (Brazil); Garretto, Luiza Samarane; Paula, Marcela Mascarenhas De; Carvalho, Marina Oliveira; Alves, Marina Rangel Moreira Barros [Faculdade de Saude e Ecologia Humana (FASEH), Vespasiano, MG (Brazil)

    2013-01-15

    The myocardial bridge (MB) is defined as a segment of an epicardial coronary artery that has an intramural course in the myocardium. Although MB is clinically silent in most cases, has been associated with myocardial ischemia, arrhythmias and sudden death. Coronary conventional angiography is the gold standard for detection of MB, but is invasive and cannot be sufficiently sensitive compared to autopsy studies. Recently, multislice computed tomography of coronary arteries (MCTCA) has allowed the detection of coronary artery course, including PM. Objectives: to evaluate MB prevalence in patients with suspected coronary artery disease undergoing MCTCA and to evaluate the predictive value of this method at medium term. Methods: during the period 2008 to 2011, 498 consecutive patients were examined by TMC for the diagnosis of coronary artery disease, being conducted to evaluate the presence of BM and followed for a mean follow-up of 23 months for the occurrence of cardiovascular hard events (death, hospitalization or revascularization). Results: patients mean age was 55.3 ± 14.2, being male 71.1%. Among the patients, 7.6% (38 patients) showed MB. Main findings included angina pectoris in 40% and a positive stress test in 34%. 34.2% had atherosclerotic disease, and one patient had significant coronary stenosis. During follow-up, no patients showed adverse events. Conclusion: MCTCA is a noninvasive technique with high accuracy in anatomical evaluation of the coronary arteries and may be particularly useful to assess the incidence, location and morphology of myocardial bridging in vivo. (author)

  12. Computed tomographic Assessment of Lateral Lamella of Cribiform Plate and Comparison of Depth of Olfactory Fossa

    Directory of Open Access Journals (Sweden)

    M Bista

    2010-06-01

    Full Text Available INTRODUCTION: Endoscopic sinus surgery is an upcoming branch in rhinological practice but with some major risks since it has to play around the skull base area. Lateral lamella of cribriform plate is the thinnest area of the skull base. Thus this study is undertaken to evaluate the height of lateral lamella of cribriform plate and the depth of olfactory fossae by the help of computed tomographic images. METHODS: Computed tomographic study of 50 patients was done in Advanced Imaging and Diagnostic center, Kathmandu Medical College. Coronal sections at the centre of infra-orbital foramina were taken as reference slide. The height of cribriform plate point was subtracted from the height of medial ethmoidal roof point to measure the length of lateral lamella of cribriform plates on both sides. RESULTS: The median height of LLCP in 100 slides was 2.8 mm. LLCP height was 0 to 3.9 mm in 86 slides, 4 to 7 mm in 12 slides and greater than 7mm in 2 slides. The LLCP length was greater in right side in 28 (56% patients and was greater in left side in 19 (38% patients. It was equal in both sides in only three patients (6%. CONCLUSIONS: As regards the length of LLCP; 0 to 3.9 mm length was most common. The olfactory fossa depth was more in the right side compared to the left side. Thus, right side is more vulnerable to injury during surgery. Thus adequate caution has to be exercised by the rhinological surgeon during endoscopic sinus surgery. Keywords: lateral lamella of Cribriform plate, medical ethmoidal roof, olfactory fossa.

  13. Paradigm of pretest risk stratification before coronary computed tomography

    DEFF Research Database (Denmark)

    Jensen, Jesper Møller; Øvrehus, Kristian; Nielsen, Lene H

    2009-01-01

    BACKGROUND: The optimal method of determining the pretest risk of coronary artery disease as a patient selection tool before coronary multidetector computed tomography (MDCT) is unknown. OBJECTIVE: We investigated the ability of 3 different clinical risk scores to predict the outcome of coronary...... by receiver operating characteristic analysis. The distribution of low-, intermediate-, and high-risk persons, respectively, was established and compared for each of the 3 risk models. RESULTS: Overall, all risk prediction models performed equally well. However, the Duke risk model classified the low......-risk patients more correctly than did the other models (P value of the Duke risk model was superior to the other risk models (P

  14. Removal of ring artifacts in computed tomographic imaging using iterative center weighted median filter.

    Science.gov (United States)

    Sadi, Fazle; Lee, Soo Yeol; Hasan, Md Kamrul

    2010-01-01

    A new iterative center weighted median filter (ICWMF) for ring artifact reduction from the micro-computed tomographic (micro-CT) image is proposed in this paper. The center weight of the median filter is computed based on the characteristic of the ring artifact in the mean curve of the projection data. The filter operates on the deviation of the mean curve to smooth the ring generating peaks and troughs iteratively while preserving the details due to image. A convergence criterion for the iterative algorithm is determined from the distribution of the local deviation computed from the mean curve deviation. The estimate of the mean curve obtained using the ICWMF is used to correct the ring corrupted projection data from which reconstruction gives the ring artifact suppressed micro-CT image. Test results on both the synthetic and real images demonstrate that the ring artifacts can be more effectively suppressed using our method as compared to other ring removal techniques reported in the literature. 2009 Elsevier Ltd. All rights reserved.

  15. Coronary Computed Tomography Angiography Predicts Guidewire Crossing and Success of Percutaneous Intervention for Chronic Total Occlusion: Korean Multicenter CTO CT Registry Score as a Tool for Assessing Difficulty in Chronic Total Occlusion Percutaneous Coronary Intervention.

    Science.gov (United States)

    Yu, Cheol-Woong; Lee, Hyun-Jong; Suh, Jon; Lee, Nae-Hee; Park, Sang-Min; Park, Taek Kyu; Yang, Jeong Hoon; Song, Young Bin; Hahn, Joo-Yong; Choi, Seung Hyuk; Gwon, Hyeon-Cheol; Lee, Sang-Hoon; Choe, Yeon Hyeon; Kim, Sung Mok; Choi, Jin-Ho

    2017-04-01

    We developed a model that predicts difficulty of percutaneous coronary intervention for coronary chronic total occlusion (CTO) using coronary computed tomographic angiography. A total of 684 CTO lesions with preprocedural computed tomographic angiography were enrolled from 4 centers. Data were randomly divided into derivation and validation datasets at 2:1 ratio. The end point was successful guidewire crossing ≤30 minutes, which was met in 50%. The KCCT (Korean Multicenter CTO CT Registry) score was developed based on independent predictors identified by multivariable analysis, which were proximal blunt entry, proximal side branch, bending, occlusion length ≥15 mm, severe calcification, whole luminal calcification, reattempt, and ≥12 months or unknown duration of occlusion. The KCCT score was compared with the other prediction scores, including angiography-based J-CTO, PROGRESS-CTO, CL-score, and CT-based CT-RECTOR. The probability of guidewire crossing ≤30 minutes declined consistently from 100% to 0% according to the KCCT score (PCTO percutaneous coronary intervention. © 2017 American Heart Association, Inc.

  16. Significance of coronary artery calcification demonstrated by computed tomography in detecting coronary artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Shiraki, Teruo; Akiyama, Yoko; Kita, Masahide [Iwakuni national Hospital, Yamaguchi (Japan)] [and others

    2002-02-01

    Serial 27 patients with angina attack were enrolled in this trial. Plain computed tomography (CT) of the chest and coronary angiogram were performed simultaneously. Calcification of main branch of coronary arteies (left main trunk, left anterior desending artery, left circumflex artery, right coronary artery) was judged visually. More than 50% stenosis was defined significant by quantitative coronary angiogram. Correlation between calcified lesions detected by CT and angiographic stenoses showed high specificity and negative predictive value was also high (sensitity=58%, specificity=80%, positive predictive value=27%, negative predictive value=94%, p<0.05). There was no significant correlation between patients with calcification of corornary artery and angiographic stenosis. The present study showed the low probability of significant stenosis without calcification and the high probability with multiple calcified lesions. (author)

  17. Functional testing or coronary computed tomography angiography in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Jørgensen, Mads E.; Andersson, Charlotte; Nørgaard, Bjarne Linde

    2017-01-01

    BACKGROUND: The choice of either anatomical or functional noninvasive testing to evaluate suspected coronary artery disease might affect subsequent clinical management and outcomes. OBJECTIVES: This study analyzed the association of initial noninvasive cardiac testing in outpatients with stable...... symptoms, with subsequent use of medications, invasive procedures, and clinical outcomes. METHODS: We studied patients enrolled in a Danish nationwide register who underwent initial noninvasive cardiac testing with either coronary computed tomography angiography (CTA) or functional testing (exercise.......05), and a lower risk of MI (hazard ratio: 0.71; 95% confidence interval: 0.61 to 0.82). CONCLUSIONS: In stable patients undergoing initial evaluation for suspected coronary artery disease, coronary CTA was associated with greater use of statins, aspirin, and invasive procedures, and higher costs than functional...

  18. The prevalence and characteristics of intra-atrial right coronary artery anomaly in 9,284 patients referred for coronary computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Opolski, Maksymilian P., E-mail: opolski.mp@gmail.com [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Pregowski, Jerzy, E-mail: jerzypregowski74@gmail.com [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Kruk, Mariusz, E-mail: mariuszkruk2000@yahoo.com [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Staruch, Adam D., E-mail: adstarman@gmail.com [Medical University of Warsaw, Warsaw (Poland); Witkowski, Adam, E-mail: witkowski@hbz.pl [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Demkow, Marcin, E-mail: mdemkow@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Hryniewiecki, Tomasz, E-mail: t.hryniewiecki@ikard.pl [Department of Acquired Cardiac Defects, Institute of Cardiology, Warsaw (Poland); Michalek, Piotr, E-mail: p.michalek@ikard.pl [Department of Immediate Diagnostics, Institute of Cardiology, Warsaw (Poland); Ruzyllo, Witold, E-mail: w.ruzyllo@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Kepka, Cezary, E-mail: c.kepka@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland)

    2014-07-15

    Objective: To determine the prevalence, radiologic patterns and clinical characteristics of intra-atrial right coronary artery (IARCA) among adult coronary computed tomography angiography (CCTA) population. Methods: We included 9,284 consecutive subjects who underwent CCTA at a single high-volume center. The presence of IARCA including the number, length and diameter of IARCA segments with accompanying atherosclerosis and coronary anomalies were evaluated. Additionally, clinical characteristics and midterm follow-up of IARCA patients were recorded. Results: The IARCA prevalence was 0.15% (14/9,284) with 15 intra-atrial segments. The intra-atrial segment length ranged from 14 to 53 mm, and the mean diameter proximal to the entry site was 3.3 ± 0.7 mm. IARCA was more often associated with intramuscular course of the left anterior descending coronary artery (29% vs. 4%, p = 0.001) and anomalous origin of the left circumflex artery from the right aortic sinus (14% vs. 0.3%, p = 0.001) compared with non-IARCA cases. The majority of IARCA patients were women (86%) presenting with supraventricular arrhythmia (71%). Compared with computed tomographic population without IARCA, IARCA subjects were younger (60 ± 12 vs. 54 ± 14 years, p = 0.037) and more often women (51% vs. 86%, p = 0.013). At a mean of 20 months follow-up of IARCA patients there were no adverse cardiac events except for supraventricular tachycardia episodes occurring in 36% of subjects. Conclusions: IARCA occurs rarely and is often associated with additional coronary anomalies. The clinical profile of IARCA patients is most often represented by middle-aged women with supraventricular arrhythmia showing favorable midterm prognosis.

  19. Two methods of Haustral fold detection from computed tomographic virtual colonoscopy images

    Science.gov (United States)

    Chowdhury, Ananda S.; Tan, Sovira; Yao, Jianhua; Linguraru, Marius G.; Summers, Ronald M.

    2009-02-01

    Virtual colonoscopy (VC) has gained popularity as a new colon diagnostic method over the last decade. VC is a new, less invasive alternative to the usually practiced optical colonoscopy for colorectal polyp and cancer screening, the second major cause of cancer related deaths in industrial nations. Haustral (colonic) folds serve as important landmarks for virtual endoscopic navigation in the existing computer-aided-diagnosis (CAD) system. In this paper, we propose and compare two different methods of haustral fold detection from volumetric computed tomographic virtual colonoscopy images. The colon lumen is segmented from the input using modified region growing and fuzzy connectedness. The first method for fold detection uses a level set that evolves on a mesh representation of the colon surface. The colon surface is obtained from the segmented colon lumen using the Marching Cubes algorithm. The second method for fold detection, based on a combination of heat diffusion and fuzzy c-means algorithm, is employed on the segmented colon volume. Folds obtained on the colon volume using this method are then transferred to the corresponding colon surface. After experimentation with different datasets, results are found to be promising. The results also demonstrate that the first method has a tendency of slight under-segmentation while the second method tends to slightly over-segment the folds.

  20. Comparison between clinical indicators of transmembrane oxygenator thrombosis and multidetector computed tomographic analysis.

    Science.gov (United States)

    Panigada, Mauro; L'Acqua, Camilla; Passamonti, Serena Maria; Mietto, Cristina; Protti, Alessandro; Riva, Roberto; Gattinoni, Luciano

    2015-04-01

    This study aims to assess whether multidetector computed tomography (MDCT) could accurately confirm the clinical suspicion of transmembrane oxygenator thrombosis (MOT) during extracorporeal membrane oxygenation (ECMO). Twenty-seven oxygenators were examined using MDCT at the end of patient treatment. Transmembrane oxygenator thrombosis was suspected in 15 of them according to the presence of at least 2 of the following clinical indicators: (1) increase in d-dimer, (2) decrease in platelet count, (3) decrease in oxygenator performance, and (4) presence of clots on the surface of the oxygenator. Transmembrane oxygenator thrombosis was confirmed by MDCT in 5 (33%) of them. Transmembrane oxygenator thrombosis was unexpectedly found in 5 (41%) of the remaining 12 oxygenators not suspected for MOT. Eight (80%) of these oxygenators had clots accounting for less than 1% of total volume. Clots were mainly detectable at the apical corner of the oxygenator, most likely due to greater blood stasis. We found a significant increase in d-dimer and in membrane oxygenator shunt and a decrease in platelet count from the start to the discontinuation of ECMO. Hemostatic abnormalities significantly reverted 48 hours after oxygenator removal, suggesting the role of ECMO in activation of the coagulation cascade. Multidetector computed tomographic scan could not accurately confirm the clinical suspicion of MOT.

  1. Measurement of facial soft tissues thickness using 3D computed tomographic images

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Ho Gul; Kim, Kee Deog; Shin, Dong Won; Hu, Kyung Seok; Lee, Jae Bum; Park, Hyok; Park, Chang Seo [Yonsei Univ. Hospital, Seoul (Korea, Republic of); Han, Seung Ho [Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2006-03-15

    To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side. The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. There were no statistically significant differences between the direct measurements and those using the 3D images(p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissue thickness more easily in forensic science and anthropology.

  2. Aortic dissection or renal infarction: Multislice computed tomographic angiography can tell

    Directory of Open Access Journals (Sweden)

    Stojanović Miloš

    2012-01-01

    Full Text Available Introduction. Acute renal infarction as a consequence of renal artery occlusion often goes unrecognized, mostly due to the non-specific clinical features. A quick diagnosis, ideally within three hours of presentation, is a key to renal function recovery. Case Outline. A 62-year-old male patient was admitted with a sudden abdominal pain, right flank pain and nausea. He had a diastolic hypertension at admission and his previous medical history showed atrial fibrillation. Initial clinical diagnosis was aortic dissection. Laboratory findings included elevated lactate dehydrogenase (LDH and serum creatinine levels. There were no signs of aortic dissection or aneurismatic lesions registered during a multislice computed tomographic (MSCT angiography. However, MSCT angiography demonstrated left “upper” renal artery thrombosis and renal infarction - avascular area of the upper two thirds of the left kidney sharply demarcated from the surrounding parenchyma. Both kidneys excreted the contrast. Anticoagulant therapy was initiated, along with antiarrythmic and antihypertensive medications. The follow-up by computed tomography was performed after nine weeks, and it showed a partial revascularization of the previously affected area. Conclusion. Concomitant presence of flank/abdominal pain, an increased risk for thromboembolism and an elevated LDH suggested a possibility of renal infarction. MSCT angiography is a non-invasive and accurate method in the diagnosis of renal artery occlusion and the resulting renal infarction.

  3. CORONARY ANGIOGRAPHY WITH DUAL SOURCE COMPUTED TOMOGRAPHY: INITIAL EXPERIENCE

    Institute of Scientific and Technical Information of China (English)

    Zhu-hua Zhang; Wen-min Zhao; Wen-bin Mou; Li-ren Zhang; Wen-ling Zhu; Qi Miao; Qi Fang; Zheng-yu Jin; Shu-yang Zhang; Song-bai Lin; Dong-jing Li; Ling-yan Kong; Yi-ning Wang; Lan Song; Yun Wang

    2007-01-01

    To explore the scan technique and image quality of coronary angiography with dual source computed tomography (CT) without oral metoprolol preparation.Methods Plain and enhanced dual source CT coronary angiography without oral metoprolol preparation was prospectively performed in 600 patients. Calcium scoring with plain scan images as well as multi-planar reconstruction( MPR ), maximum intensity projection (MIP), and volume rendering technique (VRT) reconstruction with enhanced scan images were performed in all cases. The scan technique and post-reconstruction experience was summarized. The image quality was classified as 1 to 4 points, and coronary segments classified according to the American Heart Association standards were evaluated.Results The average calcium score of the 600 cases was 213.6 ± 298.7 (0-3 216. 5). The average heart rate of the enhanced scan was 82.1 ± 16.2 (47-139) bpm. The post-reconstruction methods with which coronary segments could be shown as best as possible consisted of single phase reconstruction method, two or more phases supplemented method, and electrocardiogram editing method. Altogether 8 457 coronary segments were evaluated, among which 97.2% were evaluated as point 1, 1.7% point 2, 0.5% point 3, and0.6% point 4. The coronary segments in 261 cases were completely normal, while 360 segments were diagnosed with < 50% stenosis and 625 segments with ≥50%stenosis.Conclusions Excellent coronary artery image can be obtained with dual source CT in patients with any heart rate without oral metoprolol preparation. Heart rate is not a major source of the artifact, coronary segments can be well shown with single or multiple-phase reconstruction method.

  4. X-ray micro computed tomography for the visualization of an atherosclerotic human coronary artery

    Science.gov (United States)

    Matviykiv, Sofiya; Buscema, Marzia; Deyhle, Hans; Pfohl, Thomas; Zumbuehl, Andreas; Saxer, Till; Müller, Bert

    2017-06-01

    Atherosclerosis refers to narrowing or blocking of blood vessels that can lead to a heart attack, chest pain or stroke. Constricted segments of diseased arteries exhibit considerably increased wall shear stress, compared to the healthy ones. One of the possibilities to improve patient’s treatment is the application of nano-therapeutic approaches, based on shear stress sensitive nano-containers. In order to tailor the chemical composition and subsequent physical properties of such liposomes, one has to know precisely the morphology of critically stenosed arteries at micrometre resolution. It is often obtained by means of histology, which has the drawback of offering only two-dimensional information. Additionally, it requires the artery to be decalcified before sectioning, which might lead to deformations within the tissue. Micro computed tomography (μCT) enables the three-dimensional (3D) visualization of soft and hard tissues at micrometre level. μCT allows lumen segmentation that is crucial for subsequent flow simulation analysis. In this communication, tomographic images of a human coronary artery before and after decalcification are qualitatively and quantitatively compared. We analyse the cross section of the diseased human coronary artery before and after decalcification, and calculate the lumen area of both samples.

  5. Calcium score of small coronary calcifications on multidetector computed tomography

    DEFF Research Database (Denmark)

    Groen, J M; Kofoed, K F; Zacho, M;

    2013-01-01

    Multi detector computed tomography (MDCT) underestimates the coronary calcium score as compared to electron beam tomography (EBT). Therefore clinical risk stratification based on MDCT calcium scoring may be inaccurate. The aim of this study was to assess the feasibility of a new phantom which ena...

  6. Coronary computed tomography - present status and future directions

    NARCIS (Netherlands)

    Apfaltrer, P.; Schoepf, U. J.; Vliegenthart, R.; Rowe, G. W.; Spears, J. R.; Fink, C.; Nance, J. W.

    2011-01-01

    The use of coronary computed tomography angiography (cCTA) is growing rapidly, in large part because of fast-paced technical innovations that have increased diagnostic accuracy while providing new opportunities for radiation dose reduction. cCTA using recent generation CT scanners has been repeatedl

  7. Computational modeling of optical projection tomographic microscopy using the finite difference time domain method.

    Science.gov (United States)

    Coe, Ryan L; Seibel, Eric J

    2012-12-01

    We present a method for modeling image formation in optical projection tomographic microscopy (OPTM) using high numerical aperture (NA) condensers and objectives. Similar to techniques used in computed tomography, OPTM produces three-dimensional, reconstructed images of single cells from two-dimensional projections. The model is capable of simulating axial scanning of a microscope objective to produce projections, which are reconstructed using filtered backprojection. Simulation of optical scattering in transmission optical microscopy is designed to analyze all aspects of OPTM image formation, such as degree of specimen staining, refractive-index matching, and objective scanning. In this preliminary work, a set of simulations is performed to examine the effect of changing the condenser NA, objective scan range, and complex refractive index on the final reconstruction of a microshell with an outer radius of 1.5 μm and an inner radius of 0.9 μm. The model lays the groundwork for optimizing OPTM imaging parameters and triaging efforts to further improve the overall system design. As the model is expanded in the future, it will be used to simulate a more realistic cell, which could lead to even greater impact.

  8. Assessment of Potential Live Kidney Donors and Computed Tomographic Renal Angiograms at Christchurch Hospital

    Directory of Open Access Journals (Sweden)

    Thamer Alsulaiman

    2016-01-01

    Full Text Available Aims. To examine the outcome of potential live kidney donors (PLKD assessment program at Christchurch Hospital and, also, to review findings of Computed Tomographic (CT renal angiograms that led to exclusion in the surgical assessment. Methods. Clinical data was obtained from the database of kidney transplants, Proton. Radiological investigations were reviewed using the hospital database, Éclair. The transplant coordinator was interviewed to clarify information about PLKD who did not proceed to surgery, and a consultant radiologist was interviewed to explain unfavorable findings on CT renal angiograms. Results. 162 PLKD were identified during the period January 04–June 08. Of those, 65 (40% proceeded to have nephrectomy, 15 were accepted and planned to proceed to surgery, 13 were awaiting further assessment, and 69 (42.5% did not proceed to nephrectomy. Of the 162 PLKD, 142 (88% were directed donors. The proportion of altruistic PLKD who opted out was significantly higher than that of directed PLKD (45% versus 7%, P=0.00004. Conclusions. This audit demonstrated a positive experience of live kidney donation at Christchurch Hospital. CT renal angiogram can potentially detect incidental or controversial pathologies in the kidney and the surrounding structures. Altruistic donation remains controversial with higher rates of opting out.

  9. Computed tomographic findings of skeletal muscles in amyotrophic lateral sclerosis (ALS)

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Ryosuke; Imai, Terukuni; Sadashima, Hiromichi; Matsumoto, Sadayuki; Yamamoto, Toru; Kusaka, Hirobumi; Yamasaki, Masahiro; Maya, Kiyomi; Tanabe, Masaya (Kitano Hospital, Osaka (Japan))

    1989-04-01

    We evaluated the Computed Tomographic (CT) findings of skeletal muscles in 12 cases of amyotrophic lateral sclerosis (ALS), 1 case of spinal progressive muscular atrophy (SPMA), and 1 case of Kugelberg-Welander disease. CT examination was performed in the neck, shoulders, abdomen, pelvis, thighs, and lower legs, 15 muscles were selected for evaluation. The following muscles tended to be affected: m. transversospinalis (12 cases were abnormal), m. deltoideus (10), m. subscapularis (10), m. infraspinatus (10), mm. dorsi (12), hamstring muscles (14), m. tibialis anterior (14), and m. triceps surae (14). On the contrary, the following muscles tended to be preserved: m. sternocleidomastoideus (only 7 cases were abnormal), m. psoas major (7), m. gluteus maximus (7), m. rectus femoris (7), m. sartorius (7) and m. gracilis (6). The distribution of the muscles affected showed neither proximal nor distal dominancy. As the disease advanced, however, all the muscles became affected without any severity. CT findings of skeletal muscles in ALS were characterized by muscle atrophy and fat infiltration, which showed a patchy, linear, or moth-eaten appearance. In mildly affected cases, there was muscle atrophy without internal architectual changes. In moderately affected cases, muscle atrophy advanced and internal architectural changes (patchy, linear, and moth-eaten fat infiltration) became evident. In most advanced cases, every muscle showed a ragged appearance because of severe muscle atrophy and internal architectural changes. These findings were well distinguished from those of SPMA, which resembled the CT pattern of primary muscle diseases. (author).

  10. X-rays computed tomographic scans of lower limb and trunk muscles in facioscapulohumeral muscular dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Horikawa, Hirosei; Mano, Yukio; Takayanagi, Tetsuya (Nara Medical Univ., Kashihara (Japan)); Takahashi, Keiichi; Nishio, Hisahide

    1992-10-01

    X-rays computed tomographic (CT) scans of muscles of the lower limbs and the trunk in 14 patients with facioscapulohumeral muscular dystrophy (FSH) were studied. The CT scans showed that the affected muscles were decreased in density and size. The laterality of muscular involvement was sometimes observed. The muscular lesions in the lower limbs showed proximal distribution. In the thigh, the hamstrings were affected first, the adductor muscles second, and then the muscular involvement progressed to the quadriceps femoris muscle. In the lower leg, the gastrocnemius and soleus muscles were relatively spared as compared with the tibialis anterior muscle. In the lumbar girdle, the abdominal muscles were involved first, the gluteal muscles second, the back muscles third, and the psoas major muscle were relatively spared. The muscular weakness of this distribution exacerbated lumbar lordosis. The neck muscles were less affected than those of the lumbar girdle. The CT scans in FSH demonstrated the characteristic pattern of muscular involvement, which differed from the inherited muscular diseases such as Duchenne muscular dystrophy, myotonic dystrophy, and others. (author).

  11. Utility of Computed Tomographic Enteroclysis/Enterography for the Assessment of Mucosal Healing in Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Shinichi Hashimoto

    2013-01-01

    Full Text Available Aim. When determining therapeutic strategy, it is important to diagnose small intestinal lesions in Crohn's disease (CD precisely and to evaluate mucosal healing as well as clinical remission in CD. The purpose of this study was to compare findings from computed tomographic enteroclysis/enterography (CTE with those from the mucosal surface and to determine whether the state of mucosal healing can be determined by CTE. Materials and Methods. Of the patients who underwent CTE for CD, 39 patients were examined whose mucosal findings could be confirmed by colonoscopy, capsule endoscopy, balloon endoscopy, or with the resected surgical specimens. Results. According to the CTE findings, patients were determined to be in the active CD group (n=31 or inactive CD group (n=8. The proportion of previous surgery, clinical remission, stenosis, and CDAI score all showed significant difference between groups. Mucosal findings showed an association with ulcer in 93.6% of active group patients but in only 12.5% of inactive group patients (P<0.0001, whereas mucosal healing was found in 62.5% of inactive group patients but in only 3.2% of active group patients (P<0.0001. Conclusion. CTE appeared to be a useful diagnostic method for assessment of mucosal healing in Crohn's disease.

  12. Value of computed tomographic angiography in neck and extremity pediatric vascular trauma.

    Science.gov (United States)

    Hogan, Anthony R; Lineen, Edward B; Perez, Eduardo A; Neville, Holly L; Thompson, William R; Sola, Juan E

    2009-06-01

    We sought to define the sensitivity and specificity of computed tomographic angiography (CTA) in pediatric vascular injuries. All neck and extremity CTAs performed in pediatric patients at a level 1 trauma center were reviewed from 2001 to 2007. Overall, 78 patients were identified with an average age of 15.0 +/- 4.0 (0-18 years). Males outnumbered females 3.6:1. CTA was performed for 41 penetrating and 37 blunt traumas. Most penetrating injuries were due to missile wounds (71%) or stab wounds (17%). Eleven major vascular injuries resulted from penetrating trauma. For penetrating trauma, CTA was 100% sensitive and 93% specific. CTA for penetrating trauma had a positive predictive value (PPV) of 85% and negative predictive value (NPV) of 100%. Most blunt injuries were due to motor vehicle accidents (57%), followed by pedestrian hit by car (27%). Eight major vascular injuries resulted from blunt trauma. For blunt trauma, CTA was 88% sensitive and 100% specific. CTA for blunt trauma had a PPV of 100% and an NPV of 97%. The accuracy for penetrating and blunt trauma was 95% and 97%, respectively. CTA is highly sensitive, specific, and accurate for pediatric neck and extremity vascular trauma.

  13. Computed tomographic findings and treatment of a bull with pituitary gland abscess.

    Science.gov (United States)

    Braun, Ueli; Malbon, Alexandra; Kochan, Manon; Riond, Barbara; Janett, Fredi; Iten, Cornelia; Dennler, Matthias

    2017-01-13

    In cattle, the prognosis of brain abscess is unfavourable and treatment is therefore not recommended. To the knowledge of the authors, there has been no report of successful treatment of a brain abscess in cattle.This report describes the clinical, computed tomographic and postmortem findings in a Holstein-Friesian bull with a hypophyseal abscess. The main clinical findings were generalised ataxia, ptyalism, prolapse of the tongue, dropped jaw, dysphagia, head tilt and unilateral ptosis. Cerebrospinal fluid evaluation revealed 2437 leukocytes/µl and severe pleocytosis. CT examination of the head showed a cavitary lesion consistent with an abscess in the hypophysis. Treatment consisted of gentamicin and flunixin meglumine for 3 days and amoxicillin for 40 days. The neurological signs resolved within 8 days of the start of treatment. The bull was slaughtered 11 months later because of infertility, and a postmortem examination was carried out. Histologically, a mild chronic non suppurative meningoencephalitis restricted to the ventral diencephalon was diagnosed. In addition, there was mild to moderate multifocal chronic lymphoplasmacytic hypophysitis with mild multifocal fibrosis. This case report stresses the significance of CT in confirming the clinical and laboratory diagnosis of central nervous system disorders in cattle and for localising brain lesions. Treatment of the brain abscess resulted, with respect to the central nervous disorder, in a successful outcome and was encouraging considering that most cases have an unfavourable prognosis.

  14. Thoracic pathologies on scout views and bolus tracking slices for computed tomographic cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Groth, M.; Fiehler, J.; Buhk, J.H. [University Medical Center Hamburg-Eppendorf (Germany). Dept. of Diagnostic and Interventional Neuroradiology; Henes, F.O. [University Medical Center Hamburg-Eppendorf (Germany). Dept. of Diagnostic and Interventional Radiology

    2015-08-15

    To evaluate the incidence of additional thoracic pathologic findings (TPF) detected on scout views and corresponding bolus tracking slices (SVBT) for computed tomographic cerebral angiography (CTCA) and to test the reliability and accuracy of these findings. The study collective included 505 consecutive patients who underwent multidetector CTCA. Appendant SVBT of all patients were reviewed for any pathologic findings and patient medical reports were analyzed, if any medical treatment was initiated for the detected pathologic findings. In 18 patients thoracic CT scans were performed in the same session. These were additionally reviewed by two blinded observers to test for intra- and interobserver reliability as well as for accuracy of detecting thoracic pathologies on SVBT. TPF were detected in 165 (33 %) SVBT. The five most common pathologic findings were: pleural effusion, 12 %; pneumonia, 8 %; atelectasis/dystelecatsis, 6 %; pericardial effusion, 2 % and elevated diaphragm, 1 %. For 48 % of these findings medical treatment was initiated. SVBT showed a sensitivity of 53 %, a specificity of 99 %, a positive predictive value of 89 %, a negative predictive value of 94 % and accuracy of 94 % for the detection of TPF. The intraobserver reliability was very good and the interobserver reliability showed moderate agreement. SVBT for CTCA should be reviewed with care by radiologists, since additional TPF can affect patient management. Nevertheless, despite a high specificity of SVBT for detecting TPF, an only moderate sensitivity has to be taken into account.

  15. Assessment of Potential Live Kidney Donors and Computed Tomographic Renal Angiograms at Christchurch Hospital.

    Science.gov (United States)

    Alsulaiman, Thamer; Mark, Stephen; Armstrong, Sarah; McGregor, David

    2016-01-01

    Aims. To examine the outcome of potential live kidney donors (PLKD) assessment program at Christchurch Hospital and, also, to review findings of Computed Tomographic (CT) renal angiograms that led to exclusion in the surgical assessment. Methods. Clinical data was obtained from the database of kidney transplants, Proton. Radiological investigations were reviewed using the hospital database, Éclair. The transplant coordinator was interviewed to clarify information about PLKD who did not proceed to surgery, and a consultant radiologist was interviewed to explain unfavorable findings on CT renal angiograms. Results. 162 PLKD were identified during the period January 04-June 08. Of those, 65 (40%) proceeded to have nephrectomy, 15 were accepted and planned to proceed to surgery, 13 were awaiting further assessment, and 69 (42.5%) did not proceed to nephrectomy. Of the 162 PLKD, 142 (88%) were directed donors. The proportion of altruistic PLKD who opted out was significantly higher than that of directed PLKD (45% versus 7%, P = 0.00004). Conclusions. This audit demonstrated a positive experience of live kidney donation at Christchurch Hospital. CT renal angiogram can potentially detect incidental or controversial pathologies in the kidney and the surrounding structures. Altruistic donation remains controversial with higher rates of opting out.

  16. Inspiratory and expiratory computed tomographic volumetry for lung volume reduction surgery.

    Science.gov (United States)

    Morimura, Yuki; Chen, Fengshi; Sonobe, Makoto; Date, Hiroshi

    2013-06-01

    Three-dimensional (3D) computed tomographic (CT) volumetry has been introduced into the field of thoracic surgery, and a combination of inspiratory and expiratory 3D-CT volumetry provides useful data on regional pulmonary function as well as the volume of individual lung lobes. We report herein a case of a 62-year-old man with severe emphysema who had undergone lung volume reduction surgery (LVRS) to assess this technique as a tool for the evaluation of regional lung function and volume before and after LVRS. His postoperative pulmonary function was maintained in good condition despite a gradual slight decrease 2 years after LVRS. This trend was also confirmed by a combination of inspiratory and expiratory 3D-CT volumetry. We confirm that a combination of inspiratory and expiratory 3D-CT volumetry might be effective for the preoperative assessment of LVRS in order to determine the amount of lung tissue to be resected as well as for postoperative evaluation. This novel technique could, therefore, be used more widely to assess local lung function.

  17. Quantitative analysis of periapical lesions on cone beam computed tomograph and periapical radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hoa; Lee, Wan; Kim, Kyung Soo; Roh, Young Chea; Lee, Byung Do [Department of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Kim, De Sok [Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Deajeon (Korea, Republic of)

    2009-03-15

    To detect the progression of experimentally induced periapical lesions on periapical radiograph and cone beam computed tomograph (CBCT) by quantitative analysis. After the removal of coronal pulps from premolars of two Beagle dogs, the root canals of premolars were exposed to oral environment during one week and then sealed for 70 days. Digital periapical radiographs and CBCTs were taken at baseline and every 7 days for 77 days after pulp exposure. We examined occurrence and areas of periapical bone resorption. Three comparative groups of CBCT radiographs were prepared by average projection of thin slabs with different bucco-lingual thicknesses (0.1, 3.0, and 8.0 mm) using a 3D visualization software. Radiographic densities were compensated by image normalization. Digital images were processed with mathematical morphology operations. The radiographic density and morphological features of periapical lesions were compared among three groups of CBCT in different time points. In the CBCT group with 0.1 mm thickness, radiographic density (p<0.05) and trabecular bone area (p<0.01) were significantly decreased at the fifth week. However, in the CBCT groups with 3 mm and 8 mm thickness and periapical radiographs, none of densitometric and morphological features showed any significant differences in different time points. Radiographic density of periapical lesion showed increasing tendency at the eleventh week after pulp exposure. Radiographic detection of periapical lesions was possible at the fifth week after pulp contamination by quantitative method and was affected by buccolingual bone thickness.

  18. Computed tomographic features of 23 sporadic cases with Legionella pneumophila pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Yu Hui [Department of Respiratory Diseases, Shanghai Pneumology Hospital, Tongji University, Shanghai (China); Higa, Futoshi; Hibiya, Kenji; Furugen, Makoto [Department of Medicine and Therapeutics, Control and Prevention of Infectious Diseases (First Department of Internal Medicine), Faculty of Medicine, University of the Ryukyus, Okinawa (Japan); Sato, Yoko [Tomishiro Chuo Hospital, Okinawa (Japan); Shinzato, Takashi [Nakagami General Hospital, Okinawa (Japan); Haranaga, Shusaku; Yara, Satomi; Tateyama, Masao [Department of Medicine and Therapeutics, Control and Prevention of Infectious Diseases (First Department of Internal Medicine), Faculty of Medicine, University of the Ryukyus, Okinawa (Japan); Fujita, Jiro, E-mail: fujita@med.u-ryukyu.ac.j [Department of Medicine and Therapeutics, Control and Prevention of Infectious Diseases (First Department of Internal Medicine), Faculty of Medicine, University of the Ryukyus, Okinawa (Japan); Li, Huiping [Department of Respiratory Diseases, Shanghai Pneumology Hospital, Tongji University, Shanghai (China)

    2010-06-15

    Objective: To describe the chest computed tomographic (CT) findings of Legionella pneumophila pneumonia. Methods: CT scans obtained from 23 sporadic cases of L. pneumophila pneumonia were retrospectively reviewed. Chest CT findings were analyzed with regard to the patterns and distributions of pulmonary abnormalities. We also analyzed the histopathology of lungs from guinea pigs with experimentally induced L. pneumophila pneumonia. Results: Consolidation and ground-glass opacity (GGO) were the main findings of CT scans in L. pneumophila pneumonia. The distribution of opacities was categorized as non-segmental (n = 20) and segmental (n = 4). Non-segmental distribution may follow an onset of segmental distribution. Pleural effusion was observed in 14 (58.3%) patients, of which 13 were accompanied with non-segmental distribution. Abscess formation was observed in only one immunocompromised patient. In the animal pneumonia model, the lesions comprised of terminal bronchioles, alveolar spaces, and interstitia. Small bacilli were observed to be contained by many macrophages within the alveoli. Conclusion: Non-segmental distribution was significantly more frequent than segmental distribution in L. pneumophila pneumonia. It is possible that L. pneumophila infection initially results in segmental pneumonia, which progresses to typical non-segmental distribution.

  19. Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers

    Institute of Scientific and Technical Information of China (English)

    Gitsios; Gitsioudis; Hugo; A; Katus; Grigorios; Korosoglou

    2014-01-01

    Chronic inflammatory mechanisms in the arterial wall lead to atherosclerosis,and include endothelial cell damage,inflammation,apoptosis,lipoprotein deposition,calcification and fibrosis.Cardiac computed tomography angiography(CCTA)has been shown to be a promising tool for non-invasive assessment of theses specific compositional and structural changes in coronary arteries.This review focuses on the technical background of CCTA-based quantitative plaque characterization.Furthermore,we discuss the available evidence for CCTA-based plaque characterization and the potential role of CCTA for risk stratification of patients with coronary artery disease.

  20. Arterial Obstruction on Computed Tomographic or Magnetic Resonance Angiography and Response to Intravenous Thrombolytics in Ischemic Stroke.

    Science.gov (United States)

    Mair, Grant; von Kummer, Rüdiger; Adami, Alessandro; White, Philip M; Adams, Matthew E; Yan, Bernard; Demchuk, Andrew M; Farrall, Andrew J; Sellar, Robin J; Sakka, Eleni; Palmer, Jeb; Perry, David; Lindley, Richard I; Sandercock, Peter A G; Wardlaw, Joanna M

    2017-02-01

    Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase. Readers, masked to clinical, treatment, and outcome data, assessed prerandomization computed tomographic angiography and magnetic resonance angiography for presence, extent, location, and completeness of obstruction and collaterals. We compared angiography findings to 6-month functional outcome (Oxford Handicap Scale) and tested for interactions with alteplase, using ordinal regression in adjusted analyses. We also meta-analyzed all available angiography data from other randomized controlled trials of intravenous thrombolytics. In IST-3, 300 patients had prerandomization angiography (computed tomographic angiography=271 and magnetic resonance angiography=29). On multivariable analysis, more extensive angiographic obstruction and poor collaterals independently predicted poor outcome (P1 indicates benefit) in patients with (odds ratio, 2.07; 95% confidence interval, 1.18-3.64; P=0.011) versus without (odds ratio, 0.88; 95% confidence interval, 0.58-1.35; P=0.566) arterial obstruction (P for interaction 0.017). Intravenous thrombolytics provide benefit to stroke patients with computed tomographic angiography or magnetic resonance angiography evidence of arterial obstruction, but the sample was underpowered to demonstrate significant treatment benefit or harm among patients with apparently patent arteries. URL: http://www.isrctn.com. Unique identifier: ISRCTN25765518. © 2016 The Authors.

  1. Consistency between computed tomographic enterography and enteroscopy in the detection of small intestinal Crohn’s disease

    Institute of Scientific and Technical Information of China (English)

    徐安涛

    2014-01-01

    Objective To evaluate the diagnostic value of computed tomographic enterography(CTE)in the detection of small intestinal Crohn’s disease(CD)with balloon-assisted enterography(BAE)as reference standard.Methods The CTE and BAE data of 81 patients with CD were retrospectively analyzed.The small intestine of CD patients was divided into four segments,such as duode-

  2. Arterial Obstruction on Computed Tomographic or Magnetic Resonance Angiography and Response to Intravenous Thrombolytics in Ischemic Stroke

    Science.gov (United States)

    Mair, Grant; von Kummer, Rüdiger; Adami, Alessandro; White, Philip M.; Adams, Matthew E.; Yan, Bernard; Demchuk, Andrew M.; Farrall, Andrew J.; Sellar, Robin J.; Sakka, Eleni; Palmer, Jeb; Perry, David; Lindley, Richard I.; Sandercock, Peter A.G.

    2017-01-01

    Background and Purpose— Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. Methods— We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase. Readers, masked to clinical, treatment, and outcome data, assessed prerandomization computed tomographic angiography and magnetic resonance angiography for presence, extent, location, and completeness of obstruction and collaterals. We compared angiography findings to 6-month functional outcome (Oxford Handicap Scale) and tested for interactions with alteplase, using ordinal regression in adjusted analyses. We also meta-analyzed all available angiography data from other randomized controlled trials of intravenous thrombolytics. Results— In IST-3, 300 patients had prerandomization angiography (computed tomographic angiography=271 and magnetic resonance angiography=29). On multivariable analysis, more extensive angiographic obstruction and poor collaterals independently predicted poor outcome (PHandicap Scale (P≥0.075) in IST-3. In meta-analysis (5 trials of alteplase or desmoteplase, including IST-3, n=591), there was a significantly increased benefit of thrombolytics on outcome (odds ratio>1 indicates benefit) in patients with (odds ratio, 2.07; 95% confidence interval, 1.18–3.64; P=0.011) versus without (odds ratio, 0.88; 95% confidence interval, 0.58–1.35; P=0.566) arterial obstruction (P for interaction 0.017). Conclusions— Intravenous thrombolytics provide benefit to stroke patients with computed tomographic angiography or magnetic resonance angiography evidence of arterial obstruction, but the sample was underpowered to demonstrate significant

  3. Clinical usefulness of facial soft tissues thickness measurement using 3D computed tomographic images

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    Jeong, Ho Gul; Kim, Kee Deog; Hu, Kyung Seok; Lee, Jae Bum; Park, Hyok [Maxtron Inc., Seoul (Korea, Republic of); Han, Seung Ho [Catholic Univ. of Korea, Seoul (Korea, Republic of); Choi, Seong Ho; Kim, Chong Kwan; Park, Chang Seo [Yonsei Univ., Seoul (Korea, Republic of)

    2006-06-15

    To evaluate clinical usefulness of facial soft tissue thickness measurement using 3D computed tomographic images. One cadaver that had sound facial soft tissues was chosen for the study. The cadaver was scanned with a Helical CT under following scanning protocols about slice thickness and table speed: 3 mm and 3 mm/sec, 5 mm and 5 mm/sec, 7 mm and 7 mm/sec. The acquired data were reconstructed 1.5, 2.5, 3.5 mm reconstruction interval respectively and the images were transferred to a personal computer. Using a program developed to measure facial soft tissue thickness in 3D image, the facial soft tissue thickness was measured. After the ten-time repeation of the measurement for ten times, repeated measure analysis of variance (ANOVA) was adopted to compare and analyze the measurements using the three scanning protocols. Comparison according to the areas was analysed by Mann-Whitney test. There were no statistically significant intraobserver differences in the measurements of the facial soft tissue thickness using the three scanning protocols (p>0.05). There were no statistically significant differences between measurements in the 3 mm slice thickness and those in the 5 mm, 7 mm slice thickness (p>0.05). There were statistical differences in the 14 of the total 30 measured points in the 5 mm slice thickness and 22 in the 7 mm slice thickness. The facial soft tissue thickness measurement using 3D images of 7 mm slice thickness is acceptable clinically, but those of 5 mm slice thickness is recommended for the more accurate measurement.

  4. [¹³N]Ammonia positron emission tomographic/computed tomographic imaging targeting glutamine synthetase expression in prostate cancer.

    Science.gov (United States)

    Shi, Xinchong; Zhang, Xiangsong; Yi, Chang; Liu, Yubo; He, Qiao

    2014-01-01

    The purpose of this study was to investigate the expression of glutamine synthetase (GS) in prostate cancer (PCa) and the utility of [¹³N]ammonia positron emission tomography/computed tomography (PET/CT) in the imaging of PCa. The uptake ratio of [¹³N]ammonia and the expression of GS in PC3 and DU145 cells was measured. Thirty-four patients with suspected PCa underwent [¹³N]ammonia PET/CT imaging, and immunohistochemistry staining of GS was performed. The uptake of [¹³N]ammonia in PC3 and DU145 cells elevated along with the decrease in glutamine in medium. The expression of GS messenger ribonucleic acid and protein also increased when glutamine was deprived. In biopsy samples, the GS expression scores were significantly higher in PCa tissue than in benign tissues (p glutamine. GS is the main reason for the uptake of [¹³N]ammonia, and [¹³N]ammonia is a useful tracer for PCa imaging.

  5. High-resolution computed tomographic findings of Aspergillus infection in lung transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    Gazzoni, Fernando Ferreira, E-mail: gazzoni4@gmail.com [Hospital de Clínicas de Porto Alegre, Av. Cristovão Colombo 4105, ap.603-C, Post Code: 90560-005, Porto Alegre, RS (Brazil); Hochhegger, Bruno, E-mail: brunohochhegger@gmail.com [Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS (Brazil); Severo, Luiz Carlos, E-mail: severo@santacasa.tche.br [Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2° andar, Post Code: 90035-003, Porto Alegre, RS (Brazil); Marchiori, Edson, E-mail: edmarchiori@gmail.com [Federal University of Rio de Janeiro, Radiology Department, Av. Pedro Calmon, n° 550 – Cidade Universitária, Post Code: 21941-901, Rio de Janeiro, RJ (Brazil); Pasqualotto, Alessandro, E-mail: acpasqualotto@hotmail.com [Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS (Brazil); Sartori, Ana Paula Garcia, E-mail: ana_sartori@hotmail.com [Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS (Brazil); Schio, Sadi, E-mail: smschio@hotmail.com [Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS (Brazil); Camargo, José, E-mail: jjcamargo@terra.com.br [Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS (Brazil)

    2014-01-15

    Objective: The aim of this study was to assess high-resolution computed tomographic (HRCT) findings at presentation in lung transplant patients diagnosed with pulmonary Aspergillus infection. Materials and methods: We retrospectively reviewed HRCT findings from 23 patients diagnosed with pulmonary aspergillosis. Imaging studies were performed 2–5 days after the onset of symptoms. The patient sample comprised 12 men and 11 women aged 22–59 years (mean age, 43.6 years). All patients had dyspnea, tachypnea, and cough. Diagnoses were established with Platelia Aspergillus enzyme immunoassays for galactomannan antigen detection in bronchoalveolar lavage and recovery of symptoms, and HRCT findings after voriconazole treatment. The HRCT scans were reviewed independently by two observers who reached a consensus decision. Results: The main HRCT pattern, found in 65% (n = 15) of patients, was centrilobular tree-in-bud nodules associated with bronchial thickening. This pattern was described in association with areas of consolidation and ground-glass opacities in 13% (n = 3) of patients. Consolidation and ground-glass opacities were the main pattern in 22% (n = 5) of patients. The pattern of large nodules with and without the halo sign was observed in 13% (n = 3) of patients, and were associated with consolidation and ground-glass opacities in one case. Conclusion: The predominant HRCT findings in lung transplant patients with pulmonary aspergillosis were bilateral bronchial wall thickening and centrilobular opacities with the tree-in-bud pattern. Ground-glass opacities and/or bilateral areas of consolidation were also common findings. Pulmonary nodules with the halo sign were found in only 13% of patients.

  6. Fibromuscular dysplasia in living renal donors: Still a challenge to computed tomographic angiography

    Energy Technology Data Exchange (ETDEWEB)

    Blondin, D., E-mail: blondin@med.uni-duesseldorf.d [Institute of Radiology, University Hospital Duesseldorf, Moorenstr. 5, D-40225 Duesseldorf (Germany); Lanzman, R.; Schellhammer, F. [Institute of Radiology, University Hospital Duesseldorf, Moorenstr. 5, D-40225 Duesseldorf (Germany); Oels, M. [Department of Nephrology (Germany); Grotemeyer, D. [Department of Vascular Surgery and Renal Transplantation (Germany); Baldus, S.E. [Institute of Pathology (Germany); Rump, L.C. [Department of Nephrology (Germany); Sandmann, W. [Department of Vascular Surgery and Renal Transplantation (Germany); Voiculescu, A. [Department of Nephrology (Germany)

    2010-07-15

    Background: Computed tomographic angiography has become the standard evaluating method of potential living renal donors in most centers. Although incidence of fibromuscular dysplasia is low (3.5-6%), this pathology may be relevant for success of renal transplantation. The incidence of FMD in our population of LRD and reliability of CTA for detecting vascular pathology were the aims of this study. Materials and methods: 101 living renal donors, examined between 7/2004 and 9/2008 by CTA, were included in a retrospective evaluation. The examinations were carried out using a 64 Multi-detector CT (Siemens Medical Solutions, Erlangen). The presence or absence of the characteristic signs of fibromuscular dysplasia, as 'string-of-beads' appearance, focal stenosis or aneurysms, were assessed and graded from mild (=1) to severe (=3). Furthermore, vascular anatomy and arterial stenosis were investigated in this study. Retrospective analysis of CTA and ultrasound were compared with operative and histological reports. Results: Four cases of fibromuscular dysplasia (incidence 3.9%) in 101 renal donors were diagnosed by transplanting surgeons and histopathology, respectively. Three cases could be detected by CTA. In one donor even retrospective analysis of CTA was negative. Ten accessory arteries, 14 venous anomalies and 12 renal arteries stenosis due to atherosclerosis were diagnosed by CTA and could be confirmed by the operative report. Conclusion: CTA is sufficient for detection of hemodynamic relevant stenosis and vascular anatomy. Only one patient with a mild form of FMD was under estimated. Therefore, if the CTA shows slightest irregularities which are not typical for atherosclerotic lesions, further diagnostic work up by DSA might still be necessary.

  7. Computed tomographic evaluation of dynamic alteration of the canine lumbosacral intervertebral neurovascular foramina.

    Science.gov (United States)

    Worth, Andrew J; Hartman, Angela; Bridges, Janis P; Jones, Boyd R; Mayhew, Joe I G

    2017-02-01

    To develop a computed tomographic (CT) method to measure the volume of the lumbosacral intervertebral neurovascular foramina (IVF) in dogs, and determine the effect of the range of motion of the lumbosacral (LS) junction on this measurement in German shepherd dogs (GSDs) with degenerative lumbosacral stenosis (DLSS) compared to unaffected controls. In vivo analysis and retrospective case series. Twenty-four working Police GSDs, 12 diagnosed with DLSS and 12 unaffected by DLSS were compared to 10 Greyhounds without DLSS. Three-dimensional renderings of CT data were used to measure the lumbosacral foraminal volume of dogs positioned in dorsal recumbency with the LS junction alternately positioned in extension, neutral position, and flexion. Volumetric analysis of the IVF was found repeatable for the extended and neutral positions (interclass correlation coefficient of 0.89 and 0.8, respectively). The mean lumbosacral IVF volume was decreased by 74% between LS flexion and extension in Greyhounds, compared to 79 and 85% reductions in GSDs unaffected and affected by DLSS, respectively. The lumbosacral IVF volume was decreased by 23% when comparing extended to neutral LS positions in Greyhounds, 29% in unaffected GSDs, and 31% in affected GSDs. IVF volumes were smaller in affected GSDs compared to unaffected GSDs (P < .05) and Greyhounds (P < .01). Positioning the LS junction in full extension decreases the volume of the lumbosacral IVF. This dynamic narrowing was more pronounced in GSDs with signs of DLSS than in GSDs not overtly affected by DLSS. © 2017 The American College of Veterinary Surgeons.

  8. Micro-computed Tomographic Analysis of Mandibular Second Molars with C-shaped Root Canals.

    Science.gov (United States)

    Amoroso-Silva, Pablo Andrés; Ordinola-Zapata, Ronald; Duarte, Marco Antonio Hungaro; Gutmann, James L; del Carpio-Perochena, Aldo; Bramante, Clovis Monteiro; de Moraes, Ivaldo Gomes

    2015-06-01

    The goal of the present study was to evaluate the morphometric aspects of the internal anatomy of the root canal system of mandibular second molars with C-shaped canals. Fifty-two extracted second mandibular molars with C-shaped canals, fused roots, and radicular grooves were selected from a Brazilian population. The samples were scanned with a micro-computed tomographic scanner at a voxel size of 19.6 μm. The root canal cross sections were recorded as C1, C2, C3, and C4 root canal configurations according to the modified Melton classification. Morphometric parameters, including the major and minor diameters of the root canals, the aspect ratio, the roundness, and the tridimensional configuration (merging, symmetric, and asymmetric), were evaluated. The 3-dimensional reconstruction images of the teeth indicated an even distribution within the sample. The analysis of the prevalence of the different cross-sectional configurations of the C-shaped molars revealed that these were predominantly of the C4 and C3 configurations (1 mm from the apex) and the C1 and C2 configurations in the cervical third. According to the morphometric parameters, the C1 and the distal aspect of the C2 configurations exhibited the lowest roundness values and higher values for the area, major diameter, and aspect ratio in the apical third. Mandibular molars with C-shaped root canals exhibited similar distributions of symmetric, asymmetric, and merging type canals. The C1 configuration and the distal aspect of the C2 configuration exhibited the highest area values, low roundness values, and large apical diameters. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. A Cone-Beam Computed Tomographic Study on Mandibular First Molars in a Chinese Subpopulation.

    Science.gov (United States)

    Zhang, Xin; Xiong, Shijiang; Ma, Yue; Han, Ting; Chen, Xinyu; Wan, Fang; Lu, Yating; Yan, Songhe; Wang, Yan

    2015-01-01

    The purpose of this study was to conduct a cone-beam computed tomographic (CBCT) investigation on the root and canal configuration of the mandibular first molars, especially the morphology of the disto-lingual (DL) root, in a Chinese subpopulation. A total of 910 CBCT images of the mandibular first molars were collected from 455 patients who underwent CBCT examinations as a preoperative assessment for implants or orthodontic treatment. The following information was analyzed and evaluated: tooth position, gender, root and root canal number per tooth, root canal type of the mesial root(s) and distal root(s), angle of the DL root canal curvature, distance between two distal canal orifices in the teeth with DL root, and angle of disto-buccal canal orifice-disto-lingual canal orifice-mesio-lingual canal orifice (DB-DL-ML). Most of the mandibular first molars (64.9%, n = 591) had two roots with three root canals, and most of the mesial root canals (87.7%, n = 798) were type VI. The prevalence of the DL root was 22.1% (n = 201). The right side had a higher prevalence of DL root than the left side (p<0.05). Additionally, the curvature of the DL root canal were greater in the bucco-lingual (BL) orientation (30.10°±14.02°) than in the mesio-distal (MD) orientation (14.03°± 8.56°) (p<0.05). Overall there was a high prevalence of DL root in the mandibular first molars, and most of the DL roots were curved in different degrees. This study provided detailed information about the root canal morphology of the mandibular first molars in a Chinese subpopulation.

  10. A Cone-Beam Computed Tomographic Study on Mandibular First Molars in a Chinese Subpopulation.

    Directory of Open Access Journals (Sweden)

    Xin Zhang

    Full Text Available The purpose of this study was to conduct a cone-beam computed tomographic (CBCT investigation on the root and canal configuration of the mandibular first molars, especially the morphology of the disto-lingual (DL root, in a Chinese subpopulation. A total of 910 CBCT images of the mandibular first molars were collected from 455 patients who underwent CBCT examinations as a preoperative assessment for implants or orthodontic treatment. The following information was analyzed and evaluated: tooth position, gender, root and root canal number per tooth, root canal type of the mesial root(s and distal root(s, angle of the DL root canal curvature, distance between two distal canal orifices in the teeth with DL root, and angle of disto-buccal canal orifice-disto-lingual canal orifice-mesio-lingual canal orifice (DB-DL-ML. Most of the mandibular first molars (64.9%, n = 591 had two roots with three root canals, and most of the mesial root canals (87.7%, n = 798 were type VI. The prevalence of the DL root was 22.1% (n = 201. The right side had a higher prevalence of DL root than the left side (p<0.05. Additionally, the curvature of the DL root canal were greater in the bucco-lingual (BL orientation (30.10°±14.02° than in the mesio-distal (MD orientation (14.03°± 8.56° (p<0.05. Overall there was a high prevalence of DL root in the mandibular first molars, and most of the DL roots were curved in different degrees. This study provided detailed information about the root canal morphology of the mandibular first molars in a Chinese subpopulation.

  11. Computed tomographic-guided iodine-125 interstitial implants for malignant thoracic tumors

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Qiming [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); The Department of Radiology, Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan Bei Road, Quanzhou 362000 (China); Chen, Jin; Chen, Qunlin [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Lai, Qingquan; Cai, Siqing [The Department of Radiology, Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan Bei Road, Quanzhou 362000 (China); Luo, Kaidong [The Department of Radiology, Longyan Hosptial of Traditional Chinese Medical, 59 Longteng Middle Road, Longyan 364000 (China); Lin, Zhengyu, E-mail: linsinlan@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China)

    2013-11-01

    Purpose: To evaluate the feasibility and efficacy of percutaneous interstitial brachytherapy using iodine-125 ({sup 125}I) radioactive seeds under computed tomographic (CT) guidance for malignant thoracic tumors. Materials and methods: Forty-one patients (34 males, 7 females; 18–90 years; mean, 63.7 years) with 77 lesions (3 in the mediastinum, 7 in the chest wall, 67 in the lung) underwent percutaneous interstitial implantation of {sup 125}I radioactive seeds under CT guidance. A treatment planning system (TPS) was employed to calculate the number and distribution of seeds preoperatively. An 18-G needle was inserted into the lesions under CT guidance and send the seeds according to TPS. Two patients with mediastinal lesions undergoing seed implantation received an artificial pneumothorax. One patient with lung carcinoma adjacent to the anterior mediastinum underwent seed implantation through the sternum. Follow-up CT was done every 2 months postoperatively. Results: The procedure was successful in all patients. No major procedure-associated death occurred. The mean duration of follow-up was 19.4 ± 1.3 months (3–49 months). A complete response (CR) was seen in 49 lesions (63.6%), partial response (PR) in 9 lesions (11.7%), stable disease (SD) in 12 lesions (12.8%), and progressive disease (PD) in 7 lesions (7.4%). The overall response rate (CR + PR) was 75.3%; the local control rate (CR + PR + SD) was 90.9%. The 1-, 2- and 3-year progression-free rates for local tumors were 91%, 88% and 88%, respectively. The 1-, 2- and 3-year survival rates were 87%, 74% and 68%, respectively. Conclusion: Implantation of CT-guided {sup 125}I seeds is feasible and effective for patients with malignant thoracic tumors.

  12. Role of computed tomographic colonoscopy of postoperative surveillance in patient with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Dae Won Jun; Dong Hoo Lee; Oh Young Lee; Hyun Chul Lim; Sung Joon Kwon; Hang Lak Lee; Byung Chul Yoon; Ho Soon Choi; Joon Soo Hahm; Min Ho Lee

    2007-01-01

    AIM: To examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy (CTC) as well as the feasibility of contrast enhanced CTC in patients with gastric cancer.METHODS: To examine the incidence of colon polyp we selected postoperative 188 gastric cancer patients, which we refer to as the 'colon polyp survey group'. To examine the feasibility of CTC for early detection of colon cancer or advanced colon adenoma, we selected 47 gastric cancer patients (M:F 29:18, mean age 53.8 years), which we call the 'CT colonoscopy group'. All the 47 patients underwent successive CTC and colonoscopy on the same day.RESULTS: Totally 109 colon polyps were observed from 59 out of 188 gastric cancer patients, the incidence rate of colon polyps in gastric cancer patients being 31.4%. The sensitivity of CTC in detecting individuals with at least 1 lesion of any size was 57.1%, the specificity was 72.7%, the positive predictive value was 47.1%, and the negative predictive value was 71.9%. When the cutoff size was decreased to 6 mm, the sensitivity and specificity were 80.0% and 92.9%, respectively, with positive and negative predictive values of 57.1% and 97.5%, respectively. Only one patient was classified as false negative by virtual colonoscopy.CONCLUSION: The diagnostic yield of colorectal polyp was 31.4% in patients with gastric cancer, and contrast enhanced CTC is an acceptable tool for the detection of synchronous colorectal advanced adenoma and postoperative surveillance of gastric cancer patients.

  13. Quantification of left coronary bifurcation angles and plaques by coronary computed tomography angiography for prediction of significant coronary stenosis: A preliminary study with dual-source CT

    Science.gov (United States)

    Cui, Yue; Zeng, Wenjuan; Yu, Jie; Lu, Jing; Hu, Yuannan; Diao, Nan; Liang, Bo; Han, Ping; Shi, Heshui

    2017-01-01

    Purpose To evaluate the diagnostic performance of left coronary bifurcation angles and plaque characteristics for prediction of coronary stenosis by dual-source CT. Methods 106 patients suspected of coronary artery disease undergoing both coronary computed tomography angiography (CCTA) and invasive coronary angiography (CAG) within three months were included. Left coronary bifurcation angles including the angles between the left anterior descending artery and left circumflex artery (LAD-LCx), left main coronary artery and left anterior descending artery (LM-LAD), left main coronary artery and left circumflex artery (LM-LCx) were measured on CT images. CCTA plaque parameters were calculated by plaque analysis software. Coronary stenosis ≥ 50% by CAG was defined as significant. Results 106 patients with 318 left coronary bifurcation angles and 126 vessels were analyzed. The bifurcation angle of LAD-LCx was significantly larger in left coronary stenosis ≥ 50% than stenosis coronary stenosis (OR = 1.423, P = 0.002). In ROC curve analysis, LAD-LCx predicted significant left coronary stenosis with a sensitivity of 66.7%, specificity of 78.4%, positive predictive value of 85.2% and negative predictive value of 55.8%. The lipid plaque volume improved the diagnostic performance of CCTA diameter stenosis (AUC: 0.854 vs. 0.900, P = 0.045) in significant coronary stenosis. Conclusions The bifurcation angle of LAD-LCx could predict significant left coronary stenosis. Wider LAD-LCx is related to non-calcified lesions. Lipid plaque volume could improve the diagnostic performance of CCTA for coronary stenosis prediction. PMID:28346530

  14. Myocardial bridging: evaluation with multislice computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Barros, M.V.L. de; Rabelo, D.R.; Nunes, M.C.P.; Siqueira, M.H.A. [Mater Dei Hospital, Belo Horizonte, MG (Brazil)

    2012-04-15

    Myocardial bridging (MB) is defined as a segment of a major epicardial coronary artery that proceeds intramurally through the myocardium beneath the muscle bridge. Although MB is clinically silent in most cases, it has been associated with myocardial ischemia, myocardial infarction, arrhythmia, and sudden death. Conventional coronary angiography (CCA) is the gold standard for detection, but it is invasive and may not be sensitive enough to detect a thin bridge. Recently, multislice computed tomography coronary angiography (MCTCA) have made possible the clear detection of the entire running courses of coronary arteries and the MB itself. Objective: To evaluate the prevalence MB in patients suspect to coronary artery disease submitted to MCTCA and assessing the predictive value of this method in the midterm. Methods: 498 consecutive patients were examined by MCTCA for the diagnosis of coronary artery disease and followed for a mean follow-up of 17 months for the occurrence of cardiovascular events (death, hospitalization and / or revascularization myocardial). Results: The mean age of patients was 58.4 ± 12.5 years old, 74.3% male. Among the patients, 6,02% (30 patients) showed MB. The major indications were angina pectoris in 45,8% and positive stress testing in 33,3%. 62,5% showed absent atherosclerotic disease and only 1 patient showed moderade descending anterior stenosis. During the follow-up none patient showed hard events. Conclusion: Patients with MB could present with angina pectoris and positive stress testing and showed midterm excellent prognosis. MCTCA is an alternative noninvasive imaging tool that allows for easy and accurate evaluation of MB.

  15. Non-invasive coronary angiography with multislice spiral computed tomography: impact of heart rate

    NARCIS (Netherlands)

    B.J.W.M. Rensing (Benno); R.J.M. van Geuns (Robert Jan); J. Vos (Jeroen); P.M.T. Pattynama (Peter); G.P. Krestin (Gabriel); P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); K. Nieman (Koen)

    2002-01-01

    textabstractOBJECTIVE: To evaluate the impact of heart rate on the diagnostic accuracy of coronary angiography by multislice spiral computed tomography (MSCT). DESIGN: Prospective observational study. PATIENTS: 78 patients who underwent both conventional and MSCT coronary angiograp

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    To determine via meta-analysis the diagnostic accuracy of 64-slice computed tomography coronary angiography (CTA) for assessment of significant obstructive coronary artery stenosis at different coronary artery calcium score (CACS) levels. Data of 12,053 versus 5,890 segments, 906 versus 758...... arteries and 1,120 versus 514 patients in low versus high CACS subgroups from 19 eligible studies were compared. The per-patient prevalence of coronary artery disease was 48% versus 68%, respectively. Subgroups were stratified by different CACS thresholds ranging from 100 to 400. Meta-analyses of per......-patient data comparing overall low versus high CACS subgroups resulted in a sensitivity of 97.5 (95.5-99)% versus 97 (94.5-98.5)%, specificity of 85 (82-88)% versus 66.5 (58-74.5)%, diagnostic odds ratio of 153 (81-290) versus 40 (20-83), positive predictive value of 85 (82-87)% versus 86 (84-88)%, negative...

  17. The Incremental Prognostic Value of Cardiac Computed Tomography in Comparison with Single-Photon Emission Computed Tomography in Patients with Suspected Coronary Artery Disease.

    Science.gov (United States)

    Lee, Heesun; Yoon, Yeonyee E; Park, Jun-Bean; Kim, Hack-Lyoung; Park, Hyo Eun; Lee, Seung-Pyo; Kim, Hyung-Kwan; Choi, Su-Yeon; Kim, Yong-Jin; Cho, Goo-Yeong; Zo, Joo-Hee; Sohn, Dae-Won

    2016-01-01

    Coronary computed tomographic angiography (CCTA) facilitates comprehensive evaluation of coronary artery disease (CAD), including plaque characterization, and can provide additive diagnostic value to single-photon emission computed tomography (SPECT). However, data regarding the incremental prognostic value of CCTA to SPECT remain sparse. We evaluated the independent and incremental prognostic value of CCTA, as compared with clinical risk factors and SPECT. A total of 1,077 patients with suspected CAD who underwent both SPECT and cardiac CT between 2004 and 2012 were enrolled retrospectively. Presence of reversible or fixed perfusion defect (PD) and summed stress score were evaluated on SPECT. Presence, extent of coronary atherosclerosis and diameter stenosis (DS) were evaluated on CCTA. Plaque composition was categorized as non-calcified, mixed, or calcified according to the volume of calcified component (>130 Hounsfield Units). Patients were followed up for the occurrence of adverse cardiac events including cardiac death, non-fatal myocardial infarction, unstable angina, and late revascularization (>90 days after imaging studies). During follow-up (median 23 months), adverse cardiac events were observed in 71 patients (6.6%). When adjusted for clinical risk factors and SPECT findings, the presence of any coronary plaque, any plaque in ≥3 segments, coronary artery calcium score (CACS) ≥400, a plaque ≥50% DS, presence of non-calcified plaque (NCP) or mixed plaque (MP), and NCP/MP in ≥2 segments were independent predictors of adverse cardiac events; however, the presence of calcified plaque (CP) was not. Conventional CCTA findings, including CACS ≥400 and a plaque ≥50% DS, demonstrated incremental prognostic value over clinical risk factors and SPECT (χ² 54.19 to 101.03; p incremental prognostic value in relation to SPECT evaluation of myocardial ischemia. Specifically, segmentally-analyzed plaque composition with CCTA provides further risk

  18. Quantification of normative ranges and baseline predictors of aortoventricular interface dimensions using multi-detector computed tomographic imaging in patients without aortic valve disease

    Energy Technology Data Exchange (ETDEWEB)

    Gooley, Robert P., E-mail: robert.gooley@monashhealth.org [MonashHeart, Monash Health, Melbourne 3168 (Australia); Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168 (Australia); Cameron, James D., E-mail: james.cameron@monash.edu [MonashHeart, Monash Health, Melbourne 3168 (Australia); Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168 (Australia); Soon, Jennifer, E-mail: jenn.sa@gmail.com [MonashHeart, Monash Health, Melbourne 3168 (Australia); Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168 (Australia); Loi, Duncan, E-mail: dloi2@student.monash.edu [Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168 (Australia); Chitale, Gauri, E-mail: gchi21@student.monash.edu [Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168 (Australia); Syeda, Rifath, E-mail: rssye1@student.monash.edu [Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168 (Australia); Meredith, Ian T., E-mail: ian.meredith@myheart.id.au [MonashHeart, Monash Health, Melbourne 3168 (Australia); Monash Cardiovascular Research Centre, Department of Medicine (MMC), Monash University, Melbourne 3168 (Australia)

    2015-09-15

    Highlights: • MDCT imaging of the aortoventricular interface is increasingly common. • We present normative ranges for aortoventricular interface dimensions. • Such techniques and ranges should be used to standardise reporting and research. - Abstract: Background: Multidetector computed tomographic (MDCT) assessment of the aortoventricular interface has gained increased importance with the advent of minimally invasive treatment modalities for aortic and mitral valve disease. This has included a standardised technique of identifying a plane through the nadir of each coronary cusp, the basal plane, and taking further measurements in relation to this plane. Despite this there is no published data defining normal ranges for these aortoventricular metrics in a healthy cohort. This study seeks to quantify normative ranges for MDCT derived aortoventricular dimensions and evaluate baseline demographic and anthropomorphic associates of these measurements in a normal cohort. Methods: 250 consecutive patients undergoing MDCT coronary angiography were included. Aortoventricular dimensions at multiple levels of the aortoventricular interface were assessed and normative ranges quantified. Multivariate linear regression was performed to identify baseline predictors of each metric. Results: The mean age was 59 ± 12 years. The basal plane was eccentric (EI = 0.22 ± 0.06) while the left ventricular outflow tract was more eccentric (EI = 0.32 ±0.06), with no correlation to gender, age or hypertension. Male gender, height and body mass index were consistent independent predictors of larger aortoventricular dimensions at all anatomical levels, while age was predictive of supra-annular measurements. Conclusions: Male gender, height and BMI are independent predictors of all aortoventricular dimensions while age predicts only supra-annular dimensions. Use of defined metrics such as the basal plane and formation of normative ranges for these metrics allows reference for clinical

  19. OPTICAL COMPUTING: Analysis of the tomographic contrast during the immersion bleaching of layered biological tissues

    Science.gov (United States)

    Prokhorov, I. V.; Yarovenko, I. P.

    2010-01-01

    The control of optical properties of biological tissues irradiated by a cw laser source is considered. Within the framework of the stationary model of the radiation transfer, basic factors affecting the tomographic contrast of a layered medium are revealed theoretically and numerically, when immersion liquids, decreasing the radiation scattering level in a medium, are used.

  20. Prevalence and characteristics of major and minor coronary artery anomalies in an adult population assessed by computed tomography coronary angiography

    NARCIS (Netherlands)

    G.A. Rodriguez-Granillo (Gaston); M.A. Rosales (Miguel); F. Pugliese (Francesca); C. Fernandez-Pereira (Carlos); A. Rodriguez (Alfredo Chapin)

    2009-01-01

    textabstractAims: There is conflicting data regarding the prevalence and characteristics of coronary artery anomalies (CAAs). We sought to explore the prevalence and characteristics of major and minor CAAs using computed tomography coronary angiography (CCTA). Methods and results: We prospectively s

  1. Pipelining Computational Stages of the Tomographic Reconstructor for Multi-Object Adaptive Optics on a Multi-GPU System

    KAUST Repository

    Charara, Ali

    2014-11-01

    The European Extremely Large Telescope project (E-ELT) is one of Europe\\'s highest priorities in ground-based astronomy. ELTs are built on top of a variety of highly sensitive and critical astronomical instruments. In particular, a new instrument called MOSAIC has been proposed to perform multi-object spectroscopy using the Multi-Object Adaptive Optics (MOAO) technique. The core implementation of the simulation lies in the intensive computation of a tomographic reconstruct or (TR), which is used to drive the deformable mirror in real time from the measurements. A new numerical algorithm is proposed (1) to capture the actual experimental noise and (2) to substantially speed up previous implementations by exposing more concurrency, while reducing the number of floating-point operations. Based on the Matrices Over Runtime System at Exascale numerical library (MORSE), a dynamic scheduler drives all computational stages of the tomographic reconstruct or simulation and allows to pipeline and to run tasks out-of order across different stages on heterogeneous systems, while ensuring data coherency and dependencies. The proposed TR simulation outperforms asymptotically previous state-of-the-art implementations up to 13-fold speedup. At more than 50000 unknowns, this appears to be the largest-scale AO problem submitted to computation, to date, and opens new research directions for extreme scale AO simulations. © 2014 IEEE.

  2. Optimisation of coronary vascular territorial 3D echocardiographic strain imaging using computed tomography

    DEFF Research Database (Denmark)

    de Knegt, Martina Chantal; Fuchs, A; Weeke, P;

    2016-01-01

    Current echocardiographic assessments of coronary vascular territories use the 17-segment model and are based on general assumptions of coronary vascular distribution. Fusion of 3D echocardiography (3DE) with multidetector computed tomography (MDCT) derived coronary anatomy may provide a more acc...

  3. Computer-aided detection of pulmonary embolism in computed tomographic pulmonary angiography (CTPA): performance evaluation with independent data sets.

    Science.gov (United States)

    Zhou, Chuan; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M; Chughtai, Aamer; Patel, Smita; Wei, Jun; Cascade, Philip N; Kazerooni, Ella A

    2009-08-01

    The authors are developing a computer-aided detection system for pulmonary emboli (PE) in computed tomographic pulmonary angiography (CTPA) scans. The pulmonary vessel tree is extracted using a 3D expectation-maximization segmentation method based on the analysis of eigen-values of Hessian matrices at multiple scales. A parallel multiprescreening method is applied to the segmented vessels to identify volume of interests (VOIs) that contained suspicious PE. A linear discriminant analysis (LDA) classifier with feature selection is designed to reduce false positives (FPs). Features that characterize the contrast, gray level, and size of PE are extracted as input predictor variables to the LDA classifier. With the IRB approval, 59 CTPA PE cases were collected retrospectively from the patient files (UM cases). With access permission, 69 CTPA PE cases were randomly selected from the data set of the prospective investigation of pulmonary embolism diagnosis (PIOPED) II clinical trial. Extensive lung parenchymal or pleural diseases were present in 22/59 UM and 26/69 PIOPED cases. Experienced thoracic radiologists manually marked 595 and 800 PE as the reference standards in the UM and PIOPED data sets, respectively. PE occlusion of arteries ranged from 5% to 100%, with PE located from the main pulmonary artery to the subsegmental artery levels. Of the 595 PE identified in the UM cases, 245 and 350 PE were located in the subsegmental arteries and the more proximal arteries, respectively. The detection performance was assessed by free response ROC (FROC) analysis. The FROC analysis indicated that the PE detection system could achieve an overall sensitivity of 80% at 18.9 FPs/case for the PIOPED cases when the LDA classifier was trained with the UM cases. The test sensitivity with the UM cases was 80% at 22.6 FPs/cases when the LDA classifier was trained with the PIOPED cases. The detection performance depended on the arterial level where the PE was located and on the

  4. Cost-effectiveness of computed tomography coronary angiography versus conventional invasive coronary angiography.

    Science.gov (United States)

    Darlington, Meryl; Gueret, Pascal; Laissy, Jean-Pierre; Pierucci, Antoine Filipovic; Maoulida, Hassani; Quelen, Céline; Niarra, Ralph; Chatellier, Gilles; Durand-Zaleski, Isabelle

    2015-07-01

    To determine the costs and cost-effectiveness of a diagnostic strategy including computed tomography coronary angiography (CTCA) in comparison with invasive conventional coronary angiography (CA) for the detection of significant coronary artery disease from the point of view of the healthcare provider. The average cost per CTCA was determined via a micro-costing method in four French hospitals, and the cost of CA was taken from the 2011 French National Cost Study that collects data at the patient level from a sample of 51 public or not-for-profit hospitals. The average cost of CTCA was estimated to be 180 (95 % CI 162-206) based on the use of a 64-slice CT scanner active for 10 h per day. The average cost of CA was estimated to be 1,378 (95 % CI 1,126-1,670). The incremental cost-effectiveness ratio of CA for all patients over a strategy including CTCA triage in the intermediate risk group, no imaging test in the low risk group, and CA in the high risk group, was estimated to be 6,380 (95 % CI 4,714-8,965) for each additional correctly classified patient. This strategy correctly classifies 95.3 % (95 % CI 94.4-96.2) of all patients in the population studied. A strategy of CTCA triage in the intermediate-risk group, no imaging test in the low-risk group, and CA in the high-risk group, has good diagnostic accuracy and could significantly cut costs. Medium-term and long-term outcomes need to be evaluated in patients with coronary stenosis potentially misclassified by CTCA due to false negative examinations.

  5. Tuning the cache memory usage in tomographic reconstruction on standard computers with Advanced Vector eXtensions (AVX).

    Science.gov (United States)

    Agulleiro, Jose-Ignacio; Fernandez, Jose-Jesus

    2015-06-01

    Cache blocking is a technique widely used in scientific computing to minimize the exchange of information with main memory by reusing the data kept in cache memory. In tomographic reconstruction on standard computers using vector instructions, cache blocking turns out to be central to optimize performance. To this end, sinograms of the tilt-series and slices of the volumes to be reconstructed have to be divided into small blocks that fit into the different levels of cache memory. The code is then reorganized so as to operate with a block as much as possible before proceeding with another one. This data article is related to the research article titled Tomo3D 2.0 - Exploitation of Advanced Vector eXtensions (AVX) for 3D reconstruction (Agulleiro and Fernandez, 2015) [1]. Here we present data of a thorough study of the performance of tomographic reconstruction by varying cache block sizes, which allows derivation of expressions for their automatic quasi-optimal tuning.

  6. Tuning the cache memory usage in tomographic reconstruction on standard computers with Advanced Vector eXtensions (AVX

    Directory of Open Access Journals (Sweden)

    Jose-Ignacio Agulleiro

    2015-06-01

    Full Text Available Cache blocking is a technique widely used in scientific computing to minimize the exchange of information with main memory by reusing the data kept in cache memory. In tomographic reconstruction on standard computers using vector instructions, cache blocking turns out to be central to optimize performance. To this end, sinograms of the tilt-series and slices of the volumes to be reconstructed have to be divided into small blocks that fit into the different levels of cache memory. The code is then reorganized so as to operate with a block as much as possible before proceeding with another one. This data article is related to the research article titled Tomo3D 2.0 – Exploitation of Advanced Vector eXtensions (AVX for 3D reconstruction (Agulleiro and Fernandez, 2015 [1]. Here we present data of a thorough study of the performance of tomographic reconstruction by varying cache block sizes, which allows derivation of expressions for their automatic quasi-optimal tuning.

  7. Thanatophoric dysplasia: case report of an autopsy complemented by postmortem computed tomographic study

    Directory of Open Access Journals (Sweden)

    Éber Emanuel Mayoral

    2014-06-01

    Full Text Available Thanatophoric dysplasia (TD is one of the most common lethal skeletal dysplasias, which was first designated as thanatophoric dwarfism and described in 1967. The authors report a case of a Caucasian girl with TD, born to a 31-year-old woman without comorbidities. The newborn presented respiratory distress immediately after delivery, progressing to death in less than 2 hours. An autopsy was carried out after postmortem tomographic examination. The autopsy findings depicted extensive malformations of the skeletal system and the brain. The aim of this report is to discuss the pathogenesis and correlate the morphologic features of TD that were disclosed at the tomography and the autopsy.

  8. Dental computed tomographic imaging as age estimation: morphological analysis of the third molar of a group of Turkish population.

    Science.gov (United States)

    Cantekin, Kenan; Sekerci, Ahmet Ercan; Buyuk, Suleyman Kutalmis

    2013-12-01

    Computed tomography (CT) is capable of providing accurate and measurable 3-dimensional images of the third molar. The aims of this study were to analyze the development of the mandibular third molar and its relation to chronological age and to create new reference data for a group of Turkish participants aged 9 to 25 years on the basis of cone-beam CT images. All data were obtained from the patients' records including medical, social, and dental anamnesis and cone-beam CT images of 752 patients. Linear regression analysis was performed to obtain regression formulas for dental age calculation with chronological age and to determine the coefficient of determination (r) for each sex. Statistical analysis showed a strong correlation between age and third-molar development for the males (r2 = 0.80) and the females (r2 = 0.78). Computed tomographic images are clinically useful for accurate and reliable estimation of dental ages of children and youth.

  9. A machine-learning approach for computation of fractional flow reserve from coronary computed tomography.

    Science.gov (United States)

    Itu, Lucian; Rapaka, Saikiran; Passerini, Tiziano; Georgescu, Bogdan; Schwemmer, Chris; Schoebinger, Max; Flohr, Thomas; Sharma, Puneet; Comaniciu, Dorin

    2016-07-01

    Fractional flow reserve (FFR) is a functional index quantifying the severity of coronary artery lesions and is clinically obtained using an invasive, catheter-based measurement. Recently, physics-based models have shown great promise in being able to noninvasively estimate FFR from patient-specific anatomical information, e.g., obtained from computed tomography scans of the heart and the coronary arteries. However, these models have high computational demand, limiting their clinical adoption. In this paper, we present a machine-learning-based model for predicting FFR as an alternative to physics-based approaches. The model is trained on a large database of synthetically generated coronary anatomies, where the target values are computed using the physics-based model. The trained model predicts FFR at each point along the centerline of the coronary tree, and its performance was assessed by comparing the predictions against physics-based computations and against invasively measured FFR for 87 patients and 125 lesions in total. Correlation between machine-learning and physics-based predictions was excellent (0.9994, P machine-learning algorithm with a sensitivity of 81.6%, a specificity of 83.9%, and an accuracy of 83.2%. The correlation was 0.729 (P machine-learning model on a workstation with 3.4-GHz Intel i7 8-core processor. Copyright © 2016 the American Physiological Society.

  10. The association between coronary calcification assessed by electron beam computed tomography and measures of extracoronary atherosclerosis - The Rotterdam Coronary Calcification Study

    NARCIS (Netherlands)

    Oei, HHS; Vliegenthart, R; Hak, AE; del Sol, AI; Hofman, A; Oudkerk, M; Witteman, JCM

    2002-01-01

    OBJECTIVES The present study was designed to examine the associations of coronary calcification assessed by electron beam computed tomography (CT) with measures of extracoronary atherosclerosis. BACKGROUND Although measures of extracoronary atherosclerosis have been used to predict coronary events,

  11. Computed tomographic study of 50 patients with hypodense hepatic injuries in childhood; Estudo de 50 casos por tomografia computadorizada de lesoes hipodensas hepaticas fundamentais na infancia

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Ines Minniti Rodrigues; Alvares, Beatriz Regina; Baracat, Jamal; Martins, Daniel Lahan [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Radiologia]. E-mail: iminniti@fcm.unicamp.br; Pereira, Ricardo Minniti Rodrigues [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas

    2006-03-15

    Objective: To describe the different tomographic findings in hypodense hepatic lesions in children and its differential diagnosis. Materials and methods: computed tomographic studies were obtained from 50 patients (age range: 0-16 years) with low-density liver lesions previously diagnosed by ultrasound. Images were made before and after administration of intravenous contrast medium. Image findings were analyzed and afterwards correlated with anatomopathological diagnosis. Results: forty-seven of 50 cases were confirmed, 30 by anatomopathological diagnosis. Most of then were benign lesions, hemangioma in 20%. Such lesions presented a homogeneous contrast absorption, mainly at the delayed phase, differing from malignant lesions. Metastasis was the most frequently found malignant lesion (18%). Conclusion: computed tomographic study is of great value in complementing the diagnosis of hypodense hepatic lesions in children, and must follow ultrasound diagnosis as a routine procedure. (author)

  12. Coronary artery anomalies in Turner Syndrome

    DEFF Research Database (Denmark)

    Viuff, Mette H; Trolle, Christian; Wen, Jan;

    2016-01-01

    BACKGROUND: Congenital heart disease, primarily involving the left-sided structures, is often seen in patients with Turner Syndrome. Moreover, a few case reports have indicated that coronary anomalies may be more prevalent in Turner Syndrome than in the normal population. We therefore set out...... to systematically investigate coronary arterial anatomy by computed tomographic coronary angiography (coronary CTA) in Turner Syndrome patients. METHODS: Fifty consecutive women with Turner Syndrome (mean age 47 years [17-71]) underwent coronary CTA. Patients were compared with 25 gender-matched controls. RESULTS......: Coronary anomaly was more frequent in patients with Turner Syndrome than in healthy controls [20% vs. 4% (p = 0.043)]. Nine out of ten abnormal cases had an anomalous left coronary artery anatomy (absent left main trunk, n = 7; circumflex artery originating from the right aortic sinus, n = 2). One case had...

  13. Assessment of coronary artery disease using coronary computed tomography angiography in patients with aortic valve stenosis referred for surgical aortic valve replacement

    DEFF Research Database (Denmark)

    Larsen, Linnea Hornbech; Kofoed, K Fuglsang; Dalsgaard, M

    2013-01-01

    BACKGROUND: In patients referred for aortic valve replacement (AVR) a pre-surgical assessment of coronary artery disease is mandatory to determine the possible need for additional coronary artery bypass grafting. The diagnostic accuracy of coronary computed tomography angiography (coronary CTA......) was evaluated in patients with aortic valve stenosis referred for surgical AVR. METHODS: Between March 2008 and March 2010 a total of 181 consecutive patients were included. All patients underwent pre-surgical coronary CTA (64- or 320-detector CT scanner) and invasive coronary angiography (ICA). The analyses...... with disagreement between ICA and coronary CTA in univariate analysis. CONCLUSION: In patients with aortic valve stenosis referred for surgical AVR the diagnostic accuracy of coronary CTA to identify significant coronary artery disease is moderate. Coronary CTA may be used successfully in a subset of patients...

  14. Clinical, histologic, and computed tomographic features of oral papillary squamous cell carcinoma in dogs: 9 cases (2008- 2011).

    Science.gov (United States)

    Soukup, Jason W; Snyder, Christopher J; Simmons, Betsie T; Pinkerton, Marie E; Chun, Ruthanne

    2013-01-01

    Medical records of dogs diagnosed with oral papillary squamous cell carcinoma between December 2008 and April 2011 were reviewed. Information abstracted included signalment, tumor location, tumor size, computed tomographic (CT) features, evidence of metastatic disease based on cytologic examination of lymph node aspirates and thoracic radiography, treatment, surgical margins, histologic features, and treatment outcome. Dogs included in the study were all sexually altered, predominantly large breed dogs with a mean age of 3.9-years (range, 0.5 to 9.0-years). The most common location was the rostral maxilla. Invasion of underlying bone and lymphadenopathy were evident on CT imaging in most dogs. No evidence of metastasis was found on mandibular lymph node cytology and thoracic radiography. Histologic analysis revealed similar morphologic findings for all surgically resected tumors. Surgical excision with 1-2 cm margins was complete in all cases, with a mean tumor-free interval of 12.1-months.

  15. Comparison of alveolar ridge preservation method using three dimensional micro-computed tomographic analysis and two dimensional histometric evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Young Seok; Kim, Sung Tae; Oh, Seung Hee; Park, Hee Jung; Lee, Sophia; Kim, Taeil; Lee, Young Kyu; Heo, Min Suk [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2014-06-15

    This study evaluated the efficacy of alveolar ridge preservation methods with and without primary wound closure and the relationship between histometric and micro-computed tomographic (CT) data. Porcine hydroxyapatite with polytetrafluoroethylene membrane was implanted into a canine extraction socket. The density of the total mineralized tissue, remaining hydroxyapatite, and new bone was analyzed by histometry and micro-CT. The statistical association between these methods was evaluated. Histometry and micro-CT showed that the group which underwent alveolar preservation without primary wound closure had significantly higher new bone density than the group with primary wound closure (P<0.05). However, there was no significant association between the data from histometry and micro-CT analysis. These results suggest that alveolar ridge preservation without primary wound closure enhanced new bone formation more effectively than that with primary wound closure. Further investigation is needed with respect to the comparison of histometry and micro-CT analysis.

  16. Computed tomographic studies of the basis pedunculi in chronic hemiplegic patients: Topographic correlation between cerebral lesion and midbrain shrinkage

    Energy Technology Data Exchange (ETDEWEB)

    Warabi, T.; Miyasaka, K.; Inoue, K.; Nakamura, N.

    1987-09-01

    A computed tomographic method for analyzing the shrinkage of the basis pedunculi (BP) due to the secondary degeneration of the descending fibers was applied in correlation to the site of cerebral lesions in 89 chronic hemiplegic patients. Cerebral lesions in the anterior corona radiata or the anterior limb of the capsula interna caused shrinkage of the medial BP. Lesions in the central corona radiata or the genu and posterior limb of the capsula interna caused shrinkage of the central BP, while lesions of the posterior corona radiata or the posterior limb of the capsula interna caused shrinkage of the lateral BP. These results suggested that CT images are able to reveal the principle sites of atrophy of the descending fiber tracts in chronic hemiplegia.

  17. Laparoscopic Sentinel Node Biopsy Using Real-time 3-dimensional Single-photon Emission Computed Tomographic Guidance in Endometrial Cancer.

    Science.gov (United States)

    Fernandez-Prada, Sara; Delgado-Sanchez, Elsa; De Santiago, Javier; Zapardiel, Ignacio

    2015-01-01

    In endometrial cancer, the histopathological analysis of the lymphatic nodes is essential to establish a correct prognosis and tailored adjuvant treatment. It is well-known that patients with early-stage endometrial cancer have a low incidence of nodal disease. In this group, systematic lymphadenectomy is not recommended. To improve the detection rate of sentinel nodes in clinical practice, new techniques are emerging like real-time 3-dimensional single-photon emission computed tomographic (SPECT) imaging. We report our experience using this innovative technique for intraoperative detection of sentinel nodes in endometrial cancer. The real-time 3-dimensional SPECT sentinel node biopsy seems to be feasible and accurate in endometrial cancer although further studies are needed to set the precision and predictive values compared with the current differed SPECT techniques and blue dye techniques. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  18. Three-dimensional multislice spiral computed tomographic angiography: a potentially useful tool for safer free tissue transfer to complicated regions

    DEFF Research Database (Denmark)

    Demirtas, Yener; Cifci, Mehmet; Kelahmetoglu, Osman;

    2009-01-01

    Three-dimensional multislice spiral computed tomographic angiography (3D-MSCTA) is a minimally invasive method of vascular mapping. The aim of this study was to evaluate the clinical usefulness of this imaging technique in delineating the recipient vessels for safer free tissue transfer...... to complicated regions. 3D-MSCTA was performed preoperatively in 26 patients scheduled for free tissue transfer, in whom the availability of the recipient vessels were considered to be uncertain, and 23 of these were operated on. Radiographic and operative findings regarding the availability of the recipient......-MSCTA provides a noninvasive means of preoperatively assessing recipient site vessels for anatomic variations and suitability before free tissue transfer and enables the surgeon to establish an appropriate treatment plan. But it is not 100% reliable yet and the possibility of false-positive results should...

  19. Removal of filling materials from oval-shaped canals using laser irradiation: a micro-computed tomographic study.

    Science.gov (United States)

    Keleş, Ali; Arslan, Hakan; Kamalak, Aliye; Akçay, Merve; Sousa-Neto, Manoel D; Versiani, Marco Aurélio

    2015-02-01

    The aim of this study was to assess the efficacy of lasers in removing filling remnants from oval-shaped canals after retreatment procedures with rotary instruments using micro-computed tomographic imaging. The root canals of 42 mandibular canines were prepared and obturated using the warm vertical compaction technique. Retreatment was performed with rotary instruments, and the specimens were distributed in 3 groups (n = 14) according to the laser device used in a later stage of retreatment procedure: Er:YAG, Er:YAG laser-based photon-induced photoacoustic streaming, and Nd:YAG. The specimens were scanned in a micro-computed tomographic device after root canal filling and each stage of retreatment at a resolution of 13.68 μm. The percentage differences of the remaining filling material before and after laser application within and between groups were statistically compared using the paired sample t test and 1-way analysis of variance test, respectively. Significance level was set at 5%. Overall, filling residues were located mainly in the apical third and into canal irregularities after the retreatment procedures. After using rotary instruments, the mean percentage volume of the filling remnants ranged from 13%-16%, with no statistical significant difference between groups (P > .05). Within groups, additional laser application had a significant reduction in the amount of the remaining filling materials (P materials. The additional use of lasers improved the removal of filling material after the retreatment procedure with rotary instruments. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar.

    Science.gov (United States)

    Filpo-Perez, Carolina; Bramante, Clovis Monteiro; Villas-Boas, Marcelo Haas; Húngaro Duarte, Marco Antonio; Versiani, Marco Aurélio; Ordinola-Zapata, Ronald

    2015-02-01

    The aim of this study was to evaluate the morphologic aspects of the root canal anatomy of the distal root of a mandibular first molar using micro-computed tomographic analysis. One-hundred distal roots of mandibular first molars were scanned using a micro-computed tomographic device at an isotropic resolution of 19.6 μm. The percentage frequency distribution of the morphologic configuration of the root canal was performed according to the Vertucci classification system. Two-dimensional parameters (area, perimeter, roundness, aspect ratio, and major and minor diameters) and the cross-sectional shape of the root canal were analyzed in the apical third at every 1-mm interval from the main apical foramen in roots presenting Vertucci types I and II configurations (n = 79). Data were statistically compared using the Kruskal-Wallis and Dunn tests with a significance level set at 5%. Seventy-six percent of the distal roots had a single root canal. Two, three, and four canals were found in 13%, 8%, and 3% of the sample, respectively. In 13 specimens, the configuration of the root canal did not fit into Vertucci's classification. Overall, 2-dimensional parameter values significantly increased at the 3-mm level (P molars showed a high prevalence of single root canals. The prevalence of long oval and flattened canals increased in the coronal direction. In 13% of the samples, canal configurations that were not included in Vertucci's configuration system were found. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Use of a Diagnostic Score to Prioritize Computed Tomographic (CT) Imaging for Patients Suspected of Ischemic Stroke Who May Benefit from Thrombolytic Therapy

    NARCIS (Netherlands)

    Hwong, Wen Yea; Bots, Michiel L; Selvarajah, Sharmini; Kappelle, L Jaap; Abdul Aziz, Zariah; Sidek, Norsima Nazifah; Vaartjes, Ilonca

    2016-01-01

    BACKGROUND: A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy.

  2. Hepatic Rupture Caused by Hemolysis, Elevated Liver Enzyme, and Low Platelet Count Syndrome: A Case Report with Computed Tomographic and Conventional Angiographic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Cheong Bok; Ahn, Jae Hong; Choi, Soo Jung; Lee, Jong Hyeog; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Sik [Dept. of Radiology, Asan Foundation, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2013-03-15

    The authors recently obtained successful clinical outcome after embolization of the hepatic artery and right inferior phrenic artery in a pregnant patient with hemolysis, elevated liver enzyme, and low platelet count (HELLP) syndrome causing hepatic rupture. We report the computed tomographic and conventional angiographic findings in a case of HELLP syndrome, resulting in hepatic infarction and rupture with active bleeding.

  3. Does coronary calcium scoring with a SCORE better predict significant coronary artery stenosis than without? Correlation with computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Durhan, Gamze; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Akata, Deniz [Hacettepe University Medical School, Department of Radiology, Ankara (Turkey); Sunman, Hamza; Aytemir, Kudret [Hacettepe University Medical School, Department of Cardiology, Ankara (Turkey); Karakaya, Jale; Karaagaoglu, Ergun [Hacettepe University, Department of Biostatistics, Ankara (Turkey)

    2014-12-03

    To determine effectiveness of coronary artery calcium score (CACS) alone and combined with Systematic Coronary Risk Evaluation (SCORE) in adult patients for significant coronary artery stenosis by using computed tomography coronary angiography (CTCA) as reference standard. Two thousand twenty-one patients with suspected coronary artery disease (CAD) underwent CACS test and CTCA. Patients were examined with dual-source CT and were grouped according to their age, gender, CACS, and estimated SCORE risk. Coronary plaque existence and degree of stenosis were assessed with CTCA. Sensitivity, specificity, and ROC curves were analyzed. CACS was the single independent variable in estimating relative risk of critical stenosis and had superior outcome when compared with SCORE risk in logistic regression and ROC curve. Area under the ROC curve was greatest in the interval between 50-59 years. When SCORE was combined with CACS in patients with zero CACS, percentage of significant stenosis increased from 1.4% to 7.0% in patients with high or very high SCORE risk, and decreased to 0.9 % in patients with low or moderate SCORE risk. CACS combination with SCORE risk predicts coronary artery stenosis. When CACS is zero, CTCA can be performed in patients with high or very high SCORE risk. (orig.)

  4. Coronary Computed Tomography Angiography in the Assessment of Acute Chest Pain in the Emergency Room

    Energy Technology Data Exchange (ETDEWEB)

    Prazeres, Carlos Eduardo Elias dos; Cury, Roberto Caldeira; Carneiro, Adriano Camargo de Castro [Hospital do Coração - HCor, Associação do Sanatório Sírio, São Paulo, SP (Brazil); Rochitte, Carlos Eduardo, E-mail: rochitte@cardiol.br [Hospital do Coração - HCor, Associação do Sanatório Sírio, São Paulo, SP (Brazil); Instituto do Coração - InCor - HCFMUSP, São Paulo, SP (Brazil)

    2013-12-15

    The coronary computed tomography angiography has recently emerged as an accurate diagnostic tool in the evaluation of coronary artery disease, providing diagnostic and prognostic data that correlate directly with the data provided by invasive coronary angiography. The association of recent technological developments has allowed improved temporal resolution and better spatial coverage of the cardiac volume with significant reduction in radiation dose, and with the crucial need for more effective protocols of risk stratification of patients with chest pain in the emergency room, recent evaluation of the computed tomography coronary angiography has been performed in the setting of acute chest pain, as about two thirds of invasive coronary angiographies show no significantly obstructive coronary artery disease. In daily practice, without the use of more efficient technologies, such as coronary angiography by computed tomography, safe and efficient stratification of patients with acute chest pain remains a challenge to the medical team in the emergency room. Recently, several studies, including three randomized trials, showed favorable results with the use of this technology in the emergency department for patients with low to intermediate likelihood of coronary artery disease. In this review, we show data resulting from coronary angiography by computed tomography in risk stratification of patients with chest pain in the emergency room, its diagnostic value, prognosis and cost-effectiveness and a critical analysis of recently published multicenter studies.

  5. Compositional volumetry of non-calcified coronary plaques by multislice computed tomography: An ex vivo feasibility study

    NARCIS (Netherlands)

    N. Bruining (Nico); J.R.T.C. Roelandt (Jos); S. Verheye (Stefan); M.W. Knaapen (Michiel); Y. Onuma (Yoshinobu); E.S. Regar (Eveline); F. Cademartiri (Filippo); S. de Winter (Sebastiaan); G.J.J. van Langenhove (Glenn); P.W.J.C. Serruys (Patrick); R. Hamers (Ronald); P.J. de Feyter (Pim)

    2009-01-01

    textabstractAims: Non-invasive quantitative compositional analysis of coronary plaque would be a major advantage to study coronary artery disease. This study explores the application to use the Hounsfield units (HU) distribution of coronary plaques imaged by multislice computed tomography-coronary

  6. Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: Results from the confirm (coronary CT angiography evaluation for clinical outcomes: An international multicenter registry) registry

    NARCIS (Netherlands)

    B.J.W. Chow (Benjamin); G.R. Small (Gary); Y. Yam (Yeung); L. Chen (Li); R. McPherson (Ruth); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor Y.); K. Chinnaiyan (Kavitha); R.C. Cury (Ricardo); A. Delago (Augustin); A. Dunning (Allison); G. Feuchtner (Gundrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); R.P. Karlsberg (Ronald); P.A. Kaufmann (Philipp A.); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); T.M. LaBounty (Troy); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective - We sought to examine the risk of mortality associated with nonobstructive coronary artery disease (CAD) and to determine the impact of baseline statin and aspirin use on mortality. Approach and Results - Coronary computed tomographic angiography permits direct visualization o

  7. Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: Results from the confirm (coronary CT angiography evaluation for clinical outcomes: An international multicenter registry) registry

    NARCIS (Netherlands)

    B.J.W. Chow (Benjamin); G.R. Small (Gary); Y. Yam (Yeung); L. Chen (Li); R. McPherson (Ruth); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor Y.); K. Chinnaiyan (Kavitha); R.C. Cury (Ricardo); A. Delago (Augustin); A. Dunning (Allison); G. Feuchtner (Gundrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); R.P. Karlsberg (Ronald); P.A. Kaufmann (Philipp A.); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); T.M. LaBounty (Troy); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective - We sought to examine the risk of mortality associated with nonobstructive coronary artery disease (CAD) and to determine the impact of baseline statin and aspirin use on mortality. Approach and Results - Coronary computed tomographic angiography permits direct visualization o

  8. Corrected coronary opacification decrease from coronary computed tomography angiography: Validation with quantitative 13N-ammonia positron emission tomography.

    Science.gov (United States)

    Benz, Dominik C; Gräni, Christoph; Ferro, Paola; Neumeier, Luis; Messerli, Michael; Possner, Mathias; Clerc, Olivier F; Gebhard, Catherine; Gaemperli, Oliver; Pazhenkottil, Aju P; Kaufmann, Philipp A; Buechel, Ronny R

    2017-07-06

    To assess the functional relevance of a coronary artery stenosis, corrected coronary opacification (CCO) decrease derived from coronary computed tomography angiography (CCTA) has been proposed. The present study aims at validating CCO decrease with quantitative 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI). This retrospective study consists of 39 patients who underwent hybrid CCTA/PET-MPI. From CCTA, attenuation in the coronary lumen was measured before and after a stenosis and corrected to the aorta to calculate CCO and its decrease. Relative flow reserve (RFR) was calculated by dividing the stress myocardial blood flow (MBF) of a vessel territory subtended by a stenotic coronary by the stress MBF of the reference territories without stenoses. RFR was abnormal in 11 vessel territories (27%). CCO decrease yielded a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy for prediction of an abnormal RFR of 73%, 70%, 88%, 47%, and 70%, respectively. CCTA-derived CCO decrease has moderate diagnostic accuracy to predict an abnormal RFR in PET-MPI. However, its high negative predictive value to rule out functional relevance of a given lesion may confer clinical implications in the diagnostic work-up of patients with a coronary stenosis.

  9. Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies.

    Science.gov (United States)

    Zimmerman, Stefan L; Lin, Cheng T; Chu, Linda C; Eng, John; Fishman, Elliot K

    2016-06-01

    The feasibility of remote reading of coronary CT examinations on tablet computers has not been evaluated. The purpose of this study is to evaluate the accuracy of coronary CT angiography reading using an iPad compared to standard 3D workstations. Fifty coronary CT angiography exams, including a spectrum of coronary artery disease and anatomic variants, were reviewed. Coronary CT angiography exams were interpreted by two readers independently on an iPad application (Siemens Webviewer) and a clinical 3D workstation at sessions 2 weeks apart. Studies were scored per vessel for severity of stenosis on a 0-3 scale (0 none, 1 Coronary anomalies were recorded. A consensus read by two experienced cardiac imagers was used as the reference standard. Level of agreement with the reference for iPad and 3D workstations was compared. Multivariate logistic regression was used to analyze the relationship between agreement and display type and to adjust for inter-reader differences. For both readers, there was no significant difference in agreement with the reference standard for per-vessel stenosis scores using either the 3D workstation or the iPad. In a multivariable logistic regression analysis including reader, workstation, and vessel as co-variates, there was no significant association between workstation type or reader and agreement with the reference standard (p > 0.05). Both readers identified 100 % of coronary anomalies using each technique. Reading of coronary CT angiography examinations on the iPad had no influence on stenosis assessment compared to the standard clinical workstation.

  10. Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography

    Directory of Open Access Journals (Sweden)

    Cheng-Hsi Chen

    2013-03-01

    Conclusion: Carotid duplex may detect subclinical vascular atherosclerosis in more than half of asymptomatic patients without coronary artery calcification detected by coronary computed tomography. These findings have important implications for early-stage atherosclerosis screening and implementation of primary preventive intervention.

  11. Comparison of coronary imaging between magnetic resonance imaging and electron beam computed tomography

    NARCIS (Netherlands)

    van Geuns, RJM; Oudkerk, M; Rensing, BJWM; Bongaerts, AHH; de Bruin, Hein G.; Wielopolski, PA; van Ooijen, P; de Feyter, PJ; Serruys, PW

    2002-01-01

    In 27 patients, we compared the diagnostic value of magnetic resonance imaging (MRI) and electron beam computed tomography (EBCT) for noninvasive detection of coronary artery stenosis using conventional coronary angiography as the "gold standard." The overall sensitivity and specificity for EBCT to

  12. Atherosclerotic plaque burden in cocaine users with acute chest pain : Analysis by coronary computed tomography angiography

    NARCIS (Netherlands)

    Ebersberger, Ullrich; Sudarski, Sonja; Schoepf, U. Joseph; Bamberg, Fabian; Tricarico, Francesco; Apfaltrer, Paul; Blanke, Philipp; Schindler, Andreas; Makowski, Marcus R.; Headden, Gary F.; Leber, Alexander W.; Hoffmann, Ellen; Vliegenthart, Rozemarijn

    2013-01-01

    Chest pain associated with cocaine use represents an increasing problem in the emergency department (ED). Cocaine use has been linked to the acute coronary syndrome (ACS) and acute myocardial infarction (AMI). We used coronary computed tomography angiography (cCTA) to evaluate the prevalence, severi

  13. Communication between the right and circumflex coronary arteries discovered incidentally by multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Se Hwan; Kim, Eui Jong; Woo, Jong Shin; Kim, Soo Joong; Youn, Hyo Chul; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2016-09-15

    Intercoronary communication is a rare congenital coronary anomaly. We present a case of a 48-year-old man with an incidentally discovered communication between the right and circumflex coronary arteries, who was admitted with chest tightness and exertional dyspnea. The initial diagnosis was made using electrocardiogram-gated multidetector computed tomography.

  14. Diagnostic Performance of Coronary Computed Tomography Angiography and Myocardial Perfusion Imaging in Kidney Transplantation Candidates

    DEFF Research Database (Denmark)

    Winther, Simon; Svensson, My; Jørgensen, Hanne Mari Skou;

    2014-01-01

    Objectives To compare the diagnostic accuracy of coronary artery calcium score (CACS), coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), and a combination of these in the diagnosis of obstructive coronary artery disease (CAD) in patients with chr......Objectives To compare the diagnostic accuracy of coronary artery calcium score (CACS), coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), and a combination of these in the diagnosis of obstructive coronary artery disease (CAD) in patients...... stress tests, while the diagnostic performance of CCTA remains unknown. Methods We prospectively studied 138 patients referred for pre-transplant cardiac evaluation (mean age 54 [22-72] years, 68% males, 43% treated with dialysis). All patients underwent CACS, CCTA, SPECT, and invasive coronary...... angiography. The results of the noninvasive tests were merged into integrated Hybrid (CACS/SPECT) and Hybrid (CCTA/SPECT). Results The overall prevalence of obstructive CAD (≥50% reduction in luminal diameter) according to quantitative invasive coronary angiography was 22%. Two-thirds of the patients...

  15. Visualization of anomalous coronary arteries on dual-source computed tomography

    NARCIS (Netherlands)

    de Jonge, G. J.; van Ooijen, P. M. A.; Piers, L. H.; Dikkers, R.; Tio, R. A.; Willems, T. P.; van den Heuvel, A. F. M.; Zijlstra, F.; Oudkerk, M.

    2008-01-01

    The purpose of this study is to assess the capability of dual-source computed tomography (DSCT) in evaluating coronary artery anomalies. Early detection and evaluation of coronary artery anomalies is essential because of their potential association with myocardial ischemia and sudden death. In 16 pa

  16. Evaluation of computerized detection of pulmonary embolism in independent data sets of computed tomographic pulmonary angiographic (CTPA) scans

    Science.gov (United States)

    Zhou, Chuan; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M.; Chughtai, Aamer; Patel, Smita; Wei, Jun; Cascade, Philip N.; Kazerooni, Ella A.

    2009-02-01

    Computed tomographic pulmonary angiography (CTPA) has been reported to be an effective means for clinical diagnosis of pulmonary embolism (PE). We are developing a computer-aided diagnosis (CAD) system for assisting radiologists in detection of pulmonary embolism in CTPA images. The pulmonary vessel tree is extracted based on the analysis of eigenvalues of Hessian matrices at multiple scales followed by 3D hierarchical EM segmentation. A multiprescreening method is designed to identify suspicious PEs along the extracted vessels. A linear discriminant analysis (LDA) classifier with feature selection is then used to reduce false positives (FPs). Two data sets of 59 and 69 CTPA PE cases were randomly selected from patient files at the University of Michigan (UM) and the PIOPED II study, respectively, and used as independent training and test sets. The PEs that were identified by three experienced thoracic radiologists were used as the gold standard. The detection performance of the CAD system was assessed by free response receiver operating characteristic analysis. The results indicated that our PE detection system can achieve a sensitivity of 80% at 18.9 FPs/case on the PIOPED cases when the LDA classifier was trained with the UM cases. The test sensitivity with the UM cases is 80% at 22.6 FPs/cases when the LDA classifier was trained with the PIOPED cases.

  17. Triple rule-out computed tomographic angiography for chest pain: a diagnostic systematic review and meta-analysis.

    Science.gov (United States)

    Ayaram, David; Bellolio, M Fernanda; Murad, M Hassan; Laack, Torrey A; Sadosty, Annie T; Erwin, Patricia J; Hollander, Judd E; Montori, Victor M; Stiell, Ian G; Hess, Erik P

    2013-09-01

    The objective was to compare the image quality, diagnostic accuracy, radiation exposure, and contrast volume of "triple rule-out" (TRO) computed tomography (CT) to other diagnostic modalities commonly used to evaluate patients with nontraumatic chest pain (dedicated coronary, pulmonary embolism [PE], and aortic dissection CT; invasive coronary angiography; and nuclear stress testing). Four electronic databases were searched, along with reference lists and contacted content experts, for relevant studies from inception until October 2012. Eligible studies enrolled patients with nontraumatic chest pain, shortness of breath, suspected acute coronary syndrome (ACS), PE, or aortic dissection; used at least 64-slice CT technology; and compared TRO CT to another diagnostic modality. Eleven studies enrolling 3,539 patients (791 TRO and 2,748 non-TRO) were included (one randomized controlled trial and 10 observational). There was no significant difference in image quality between TRO and dedicated CT scans. TRO CT had the following pooled diagnostic accuracy estimates for coronary artery disease: sensitivity of 94.3% (95% confidence interval [CI] = 89.1% to 97.5%), specificity of 97.4% (95% CI = 96.1% to 98.4%), positive likelihood ratio (LR+) of 17.71 (95% CI = 3.92 to 79.96), and negative likelihood ratio (LR-) of 0.08 (95% CI = 0.02 to 0.27). There were insufficient numbers of patients with PE or aortic dissection to generate diagnostic accuracy estimates for these conditions. Use of TRO CT involved greater radiation exposure (mean difference [MD] = 4.84 mSv, 95% CI = 1.65 to 8.04 mSv) and contrast exposure (MD = 38.0 mL, 95% CI = 28.1 to 48.0 mL) compared to non-TRO CT patients. Triple rule-out CT is highly accurate for detecting coronary artery disease. Given the low (TRO CT in the diagnosis of these conditions. © 2013 by the Society for Academic Emergency Medicine.

  18. A Method for Identifying Contours in Processing Digital Images from Computer Tomograph

    Science.gov (United States)

    Roşu, Şerban; Pater, Flavius; Costea, Dan; Munteanu, Mihnea; Roşu, Doina; Fratila, Mihaela

    2011-09-01

    The first step in digital processing of two-dimensional computed tomography images is to identify the contour of component elements. This paper deals with the collective work of specialists in medicine and applied mathematics in computer science on elaborating new algorithms and methods in medical 2D and 3D imagery.

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

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Liu

    2007-06-01

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

  20. Differential diagnosis of solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomograph

    Energy Technology Data Exchange (ETDEWEB)

    Chu, Zhi-gang; Sheng, Bo; Liu, Meng-qi; Lv, Fa-jin; Li, Qi; Ouyang, Yu, E-mail: cyscitg@163.com [Hospital of Chongqing Medical University, Department of Radiology, Chongqing (China)

    2016-10-15

    Objectives: To clarify differences between solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomography. Methods: In total, 64 and 132 patients with solitary pulmonary inflammatory masses/nodules and peripheral lung cancers, respectively, were enrolled in this study. Their computed tomographic findings were summarized and compared retrospectively. Results: Compared with the peripheral lung cancers, the inflammatory lesions were located closer to the pleura (p<0.0001). The majority of the inflammatory lesions were patchy and oval-shaped (82.8%), whereas most of the tumors were lobulated (82.6%). Almost all the inflammatory cases were unclear (93.8%), whereas most of the tumors had speculated margins (72.7%). Computed tomography values were significantly higher for the inflammatory lesions than for the cancers (p<0.0001). More than half of the inflammatory lesions had defined necrosis (59.3%). Furthermore, 49.2% of the cancers enhanced inhomogeneously, but only 24.6% had ill-defined necrosis or cavities. The peripheral zones of 98.4% of the inflammatory lesions and 72.7% of the tumors were unclear, with peripheral scattered patches (92.2%) and beam-shaped opacity (66.7%) being the most common findings, respectively. Adjacent pleural thickening was more frequent for the inflammatory lesions than the cancers (95.3% vs. 21.1%, p<0.0001), whereas pleural indentation was found in 67.4% of the subjects with cancer. In addition, hilar (p=0.034) and mediastinal (p=0.003) lymphadenopathy were more commonly detected in the cancers than in the inflammatory cases. Conclusions: Contrast-enhanced computed tomography findings for pulmonary inflammatory lesions and peripheral lung cancers were significantly different in many aspects. Developing a comprehensive understanding of these differences is helpful for directing their management. (author)

  1. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography

    DEFF Research Database (Denmark)

    Rochitte, Carlos E; George, Richard T; Chen, Marcus Y

    2014-01-01

    AIMS: To evaluate the diagnostic power of integrating the results of computed tomography angiography (CTA) and CT myocardial perfusion (CTP) to identify coronary artery disease (CAD) defined as a flow limiting coronary artery stenosis causing a perfusion defect by single photon emission computed...... tomography (SPECT). METHODS AND RESULTS: We conducted a multicentre study to evaluate the accuracy of integrated CTA-CTP for the identification of patients with flow-limiting CAD defined by ≥50% stenosis by invasive coronary angiography (ICA) with a corresponding perfusion deficit on stress single photon...

  2. The influence of cardiac function on coronary arterial enhancement at coronary computed tomography angiography: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Maryam Moradi

    2016-01-01

    Full Text Available Background: The purpose of this study was to evaluate the influence of ejection fraction (EF on peak aortic time (PAT and peak aortic enhancement (PAE during coronary computed tomography angiography (CTA. Materials and Methods: One-hundred and twenty patients (64 men, 56 women underwent measurement of coronary CTA with a measurement of EF within 3 months of coronary CTA. Pearson's correlation coefficient analysis was used to investigate the relationships between EF, PAT and PAE, and peak attenuation of all coronary arteries. Results: The range of EF was (25%–70% (mean: 55 ± 7.7. The range of PAT and PAE of ascending aorta on bolus test was 13–31 s (mean: 19.3 ± 2 and 153–435 HU (mean: 235 ± 40.6, respectively. Mean peak attenuation of ascending aorta, right coronary artery, left coronary artery, left circumflex artery, and left anterior descending were (561 ± 119, (476 ± 109, (505 ± 108, (467 ± 113, and (473 ± 104, respectively. There was a negative correlation between EF and PAT (r = −0.266, P = 0.003; however, there was no significant correlation between EF and PAE (r = −0.027, P = 0.767.In addition, there was no significant correlation between EF and the peak attenuation of coronary arteries. Conclusion: PAT was related to EF, but there was no relationship between PAE and EF. One of the explanation is that the left ventricular EF used for our study was assessed with echocardiography which is used roughly estimation of EF with interval of 5%–10% and may cause confounding results.

  3. Patients With Suspected Coronary Artery Disease Referred for Examinations in the Era of Coronary Computed Tomography Angiography

    DEFF Research Database (Denmark)

    Zorlak, Adja; Zorlak, Amet; Thomassen, Anders

    2015-01-01

    Invasive coronary angiography (ICA) is the gold standard in the diagnosis of coronary artery disease (CAD), however, associated with rare but severe complications. Patients with a high pretest risk should be referred directly for ICA, whereas a noninvasive strategy is recommended in the remaining......-photon emission computed tomography (SPECT), or ICA qualified for inclusion. The patients were followed for 1 year, and additional downstream diagnostic tests and need of coronary revascularization were registered. A total of 1,069 patients were included. A noninvasive test was the first examination in 797......], p = 0.09). In conclusion, a noninvasive diagnostic test was chosen as the first test in 3 of 4 patients. Of the patients referred directly for noninvasive examination, 1/5 had significant CAD, whereas 1/3 of those for invasive examination....

  4. Coronary revascularization treatment based on dual-source computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dikkers, R.; Willems, T.P.; Jonge, G.J. de; Zaag-Loonen, H.J. van der; Ooijen, P.M.A. van; Oudkerk, M. [University of Groningen, Department of Radiology, Groningen (Netherlands); University Medical Center, Groningen (Netherlands); Piers, L.H.; Tio, R.A.; Zijlstra, F. [University of Groningen, Department of Cardiology, Groningen (Netherlands); University Medical Center, Groningen (Netherlands)

    2008-09-15

    Therapy advice based on dual-source computed tomography (DSCT) in comparison with coronary angiography (CAG) was investigated and the results evaluated after 1-year follow-up. Thirty-three consecutive patients (mean age 61.9 years) underwent DSCT and CAG and were evaluated independently. In an expert reading (the ''gold standard''), CAG and DSCT examinations were evaluated simultaneously by an experienced radiologist and cardiologist. Based on the presence of significant stenosis and current guidelines, therapy advice was given by all readers blinded from the results of other readings and clinical information. Patients were treated based on a multidisciplinary team evaluation including all clinical information. In comparison with the gold standard, CAG had a higher specificity (91%) and positive predictive value (PPV) (95%) compared with DSCT (82% and 91%, respectively). DSCT had a higher sensitivity (96%) and negative predictive value (NPV) (89%) compared with CAG (91% and 83%, respectively). The DSCT-based therapy advice did not lead to any patient being denied the revascularization they needed according to the multidisciplinary team evaluation. During follow-up, two patients needed additional revascularization. The high NPV for DSCT for revascularization assessment indicates that DSCT could be safely used to select patients benefiting from medical therapy only. (orig.)

  5. Computer tomographic investigation of subcutaneous adipose tissue as an indicator of body composition

    DEFF Research Database (Denmark)

    McEvoy, Fintan; Madsen, Mads T.; Nielsen, Mai B.;

    2009-01-01

    Background Modern computer tomography (CT) equipment can be used to acquire whole-body data from large animals such as pigs in minutes or less. In some circumstances, computer assisted analysis of the resulting image data can identify and measure anatomical features. The thickness of subcutaneous...... and expressed as a proportion of total volume (fat-index). A computer algorithm was used to determined 10,201 subcutaneous adipose thickness measurements in each pig for each scan. From these data, sites were selected where correlation with fat-index was optimal. Results Image analysis correctly identified...... intercostal spaces cranially. Conclusion The approach to image analysis reported permits the creation of various maps showing adipose thickness or correlation of thickness with other variables by location on the surface of the pig. The method identified novel adipose thickness measurement positions...

  6. Measurement of cochlea to facial nerve canal with thin-section computed tomographic image.

    Science.gov (United States)

    Jiang, Ying; Liu, Xiangliang; Yao, Jihang; Tian, Yong; Xia, Changli; Li, Youqiong; Fu, Yan; Luo, Qi

    2013-03-01

    Facial nerve (FN) paralysis is a rare but devastating complication of cochlear implant surgery. This study aimed to measure the cupula of the cochlea to the tympanic segment of the FN canal, cupula of the cochlea to the mastoid segment of the FN canal, and the geniculate ganglion to provide a more secure and accurate orientation of the FN canal and to facilitate operation on the cochlea by avoiding potential damage to FN. Using computed tomography, we scanned skulls of 120 volunteers who suffer no cases of skull base lesions. Multiplane reconstruction images were prepared with high-resolution computed tomography. Preoperative evaluation of the FN anatomy within the temporal bone by high-resolution computed tomography helps in minimizing surgical trauma to the nerve, and these results can help guide clinical surgery on the cochlea.

  7. The impact of reorienting cone-beam computed tomographic images in varied head positions on the coordinates of anatomical landmarks

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hun; Jeong, Ho Gul; Hwang, Jae Joon; Lee, Jung Hee; Han, Sang Sun [Dept. of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul (Korea, Republic of)

    2016-06-15

    The aim of this study was to compare the coordinates of anatomical landmarks on cone-beam computed tomographic (CBCT) images in varied head positions before and after reorientation using image analysis software. CBCT images were taken in a normal position and four varied head positions using a dry skull marked with 3 points where gutta percha was fixed. In each of the five radiographic images, reference points were set, 20 anatomical landmarks were identified, and each set of coordinates was calculated. Coordinates in the images from the normally positioned head were compared with those in the images obtained from varied head positions using statistical methods. Post-reorientation coordinates calculated using a three-dimensional image analysis program were also compared to the reference coordinates. In the original images, statistically significant differences were found between coordinates in the normal-position and varied-position images. However, post-reorientation, no statistically significant differences were found between coordinates in the normal-position and varied-position images. The changes in head position impacted the coordinates of the anatomical landmarks in three-dimensional images. However, reorientation using image analysis software allowed accurate superimposition onto the reference positions.

  8. Early onset cerebellar ataxia with retained tendon reflexes (EOCA and olivopontocerebellar atrophy (OPCA : a computed tomographic study.

    Directory of Open Access Journals (Sweden)

    Pal P

    1999-10-01

    Full Text Available Computed tomographic (CT studies in olivopontocerebellar atrophies (OPCA and ′early onset cerebellar ataxia with retained tendon reflexes (EOCA′ are few and vary widely in methodology and criteria for cerebellar and brainstem atrophy. In this prospective study, CT scan observations on 26 patients (EOCA-11, OPCA-15 were compared with 31 controls using qualitative and quantitative assessment of cisterns, ventricles and atrophy of brain. Vermian and/or cerebellar hemispheric (predominantly anterior atrophy was present in 80.8% and both were equally common. Cerebral cortical atrophy (26.9% and leukoariosis (15.4% were less frequently seen. Statistically significant atrophy of pons, brachium pontis, cerebellum and midbrain was noted in patient group. No significant differences were observed between EOCA and OPCA groups. Evidence of atrophy did not correlate with either the duration of illness or the severity of cerebellar ataxia in both the groups. The severity of brainstem atrophy in 14 patients with and 12 patients without abnormal brainstem auditory evoked response did not differ significantly. This study highlights the methodology of CT evaluation for brainstem and cerebellar atrophy, draws attention to cerebral atrophy and emphasizes the lack of significant differences in CT morphology between OPCA and EOCA patients.

  9. Analysis of factors influencing the integrated bolus peak timing in contrast-enhanced brain computed tomographic angiography

    Energy Technology Data Exchange (ETDEWEB)

    Son, Soon Yong [Wonkwang Health Science University, Iksan (Korea, Republic of); Choi, Kwan Woo [Asan Medical Center, Seoul (Korea, Republic of); Jeong, Hoi Woun [Baekseok Culture University College, Cheonan (Korea, Republic of); Jang, Seo Goo [Soonchunhyang University, Asan (Korea, Republic of); Jung, Jae Young [Sanggye Paik Hospital, Seoul (Korea, Republic of); Yun, Jung Soo [Samsung Medical Center, Seoul (Korea, Republic of); Kim, Ki Won [Kyung Hee University Hospital at Gang-dong, Seoul (Korea, Republic of); Lee, Young Ah; Son, Jin Hyun; Min, Jung Whan [Shingu University College, Sungnam (Korea, Republic of)

    2016-03-15

    The objective of this study was to analyze the factors influencing integrated bolus peak timing in contrast- enhanced computed tomographic angiography (CTA) and to determine a method of calculating personal peak time. The optimal time was calculated by performing multiple linear regression analysis, after finding the influence factors through correlation analysis between integrated peak time of contrast medium and personal measured value by monitoring CTA scans. The radiation exposure dose in CTA was 716.53 mGy·cm and the radiation exposure dose in monitoring scan was 15.52 mGy (2 - 34 mGy). The results were statistically significant (p < .01). Regression analysis revealed, a -0.160 times decrease with a one-step increase in heart rate in male, and -0.004, -0.174, and 0.006 times decrease with one-step in DBP, heart rate, and blood sugar, respectively, in female. In a consistency test of peak time by calculating measured peak time and peak time by using the regression equation, the consistency was determined to be very high for male and female. This study could prevent unnecessary dose exposure by encouraging in clinic calculation of personal integrated peak time of contrast medium prior to examination.

  10. The impact of reorienting cone-beam computed tomographic images in varied head positions on the coordinates of anatomical landmarks

    Science.gov (United States)

    Kim, Jae Hun; Hwang, Jae Joon; Lee, Jung-Hee

    2016-01-01

    Purpose The aim of this study was to compare the coordinates of anatomical landmarks on cone-beam computed tomographic (CBCT) images in varied head positions before and after reorientation using image analysis software. Materials and Methods CBCT images were taken in a normal position and four varied head positions using a dry skull marked with 3 points where gutta percha was fixed. In each of the five radiographic images, reference points were set, 20 anatomical landmarks were identified, and each set of coordinates was calculated. Coordinates in the images from the normally positioned head were compared with those in the images obtained from varied head positions using statistical methods. Post-reorientation coordinates calculated using a three-dimensional image analysis program were also compared to the reference coordinates. Results In the original images, statistically significant differences were found between coordinates in the normal-position and varied-position images. However, post-reorientation, no statistically significant differences were found between coordinates in the normal-position and varied-position images. Conclusion The changes in head position impacted the coordinates of the anatomical landmarks in three-dimensional images. However, reorientation using image analysis software allowed accurate superimposition onto the reference positions. PMID:27358821

  11. Three-dimensional computed tomographic evaluation of Le Fort III distraction osteogenesis with an external device in syndromic craniosynostosis.

    Science.gov (United States)

    Wery, M F; Nada, R M; van der Meulen, J J; Wolvius, E B; Ongkosuwito, E M

    2015-03-01

    There is little anteroposterior growth of the midface in patients with syndromic craniosynostosis who are followed up over time without intervention. A Le Fort III with distraction osteogenesis can be done to correct this. This is a controlled way in which to achieve appreciable stable advancement of the midface without the need for bone grafting, but the vector of the movement is not always predictable. The purpose of this study was to evaluate the 3-dimensional effect of Le Fort III distraction osteogenesis with an external frame. Ten patients (aged 7-19 years) who had the procedure were included in the study. The le Fort III procedure and the placement of the external frame were followed by an activation period and then a 3-month retention period. Computed tomographic (CT) images taken before and after operation were converted and loaded into 3-dimensional image rendering software and compared with the aid of a paired sample t test and a colour-coded qualitative analysis. Comparison of the CT data before and after distraction indicated that the amount of midface advancement was significant. Le Fort III distraction osteogenesis is an effective way to advance the midface. However, the movement during osteogenesis is not always exactly in the intended direction, and a secondary operation is often necessary. Three-dimensional evaluation over a longer period of time is necessary.

  12. Complimentary Imaging Modalities for Investigating Obscure Gastrointestinal Bleeding: Capsule Endoscopy, Double-Balloon Enteroscopy, and Computed Tomographic Enterography

    Directory of Open Access Journals (Sweden)

    Ye Chu

    2016-01-01

    Full Text Available Objectives. The complimentary value of computed tomographic enterography (CTE and double-balloon enteroscopy (DBE combined with capsule endoscopy (CE was evaluated in the diagnosis of obscure gastrointestinal bleeding (OGIB. Methods. Patients who received CE examinations at Ruijin Hospital between July 2007 and July 2014 with the indication of OGIB were identified, and those who also underwent DBE and/or CTE were included. Their clinical information was retrieved, and results from each test were compared with findings from the other two examinations. Results. The overall diagnostic yield of CE was comparable with DBE (73.9% versus 60.9% but was significantly higher than the yield of CTE (87% versus 25%, p<0.001. The diagnostic yield of angiodysplasia at CE was significantly higher than CTE (73% versus 8%, p<0.001 and DBE (39.1% versus 17.4%, p=0.013, while no significant difference was found between the three approaches for small bowel tumors. DBE and CTE identified small bowel diseases undetected or undetermined by CE. Conversely, CE improved diagnosis in the cases with negative CTE and DBE, and findings at initial CE directed further diagnosis made by DBE. Conclusions. Combination of the three diagnostic platforms provides complementary value in the diagnosis of OGIB.

  13. Maxillary sinus and posterior teeth: accessing close relationship by cone-beam computed tomographic scanning in a Brazilian population.

    Science.gov (United States)

    Pagin, Otávio; Centurion, Bruna Stuchi; Rubira-Bullen, Izabel Regina Fischer; Alvares Capelozza, Ana Lúcia

    2013-06-01

    This study aimed to evaluate the close proximity established between the maxillary sinus floor and posterior teeth roots apices by using cone-beam computed tomographic scanning. The relationship of maxillary sinuses and posterior teeth roots, which were divided into 2 groups, was analyzed using i-CAT Vision software (Imaging Sciences, Hatfield, PA). Group 1 included all root apices found in close contact with the maxillary sinus floor without sinus floor elevation, whereas group 2 included all root apices that were protruded within the sinus producing an elevation of the bony cortical. A total of 100 maxillary sinuses and 601 roots apices were evaluated. Group 1 presented 130 of 601 (21.6%) roots and group 2 presented 86 of 601 (14.3%) roots. The second molar mesiobuccal root apex is frequently found in close proximity with the sinus floor, and the relation between these anatomic structures should be considered in order to prevent an iatrogenic procedure and minimize the risks from an infectious disease within the sinus. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  14. Tomographic measurement of temperature change in phantoms of the human body by chirp radar-type microwave computed tomography.

    Science.gov (United States)

    Miyakawa, M

    1993-07-01

    The chirp radar-type microwave computed tomograph (CT) measures the temperature change in a human body noninvasively. The paper examines its feasibility. A chirp pulse signal between 1 and 2 GHz is radiated from the transmitting antenna to the phantom. The transmitted waves are detected by the receiving antenna, which is placed on the opposite side of the object, and the beat signal between the incident wave and the transmitted wave is produced by the mixer. By spectral analysis of the beat signal, only those signals transmitted on the straight line between the transmitting antenna and the receiving antenna are discriminated from multipath signals. The microwave tomogram can therefore be reconstructed easily using the conventional algorithms for an X-ray CT image. The microwave CT can use the chirp signal to remove the influence of multipath signals caused by diffraction and reflection. The imaging of dielectric materials with complicated structures is thus possible. The experimental results using phantoms show that the spatial resolution of this microwave CT is about 10 mm and that a two-dimensional distribution of temperature change can be measured.

  15. Computer tomographic and sonographic demonstration of renal haematomas following percutaneous renal biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Nebel, G.; Lingg, G.; Berg, E.; Fischer, R.

    1982-04-01

    The incidence of post-puncture haematomas following percutaneous renal biopsy in 23 patients (24 punctures) is reported. The incidence of renal haematomas was 29.1%. The diagnostic value of computer tomography and sonography is discussed. Amongst small haematomas (less than 7 ml. blood), which could only be demonstrated by computer tomography, 8.2% were purely intrarenal, 8.2% were sub-capsular and 12.3% showed combined intrarenal, subcapsular and perirenal bleeding. The incidence of sub-capsular and perirenal haematomas of 20.5% is considerably lower than has previously been reported in literature.

  16. Sixty-four-multi-detector computed tomography diagnosis of coronary artery anomalies in 66 patients

    Institute of Scientific and Technical Information of China (English)

    YANG Shan; ZENG Meng-su; ZHANG Zhi-yong; LING Zhi-qing; MA Jian-ying; CHEN Gang

    2010-01-01

    Background The abnormalities of coronary arteries, though rare and sometimes benign, may first present clinically as myocardial infarction or sudden death. Multi-detector computed tomography (MDCT) is a non-invasive test that is highly suitable for detecting these anomalies. The study aimed to review the 64-MDCT appearance of the coronary artery anomalies in 66 patients and to discuss the clinical importance of these anomalies.Methods In 6014 consecutive patients examined over 12 months by 64-MDCT for the study of coronary artery disease, 66 were diagnosed for coronary artery anomalies. All patients were symptomatic for one or more of the following diseases: chest pain, dyspnoea, palpitations, arrhythmia and myocardial infarction. Nine patients had undergone a coronary angiography. All the CT images were evaluated by two radiologists and one cardiologist. The right coronary artery (RCA) and the conus branch arising separately, myocardial bridging and duplication of arteries were not analysed in our study.Results The incidence of coronary artery anomalies found in our study group was 1.097%. In the selected patients, seven different types of coronary anomalies were found by 64-MDCT examination. The high takeoff, origin of the coronary artery from the opposite or noncoronary sinus with an anomalous course, and coronary artery fistula were the three common forms of anomalies (n=16, 18 and 16, respectively). Compared with the results of the coronary angiography, the number of the drainage sites of two coronary artery fistula was less in MDCT images (3 small sites in total). In all cases, coronary artery computed tomography angiography (CTA) technique was able to recognize the origin of the coronary artery, its three-dimensional course and its spatial relationship with the adjacent structures. Conventional coronary angiography in two cases, however, was unable to provide sufficient information for correct and complete diagnosis.Conclusions In conclusion, the study

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

    Science.gov (United States)

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

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

  18. Efficacy of 3-D computed tomographic reconstruction in evaluating anatomical relationships of colovesical fistula.

    Science.gov (United States)

    Shinojima, Toshiaki; Nakajima, Fumio; Koizumi, Jun

    2002-04-01

    A case of colovesical fistula is reported. The anatomy of the pelvis was determined preoperatively with 3-D computed tomography (CT), and the fistula, including adjacent structures, could clearly be seen. Compared with conventional axial CT imaging, 3-D CT provided better and more complete visualization of the anatomical relationships, which facilitated the surgical procedure and provided a good outcome.

  19. Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening

    NARCIS (Netherlands)

    Scholten, E.T.; Horeweg, N.; Koning, H.J. de; Vliegenthart, R.; Oudkerk, M.; Mali, W.P.; Jong, P.A. de

    2015-01-01

    OBJECTIVES: To analyse computed tomography (CT) findings of interval and post-screen carcinomas in lung cancer screening. METHODS: Consecutive interval and post-screen carcinomas from the Dutch-Belgium lung cancer screening trial were included. The prior screening and the diagnostic chest CT were

  20. Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening

    NARCIS (Netherlands)

    Scholten, Ernst Th.; Horeweg, Nanda; de Koning, Harry J.; Vliegenthart, Rozemarijn; Oudkerk, Matthijs; Mali, Willem P. Th. M.; de Jong, Pim A.

    Objectives To analyse computed tomography (CT) findings of interval and post-screen carcinomas in lung cancer screening. Methods Consecutive interval and post-screen carcinomas from the Dutch-Belgium lung cancer screening trial were included. The prior screening and the diagnostic chest CT were

  1. Identification of Chronic Obstructive Pulmonary Disease in Lung Cancer Screening Computed Tomographic Scans

    NARCIS (Netherlands)

    Mets, Onno M.; Buckens, Constantinus F. M.; Zanen, Pieter; Isgum, Ivana; van Ginneken, Bram; Prokop, Mathias; Gietema, Hester A.; Lammers, Jan-Willem J.; Vliegenthart, Rozemarijn; Oudkerk, Matthijs; van Klaveren, Rob J.; de Koning, Harry J.; Mali, Willem P. Th M.; de Jong, Pim A.

    2011-01-01

    Context Smoking is a major risk factor for both cancer and chronic obstructive pulmonary disease (COPD). Computed tomography (CT)-based lung cancer screening may provide an opportunity to detect additional individuals with COPD at an early stage. Objective To determine whether low-dose lung cancer

  2. Identification of chronic obstructive pulmonary disease in lung cancer screening computed tomographic scans

    NARCIS (Netherlands)

    Mets, O.M.; Buckens, C.F.; Zanen, P.; Isgum, I.; Ginneken, B. van; Prokop, M.; Gietema, H.A.; Lammers, J.W.; Vliegenthart, R.; Oudkerk, M.; Klaveren, R.J. van; Koning, H.J. de; Mali, W.P.Th.; Jong, P.A. de

    2011-01-01

    CONTEXT: Smoking is a major risk factor for both cancer and chronic obstructive pulmonary disease (COPD). Computed tomography (CT)-based lung cancer screening may provide an opportunity to detect additional individuals with COPD at an early stage. OBJECTIVE: To determine whether low-dose lung cancer

  3. Computed tomographic study of the skeletal musculature of the lower body in 45 postpolio patients

    NARCIS (Netherlands)

    Ivanyi, B; Redekop, W; de Jongh, R; de Visser, Marianne

    1998-01-01

    Muscle computed tomography (CT) and muscle strength assessment of the pelvic girdle and leg muscles were performed in 32 postpolio patients experiencing new muscle weakness, and in 13 postpolio patients with stable neuromuscular condition. Muscles of the postpolio patients experiencing new muscle we

  4. Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening

    NARCIS (Netherlands)

    Scholten, E.T.; Horeweg, N.; Koning, H.J. de; Vliegenthart, R.; Oudkerk, M.; Mali, W.P.; Jong, P.A. de

    2015-01-01

    OBJECTIVES: To analyse computed tomography (CT) findings of interval and post-screen carcinomas in lung cancer screening. METHODS: Consecutive interval and post-screen carcinomas from the Dutch-Belgium lung cancer screening trial were included. The prior screening and the diagnostic chest CT were re

  5. 64-multyslice computed tomography: detection of coronary artery disease in patients with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    A. S. Nikonenko

    2015-02-01

    Full Text Available At present time, the death rate from cardiovascular disease occupies leading position in the structure of total mortality worldwide. The opportunity to conduct non-invasive studies of the coronary arteries has appeared through the development and implementation of multislice computed tomography (MSCT into medical practice, which carry 64 or more sections. Aim. The purpose of this research is the identification of diagnostic capabilities of 64-slice MSCT in the verification of the severity of coronary artery lesions in patients with proven coronary artery disease. Methods and results. The study has been conducted on a 64-slice CT scanner Optima 660 (GE, USA. The degree of stenosis and calcification of the coronary arteries and also central hemodynamics have been studied. The analysis of survey results of 65 patients with coronary heart disease (30.8% of patients had a history of myocardial infarction has been carried out. The average age of patients in observation group was 60.2 ± 10.56 years. Male patients were dominated (75.4%. According to the 64-slice MSCT it has been found that coronary artery stenosis occurs ≥ 50% in 90.0% of patients with myocardial infarction, and in 32.5% of patients with symptomatic coronary artery disease. Conclusion. Therefore, MSCT has sufficient specificity in the diagnosis of occlusive and stenotic lesions of the coronary arteries, and can be used for screening patients with suspected coronary artery disease.

  6. Visualization of anomalous coronary arteries on dual-source computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Jonge, G.J. de; Ooijen, P.M.A. van; Dikkers, R.; Willems, T.P.; Oudkerk, M. [University Medical Center Groningen, University of Groningen, Department of Radiology, Hanzeplein 1, P.O. Box 30.001, Groningen (Netherlands); Piers, L.H.; Tio, R.A.; Heuvel, A.F.M. van den; Zijlstra, F. [University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen (Netherlands)

    2008-11-15

    The purpose of this study is to assess the capability of dual-source computed tomography (DSCT) in evaluating coronary artery anomalies. Early detection and evaluation of coronary artery anomalies is essential because of their potential association with myocardial ischemia and sudden death. In 16 patients (12 men, mean age 50 {+-} 14 years), anomalous coronary arteries were detected on contrast-enhanced DSCT in a patient cohort of 230 individuals (incidence of 7%). Six different types of anomalies were diagnosed (three fistula, four anomalies of the circumflex artery, four anomalous right coronary arteries, three anomalies of the left coronary artery, one absent left main coronary artery, and one left coronary artery arising from the pulmonary trunk). Of the 16 patients, 10 also underwent conventional coronary angiography (CAG). Retrospective evaluation of the CAGs by an experienced interventional cardiologist resulted in a precise diagnosis in 50% of patients. With DSCT, sufficient image quality and exact visualization of the aberrant anatomy were achieved in all patients. Therefore, DSCT seems to be an accurate diagnostic tool for examining the precise origin, course, and shape of aberrant coronary arteries. (orig.)

  7. Middle east respiratory syndrome-corona virus infection: A case report of sieral computed tomographic findings in a young male patient

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Won Jin; Lee, Ki Nam; Kang, Eun Ju; Lee, Hyuck [Dong A University Hospital, Busan (Korea, Republic of)

    2016-02-15

    Radiologic findings of Middle East respiratory syndrome (MERS), a novel coronavirus infection, have been rarely reported. We report a 30-year-old male presented with fever, abdominal pain, and diarrhea, who was diagnosed with MERS. A chest computed tomographic scan revealed rapidly developed multifocal nodular consolidations with ground-glass opacity halo and mixed consolidation, mainly in the dependent and peripheral areas. After treatment, follow-up imaging showed that these abnormalities markedly decreased but fibrotic changes developed.

  8. Computed tomography imaging of early coronary artery lesions in stable individuals with multiple cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Xi Yang

    2015-04-01

    Full Text Available OBJECTIVES: To investigate the prevalence, extent, severity, and features of coronary artery lesions in stable patients with multiple cardiovascular risk factors. METHODS: Seventy-seven patients with more than 3 cardiovascular risk factors were suspected of having coronary artery disease. Patients with high-risk factors and 39 controls with no risk factors were enrolled in the study. The related risk factors included hypertension, impaired glucose tolerance, dyslipidemia, smoking history, and overweight. The characteristics of coronary lesions were identified and evaluated by 64-slice coronary computed tomography angiography. RESULTS: The incidence of coronary atherosclerosis was higher in the high-risk group than in the no-risk group. The involved branches of the coronary artery, the diffusivity of the lesion, the degree of stenosis, and the nature of the plaques were significantly more severe in the high-risk group compared with the no-risk group (all p < 0.05. CONCLUSION: Among stable individuals with high-risk factors, early coronary artery lesions are common and severe. Computed tomography has promising value for the early screening of coronary lesions.

  9. Utilization of cardiac computed tomography angiography and outpatient invasive coronary angiography in Ontario, Canada.

    Science.gov (United States)

    Roifman, Idan; Rezai, Mohammad R; Wijeysundera, Harindra C; Chow, Benjamin J W; Wright, Graham A; Tu, Jack V

    2015-01-01

    Cardiac computed tomography angiography (coronary CTA) has emerged as a non-invasive method of diagnosing coronary artery disease. The extent of utilization and uptake of this technology since initiation of its funding by the government of Ontario is unknown. The aim of our study was to examine coronary CTA utilization and the rates of elective invasive coronary angiography and revascularization before and after funding initiation. We studied all coronary CTAs performed on adults in Ontario after initiation of funding. We also used an interrupted time series analysis to compare the average monthly rates of invasive angiography and revascularization before and after initiation of funding. There was an initial steep increase in age-and sex-standardized rates of coronary CTA from 5.0 to 11.4/100,000 over the first two quarters after funding initiation. Afterwards, there was a gradual increase in utilization from 11.4 to 17.1/100,000 over two subsequent calendar years. There was a significant reduction in both the mean monthly outpatient invasive coronary angiography (from 20.7 to 19.9 per 100,000 (p = 0.0004)) and revascularization (from 4.9 to 4.4 per 100,000 (p utilization. The increasing use of coronary CTA was associated with a reduction in both the rates of invasive angiography and revascularization. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  10. Association of ischemic stroke to coronary artery disease using computed tomography coronary angiography

    DEFF Research Database (Denmark)

    Jensen, Jesper Møller; Medina, Hector; Nørgaard, Bjarne Linde;

    2012-01-01

    BACKGROUND: While patients with coronary artery disease (CAD) and cerebrovascular disease share similar risk factor profiles, data on whether IS can be considered a "CAD equivalent" are limited. We aimed to determine whether ischemic stroke is an independent predictor of CAD by using cardiac...... increase odds of having coronary artery plaque (odds ratio [OR] 4.9, P4 segments of plaque than 0-4 segments as compared to patients without stroke (OR 18.3, P...

  11. Computed tomographic findings in a case of renal vein thrombosis with nephrotic syndrome.

    Science.gov (United States)

    Adler, J; Greweldinger, J; Hallac, R; Frier, S

    1981-01-01

    Renal vein thrombosis is a complication of the nephrotic syndrome presumably related to compression of renal veins by edematous parenchyma and a concomitant hypercoagulable state. The diagnosis has been made by demonstrating marked widening of the left renal vein as it crosses horizontally anterior to the aorta on computed tomography. Inferior venacavography confirmed the presence of thrombosis within the vessels. CT is suggested as a method for noninvasive imaging of the renal veins which might eliminate the need for venography.

  12. High resolution computed tomographic assessment of asbestosis and cryptogenic fibrosing alveolitis: a comparative study.

    Science.gov (United States)

    al-Jarad, N; Strickland, B; Pearson, M C; Rubens, M B; Rudd, R M

    1992-01-01

    BACKGROUND: The aim of this study was to compare the distribution and configuration of lung opacities in patients with cryptogenic fibrosing alveolitis and asbestosis by high resolution computed tomography. METHODS: Eighteen patients with cryptogenic fibrosing alveolitis and 24 with asbestosis were studied. Two independent observers assessed the type and distributions of opacities in the upper, middle, and lower zones of the computed tomogram. RESULTS: Upper zone fibrosis occurred in 10 of the 18 patients with cryptogenic fibrosing alveolitis and in six of the 24 patients with asbestosis. A specific pattern in which fibrosis was distributed posteriorly in the lower zones, laterally in the middle zones, and anteriorly in the upper zones was seen in 11 patients with cryptogenic fibrosing alveolitis and in four with asbestosis. Band like intrapulmonary opacities, often merging with the pleura, were seen in 19 patients with asbestosis but in only two with cryptogenic fibrosing alveolitis. Areas with a reticular pattern and a confluent or ground glass pattern were the commonest features of cryptogenic fibrosing alveolitis (15 and 14 patients respectively) but were uncommon in asbestosis (four and three patients). Pleural thickening or plaques were seen in 21 patients with asbestosis and in none with cryptogenic fibrosing alveolitis. CONCLUSION: Apart from showing pleural disease high resolution computed tomography showed that confluent (ground glass) opacities are common in cryptogenic fibrosing alveolitis and rare in asbestosis whereas thick, band like opacities are common in asbestosis and rare in cryptogenic fibrosing alveolitis. Images PMID:1412123

  13. [Diprosopus triophthalmus. From ancient terracotta sculptures to spiral computer tomographic reconstruction].

    Science.gov (United States)

    Sokiranski, R; Pirsig, W; Nerlich, A

    2005-03-01

    A still-born male fetus from the 19th century, fixed in formalin and presenting as diprosopia triophthalmica, was analysed by helical computer tomography and virtually reconstructed without damage. This rare, incomplete, symmetrical duplication of the face on a single head with three eyes, two noses and two mouths develops in the first 3 weeks of gestation and is a subset of the category of conjoined twins with unknown underlying etiology. Spiral computer tomography of fixed tissue demonstrated in the more than 100 year old specimen that virtual reconstruction can be performed in nearly the same way as in patients (contrast medium application not possible). The radiological reconstruction of the Munich fetus, here confined to head and neck data, is the basis for comparison with a number of imaging procedures of the last 3000 years. Starting with some Neolithic Mesoamerican ceramics, the "Pretty Ladies of Tlatilco", diprosopia triophthalmica was also depicted on engravings of the 16th and 17th century A.D. by artists as well as by the anatomist Soemmering and his engraver Berndt in the 18th century. Our modern spiral computer tomography confirms the ability of our ancestors to depict diprosopia triophthalmica in paintings and sculptures with a high level of natural precision.

  14. Computed tomographic angiography as the primary diagnostic modality in penetrating lower extremity vascular injuries: a level I trauma experience.

    Science.gov (United States)

    Wallin, Dina; Yaghoubian, Arezou; Rosing, David; Walot, Irving; Chauvapun, Joe; de Virgilio, Christian

    2011-07-01

    Computed tomographic angiography (CTA) has been established as a valid modality for the assessment of extremity vascular injury. Over the last several years at our institution, CTA has evolved as the primary diagnostic modality for penetrating extremity injuries, largely replacing diagnostic angiography. The purpose of this study was to evaluate the outcomes with this imaging modality at a high-volume Level I trauma center. A retrospective review was conducted of all patients presenting with penetrating lower extremity trauma between 2008 and 2009. Patient factors collected included demographics, mechanism of injury, injury severity, presence of hard signs of vascular injury, radiologic studies, operative intervention, and outcomes. There were 132 patients with penetrating lower extremity trauma. The average age of the patients was 25 years, with an average injury severity score of 10. The injuries were primarily gunshot wounds (89%). In all, 59 patients (45%) underwent CTA. CTA of the extremity was performed as a continuation of a computed tomography of the chest/abdomen/pelvis in 28 (47%) versus a targeted CTA of the extremity in 31 (53%) patients. In all, 34 (58%) CTAs were negative for vascular injury, 19 (32%) were positive, and six (10%) were indeterminate. Of the 34 patients with a normal CTA, none went to the operating room for repair of a major vascular injury; similarly, of the 19 patients with an abnormal CTA, there were no negative operative explorations. A total of 28 (21%) patients required operative intervention for the injured extremity; procedures performed included fasciotomy, venous and arterial ligation, primary repair, and interposition grafting. There were no amputations and no mortalities. Our results support the use of CTA as the primary imaging modality in evaluating penetrating lower extremity injury. Because of its proven accuracy in detecting major vascular injury, cost-effectiveness, and ease and rapidity of administration and

  15. 3D computed tomographic evaluation of the upper airway space of patients undergoing mandibular distraction osteogenesis for micrognathia.

    Science.gov (United States)

    Bianchi, A; Betti, E; Badiali, G; Ricotta, F; Marchetti, C; Tarsitano, A

    2015-10-01

    Mandibular distraction osteogenesis (MDO) is currently an accepted method of treatment for patients requiring reconstruction of hypoplastic mandibles. To date one of the unsolved problems is how to assess the quantitative increase of mandible length needed to achieve a significant change in the volume of the posterior airway space (PAS) in children with mandibular micrognathia following distraction osteogenesis. The purpose of this study is to present quantitative volumetric evaluation of PAS in young patients having distraction osteogenesis for micrognathia using 3D-CT data sets and compare it with pre-operative situation. In this observational retrospective study, we report our experience in five consecutive patients who underwent MDO in an attempt to relieve severe upper airway obstruction. Each patient was evaluated before treatment (T0) and at the end of distraction procedure (T1) with computer tomography (CT) in axial, coronal, and sagittal planes and three-dimensional CT of the facial bones and upper airway. Using parameters to extract only data within anatomic constraints, a digital set of the edited upper airway volume was obtained. The volume determination was used for volumetric qualification of upper airway. The computed tomographic digital data were used to evaluate the upper airway volumes both pre-distraction and post-distraction. The mean length of distraction was 23 mm. Quantitative assessment of upper airway volume before and after distraction demonstrated increased volumes ranging from 84% to 3,087% with a mean of 536%. In conclusion, our study seems to show that DO can significantly increase the volume of the PAS in patients with upper airway obstruction following micrognathia, by an average of 5 times. Furthermore, the worse is the starting volume, the greater the increase in PAS to equal distraction.

  16. Angpow: a software for the fast computation of accurate tomographic power spectra

    Science.gov (United States)

    Campagne, J.-E.; Neveu, J.; Plaszczynski, S.

    2017-06-01

    Aims: The statistical distribution of galaxies is a powerful probe to constrain cosmological models and gravity. In particular, the matter power spectrum P(k) provides information about the cosmological distance evolution and the galaxy clustering. However the building of P(k) from galaxy catalogs requires a cosmological model to convert angles on the sky and redshifts into distances, which leads to difficulties when comparing data with predicted P(k) from other cosmological models, and for photometric surveys like the Large Synoptic Survey Telescope (LSST). The angular power spectrum Cℓ(z1,z2) between two bins located at redshift z1 and z2 contains the same information as the matter power spectrum, and is free from any cosmological assumption, but the prediction of Cℓ(z1,z2) from P(k) is a costly computation when performed precisely. Methods: The Angpow software aims at quickly and accurately computing the auto (z1 = z2) and cross (z1 ≠ z2) angular power spectra between redshift bins. We describe the developed algorithm based on developments on the Chebyshev polynomial basis and on the Clenshaw-Curtis quadrature method. We validate the results with other codes, and benchmark the performance. Results: Angpow is flexible and can handle any user-defined power spectra, transfer functions, and redshift selection windows. The code is fast enough to be embedded inside programs exploring large cosmological parameter spaces through the Cℓ(z1,z2) comparison with data. We emphasize that the Limber's approximation, often used to speed up the computation, gives incorrect Cℓ values for cross-correlations. The C++ code is available from http://https://gitlab.in2p3.fr/campagne/AngPow

  17. Computed tomographical (CT) anatomy of the thoracoabdominal cavity of the male turkey (Meleagris gallopavo).

    Science.gov (United States)

    Petnehazy, O; Benczik, J; Takacs, I; Petrasi, Zs; Süto, Z; Horn, P; Repa, I

    2012-02-01

    In the present work, our goal was to match high-resolution computed tomography (CT) scans with cross-sectional anatomical pictures of the turkey (Meleagris gallopavo). Two male BUT 6 (a commercial line) turkeys were used. CT scans with 1 mm slice thickness were performed. The images covered the trunk from the level of the 9th cervical vertebra to the end of the coccyx. The anatomical sections and the CT scans were matched, and the important structures were identified and labelled on the corresponding pictures. The aim of this study was to create a reference for evaluating CT scans of avian species.

  18. Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections

    Energy Technology Data Exchange (ETDEWEB)

    Carter, B.L.; Bankoff, M.S.; Fisk, J.D.

    1983-06-01

    Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination of patients with orbital and intracranial infection.

  19. Computed tomographic cholangiography in the diagnosis of choledocholithiasis; Colangio-TC en el diagnostico de coledocolitiasis

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Negrete, L.; Sanchez, J. L.; Garcia-Lozano, J.; Tejeiro, A.; Salas, J. [Hospital Valle del Nalon. Riano-Langreo. Asturias (Spain)

    2001-07-01

    Over a one-year period we performed 32 conventional computed tomography (CT) studies involving the intravenous administration of a contrast material that is cleared by the biliary system (Bilisergol), in patients in presenting clinical or radiological features of choledocholithiasis. The results were compared with the findings from endoscopic retrograde cholangiopancreatography (ERCP) and/or surgery. The sensitivity and specificity of intravenous cholangiography with conventional CT was 92 %. We demonstrate the utility of this widely available study, when performed according to protocol during apnea, with acquisition of thin sections. It is a highly sensitive and specific tool in the diagnosis of choledocholithiasis. (Author) 10 refs.

  20. Computed tomographic findings in the pituitary gland and brain of horses with pituitary pars intermedia dysfunction.

    Science.gov (United States)

    Pease, A P; Schott, H C; Howey, E B; Patterson, J S

    2011-01-01

    Pituitary pars intermedia dysfunction (PPID) is the most common endocrinologic disorder of aged horses. Pituitary glands of PPID-affected horses are larger than those of aged horses without signs of PPID, and the size difference can be detected using computed tomography (CT) imaging. Eight horses with clinical signs of PPID and supportive endocrinologic test results and 3 aged control (PPID-negative) horses. Computed tomography examination of the brain and pituitary gland was performed twice in 10 of the 11 horses, approximately 6 months apart. Six PPID-affected horses were treated with pergolide for 6 months between CT scans. The second CT scan was followed by euthanasia and pathologic examination of 6 PPID-affected horses (4 treated horses). On initial examination, pituitary glands of PPID-affected horses were larger in height (P pituitary gland length increased (P pituitary gland measurements made at the terminal CT scans and necropsy. Furthermore, pituitary gland volume calculated from the measurements was highly correlated to pituitary gland weight. Additional CT findings were bilaterally symmetrical mineralization in the thalamus and cholesterol granulomas adjacent to the lateral and fourth ventricles. CT is a useful imaging modality to determine pituitary gland size of PPID-affected horses,and CT measurements are similar to gross pathologic measurements. Copyright © 2011 by the American College of Veterinary Internal Medicine.

  1. Cone Beam Computed Tomographic Evaluation of Mandibular Asymmetry in Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Paknahad, Maryam; Shahidi, Shoaleh; Bahrampour, Ehsan; Beladi, Amir Saied; Khojastepour, Leila

    2016-07-21

      The purpose of the present study was to compare mandibular vertical asymmetry in patients with unilateral and bilateral cleft lip and palate and subjects with normal occlusion.   Cone beam computed tomography scans of three groups consisting of 20 patients with unilateral cleft lip and palate, 20 patients affected by bilateral cleft lip and palate, and a control group of 20 subjects with normal occlusion were analyzed for this study. Condylar, ramal, and condylar plus ramal asymmetry indices were measured for all subjects using the method of Habets et al. Kruskal-Wallis and Mann-Whitney tests were used to determine any significant differences between the groups for all indices at the 95% level of confidence.   There were no significant differences regarding sex for all mandibular asymmetry indices in all three groups. All Asymmetry indices (condylar, ramal, and condylar plus ramal asymmetry) were significantly higher in the unilateral cleft group compared with the other two groups.   Cone beam computed tomography images showed that patients with cleft lip and palate suffered from mandibular asymmetry. Subjects with unilateral cleft lip and palate had a more asymmetric mandible compared with the bilateral cleft lip and palate and control groups. Therefore, the mandible appears to be the leading factor in facial asymmetry in subjects with unilateral cleft lip and palate.

  2. Correlation between computed tomographic and magnetic resonance imaging findings of parenchymal lung diseases

    Energy Technology Data Exchange (ETDEWEB)

    Barreto, Miriam Menna; Rafful, Patricia Piazza [Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil); Rodrigues, Rosana Souza [Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil); D’Or Institute for Research and Education, Rio de Janeiro, RJ (Brazil); Zanetti, Gláucia [Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil); Hochhegger, Bruno [Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS (Brazil); Souza, Arthur Soares [Department of Radiology, Medical School of Rio Preto (FAMERP) and Ultra X, São José do Rio Preto, SP (Brazil); Guimarães, Marcos Duarte [Department of Imaging, Hospital AC Camargo, São Paulo, SP (Brazil); Marchiori, Edson, E-mail: edmarchiori@gmail.com [Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil)

    2013-09-15

    Computed tomography (CT) is considered to be the gold standard method for the assessment of morphological changes in the pulmonary parenchyma. Although its spatial resolution is lower than that of CT, MRI offers the advantage of characterizing different aspects of tissue based on the degree of contrast on T1-weighted image (WI) and T2-WI. In this article, we describe and correlate the MRI and CT features of several common patterns of parenchymal lung disease (air trapping, atelectasis, bronchiectasis, cavitation, consolidation, emphysema, ground-glass opacities, halo sign, interlobular septal thickening, masses, mycetoma, nodules, progressive massive fibrosis, reverse halo sign and tree-in-bud pattern). MRI may be an alternative modality for the collection of morphological and functional information useful for the management of parenchymal lung disease, which would help reduce the number of chest CT scans and radiation exposure required in patients with a variety of conditions.

  3. Cone Beam Computed Tomographic Evaluation and Diagnosis of Mandibular First Molar with 6 Canals

    Directory of Open Access Journals (Sweden)

    Shiraz Pasha

    2016-01-01

    Full Text Available Root canal treatment of tooth with aberrant root canal morphology is very challenging. So thorough knowledge of both the external and internal anatomy of teeth is an important aspect of root canal treatment. With the advancement in technology it is imperative to use modern diagnostic tools such as magnification devices, CBCT, microscopes, and RVG to confirm the presence of these aberrant configurations. However, in everyday endodontic practice, clinicians have to treat teeth with atypical configurations for root canal treatment to be successful. This case report presents the management of a mandibular first molar with six root canals, four in mesial and two in distal root, and also emphasizes the use and importance of Cone Beam Computed Tomography (CBCT as a diagnostic tool in endodontics.

  4. Electroencephalographic and computed X-ray tomographic findings in 99 Japanese cases of herpes simplex encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Kamei, Satoshi; Takasu, Toshiaki; Tamura, Masato; Otani, Sugishi.

    1988-10-01

    This is a retrospective analysis of electroencephalograms (EEG) and computed tomograms (CT) obtained from 99 Japanese patients with herpes simplex encephalitis (HSE). Abnormal findings of EEG were seen in 89 patients (99 %). Focal abnormality, which was frequently detected in the first EEG recording, was seen in 68 patients (76 %). Periodic synchronous discharge was observed in 25 patients (28 %). There were abnormal findings on CT in 88 patients (81 %). Low and high density areas were seen in 64 patients (73 %) and 26 patients (37 %), respectively, with the most frequent site being the temporal lobe. Mass effect was demonstrated in 33 patients (37 %). Electroencephalography detected the abnormal findings earlier than CT during the early stage of HSE in many instances. There was concordance between EEG and CT in the detection of HSE lesions in 45 patients (58 %). (Namekawa, K.).

  5. Imaging of anal fistulas: comparison of computed tomographic fistulography and magnetic resonance imaging.

    Science.gov (United States)

    Liang, Changhu; Lu, Yongchao; Zhao, Bin; Du, Yinglin; Wang, Cuiyan; Jiang, Wanli

    2014-01-01

    The primary importance of magnetic resonance (MR) imaging in evaluating anal fistulas lies in its ability to demonstrate hidden areas of sepsis and secondary extensions in patients with fistula in ano. MR imaging is relatively expensive, so there are many healthcare systems worldwide where access to MR imaging remains restricted. Until recently, computed tomography (CT) has played a limited role in imaging fistula in ano, largely owing to its poor resolution of soft tissue. In this article, the different imaging features of the CT and MRI are compared to demonstrate the relative accuracy of CT fistulography for the preoperative assessment of fistula in ano. CT fistulography and MR imaging have their own advantages for preoperative evaluation of perianal fistula, and can be applied to complement one another when necessary.

  6. Intracranial lesions in the acquired immunodeficiency syndrome: radiological (computed tomographic) features

    Energy Technology Data Exchange (ETDEWEB)

    Elkin, C.M.; Leon, E.; Grenell, S.L.; Leeds, N.E.

    1985-01-18

    Computed tomography (CT) delineates the presence or absence of intracerebral focal lesions in most instances. The presence of contrast enhancement, cerebral atrophy, and an intracranial mass are important in consideration of the differential diagnosis and in establishing the diagnosis. Initially the authors utilized a double dose of contrast medium in all patients after single-dose study, but little additional information was obtained. A second dose of contrast medium is now administered only to evaluate further a suspected lesion. Angiography can confirm the location of the lesion(s) and the cortical veins before biopsy. Of one hundred patients with AIDS examined, 33% had neurological symptoms excluding headache and herpes zoster. All patients with neurological symptoms were studied with noncontrast and contrast CT scanning. Twenty-seven patients in the group had abnormal scans. In 13, the abnormality was limited to a diffuse atrophic appearance, while in 14, focal lesions were identified. Representative cases are discussed and illustrated.

  7. Prostate brachytherapy seed migration to the heart seen on cardiovascular computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Shilpa Sachdeva, MD

    2017-03-01

    Full Text Available Brachytherapy consists of placing radioactive sources into or adjacent to tumors, to deliver conformal radiation treatment. The technique is used for treatment of primary malignancies and for salvage in recurrent disease. Permanent prostate brachytherapy seeds are small metal implants containing radioactive sources of I-125, Pd-103, or Cs-131 encased in a titanium shell. They can embolize through the venous system to the lungs or heart and subsequently be detected by cardiovascular computed tomography. Cardiovascular imagers should be aware of the appearance of migrated seeds, as their presence in the chest is generally benign, so that unnecessary worry and testing are avoided. We report a case of a patient who underwent brachytherapy for prostate cancer and developed a therapeutic seeds embolus to the right ventricle.

  8. Imaging of Anal Fistulas: Comparison of Computed Tomographic Fistulography and Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Changhu [Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021 (China); Lu, Yongchao [Traditional Chinese Medicine Department, Provincial Hospital Affiliated to Shandong University, Jinan 250021 (China); Zhao, Bin [Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021 (China); Du, Yinglin [Shandong Provincial Center for Disease Control and Prevention, Public Health Institute, Jinan 250014 (China); Wang, Cuiyan [Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021 (China); Jiang, Wanli [Department of Radiology, Taishan Medical University, Taian 271000 (China)

    2014-07-01

    The primary importance of magnetic resonance (MR) imaging in evaluating anal fistulas lies in its ability to demonstrate hidden areas of sepsis and secondary extensions in patients with fistula in ano. MR imaging is relatively expensive, so there are many healthcare systems worldwide where access to MR imaging remains restricted. Until recently, computed tomography (CT) has played a limited role in imaging fistula in ano, largely owing to its poor resolution of soft tissue. In this article, the different imaging features of the CT and MRI are compared to demonstrate the relative accuracy of CT fistulography for the preoperative assessment of fistula in ano. CT fistulography and MR imaging have their own advantages for preoperative evaluation of perianal fistula, and can be applied to complement one another when necessary.

  9. Computed tomographic evaluation of silicosis and coal workers' pneumoconiosis

    Energy Technology Data Exchange (ETDEWEB)

    Remy-Jardin, M.; Remy, J.; Farre, I.; Marquette, C.H. (Department of Radiology, Hopital Calmette, CHRU, Lille (France))

    1992-11-01

    The introduction of computed tomography (CT) has modified the radiologic approach to silicosis and coal worker's pneumoconiosis considerably, allowing earlier recognition and more precise characterization of pulmonary abnormalities than chest radiography. An optimal approach to CT recognition requires an understanding of the main physiologic and pathologic features that are known to occur in both pneumoconioses. This report focuses on the most common CT features of simple and complicated forms of silicosis and coal worker's pneumoconiosis as well as on the optimal scanning protocol. The respective roles of chest radiographs and CT scans in the recognition of pneumoconiosis and follow-up of exposed workers are discussed.58 references.

  10. Development of an electrical impedance computed tomographic two-phase flows analyzer. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Ovacik, L.; Jones, O.C.

    1998-08-01

    This report summarizes the work on the research project on this cooperative program between DOE and Hitachi, Ltd. Major advances were made in the computational reconstruction of images from electrical excitation and response data with respect to existing capabilities reported in the literature. A demonstration is provided of the imaging of one or more circular objects within the measurement plane with demonstrated linear resolution of six parts in two hundred. At this point it can be said that accurate excitation and measurement of boundary voltages and currents appears adequate to obtain reasonable images of the real conductivity distribution within a body and the outlines of insulating targets suspended within a homogeneous conducting medium. The quality of images is heavily dependent on the theoretical and numerical implementation of imaging algorithms. The overall imaging system described has the potential of being both fast and cost effective in comparison with alternative methods. The methods developed use multiple plate-electrode excitation in conjunction with finite element block decomposition, preconditioned voltage conversion, layer approximation of the third dimension and post processing of boundary measurements to obtain optimal boundary excitations. Reasonably accurate imaging of single and multiple targets of differing size, location and separation is demonstrated and the resulting images are better than any others found in the literature. Recommendations for future effort include the improvement in computational algorithms with emphasis on internal conductivity shape functions and the use of adaptive development of quadrilateral (2-D) or tetrahedral or hexahedral (3-D) elements to coincide with large discrete zone boundaries in the fields, development of a truly binary model and completion of a fast imaging system. Further, the rudimentary methods shown herein for three-dimensional imaging need improving.

  11. Non-obstructive coronary artery disease assessed by coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Nielsen, L.; Bøtker, H. E.; Sorensen, H.;

    2015-01-01

    Introduction: Coronary CT angiography (CTA) detects non-obstructive coronary artery disease (CAD) that may not be recognized by functional testing, but the prognostic impact is not well understood. This study aimed to compare the risk of myocardial infarction (MI) and all-cause mortality...... in patients without or with non-obstructive and obstructive CAD assessed by coronary CTA. Methods: Consecutive patients without known coronary artery disease (CAD) and with chest pain who underwent coronary CTA (>64-detector row) between January 2007 and December 2012 in the 10 centers participating.......35, 95% CI: 3.35-5.65) Ag levels had an increased risk of subsequent MI when compared to patients without CAD. In addition, the risk of MI was increased among patients with 1-, 2-, and 3- vessel/LM obstructive disease with HRs of 4.31 (95% CI: 3.70-5.02), 4.55 (95% CI: 3.72-5.56), and 6.07 (95% CI: 4...

  12. Significance of noncalcified coronary plaque in asymptomatic subjects with low coronary artery calcium score: assessment with coronary computed tomography angiography.

    Science.gov (United States)

    Yoo, Dong Hyun; Chun, Eun Ju; Choi, Sang Il; Kim, Jeong A; Jin, Kwang Nam; Yeon, Tae-Jin; Choi, Dong-Ju

    2011-12-01

    We aimed to investigate the prevalence and severity of noncalcified coronary plaques (NCP) using coronary CT angiography (CCTA) and analyze predictors of significant coronary stenosis by NCP in asymptomatic subjects with low coronary artery calcium score (CACS). The institutional review board approved this retrospective study and all patients gave written, informed consent. The presence of plaque, severity of stenosis, plaque characteristics, and CACS were assessed in 7,515 asymptomatic subjects. We evaluated the prevalence and severity of NCP in subjects having low CACS (707 subjects; men with CACS from 1 to 50 and women from 1 to 10) in comparison to those having 0 CACS (6,040 subjects) as the reference standard. Conventional risk factors were assessed for predictors of NCP and significant stenosis by NCP. We also investigated the cardiac events of the patients through medical records. Compared to subjects with 0 CACS, those with low CACS showed higher prevalence of NCP (6.9% vs. 31.5%, P NCP (0.8% vs. 7.5%, P NCP included diabetes mellitus (DM), hypertension, and elevated low-density lipoprotein (LDL)-cholesterol (all P NCP were classified into the low to intermediate risk according to Framingham Risk Score. At the median follow up of 42 months (range: 3-60 months), cardiac events were significantly higher in the low CACS group compared to the 0 CACS group (2.6% vs. 0.27%, P NCP were higher as compared to subjects having zero CACS and predictors of significant stenosis by NCP were DM, hypertension and LDL-Cholesterol. Therefore, CCTA may be useful for risk stratification of coronary artery disease as added value over CACS in selected populations with low CACS who have predictors of significant NCP.

  13. Sublingual nitroglycerin administration in coronary computed tomography angiography: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Takx, Richard A.P. [Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Sucha, Dominika; Leiner, Tim [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Park, Jakob [Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); University of Heidelberg, Department of Cardiology, Heidelberg (Germany); Hoffmann, Udo [Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)

    2015-12-15

    To systematically investigate the literature for the influence of sublingual nitroglycerin administration on coronary diameter, the number of evaluable segments, image quality, heart rate and blood pressure, and diagnostic accuracy of coronary computed tomography (CT) angiography. A systematic search was performed in PubMed, EMBASE and Web of Science. The studies were evaluated for the effect of sublingual nitroglycerin on coronary artery diameter, evaluable segments, objective and subjective image quality, systemic physiological effects and diagnostic accuracy. Due to the heterogeneous reporting of outcome measures, a narrative synthesis was applied. Of the 217 studies identified, nine met the inclusion criteria: seven reported on the effect of nitroglycerin on coronary artery diameter, six on evaluable segments, four on image quality, five on systemic physiological effects and two on diagnostic accuracy. Sublingual nitroglycerin administration resulted in an improved evaluation of more coronary segments, in particular, in smaller coronary branches, better image quality and improved diagnostic accuracy. Side effects were mild and were alleviated without medical intervention. Sublingual nitroglycerin improves the coronary diameter, the number of assessable segments, image quality and diagnostic accuracy of coronary CT angiography without major side effects or systemic physiological changes. (orig.)

  14. Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management

    Directory of Open Access Journals (Sweden)

    Narender Kumar Magu

    2014-01-01

    Full Text Available Background: Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size. Computed tomography (CT is an important option to measure true head size as images can be obtained in three dimensions. Henceforth, we subjected patients to CT scan of hip in cases with displaced fracture neck of femur. The study aims to define the term "small head or inadequate size femoral head" objectively for its prognostic significance. Materials and Methods: 70 cases of displaced femoral neck fractures underwent CT scan preoperatively for proximal femoral geometric measurements of both hips. Dual energy X-ray absorptiometry scan was done in all cases. Patients were treated with either intertrochanteric osteotomy or lag screw osteosynthesis based on the size of the head fragment on plain radiographs. Results: The average femoral head fragment volume was 57 cu cm (range 28.3-84.91 cu cm; standard deviation 14 cu cm. Proximal fragment volume of >43 cu cm was termed adequate size (type I and of ≤43 cu cm as small femoral head (type II. Fractures which united (n = 54 had a relatively large average head size (59 cu cm when compared to fractures that did not (n = 16, which had a small average head size (49 cu cm and this difference was statistically significant. In type I fractures union rate was comparable in both osteotomy and lag screw groups (P > 0.05. Lag screw fixation failed invariably, while osteotomy showed good results in type II fractures (P < 0.05. Conclusion: Computed tomography scan of the proximal femur is advisable for measuring true size of head fragment. An objective

  15. Effect of reader experience on variability, evaluation time and accuracy of coronary plaque detection with computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Saur, Stefan C.; Szekely, Gabor [ETH Zurich, Computer Vision Laboratory, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Group, Boston, MA (United States); Stolzmann, Paul; Baumueller, Stephan; Leschka, Sebastian; Scheffel, Hans; Desbiolles, Lotus [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Fuchs, Thomas J. [ETH Zurich, Department of Computer Science, Zurich (Switzerland); Cattin, Philippe C. [ETH Zurich, Computer Vision Laboratory, Zurich (Switzerland); University of Basel, Medical Image Analysis Center, Basel (Switzerland)

    2010-07-15

    To assess the effect of reader experience on variability, evaluation time and accuracy in the detection of coronary artery plaques with computed tomography coronary angiography (CTCA). Three independent, blinded readers with three different experience levels twice labelled 50 retrospectively electrocardiography (ECG)-gated contrast-enhanced dual-source CTCA data sets (15 female, age 67.3 {+-} 10.4 years, range 46-86 years) indicating the presence or absence of coronary plaques. The evaluation times for the readings were recorded. Intra- and interobserver variability expressed as {kappa} statistics and sensitivity, specificity, and negative and positive predictive values were calculated for plaque detection, with a consensus reading of the three readers taken as the standard of reference. A bootstrap method was applied in the statistical analysis to account for clustering. Significant correlations were found between reader experience and, respectively, evaluation times (r = -0.59, p < 0.05) and intraobserver variability (r = 0.73, p < 0.05). The evaluation time significantly differed among the readers (p < 0.05). The observer variability for plaque detection, compared with the consensus, varied between {kappa} = 0.582 and {kappa} = 0.802. Variability of plaque detection was significantly smaller (p < 0.05) and more accurate (p < 0.05) for the most experienced reader. Reader experience significantly correlated with observer variability, evaluation time and accuracy of coronary plaque detection at CTCA. (orig.)

  16. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images

    Directory of Open Access Journals (Sweden)

    Mamta Raghav

    2014-01-01

    Full Text Available Objectives: The aim of the present study was to infer and to record the prevalence of incidental maxillary sinus pathologies in patients presenting with dental problems using the cone-beam computed tomography (CBCT scans performed for maxillofacial diagnostic purposes. Materials and Methods: This retrospective study has evaluated 201 patients (402 maxillary sinuses consecutive CBCT for various incidental maxillary sinus pathologies by two observers. Pathologic findings were categorized as mucosal thickening (MT, opacification (OPA, polypoidal-mucosal thickening (PT, others (antrolith and discontinuity of the sinus fl oor and no pathologic findings. Correlations for pathologic findings and the factors of age and gender were calculated. Results: The prevalence for total incidental findings is 59.7%. The present study showed MT (35.1% as most prevalent finding followed by OPA in (16.6%, PT in 7.2% and others in 0.7%. There was no statistically significant difference between gender and between the age groups. There was no statistically significant difference between different indications groups for CBCT scans. Conclusions: The incidental maxillary sinus abnormalities are highly prevalent in the asymptomatic dental patients; hence oral radiologists should be aware of these incidental findings and comprehensively evaluate the entire captured CBCT volume, which can help in early diagnosis, treatment and follow-up of the patient.

  17. Computed tomographic findings of abdominal complications of Crohn's disease - pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel)]. E-mail: zisinrivka@clalit.org.il; Hertz, M. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv (Israel); Osadchy, A. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Novis, B. [Tel-Aviv Univ., Dept. of Gastroenterology, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Gayer, G. [Tel-Aviv Univ., Department of Diagnostic Imaging, Assaf Harode Medical Center, Zrifin, Sackler Faculty of Medicine, Tel Aviv (Israel)

    2005-02-15

    Crohn's disease (CD) is a chronic, transmural, inflammatory disease of the gastrointestinal tract (CIT) most often affecting the terminal ileum and colon. Diarrhea, abdominal pain, anorexia, nausea, and weight loss are the most common clinical symptoms. Abdominal complications of CD, both intestinal and extraintestinal, are frequent and variable. The most common intestinal complications include ileocolitis with external or internal fistulas and abscess formation, strictures, and bowel obstruction. Less common are free perforation, intussusception, and malignancy. The extraintestinal complications include nephrolithiasis, cholelithiasis, fatty liver, portal vein gas, and thromboembolic events. Nowadays, computed tomography (CT) provides superb anatomic detail and diagnostic accuracy of various intra-abdominal pathological processes, and it thus has become an essential diagnostic tool in the evaluation and management of patients wit known CD for the assessment of bowel wall involvement, the mesenteric extent of the disease, and inn-abdominal complications. In addition, as CT is frequently performed to evaluate patients with acute abdomen, it may encounter clinically unsuspected complications in patients with CD. This article reviews the CT features of various intra-abdominal complications of CD. (author)

  18. Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Scholten, Ernst T. [University Medical Centre, Department of Radiology, Utrecht (Netherlands); Kennemer Gasthuis, Department of Radiology, Haarlem (Netherlands); Horeweg, Nanda [Erasmus University Medical Centre, Department of Public Health, Rotterdam (Netherlands); Erasmus University Medical Centre, Department of Pulmonary Medicine, Rotterdam (Netherlands); Koning, Harry J. de [Erasmus University Medical Centre, Department of Public Health, Rotterdam (Netherlands); Vliegenthart, Rozemarijn [University of Groningen, University Medical Centre Groningen, Department of Radiology, Groningen (Netherlands); University of Groningen, University Medical Centre Groningen, Center for Medical Imaging-North East Netherlands, Groningen (Netherlands); Oudkerk, Matthijs [University of Groningen, University Medical Centre Groningen, Center for Medical Imaging-North East Netherlands, Groningen (Netherlands); Mali, Willem P.T.M.; Jong, Pim A. de [University Medical Centre, Department of Radiology, Utrecht (Netherlands)

    2015-01-15

    To analyse computed tomography (CT) findings of interval and post-screen carcinomas in lung cancer screening. Consecutive interval and post-screen carcinomas from the Dutch-Belgium lung cancer screening trial were included. The prior screening and the diagnostic chest CT were reviewed by two experienced radiologists in consensus with knowledge of the tumour location on the diagnostic CT. Sixty-one participants (53 men) were diagnosed with an interval or post-screen carcinoma. Twenty-two (36 %) were in retrospect visible on the prior screening CT. Detection error occurred in 20 cancers and interpretation error in two cancers. Errors involved intrabronchial tumour (n = 5), bulla with wall thickening (n = 5), lymphadenopathy (n = 3), pleural effusion (n = 1) and intraparenchymal solid nodules (n = 8). These were missed because of a broad pleural attachment (n = 4), extensive reticulation surrounding a nodule (n = 1) and extensive scarring (n = 1). No definite explanation other than human error was found in two cases. None of the interval or post-screen carcinomas involved a subsolid nodule. Interval or post-screen carcinomas that were visible in retrospect were mostly due to detection errors of solid nodules, bulla wall thickening or endobronchial lesions. Interval or post-screen carcinomas without explanation other than human errors are rare. (orig.)

  19. Spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia: clinical and computed tomographic features in 8 cases.

    Science.gov (United States)

    Sun, Tao-Tao; Tao, Xiao-Feng; Shi, Hui-Min

    2014-07-01

    The aim of this study was to evaluate the patient demographic and computed tomography (CT) imaging findings of spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia. Ten cases of spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia diagnosed during 1993-2013 were reviewed. Eight cases with CT images were reviewed. The mean age of diagnosis of osteosarcoma was 37.8 years (range, 8-55 years). The presence of a soft tissue extension component beyond the area of cortical bone destruction was demonstrated radiographically in 7 out of 8 cases. Mineralization of tumor matrix was seen in 6 cases. Periosteal reaction was demonstrated in only 1 case; 1 out of 6 cases showed significant enhancement on postcontrast CT images. Nine patients had surgical resections of tumor. Seven of them died of tumor, with a mean survival time of 5.3 years. This study provides CT imaging features with clinical information of spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Hyperbaric computed tomographic measurement of lung compression in seals and dolphins.

    Science.gov (United States)

    Moore, Michael John; Hammar, Terrence; Arruda, Julie; Cramer, Scott; Dennison, Sophie; Montie, Eric; Fahlman, Andreas

    2011-07-15

    Lung compression of vertebrates as they dive poses anatomical and physiological challenges. There has been little direct observation of this. A harbor and a gray seal, a common dolphin and a harbor porpoise were each imaged post mortem under pressure using a radiolucent, fiberglass, water-filled pressure vessel rated to a depth equivalent of 170 m. The vessel was scanned using computed tomography (CT), and supported by a rail and counterweighted carriage magnetically linked to the CT table movement. As pressure increased, total buoyancy of the animals decreased and lung tissue CT attenuation increased, consistent with compression of air within the lower respiratory tract. Three-dimensional reconstructions of the external surface of the porpoise chest showed a marked contraction of the chest wall. Estimation of the volumes of different body compartments in the head and chest showed static values for all compartments except the lung, which showed a pressure-related compression. The depth of estimated lung compression ranged from 58 m in the gray seal with lungs inflated to 50% total lung capacity (TLC) to 133 m in the harbor porpoise with lungs at 100% TLC. These observations provide evidence for the possible behavior of gas within the chest of a live, diving mammal. The estimated depths of full compression of the lungs exceeds previous indirect estimates of the depth at which gas exchange ceases, and concurs with pulmonary shunt measurements. If these results are representative for living animals, they might suggest a potential for decompression sickness in diving mammals.

  1. Computed tomographic differentiation between alcoholic and gallstone pancreatitis: Significance of distribution of infiltration or fluid collection

    Institute of Scientific and Technical Information of China (English)

    Young-Sun Kim; Yongsoo Kim; Sung-Kyu Kim; Hyunchul Rhim

    2006-01-01

    AIM: To evaluate the usefulness of various computed tomography (CT) findings including distribution of infiltration or fluid collection in differentiating the major etiologies of acute pancreatitis.METHODS: We reviewed 75 relatively severe cases of acute pancreatitis of alcoholic (n=43) or biliary stone(n=32) etiology having infiltration or fluid collection on CT. We compared the pancreatic size, CT grading,presence or absence of biliary calculi, and dilatation of pancreatic or bile duct. We also evaluated degree and the distribution of infiltration and fluid collection in each group.RESULTS: The sizes of pancreas were not different between alcohol group and stone group. Alcohol group showed higher CT grading than stone group (P<0.05). Presence of biliary stone and duct dilatation was statistically significant in differentiating etiology (P <0.05). Alcohol group showed significantly prominent peripancreatic pathology than stone group only in left peritoneal compartment (P = 0.020).CONCLUSION: Alcoholic pancreatitis tends to form more prominent peripancreatic changes than gallstone pancreatitis in relatively severe cases. This is evident on the anterior aspect of left abdomen. Although clinical history and some CT findings usually are a major determinant of the etiology, this pattern of peripancreatic pathology may have an ancillary role in determining the etiologies of acute pancreatitis in the equivocal cases.

  2. Quantitative and qualitative computed tomographic characteristics of bronchiectasis in 12 dogs.

    Science.gov (United States)

    Cannon, Matthew S; Johnson, Lynelle R; Pesavento, Patricia A; Kass, Philip H; Wisner, Erik R

    2013-01-01

    Bronchiectasis is an irreversible dilatation of the bronchi resulting from chronic airway inflammation. In people, computed tomography (CT) has been described as the noninvasive gold standard for diagnosing bronchiectasis. In dogs, normal CT bronchoarterial ratios have been described as qualitative CT characteristics of bronchiectasis in a cohort of dogs with confirmed disease. Inclusion criteria for the study were thoracic radiography, thoracic CT, and a diagnosis of bronchiectasis based on bronchoscopy and/or histopathology. For each included dog, a single observer measured CT bronchoarterial ratios at 6 lobar locations. Qualitative thoracic radiography and CT characteristics were recorded by consensus opinion of two board-certified veterinary radiologists. Twelve dogs met inclusion criteria. The mean bronchoarterial ratio from 28 bronchiectatic lung lobes was 2.71 ± 0.80 (range 1.4 to 4.33), and 23/28 measurements were >2.0. Averaged bronchoarterial ratios from bronchiectatic lung lobes were significantly larger (P Qualitative CT characteristics of bronchiectasis included lack of peripheral airway tapering (12/12), lobar consolidation (11/12), bronchial wall thickening (7/12), and bronchial lumen occlusion (4/12). Radiographs detected lack of airway tapering in 7/12 dogs. In conclusion, the most common CT characteristics of bronchiectasis were dilatation, a lack of peripheral airway tapering, and lobar consolidation. Lack of peripheral airway tapering was not visible in thoracic radiographs for some dogs. For some affected dogs, bronchoarterial ratios were less than published normal values. © 2013 Veterinary Radiology & Ultrasound.

  3. Three-dimensional segmentation of the tumor in computed tomographic images of neuroblastoma.

    Science.gov (United States)

    Deglint, Hanford J; Rangayyan, Rangaraj M; Ayres, Fábio J; Boag, Graham S; Zuffo, Marcelo K

    2007-09-01

    Segmentation of the tumor in neuroblastoma is complicated by the fact that the mass is almost always heterogeneous in nature; furthermore, viable tumor, necrosis, and normal tissue are often intermixed. Tumor definition and diagnosis require the analysis of the spatial distribution and Hounsfield unit (HU) values of voxels in computed tomography (CT) images, coupled with a knowledge of normal anatomy. Segmentation and analysis of the tissue composition of the tumor can assist in quantitative assessment of the response to therapy and in the planning of the delayed surgery for resection of the tumor. We propose methods to achieve 3-dimensional segmentation of the neuroblastic tumor. In our scheme, some of the normal structures expected in abdominal CT images are delineated and removed from further consideration; the remaining parts of the image volume are then examined for tumor mass. Mathematical morphology, fuzzy connectivity, and other image processing tools are deployed for this purpose. Expert knowledge provided by a radiologist in the form of the expected structures and their shapes, HU values, and radiological characteristics are incorporated into the segmentation algorithm. In this preliminary study, the methods were tested with 10 CT exams of four cases from the Alberta Children's Hospital. False-negative error rates of less than 12% were obtained in eight of 10 exams; however, seven of the exams had false-positive error rates of more than 20% with respect to manual segmentation of the tumor by a radiologist.

  4. X-ray Computed Tomographic Investigation of the Porosity and Morphology of Plasma Electrolytic Oxidation Coatings.

    Science.gov (United States)

    Zhang, Xun; Aliasghari, Sepideh; Němcová, Aneta; Burnett, Timothy L; Kuběna, Ivo; Šmíd, Miroslav; Thompson, George E; Skeldon, Peter; Withers, Philip J

    2016-04-06

    Plasma electrolytic oxidation (PEO) is of increasing interest for the formation of ceramic coatings on metals for applications that require diverse coating properties, such as wear and corrosion resistance, low thermal conductivity, and biocompatibility. Porosity in the coatings can have an important impact on the coating performance. However, the quantification of the porosity in coatings can be difficult due to the wide range of pore sizes and the complexity of the coating morphology. In this work, a PEO coating formed on titanium is examined using high resolution X-ray computed tomography (X-ray CT). The observations are validated by comparisons of surface views and cross-sectional views of specific coating features obtained using X-ray CT and scanning electron microscopy. The X-ray CT technique is shown to be capable of resolving pores with volumes of at least 6 μm(3). Furthermore, the shapes of large pores are revealed and a correlation is demonstrated between the locations of the pores, nodules on the coating surface, and depressions in the titanium substrate. The locations and morphologies of the pores, which constitute 5.7% of the coating volume, indicate that they are generated by release of oxygen gas from the molten coating.

  5. Gross, Histologic, and Computed Tomographic Anatomy of the Lacrimal System of Snakes

    Science.gov (United States)

    Souza, Nicole M.; Maggs, David J.; Park, Shin Ae; Puchalski, Sarah; Reilly, Christopher M.; Paul-Murphy, Joanne; Murphy, Christopher J.

    2014-01-01

    Objective To describe the lacrimal system of snakes using contrast micro-computed tomography (micro-CT) with 3-dimensional reconstruction, fluorescein passage (“Jones”) testing, histology, and gross dissection. Animals studied One Royal Python and 19 snake cadavers representing 10 species. Procedures Direct observation following injection of fluorescein into the subspectacular space, micro-CT following injection of 3 contrast agents into the subspectacular space, gross dissection following injection of latex into the subspectacular space, and histopathology. Results Injection of fluorescein confirmed patency but not course of the lacrimal duct. Barium enabled clear visualization of the lacrimal duct whereas two iodinated contrast agents proved inadequate. Collectively, micro-CT, anatomic dissections, and histology suggest tears are produced by a single, large, serous, retrobulbar gland, released into the subspectacular space via several ductules, and drained through a single punctum originating in the ventronasal subspectacular space and the lacrimal duct taking one of 3 routes of variable tortuosity before opening into the oral cavity in close association with the opening of the duct of the vomeronasal organ. Conclusions The ophidian lacrimal duct has a generally tortuous course and the details of its anatomy is species variable. The tortuous course of the duct likely predisposes snakes to duct occlusion and must be considered when planning medical and surgical interventions in snakes with pseudobuphthalmos and subspectacular abscessation. PMID:24862081

  6. COMPUTED TOMOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN 1018 ASYMPTOMATIC HORSES: A MULTI-INSTITUTION STUDY.

    Science.gov (United States)

    Carmalt, James L; Kneissl, Sibylle; Rawlinson, Jennifer E; Zwick, Timo; Zekas, Lisa; Ohlerth, Stefanie; Bienert-Zeit, Astrid

    2016-05-01

    Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses horses commonly had spherical hypodensities within the mandibular condyles consistent with bone cysts; and hyperdense regions of the intra-articular disc consistent with dystrophic mineralization. Findings indicated that TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology.

  7. Single-photon emission computed tomographic findings and motor neuron signs in amyotrophic lateral sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Terao, Shin-ichi; Sobue, Gen; Higashi, Naoki; Takahashi, Masahiko; Suga, Hidemichi; Mitsuma, Terunori [Aichi Medical Univ., Nagakute (Japan)

    1995-03-01

    {sup 123}I-amphetamine-single photon emission computed tomography (SPECT) was performed on 16 patients with amyotrophic lateral sclerosis (ALS) to investigate the correlation between regional cerebral blood flow (rCBF) and upper motor neuron signs. Significant decreased blood flow less than 2 SDs below the mean of controls was observed in the frontal lobe in 4 patients (25%) and in the frontoparietal lobe including the cortical motor area in 4 patients, respectively. The severity of extermity muscular weakness was significantly correlate with decrease in blood flow through the frontal lobe (p<0.05) and through the frontoparietal lobe (p<0.001). A significant correlation was also noted to exist between the severity of bulbar paralysis and decrease in blood flow through the frontoparietal lobe. No correlation, however, was observed between rCBF and severity of spasticity, presence or absence of Babinski`s sign and the duration of illness. Although muscular weakness in the limbs and bulbar paralysis are not pure upper motor neuron signs, the observed reduction in blood flow through the frontal or frontoparietal lobes appears to reflect extensive progression of functional or organic lesions of cortical neurons including the motor area. (author).

  8. Four-dimensional computed tomographic imaging in the wrist: proof of feasibility in a cadaveric model

    Energy Technology Data Exchange (ETDEWEB)

    Tay, Shian-Chao; Berger, Richard A. [Mayo Clinic College of Medicine, Orthopedics Biomechanics Laboratory, Rochester, MN (United States); Primak, Andrew N.; Amrami, Kimberly K. [Mayo Clinic College of Medicine, Department of Radiology, Rochester, MN (United States); Fletcher, Joel G.; McCollough, Cynthia H. [Mayo Clinic College of Medicine, Department of Radiology, Rochester, MN (United States); Mayo Clinic College of Medicine, CT Innovation Center, Rochester, MN (United States); Schmidt, Bernhard [Siemens Medical Solutions, Forchheim (Germany)

    2007-12-15

    High-resolution real-time three-dimensional (3D) imaging of the moving wrist may provide novel insights into the pathophysiology of joint instability. The purpose of this work was to assess the feasibility of using retrospectively gated spiral computed tomography (CT) to perform four-dimensional (4D) imaging of the moving wrist joint. A cadaver forearm from below the elbow was mounted on a motion simulator which performed radioulnar deviation of the wrist at 30 cycles per minute. An electronic trigger from the simulator provided the ''electrocardiogram'' (ECG) signal required for gated reconstructions. Four-dimensional and 3D images were compared by a blinded observer for image quality and presence of artifacts. Image quality of 4D images was found to be excellent at the extremes of radial and ulnar deviation (end-motion phases). Some artifacts were seen in mid-motion phases. 4D CT musculoskeletal imaging is feasible. Four-dimensional CT may allow clinicians to assess functional (dynamic) instabilities of the wrist joint. (orig.)

  9. A computed tomographic scan assessment of endotracheal suctioning-induced bronchoconstriction in ventilated sheep.

    Science.gov (United States)

    Lu, Q; Capderou, A; Cluzel, P; Mourgeon, E; Abdennour, L; Law-Koune, J D; Straus, C; Grenier, P; Zelter, M; Rouby, J J

    2000-11-01

    This study was directed at assessing changes in bronchial cross-sectional surface areas (BCSA) and in respiratory resistance induced by endotracheal suctioning in nine anesthetized sheep. Cardiorespiratory parameters (Swan-Ganz catheter), respiratory resistance (inspiratory occlusion technique), BCSA, and lung aeration (computed tomography) were studied at baseline, during endotracheal suctioning, and after 20 consecutive hyperinflations. Measurements performed initially at an inspired oxygen fraction (FI(O(2))) of 0.3 were repeated at an FI(O(2)) of 1.0. At an FI(O(2)) of 0.3, endotracheal suctioning resulted in atelectasis, a reduction in BCSA of 29 +/- 23% (mean +/- SD), a decrease in arterial oxygen saturation from 95 +/- 3% to 87 +/- 12% (p = 0.02), an increase in venous admixture from 19 +/- 10% to 31 +/- 19% (p = 0. 006), and an increase in lung tissue resistance (DR(rs)) (p = 0. 0003). At an FI(O(2)) of 1.0, despite an extension of atelectasis and an increase in pulmonary shunt from 19 +/- 5% to 36 +/- 2% (p sheep, the endotracheal suctioning-induced reduction of BCSA was entirely prevented. These data suggest that the endotracheal suctioning-induced decrease in BCSA is related to atelectasis and bronchoconstriction. Both effects can be reversed by hyperoxygenation maneuver before suctioning in combination with recruitment maneuver after suctioning.

  10. Intention tremor after head injury. Clinical features and computed tomographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Iwadate, Yasuo; Saeki, Naokatsu; Namba, Hiroki; Odaki, Masaru; Oka, Nobuo.

    1989-02-01

    Eight cases of intention tremor as a late complication of head injury were investigated. The patients ranged in age from 3 to 24 years. All received severe head injuries and lapsed into coma immediately afterward (Glasgow Coma Scale scores /le/8). Six patients exhibited decerebration or decortication. Hemiparesis was present in six cases and oculomotor nerve palsy in four. In the chronic stage, all patients displayed some degree of impairment of higher cortical function and five had dysarthria and/or ataxia. Initial computed tomography (CT) scans within 3 hours after the injury were obtained in five cases, of which four showed a hemorrhagic lesion in the midbrain or its surroundings. Other CT findings were diffuse cerebral swelling (four cases), intraventricular hemorrhage (three), and multiple hemorrhagic lesions (two). In the chronic stage, generalized cortical atrophy or ventricular enlargement was noted in five cases. These clinical features and CT findings indicate diffuse brain damage as well as midbrain damage and may reflect shearing injury. (author).

  11. Gross, histologic, and micro-computed tomographic anatomy of the lacrimal system of snakes.

    Science.gov (United States)

    Souza, Nicole M; Maggs, David J; Park, Shin Ae; Puchalski, Sarah M; Reilly, Christopher M; Paul-Murphy, Joanne; Murphy, Christopher J

    2015-01-01

    To describe the lacrimal system of snakes using contrast micro-computed tomography (micro-CT) with 3-dimensional reconstruction, fluorescein passage ('Jones') testing, histology, and gross dissection. One royal python and 19 snake cadavers representing 10 species. Direct observation following injection of fluorescein into the subspectacular space, micro-CT following injection of three contrast agents into the subspectacular space, gross dissection following injection of latex into the subspectacular space, and histopathology. Injection of fluorescein confirmed patency, but not course of the lacrimal duct. Barium enabled clear visualization of the lacrimal duct, whereas two iodinated contrast agents proved inadequate. Collectively, micro-CT, anatomic dissections, and histology suggest tears are produced by a single, large, serous, retrobulbar gland, released into the subspectacular space via several ductules, and drained through a single punctum originating in the ventronasal subspectacular space, and the lacrimal duct, which takes one of three routes of variable tortuosity before opening into the oral cavity in close association with the opening of the duct of the vomeronasal organ. The ophidian lacrimal duct has a generally tortuous course, and the details of its anatomy are species-variable. The tortuous course of the duct likely predisposes snakes to duct occlusion and must be considered when planning medical and surgical interventions in snakes with pseudobuphthalmos and subspectacular abscessation. © 2014 American College of Veterinary Ophthalmologists.

  12. Clinical and Radiographic Findings and Usefulness of Computed Tomographic Assessment in Two Children with Regional Odontodysplasia

    Directory of Open Access Journals (Sweden)

    Junko Matsuyama

    2014-01-01

    Full Text Available Regional odontodysplasia is a rare, severe, and nonhereditary developmental disorder in tooth formation and involves epithelial and mesenchymal-derived dental tissue. On radiographs, affected teeth have an abnormal morphology, a hypoplastic crown, and only a faint outline of hard tissue, a condition termed “ghost teeth.” We report clinical and radiographic findings from two children with regional odontodysplasia. Using computed tomography (CT, we calculated attenuation coefficients (i.e., Hounsfield units for affected teeth and assessed the condition of dental follicles. To measure density, regions of interest were delimited and CT values were calculated. In our two patients, the CT values for enamel were lower in affected teeth than in sound teeth, while CT values for dentin were similar for affected and sound teeth. The average CT value for dental follicles in affected teeth was about 65 to 120, which suggests that dense fibrous connective tissues or hard tissue-like structures might be present in dental follicles. Analysis of CT values may be quite useful in the diagnosis and treatment of regional odontodysplasia.

  13. Real-time 3D computed tomographic reconstruction using commodity graphics hardware

    Science.gov (United States)

    Xu, Fang; Mueller, Klaus

    2007-07-01

    The recent emergence of various types of flat-panel x-ray detectors and C-arm gantries now enables the construction of novel imaging platforms for a wide variety of clinical applications. Many of these applications require interactive 3D image generation, which cannot be satisfied with inexpensive PC-based solutions using the CPU. We present a solution based on commodity graphics hardware (GPUs) to provide these capabilities. While GPUs have been employed for CT reconstruction before, our approach provides significant speedups by exploiting the various built-in hardwired graphics pipeline components for the most expensive CT reconstruction task, backprojection. We show that the timings so achieved are superior to those obtained when using the GPU merely as a multi-processor, without a drop in reconstruction quality. In addition, we also show how the data flow across the graphics pipeline can be optimized, by balancing the load among the pipeline components. The result is a novel streaming CT framework that conceptualizes the reconstruction process as a steady flow of data across a computing pipeline, updating the reconstruction result immediately after the projections have been acquired. Using a single PC equipped with a single high-end commodity graphics board (the Nvidia 8800 GTX), our system is able to process clinically-sized projection data at speeds meeting and exceeding the typical flat-panel detector data production rates, enabling throughput rates of 40-50 projections s-1 for the reconstruction of 5123 volumes.

  14. Real-time 3D computed tomographic reconstruction using commodity graphics hardware

    Energy Technology Data Exchange (ETDEWEB)

    Xu Fang; Mueller, Klaus [Center for Visual Computing, Computer Science Department, Stony Brook University, Stony Brook, NY 11794-4400 (United States)

    2007-07-21

    The recent emergence of various types of flat-panel x-ray detectors and C-arm gantries now enables the construction of novel imaging platforms for a wide variety of clinical applications. Many of these applications require interactive 3D image generation, which cannot be satisfied with inexpensive PC-based solutions using the CPU. We present a solution based on commodity graphics hardware (GPUs) to provide these capabilities. While GPUs have been employed for CT reconstruction before, our approach provides significant speedups by exploiting the various built-in hardwired graphics pipeline components for the most expensive CT reconstruction task, backprojection. We show that the timings so achieved are superior to those obtained when using the GPU merely as a multi-processor, without a drop in reconstruction quality. In addition, we also show how the data flow across the graphics pipeline can be optimized, by balancing the load among the pipeline components. The result is a novel streaming CT framework that conceptualizes the reconstruction process as a steady flow of data across a computing pipeline, updating the reconstruction result immediately after the projections have been acquired. Using a single PC equipped with a single high-end commodity graphics board (the Nvidia 8800 GTX), our system is able to process clinically-sized projection data at speeds meeting and exceeding the typical flat-panel detector data production rates, enabling throughput rates of 40-50 projections s{sup -1} for the reconstruction of 512{sup 3} volumes.

  15. Three-dimensional helical computed tomographic evaluation of three obturation techniques: In vitro study

    Directory of Open Access Journals (Sweden)

    M Chokkalingam

    2011-01-01

    Full Text Available Aim: The purpose of this study was to evaluate the adequacy of three obturation techniques namely lateral condensation, EQ Fil (backfill obturation and thermafil (core carrier obturation techniques using three-dimensional (3D helical computed tomography (CT by volume rendering method. Materials and Methods: Thirty freshly extracted teeth were randomly divided into three groups of 10 teeth each. Biomechanical preparation was done in all the teeth using rotary instruments. All three sets of teeth were placed in helical CT slice scanner and were imaged before obturation. The three sets were then obturated by following methods: Group I: lateral condensation, Group II: EQ Fil (backfill and Group III: thermafil (core carrier obturation.Volume of the pulp chamber and gutta-percha after obturation were calculated using volume rendering technique and adequacy of the obturation techniques were calculated. Statistical Analysis Used: One-way ANOVA and Multiple-Range Tukey Test by Tukey-HSD procedure Results: Mean change in lateral condensation (0.005±0.002 was significantly higher than that of thermafil obturation (0.002±0.001 [P<0.05]. Conclusions: Conventional lateral condensation technique showed maximal inadequacy of obturation and thermafil obturation technique showed the least inadequacy of obturation when the volume of the specimens were calculated and reconstructed

  16. Concha bullosa, nasal septal deviation and paranasal sinusitis; a computed tomographic evaluation.

    Science.gov (United States)

    Javadrashid, R; Naderpour, M; Asghari, S; Fouladi, D F; Ghojazadeh, M

    2014-01-01

    Although concha bullosa, nasal septal deviation (NSD) and paranasal sinusitis are apparently three independent entities, some studies suggest that they are interconnected. Computed tomography (CT) is a useful and accurate imaging modality for examining this interconnection. The objective of this study is to use CT imaging to investigate the possible association between concha bullosa, NSD and paranasal sinusitis. We reviewed 206 nasal and paranasal CT images of individuals with sinonasal symptoms/cosmetic issues and investigated the association between the presence of concha bullosa and NSD with paranasal sinusitis. There was no significant relation between the presence of concha bullosa and paranasal sinusitis. The mean NSD was significantly higher in the cases with frontal, maxillary, ethmoid and sphenoid sinusitis than in unaffected subjects. Similar findings were found in the patients with any involved paranasal sinus and the controls (6.49 +/- 3.060 vs. 3.31 +/- 1.99 degrees; p or =3.5% differentiated between the presence and absence of paranasal sinusitis, with a sensitivity and specificity of 77.8% and 76.5%, respectively. A significant positive correlation was found between NSD and the number of involved sinuses (Pearson's r=0.58, psinusitis was not associated with NSD or concha bullosa. Nasal septal deviation, but possibly not concha bullosa, is associated with paranasal sinusitis and its extent. An NSD > or = 3.5 degrees is a useful predictor of paranasal sinusitis.

  17. Expiratory computed tomographic techniques: a cause of a poor rate of change in lung volume.

    Science.gov (United States)

    Morikawa, Keiko; Okada, Fumito; Mori, Hiromu

    2015-01-01

    Ninety-nine patients (29 males and 70 females; mean age, 57.1 years; range, 22-81 years) were included in this study to evaluate the factors affecting smaller lung volume changes in expiratory high-resolution computed tomography performed to depict air trapping. All patients underwent inspiratory and expiratory chest thin-section CT examinations and pulmonary function tests. Air trapping on CT images was graded subjectively. All variables (age, sex, diagnosis, pulmonary function index, and air trapping score) were compared with the degree of change in lung volume between the inspiratory and expiratory CT examinations. The variables affecting a lower degree of volume change were vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), and the FEV1.0/FVC ratio. Bronchiolitis obliterans was the dominant diagnosis in patients with insufficient degrees of breath holding and in patients with negative air trapping scores despite an abnormal air trapping index. An insufficient degree of lung changes between inspiration and expiration on CT examinations represented bronchiolitis obliterans, which resulted in low FEV1.0 and FEV1.0/FVC values. Changes in the time gap from the announcement of exhalation and breath holding to the start of scanning most effectively indicated air trapping in patients with bronchiolar disorders.

  18. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006–2011)

    Science.gov (United States)

    Arzi, Boaz; Cissell, Derek D.; Verstraete, Frank J. M.; Kass, Philip H.; DuRaine, Grayson D.; Athanasiou, Kyriacos A.

    2013-01-01

    Objective To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders. Design Retrospective case-series. Animals 41 dogs and 17 cats. Procedures Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011. Results Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs. Conclusions and Clinical Relevance Results indicated that TMJ disorders are frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and pain. PMID:23234284

  19. Spontaneous isolated mesenteric fibromatosis: sonographic and computed tomographic findings with pathologic correlation.

    Science.gov (United States)

    Ko, Sheung-Fat; Lin, Jui-Wei; Ng, Shu-Hang; Huang, Chung-Cheng; Wan, Yung-Liang; Huang, Hsuan-Ying; Sheen-Chen, Shyr-Ming

    2006-08-01

    Eight cases of spontaneous isolated mesenteric fibromatosis (SIMF) were retrospectively reviewed. Clinical presentations included palpable abdominal mass (n = 6), abdominal pain (n = 4), gastrointestinal bleeding (n = 2) and acute abdomen (n = 1). On sonography and computed tomography (CT), eight SIMFs (size range 3 to 24 cm, mean 14.8 cm) were categorized into four morphologic patterns: well-defined inhomogeneous, well-defined homogeneous, well-defined cystic or infiltrative mesenteric mass patterns. Well-defined inhomogeneous SIMF (n = 3) was correlated with the histopathologic finding of bundles of fibroblasts with unevenly intermingled hyaline and/or myxoid degeneration areas, whereas well-defined homogeneous SIMF (n = 2) showed scarce degenerative changes. Well-defined cystic SIMF (n = 2) were ascribed to the presence of large areas of myxoid and cystic degenerations. One SIMF presented as an infiltrative mesenteric mass and the patient died 10 months after diagnosis. Both cases of cystic SIMFs showed tumor recurrences and one patient died after 84 months. The other five patients were cured by radical tumor resection. In summary, sonography, similar to CT, is also useful for evaluating SIMF with protean morphologic features, ascribing to the underlying histopathologic changes with varied degrees of hyaline, myxoid or cystic degenerations.

  20. Comparison of computed tomographic and magnetic resonance perfusion measurements in acute ischemic stroke: back-to-back quantitative analysis.

    Science.gov (United States)

    Lin, Longting; Bivard, Andrew; Levi, Christopher R; Parsons, Mark W

    2014-06-01

    Magnetic resonance perfusion (MRP) and computed tomographic perfusion (CTP) are being increasingly applied in acute stroke trials and clinical practice, yet the comparability of their perfusion values is not well validated. The aim of this study was to validate the comparability of CTP and MRP measures. A 3-step approach was used. Step 1 was a derivation step, where we analyzed 45 patients with acute ischemic stroke who had both CTP and MRP performed within 2 hours of each other and within 9 hours of stroke onset. In this step, we derived the optimal perfusion map with the least difference between MRP and CTP. In step 2, the optimal map was validated on whole-brain perfusion data of 15 patients. Step 3 was to apply the optimal perfusion map to define cross-modality reperfusion from acute CTP to 24-hour MRP in 45 patients and, in turn, to assess how accurately this predicted 3-month clinical outcome. Among 8 different perfusion maps included in this study, time to peak of the residual function (T(max)) was the only one with a nonsignificant difference between CTP and MRP in delineating perfusion defects. This was validated on whole-brain perfusion data, showing high concordance of T(max) between the 2 modalities (concordance correlation coefficient of Lin, >0.91); the best concordance was at 6 s. At T(max)>6 s threshold, MRP and CTP reached substantial agreement in mismatch classification (κ >0.61). Cross-modality reperfusion calculated by T(max)>6 s strongly predicted good functional outcome at 3 months (area under the curve, 0.979; P<0.05). MRP and CTP can be used interchangeably if one uses T(max) measurement. © 2014 American Heart Association, Inc.

  1. Femoral neck anteversion, acetabular anteversion and combined anteversion in the normal Indian adult population: A computed tomographic study

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    Maheshwari Aditya

    2010-01-01

    Full Text Available Background: Abnormal femoral neck anteversion (FNA and/or acetabulum anteversion (AA have long been implicated in the etiogenesis of hip osteoarthritis (OA, developmental dysplasia of the hip (DDH, and impingement, instability and wear in total hip arthroplasty (THA. Since studies on the Indian population are sparse on this topic, the purpose of this study was to report the normal values of FNA, AA and the combined anteversion (CA= FNA+ AA in Indian adults. Materials and Methods: FNA, AA and CA were prospectively measured in 172 normal hips in 86 Indian adults using standardized computed tomographic (CT methods and this data was compared with the established Western values. Results: The median values and interquartile ranges were 8 o (6.5-10.0 o for FNA, 19 o (16.0-22.0 o for AA and 27 o (23.5-30.0 o for CA. AA and CA values were significantly (P< 0.05 lower in males, and there was also a trend towards lower FNA in males. Although a negative correlation was observed between the FNA and AA, this was not strong and may not be clinically relevant. Conclusion: When compared with the Western data, the FNA values were 3-12 o lower and the CA values were 3-5 o lower in Indian adults. The AA values were comparable, but were skewed towards the higher side. Further studies are needed to assess the clinical relevance of our basic science data in pathogenesis of OA, and to validate it in relation to hip surgeries like corrective osteotomies and THA.

  2. Combined application of virtual imaging techniques and three-dimensional computed tomographic angiography in diagnosing intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background The diagnostic value of virtual imaging combined with three-dimensional computed tomographic angiography (3D-CTA) for intracranial aneurysms has not been fully elucidated yet. This study aimed to evaluate the value of combined application of virtual imaging techniques and 3D-CTA in diagnosing patients with aneurismal subarachnoid hemorrhage (SAH) at the acute stage. Methods Eighty patients with non-traumatic SAH received 3D-CTA examinations. The raw CT data of these patients were reconstructed and transferred into the 3D mode through the surgical plan system based on virtual reality (VR) image, and the 3D virtual images of skulls and brain blood vessels were acquired. The location, size and shape of aneurysms and their anatomic relationship with adjacent tissues were measured from many points of view. Results Seventy-three aneurysms were detected in 68 of the 80 patients, but 2 aneurysms were detected in 2 of the 5 patients who had been found free of aneurysms previously and had received 3D-CTA examinations for a second time one month later. The 3D virtual images produced by the virtual imaging system were clear and vivid, and they could reveal the location and size of the aneurysm and its relations to the parent artery and skull directly. Conclusions The imaging of 3D-CTA is convenient, reliable and fast in diagnosing intracranial aneurysms and can be regarded as the first choice for the diagnosis and treatment of ruptured intracranial aneurysms. Combined with the surgical plan system based on the VR image, 3D-CTA may obtain more imaging information about aneurysms.

  3. Detection of unruptured cerebral artery aneurysms by MRA at 3.0 tesla: comparison with multislice helical computed tomographic angiography

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    Numminen, Jussi; Porras, Matti; Kangasniemi, Marko (Dept. of Radiology, Helsinki Medical Imaging Center, Helsinki Univ. Central Hospital, Helsinki (Finland)), email: jussi.numminen@hus.fi; Tarkiainen, Antti (Advanced Magnetic Imaging Center, Helsinki Univ. of Technology, Espoo (Finland)); Niemelae, Mika; Hernesniemi, Juha (Dept. of Neurosurgery, Helsinki Univ. Central Hospital, Helsinki (Finland))

    2011-07-15

    Background: Computed tomographic angiography (CTA) has become the primary non-invasive method for detection of cerebral artery aneurysms in many neurovascular centers. Purpose: To compare MR-angiography at a 3.0 tesla (3T) scanner to CTA in the detection of unruptured intracranial aneurysms. Material and Methods: CTA and 3T MRA data from 60 patients were evaluated. CTA was obtained with a 4-16-row helical CT-scanner after administration of 120 cc intravenous contrast agent, MRA was performed by a 3T MR-scanner using time-of-flight pulse sequence. Results: Fifty-five cerebral artery aneurysms were detected by MRA and 47 aneurysms by CTA. Most of the aneurysms detected by MRA but not by CTA were small internal carotid artery (ICA) aneurysms. Bone structures and venous enhancement deteriorated CTA accuracy, especially in skull base. In one patient a fairly large anterior communicating artery aneurysm was not visible in MRA due to spin saturation, although it was clearly visualized in CTA. After contrast injection the aneurysm was also seen in MRA. Although the overall image quality of MRA and CTA were comparable, MRA was more susceptible to artifacts and thus re-formatted surface-shaded volume rendered 3-dimensional images of aneurysms from MRA were inferior compared to those from CTA. Conclusion: MRA at 3T appears to be at least as sensitive as CTA in the detection of unruptured cerebral artery aneurysms, however image quality control is crucial and contrast agent enhances visualization of complex and large aneurysms

  4. Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography.

    Science.gov (United States)

    Yamashita, K; Shimizu, K

    2008-02-01

    Video-assisted breast surgery (VABS) is a less invasive and aesthetically better option for benign and malignant breast diseases and for sentinel lymph node biopsy (SLNB). The authors have performed 150 VABS procedures since December 2001. They have examined the usefulness of three-dimensional computed tomographic (3D-CT) lymphography for detecting sentinel lymph nodes (SLNs) precisely, as well as the cosmetic and treatment results of VABS. In this study, VABS was performed with a 2.5-cm skin incision in the axilla or periareola (1 cm in the axilla for SLNB), using a retraction method, for mammary gland resection, SLNB, axillary lymph node dissection, and breast reconstruction under video assistance. On the day before the surgery, 3D-CT lymphography was performed to mark SLN on the skin. Above the tumor and near the areola, 2 ml of Iopamiron 300 was injected subcutaneously. A 16-channnel multidetector-row helical CT scan image was taken after 1 min and reconstructed to produce a 3D image. Sentinel lymph node biopsy was performed by the VABS technique using the Visiport. The VABS procedure was performed for 19 benign and 131 malignant diseases, and 115 SLNBs (74 with 3D-CT) were performed. The SLNs were shown precisely by 3D-CT lymphography, as proved by a case of lymph node metastasis, in which accurate relationships between lymph ducts and SLNs were shown. These were classified into four patterns: a single duct to single node (40 cases), multiple ducts to a single node (13 cases), a single duct to multiple nodes (1 case), and multiple ducts to multiple nodes (12 cases). The SLNB procedure can be performed safely by 3D-CT lymphography and less invasively by VABS. The findings show that 3D-CT lymphography is useful for performing precise SLNB using VABS.

  5. Computed tomographic angiography criteria in the diagnosis of brain death - comparison of sensitivity and interobserver reliability of different evaluation scales

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    Sawicki, Marcin; Walecka, A. [Pomeranian Medical University, Department of Diagnostic Imaging and Interventional Radiology, Szczecin (Poland); Bohatyrewicz, R.; Solek-Pastuszka, J. [Pomeranian Medical University, Clinic of Anesthesiology and Intensive Care, Szczecin (Poland); Safranow, K. [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry, Szczecin (Poland); Walecki, J. [The Centre of Postgraduate Medical Education, Warsaw (Poland); Rowinski, O. [Medical University of Warsaw, 2nd Department of Clinical Radiology, Warsaw (Poland); Czajkowski, Z. [Regional Joint Hospital, Szczecin (Poland); Guzinski, M. [Wroclaw Medical University, Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw (Poland); Burzynska, M. [Wroclaw Medical University, Department of Anesthesiology and Intensive Therapy, Wroclaw (Poland); Wojczal, J. [Medical University of Lublin, Department of Neurology, Lublin (Poland)

    2014-08-15

    The standardized diagnostic criteria for computed tomographic angiography (CTA) in diagnosis of brain death (BD) are not yet established. The aim of the study was to compare the sensitivity and interobserver agreement of the three previously used scales of CTA for the diagnosis of BD. Eighty-two clinically brain-dead patients underwent CTA with a delay of 40 s after contrast injection. Catheter angiography was used as the reference standard. CTA results were assessed by two radiologists, and the diagnosis of BD was established according to 10-, 7-, and 4-point scales. Catheter angiography confirmed the diagnosis of BD in all cases. Opacification of certain cerebral vessels as indicator of BD was highly sensitive: cortical segments of the middle cerebral artery (96.3 %), the internal cerebral vein (98.8 %), and the great cerebral vein (98.8 %). Other vessels were less sensitive: the pericallosal artery (74.4 %), cortical segments of the posterior cerebral artery (79.3 %), and the basilar artery (82.9 %). The sensitivities of the 10-, 7-, and 4-point scales were 67.1, 74.4, and 96.3 %, respectively (p < 0.001). Percentage interobserver agreement in diagnosis of BD reached 93 % for the 10-point scale, 89 % for the 7-point scale, and 95 % for the 4-point scale (p = 0.37). In the application of CTA to the diagnosis of BD, reducing the assessment of vascular opacification scale from a 10- to a 4-point scale significantly increases the sensitivity and maintains high interobserver reliability. (orig.)

  6. Tiny staining spots in liver cirrhosis associated with HCV infection observed by computed tomographic hepatic arteriography. Follow-up study

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    Tsuchiyama, Tomoya; Terasaki, Shuichi; Kaneko, Shuichi; Kaji, Kyosuke; Kobayashi, Kenichi; Matsui, Osamu [Kanazawa Univ. (Japan). Hospital

    2002-10-01

    It is important to distinguish small lesions with increased arterial perfusion observed by computed tomographic arteriography (CT-A) from hepatocellular carcinoma (HCC). However, the clinical characteristics and prognosis of such lesions have not been clarified. We retrospectively examined 200 patients with cirrhosis related to hepatitis C virus (HCV) infection who had undergone both CT-A and CT arterioportography between 1995 and 1998, and found 80 tiny staining spots (TSS)s, with a diameter of 5-10 mm, by CT-A (35 patients). The mean TSS observation period was 29.0 months. If the major axis was larger than 10 mm and showed a 1.5-fold or more increase, the lesion was regarded as tumor growth (TG). The TSS lesions were divided into two groups according to whether the patient had or did not have HCC. The prognosis of TSS was classified into three groups; HCC-suspected group, nontumor group, and unclassified group, in which TG was negative although transcatheter arterial embolization (TAE) had been performed. Of the 40 TSSs in 14 patients without HCC, 2 (5%) were suspected as HCC. Of the 40 TSSs in 21 patients with HCC, 13 (32.5%) were suspected as HCC. There were no significant differences in the size, position, and morphology of TSSs among the three prognostic groups. Of the 7 TSSs with a high signal intensity on T2-weighted magnetic resonance (MR) images, 5 were in the HCC-suspected group. We recommend early treatment of TSSs accompanying HCC or showing features of malignancy at the imaging workup. (author)

  7. Rapid estimation of split renal function in kidney donors using software developed for computed tomographic renal volumetry

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    Kato, Fumi, E-mail: fumikato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Kamishima, Tamotsu, E-mail: ktamotamo2@yahoo.co.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Morita, Ken, E-mail: kenordic@carrot.ocn.ne.jp [Department of Urology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Muto, Natalia S., E-mail: nataliamuto@gmail.com [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Okamoto, Syozou, E-mail: shozo@med.hokudai.ac.jp [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Omatsu, Tokuhiko, E-mail: omatoku@nirs.go.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Oyama, Noriko, E-mail: ZAT04404@nifty.ne.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Terae, Satoshi, E-mail: saterae@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Kanegae, Kakuko, E-mail: IZW00143@nifty.ne.jp [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Nonomura, Katsuya, E-mail: k-nonno@med.hokudai.ac.jp [Department of Urology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Shirato, Hiroki, E-mail: shirato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan)

    2011-07-15

    Purpose: To evaluate the speed and precision of split renal volume (SRV) measurement, which is the ratio of unilateral renal volume to bilateral renal volume, using a newly developed software for computed tomographic (CT) volumetry and to investigate the usefulness of SRV for the estimation of split renal function (SRF) in kidney donors. Method: Both dynamic CT and renal scintigraphy in 28 adult potential living renal donors were the subjects of this study. We calculated SRV using the newly developed volumetric software built into a PACS viewer (n-SRV), and compared it with SRV calculated using a conventional workstation, ZIOSOFT (z-SRV). The correlation with split renal function (SRF) using {sup 99m}Tc-DMSA scintigraphy was also investigated. Results: The time required for volumetry of bilateral kidneys with the newly developed software (16.7 {+-} 3.9 s) was significantly shorter than that of the workstation (102.6 {+-} 38.9 s, p < 0.0001). The results of n-SRV (49.7 {+-} 4.0%) were highly consistent with those of z-SRV (49.9 {+-} 3.6%), with a mean discrepancy of 0.12 {+-} 0.84%. The SRF also agreed well with the n-SRV, with a mean discrepancy of 0.25 {+-} 1.65%. The dominant side determined by SRF and n-SRV showed agreement in 26 of 28 cases (92.9%). Conclusion: The newly developed software for CT volumetry was more rapid than the conventional workstation volumetry and just as accurate, and was suggested to be useful for the estimation of SRF and thus the dominant side in kidney donors.

  8. Computed tomographic angiography study of the relationship between the lingual artery and lingual markers in patients with obstructive sleep apnoea

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    Hou, T.-N., E-mail: dr-htn@hotmail.co [Department of Otolaryngology Head and Neck Surgery, Affiliated SIR RUN RUN SHAW Hospital, Zhejiang University, Hangzhou 310016 (China); Zhou, L.-N.; Hu, H.-J. [Department of Otolaryngology Head and Neck Surgery, Affiliated SIR RUN RUN SHAW Hospital, Zhejiang University, Hangzhou 310016 (China)

    2011-06-15

    Aim: To determine the relationship between the lingual artery and lingual markers for preoperative evaluation of the lingual artery in patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS). Methods: A 16-section computed tomographic angiography (CTA) of the lingual artery was performed in 87 inpatient cases with OSAHS, from December 2007 to May 2009. The course of the lingual artery and the anatomic relationship between the lingual artery and the lingual markers were analyzed using CTA imaging. Results: The course of the lingual artery with the tongue in a resting position was similar to that of the Big Dipper constellation (Plough) in the sagittal view of CTA imaging. The first segment of the lingual artery declined approximately 19.27 {+-} 5.24 mm, the middle segment of the lingual artery was forward approximately 19.30 {+-} 6.79 mm, and the ascending segment of the lingual artery rose approximately 52.49 {+-} 10.98 mm. The entry point where the lingual artery entered into the tongue was adjacent to the tip of the greater horn of the hyoid bone. The relationship between the second segment of the lingual artery and the greater horn of the hyoid bone was relatively steady with the tongue in whatever position. The interval between the bilateral greater horn of the hyoid bone equalled that between the bilateral lingual arteries. Conclusions: Recognizing some lingual markers in the patients with OSAHS, such as the greater horn of the hyoid bone, foramen cecum, circumvallate papilla, lingual vein and tongue midline, may facilitate the surgeon's ability to define the course of the lingual artery accurately in the treatment of OSAHS.

  9. Evaluation of Periapical Lesions and Their Association with Maxillary Sinus Abnormalities on Cone-beam Computed Tomographic Images.

    Science.gov (United States)

    Nunes, Carla A B C M; Guedes, Orlando Aguirre; Alencar, Ana Helena G; Peters, Ove A; Estrela, Cyntia R A; Estrela, Carlos

    2016-01-01

    Periapical inflammation is often responsible for distinct maxillary sinus (MS) changes. This retrospective, cross-sectional study evaluated the association between the clinical characteristics of periapical lesions (presence, size, and distance) in maxillary posterior teeth and the presence of sinus abnormalities by evaluating cone-beam computed tomographic (CBCT) images obtained from an archived collection. Apart from sex, no other patient information was available. The study sample was composed of CBCT images of 143 MSs of patients with at least 1 maxillary posterior tooth with a periapical lesion and 178 MSs of patients without periapical radiolucent lesions. Sinus abnormalities were classified as mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, and antral calcification; periapical radiolucent areas were classified using the CBCT periapical index, and the distance between the periapical lesion edge and the MS floor was measured. Data were analyzed using chi-square tests at a level of significance set at α = 0.05. Most sinus abnormalities were associated with at least 1 maxillary posterior tooth with a periapical lesion (P > .05). The most frequent sinus abnormality in the presence of a periapical lesion was mucosal thickening. All teeth with a CBCT periapical index score of 5 were associated with sinus abnormalities. The highest frequency of abnormalities was found when the radiolucent area was subjacent to the sinus floor. Maxillary posterior teeth with periapical radiolucent lesions had the highest frequency of sinus abnormalities. The size of a periapical lesion was not associated with the frequency of sinus abnormalities. A close spatial relationship between periapical lesions and sinuses resulted most frequently in sinus abnormalities. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Value of Computed Tomographic Perfusion-Based Patient Selection for Intra-Arterial Acute Ischemic Stroke Treatment.

    Science.gov (United States)

    Borst, Jordi; Berkhemer, Olvert A; Roos, Yvo B W E M; van Bavel, Ed; van Zwam, Wim H; van Oostenbrugge, Robert J; van Walderveen, Marianne A A; Lingsma, Hester F; van der Lugt, Aad; Dippel, Diederik W J; Yoo, Albert J; Marquering, Henk A; Majoie, Charles B L M

    2015-12-01

    The utility of computed tomographic perfusion (CTP)-based patient selection for intra-arterial treatment of acute ischemic stroke has not been proven in randomized trials and requires further study in a cohort that was not selected based on CTP. Our objective was to study the relationship between CTP-derived parameters and outcome and treatment effect in patients with acute ischemic stroke because of a proximal intracranial arterial occlusion. We included 175 patients who underwent CTP in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN). Association of CTP-derived parameters (ischemic-core volume, penumbra volume, and percentage ischemic core) with outcome was estimated with multivariable ordinal logistic regression as an adjusted odds ratio for a shift in the direction of a better outcome on the modified Rankin Scale. Interaction between CTP-derived parameters and treatment effect was determined using multivariable ordinal logistic regression. Interaction with treatment effect was also tested for mismatch (core 1.2; penumbra core >10 mL). The adjusted odds ratio for improved functional outcome for ischemic core, percentage ischemic core, and penumbra were 0.79 per 10 mL (95% confidence interval: 0.71-0.89; P<0.001), 0.82 per 10% (95% confidence interval: 0.66-0.90; P=0.002), and 0.97 per 10 mL (96% confidence interval: 0.92-1.01; P=0.15), respectively. No significant interaction between any of the CTP-derived parameters and treatment effect was observed. We observed no significant interaction between mismatch and treatment effect. CTP seems useful for predicting functional outcome, but cannot reliably identify patients who will not benefit from intra-arterial therapy. © 2015 American Heart Association, Inc.

  11. Automatic segmentation of the ribs, the vertebral column, and the spinal canal in pediatric computed tomographic images.

    Science.gov (United States)

    Banik, Shantanu; Rangayyan, Rangaraj M; Boag, Graham S

    2010-06-01

    We propose methods to perform automatic identification of the rib structure, the vertebral column, and the spinal canal in computed tomographic (CT) images of pediatric patients. The segmentation processes for the rib structure and the vertebral column are initiated using multilevel thresholding and the results are refined using morphological image processing techniques with features based on radiological and anatomical prior knowledge. The Hough transform for the detection of circles is applied to a cropped edge map that includes the thoracic vertebral structure. The centers of the detected circles are used to derive the information required for the opening-by-reconstruction algorithm used to segment the spinal canal. The methods were tested on 39 CT exams of 13 patients; the results of segmentation of the vertebral column and the spinal canal were assessed quantitatively and qualitatively by comparing with segmentation performed independently by a radiologist. Using 13 CT exams of six patients, including a total of 458 slices with the vertebra from different sections of the vertebral column, the average Hausdorff distance was determined to be 3.2 mm with a standard deviation (SD) of 2.4 mm; the average mean distance to the closest point (MDCP) was 0.7 mm with SD = 0.6 mm. Quantitative analysis was also performed for the segmented spinal canal with three CT exams of three patients, including 21 slices with the spinal canal from different sections of the vertebral column; the average Hausdorff distance was 1.6 mm with SD = 0.5 mm, and the average MDCP was 0.6 mm with SD = 0.1 mm.

  12. Computed tomographic demonstrations of HIV seropositive pulmonary tuberculosis and their relationship with CD4+T-lymphocyte count

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yu-zhong; LI Hong-jun; CHENG Jing-liang; WU Hao; BAO Dong-ying

    2011-01-01

    Background Factors of cell-mediated immunity and allergy together play their roles in the pathogenesis of pulmonary tuberculosis (PTB) and its prognosis. The purpose of this study was to investigate the computed tomographic demonstrations of HIV seropositive PTB and the relationship between its pathogenesis and CD4+ T-lymphocyte count.Methods The documented CT images of a total of 44 patients with HIV seropositive PTB, definitely diagnosed by etiological or pathological examinations, their clinical data and their CD4+ T-lymphocyte count were retrospectively reviewed.Results There were 15 cases of miliary tuberculosis, accounting for 34.1% of the total cases; 15 cases of nodular tuberculosis, 34.1%; 6 cases of ground-glass opacity, 13.6%; 5 cases of cord-liked fiber shadows, 11.4%; 16 cases of flaky and flocculating shadows, 36.4%; 5 cases of cavitation, 11.4%; 5 cases of tumor shadows, 11.4%; 2 cases of pleural thickening, 4.5% and 11 cases of pleural effusion, 25.0%; 1 case of calcification, 2.3%; 16 cases of lymphadenectasis,36.4%. The foci were located around the pulmonary hilum, anterior segment of superior lobe, basal segment of inferior lobe, medial lobe and lingual lobe. CD4+ T-lymphocyte count was closely related to the imaging demonstrations of HIV seropositive PTB.Conclusions CT scanning can demonstrate various signs of PTB. CD4+ T-lymphocyte level determines the variety of imaging demonstrations of HIV seropositive PTB and its prognosis.

  13. Relationship between cerebrospinal fluid flow through the ventriculo-peritoneal shunt and computed tomographic images of hydrocephalic patients

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Kiyonobu; Itoh, Haruhide; Someya, Shigeru; Yamamoto, Shinjiro

    1988-04-01

    Quantitative measurements of cerebrospinal fluid flow through the ventriculo-peritoneal shunt using radioisotope were carried out on 34 hydrocepalic patients (18 children and 16 adults) and the relationship between the flow rates and the computed tomographic (CT) images was studied. 1) The flow rates in the prone position was 0.04 - 0.20(mean +- SD, 0.10 +- 0.05) ml/min in 13 patients whose shunt systems were functioning adequately. There was a good correlation between the flow rates and closing pressures of the shunt valves. 2) The 21 patients with malfunctioning shunt systems were devided into two groups as follows; the obstruction or lower flow group in which the shunt flow was in 0 approx. 0.05 ml/min and the over-flow groups with rates over 0.20 ml/min. In the former group, there were 3 cases in which the shunt flow in a sitting position was very low and the cause of the malfunction was thought to be placement of an inadequate system with a higher pressure valve. 3) In 4 cases of 5 children in which the ventricles were of normal size during shunt malfunction, their ventricular sizes on CT images changed to small or slit-like ventricles after shunt revision. 4) A few cases of hydrocephalic adults, in which the shunt-catheters were thought to be obstructed with no shunt flow in the prone and sitting positions showing no progressive dilatation of the ventricles on CT images, were diagnosed with the added findings of RI cisternography as shunt-dependent arrested hydrocephalus. In the diagnosis of shunt malfunction and selection of the most adequate system in shunt revision, it is necessary to analyze together the data on CT images, quantitative measurement of shunt flow rates and RI cisternography as well as the clinical manifestations.

  14. Early follow-up after endovascular aneurysm repair: is the first postoperative computed tomographic angiography scan necessary?

    Science.gov (United States)

    Oikonomou, Kyriakos; Ventin, Felipe C; Paraskevas, Kosmas I; Geisselsöder, Peter; Ritter, Wolfgang; Verhoeven, Eric L

    2012-04-01

    To examine whether initial postoperative computed tomographic angiography (CTA) is needed in all patients undergoing endovascular aneurysm repair (EVAR). A total of 105 consecutive patients underwent EVAR with standard infrarenal devices in our department between November 2009 and May 2011. Five patients were excluded due to severe renal insufficiency, leaving 100 (85 men; median age 73 years, range 46-91) eligible for prospective enrollment in a triple-modality early postoperative follow-up protocol [intraoperative completion angiography, postoperative duplex ultrasonography (DUS), and plain abdominal radiography). Findings were compared for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) against the first postoperative CTA results for the detection of endoleaks or other signs of EVAR failure. There were 10 inconclusive DUS examinations. In the remaining 90 patients, DUS had 75.0% sensitivity, 95.4% specificity, 85.7% PPV, and 91.5% NPV for the detection of endoleaks. The intraoperative angiogram, DUS, and abdominal radiograph combined resulted in 87.5% sensitivity and 95.4% specificity, with a 65.6% PPV and 94.8% NPV for the detection of endoleaks. In 2 patients who required a reintervention for endoleak in the early postoperative period, both endoleaks were correctly detected by the triple-modality early postoperative follow-up protocol. An early follow-up protocol consisting of an intraoperative completion angiogram, DUS, and abdominal radiograph shows a high sensitivity and NPV for the detection of endoleaks and should detect early migration or kinking of the stent-graft. An initial postoperative CTA is not necessary for most patients undergoing EVAR and should be reserved for those individuals in whom the aforementioned modalities are inconclusive or show signs of endoleak or other EVAR failure.

  15. Comparison of computed tomographic findings in pulmonary mucormycosis and invasive pulmonary aspergillosis.

    Science.gov (United States)

    Jung, J; Kim, M Y; Lee, H J; Park, Y S; Lee, S-O; Choi, S-H; Kim, Y S; Woo, J H; Kim, S-H

    2015-07-01

    Because there are no available molecular markers for pulmonary mucormycosis (PM), which has low culture sensitivity, early diagnosis and treatment rely heavily on imaging modes such as computed tomography (CT). However, there are limited data comparing CT findings for PM with those for invasive pulmonary aspergillosis (IPA). Adult patients who met the modified criteria for proven and probable PM (over an 11-year period) and IPA (over a 6-year period, owing to the availability of the galactomannan assay) according to the modified European Organization for Research and Treatment of Cancer/Mycosis Study Group definitions were retrospectively enrolled. IPA cases were selected at a 1 : 4 (PM/IPA) ratio. Thoracic CT scans were reviewed by two experienced radiologists blinded to the patients' demographics and clinical outcomes. A total of 24 patients with PM, including 20 (83%) with proven PM and four (17%) with probable PM, and 96 patients with IPA, including 12 (13%) with proven IPA and 84 (87%) with probable IPA, were eventually analysed. The reverse halo sign was more common in patients with PM (54%) than in those with IPA (6%, p < 0.001), whereas some airway-invasive features, such as clusters of centrilobular nodules, peribronchial consolidations, and bronchial wall thickening, were more common in patients with IPA (IPA 52% vs. PM 29%, p 0.04; IPA 49% vs. PM 21%, p 0.01; IPA 34% vs. PM 4%, p 0.003, respectively). The reverse halo sign was more common, and airway-invasive features were less common, in patients with PM than in those with IPA. These findings may help physicians to initiate Zygomycetes-active antifungal treatment earlier.

  16. [Medical exposure from computed tomographic examination -a recommendation of dosimetry by film method-].

    Science.gov (United States)

    Yasutomo, Motokatsu; Yagi, Hirofumi

    2002-01-01

    Already, the 30 year have passed since that the CT scanner was developed by Hunsfield. And now above 16,000 sets are at work. On the other hand, as the improvements of image reconstruction algorithm and variations os scan method, the medical exposure is increasing. For example, in the case of computed radiography, medical exposure is stability by using an auto exposure controller but in the case of CT, there is no unit and usually the exposure condition of CT examination are used that of recommended an exposure condition by maker. So the medical exposure greatly differs according to the operators or the kinds of CT scanner. In addition, there is the close connection between the x-ray intensity and the image quality. Especially, in the case of CT scanner there is no saturation of x-ray intensity like the optical density of film screen system because the digital radiographic systems have the wide dynamic range. So the increase in x-ray intensity makes a contribution to improvement of the image quality. But the increase in x-ray intensity makes a contribution to the increase in medical exposure. Therefore it is very important that the CT operators grasp the medical exposure per each CT examination and patient. There are many methods of medical exposure dosimetry on CT examination. But almost all the methods except the film method are impossible to get the medical exposure per each CT examination and patient. So in this paper the film method is recommended. Because the film method is low-priced, simple, easy and immediately shows the medical exposure per each CT examination and patient. Furthermore, it is confirmed that the film method is getting the correct medical exposure because that values gotten by the film method and ionization chamber are almost equivalent.

  17. ASSOCIATION BETWEEN COMPUTED TOMOGRAPHIC CHARACTERISTICS AND FRACTURES FOLLOWING STEREOTACTIC RADIOSURGERY IN DOGS WITH APPENDICULAR OSTEOSARCOMA.

    Science.gov (United States)

    Kubicek, Lyndsay; Vanderhart, Daniel; Wirth, Kimberly; An, Qi; Chang, Myron; Farese, James; Bova, Francis; Sudhyadhom, Atchar; Kow, Kelvin; Bacon, Nicholas J; Milner, Rowan

    2016-05-01

    The objective of this observational, descriptive, retrospective study was to report CT characteristics associated with fractures following stereotactic radiosurgery in canine patients with appendicular osteosarcoma. Medical records (1999 and 2012) of dogs that had a diagnosis of appendicular osteosarcoma and undergone stereotactic radiosurgery were reviewed. Dogs were included in the study if they had undergone stereotactic radiosurgery for an aggressive bone lesion with follow-up information regarding fracture status, toxicity, and date and cause of death. Computed tomography details, staging, chemotherapy, toxicity, fracture status and survival data were recorded. Overall median survival time (MST) and fracture rates of treated dogs were calculated. CT characteristics were evaluated for association with time to fracture. Forty-six dogs met inclusion criteria. The median overall survival time was 9.7 months (95% CI: 6.9-14.3 months). The fracture-free rates at 3, 6, and 9 months were 73%, 44%, and 38% (95% CI: 60-86%, 29-60%, and 22-54%), respectively. The region of bone affected was significantly associated with time to fracture. The median time to fracture was 4.2 months in dogs with subchondral bone involvement and 16.3 months in dogs without subchondral bone involvement (P-value = 0.027, log-rank test). Acute and late skin effects were present in 58% and 16% of patients, respectively. Findings demonstrated a need for improved patient selection for this procedure, which can be aided by CT-based prognostic factors to predict the likelihood of fracture. © 2016 American College of Veterinary Radiology.

  18. Computed tomographic morphometry of thoracic pedicles: safety pedicle parameter measurement of the Chinese immature thoracic spine.

    Science.gov (United States)

    Zheng, Changkun; Huang, Qishan; Hu, Yuezheng; Wang, Xiangyang; Chen, Wei

    2009-12-01

    Our objective was to quantify the morphometric characteristics of the pedicles of the Chinese immature thoracic spine. A total of 120 patients aged 5-14 years underwent standard thoracic computed tomography (CT). The patients were grouped according to age: group 1 (5-8 years of age), group 2 (9-11 years of age) and group 3 (12-14 years of age). Images were reformatted, and multiplanar reconstructions were used to attain images of thoracic pedicles on sagittal, coronal and transverse planes. The measurements included the inner and outer pedicle diameters on the transverse plane, pedicle sagittal diameter, pedicle length and the pedicle angle on the transverse. (1) Pedicle diameters on the transverse plane decreased gradually from T1 to T4 and increased gradually from T5 to T12. The shortest transverse diameter of the thoracic pedicle was T4 or T5. (2) The sagittal diameter was significantly larger than the transverse diameter except at T1. (3) The length of the pedicle from the posterior cortex to the anterior cortex of the vertebra increased from T1 to T12. (4) The pedicle angle decreased gradually from T1 to T8 and became negative below the level of T10. The length of the pedicle changed with age significantly, but the pedicle angle changed with age insignificantly. The success of transpedicular fixation requires a better understanding of morphological features at different ages and reasonable selection of the diameter, length and direction of the pedicle screws based on X-ray and CT films.

  19. Computed tomographic assessment of a new nonsurgical sinus trephination technique using a medical bone marrow drill.

    Science.gov (United States)

    Caudal, Victor; Snead, Elisabeth C; Starrak, Gregory S; Sathya, Suresh; Feng, Cindy X

    2017-01-01

    The objective of this study was to determine the feasibility of trephination of the frontal sinus and injection of antifungal cream using a medical bone marrow drill in dogs. Results were compared with frontal sinus trephination using a standard surgical technique. Bilateral trephination of the frontal sinuses was carried out in the heads of 11 cadavers using a medical bone marrow drill and a surgical bone chuck. The time taken to carry out the procedure using both techniques was compared. Before and after injection of antifungal cream into the frontal sinuses, computed-tomography (CT) scanning was done to assess for iatrogenic trauma and to determine the degree to which the sinuses were filled with each technique and evaluate the diffusion of the cream into the nasal cavity of each dog. The mean volume of the sinuses was 8.8 mL (3.1 to 14.3 mL). Trephination, flushing, and injecting of antifungal cream were significantly faster using the medical technique. There was no significant difference in the mean filling of the frontal sinuses between the medical (82.7%) and the surgical (82.4%) technique (P-value = 0.3). Filling of the nasal cavity was classified as very good in 6/11 cases, with evidence of trauma caused by the surgical trephination technique in 1 head. Findings suggest that use of the medical bone marrow drill is highly feasible for frontal sinus trephination. Injection of antifungal cream into the frontal sinuses using the bone marrow needle resulted in good diffusion into the ipsilateral nasal cavity and could be used to treat aspergillosis when debridement or sinusoscopy is not deemed necessary.

  20. Quantitative computed tomographic imaging-based clustering differentiates asthmatic subgroups with distinctive clinical phenotypes.

    Science.gov (United States)

    Choi, Sanghun; Hoffman, Eric A; Wenzel, Sally E; Castro, Mario; Fain, Sean; Jarjour, Nizar; Schiebler, Mark L; Chen, Kun; Lin, Ching-Long

    2017-09-01

    Imaging variables, including airway diameter, wall thickness, and air trapping, have been found to be important metrics when differentiating patients with severe asthma from those with nonsevere asthma and healthy subjects. The objective of this study was to identify imaging-based clusters and to explore the association of the clusters with existing clinical metrics. We performed an imaging-based cluster analysis using quantitative computed tomography-based structural and functional variables extracted from the respective inspiration and expiration scans of 248 asthmatic patients. The imaging-based metrics included a broader set of multiscale variables, such as inspiratory airway dimension, expiratory air trapping, and registration-based lung deformation (inspiration vs expiration). Asthma subgroups derived from a clustering method were associated with subject demographics, questionnaire results, medication history, and biomarker variables. Cluster 1 was composed of younger patients with early-onset nonsevere asthma and reversible airflow obstruction and normal airway structure. Cluster 2 was composed of patients with a mix of patients with nonsevere and severe asthma with marginal inflammation who exhibited airway luminal narrowing without wall thickening. Clusters 3 and 4 were dominated by patients with severe asthma. Cluster 3 patients were obese female patients with reversible airflow obstruction who exhibited airway wall thickening without airway narrowing. Cluster 4 patients were late-onset older male subjects with persistent airflow obstruction who exhibited significant air trapping and reduced regional deformation. Cluster 3 and 4 patients also showed decreased lymphocyte and increased neutrophil counts, respectively. Four image-based clusters were identified and shown to be correlated with clinical characteristics. Such clustering serves to differentiate asthma subgroups that can be used as a basis for the development of new therapies. Copyright © 2017

  1. [Topography of ischemic strokes in Abidjan (Côte d'Ivoire): a computed tomographic approach].

    Science.gov (United States)

    Cowppli-Bony, Pascale; Yapi-Yapo, Paulette; Douayoua-Sonan, Thérèse; Kouamé, Blaise; Yapo, Félix Boa; Kouassi, Ernest Beugré

    2006-01-01

    The authors used computed tomography (CT) to assess and categorize the topography of ischemic strokes (IS) among blacks living in Abidjan, the commercial and administrative center of Côte d'Ivoire, in West Africa. This retrospective study analyzed CT data of patients admitted to the Sainte Anne Marie Polyclinic (the principal private hospital in the country) and to the neurology department of the university hospital center in Cocody, from January 1, 2000, to December 31, 2001. The study included patients who met World Health Organisation criteria for stroke and had CT performed during the hospitalization for this stroke. We examined CT data to find early and late signs of IS, analyze lesion diameter (15 mm cutoff used to distinguish infarcts from lacuna), and determine their topography (cerebral arterial territory and localization, that is, brain lobes, basal ganglia and posterior cerebral fossa). We included 260 subjects (58% males) with a median age of 45 years (range: 20-80 years). CT findings were abnormal for 224 patients with infarcts (72.7%), lacuna (27.3%), or both (8%). As reported elsewhere, the anterior arterial territory was most often affected (83.9%) with a middle cerebral artery lesion in 79.4% of patients. Posterior territory (16.1%) lesions and lacuna were probably underestimated because CT exploration is reported to be less useful for this area than for the carotid area. On the other hand, CT diagnoses infarcts more easily than it does lacuna. CT was normal for 36 patients although performed no more than 3 days after IS. These patients did not undergo CT angiography, which might have shown cerebral artery occlusion. Our study included IS of all types and typography. Stroke registries in Africa would provide useful data for better assessment of prevalence for specific topographic and etiologic types of stroke.

  2. 3D printing of preclinical X-ray computed tomographic data sets.

    Science.gov (United States)

    Doney, Evan; Krumdick, Lauren A; Diener, Justin M; Wathen, Connor A; Chapman, Sarah E; Stamile, Brian; Scott, Jeremiah E; Ravosa, Matthew J; Van Avermaete, Tony; Leevy, W Matthew

    2013-03-22

    Three-dimensional printing allows for the production of highly detailed objects through a process known as additive manufacturing. Traditional, mold-injection methods to create models or parts have several limitations, the most important of which is a difficulty in making highly complex products in a timely, cost-effective manner.(1) However, gradual improvements in three-dimensional printing technology have resulted in both high-end and economy instruments that are now available for the facile production of customized models.(2) These printers have the ability to extrude high-resolution objects with enough detail to accurately represent in vivo images generated from a preclinical X-ray CT scanner. With proper data collection, surface rendering, and stereolithographic editing, it is now possible and inexpensive to rapidly produce detailed skeletal and soft tissue structures from X-ray CT data. Even in the early stages of development, the anatomical models produced by three-dimensional printing appeal to both educators and researchers who can utilize the technology to improve visualization proficiency. (3, 4) The real benefits of this method result from the tangible experience a researcher can have with data that cannot be adequately conveyed through a computer screen. The translation of pre-clinical 3D data to a physical object that is an exact copy of the test subject is a powerful tool for visualization and communication, especially for relating imaging research to students, or those in other fields. Here, we provide a detailed method for printing plastic models of bone and organ structures derived from X-ray CT scans utilizing an Albira X-ray CT system in conjunction with PMOD, ImageJ, Meshlab, Netfabb, and ReplicatorG software packages.

  3. Risk factor profiling and study of atherosclerotic coronary plaque burden and morphology with coronary computed tomography angiography in coronary artery disease among young Indians.

    Science.gov (United States)

    Chaudhary, R; Chauhan, A; Singhal, M; Bagga, S

    2017-08-01

    With a decade earlier manifestation of coronary artery disease (CAD) and paucity of data characterizing coronary plaque with coronary computed tomography angiography (CTA) among CAD patients in India, the study aimed to analyze patient characteristics and coronary plaque burden and morphology in young Indian patients with CAD. Serial coronary CTA was performed in 96 CAD patients. Among 60 patients ≤40years, risk factor and coronary plaque analysis done using a 256- slice CT in 33 patients with acute coronary syndrome (ACS) was compared with 27 patients with chronic stable angina (CSA). Univariate and multivariate analysis was performed, for factors predicting ACS as an outcome among young CAD patients. In addition, quantitative and morphologic plaque characteristics were compared among those ≤40years and >40years. Among 60 subjects ≤40years of age, 77% had dyslipidemia, 70% high lipoprotein(a), 53.33% elevated hs-CRP and 73.33% raised homocysteine. hs-CRP (9.33 vs. 3.33, p value=0.01) and serum triglycerides (178.67 vs. 141.42, p value=0.03) were markedly raised in patients with ACS. Statistically significant number of patients in the ACS group had positive remodelling (ACS, 69.7% vs. CSA, 14.8%; p value30mg/dL and composite vulnerability score maintained a predictive value for ACS in patients ≤40years. Statistically significant number of patients in the younger age group had higher mean total plaque volume (66.17±41.31mm(3) vs. 44.94±49.07mm(3); p=0.03), remodelling index (1.5±0.27 vs. 1.08±0.38; p=0.0001). Comparing culprit lesion characteristics of ACS patients in the two age groups, positive remodelling (95.8% vs. 70.5%, p=0.02), spotty calcification (50% vs. 11.7%, p=0.01) and non-calcified plaque (95.8% vs. 70.5%, p=0.02) were significantly more frequent in patients ≤40years. ACS in young Indians is characterized by a higher prevalence of both conventional and newer risk factors. In addition, culprit lesions in young ACS patients are more

  4. Computed tomographic study of posterior cranial fossa, foramen magnum, and its surgical implications in Chiari malformations.

    Science.gov (United States)

    Iqbal, Showkathali; Robert, Ambooken P; Mathew, Dominic

    2017-01-01

    The aim of this study is to measure the height and volume of the bony part of the posterior cranial fossa (PCF) and the surface area of the foramen magnum (FM) using computed tomography (CT) scans and to correlate our clinical findings with the available current literature. This cross-sectional study was conducted in a tertiary care referral hospital in the Southern part of India during the period from January 2015 to August 2015. A total of 100 CT scans of the suspected head injury patients were collected retrospectively form the basis for this study. The height, volume of PCF and the anteroposterior (AP), transverse diameter, and surface area of the FM were measured. The values of all parameters were subjected to statistical analysis using SPSS version 16. The age of the patients were ranged between 18 and 70 years with the mean age of 41.22 ± 13.93 years. The dimensions of the posterior fossa and FM were larger in males compared to females. The mean height of the posterior fossa was 38.08 (±4.718) mm (P = 0.0001), and the mean volume of the posterior fossa was 157.23 (±6.700) mm(3) (P = 0.0001). The mean AP, transverse diameter, and the surface area of the FM were 33.13 (± 3.286) mm, 29.01 (± 3.081) mm, and 763.803 (±138.276) mm(2), respectively. The normal dimensions of the posterior fossa and FM were less in females than males and were useful to radiologists and neurosurgeons to better their diagnostic inferences, as well as to determine the proper treatment options in Chiari malformation type I (CMI) and other posterior fossa anomalies. The posterior fossa tissue volume can be reliably measured in patients with CMI using our method. More studies were required because there were variations in dimensions among individuals of different races in different regions of the world.

  5. INVESTIGATION OF IMPACTED SUPERNUMERARY TEETH: A CONE BEAM COMPUTED TOMOGRAPH (CBCT STUDY

    Directory of Open Access Journals (Sweden)

    Gökhan GÜRLER

    2017-10-01

    Full Text Available Purpose: The purpose of this study was to investigate the impacted supernumerary teeth which were initially detected on panoramic radiographs by using cone beam computed tomography (CBCT. Materials and Methods: In this retrospective study, supernumerary teeth diagnosed on panoramic radiographs taken from patients who had admitted for routine dental treatment were evaluated using CBCT. Patients’ age, gender, systemic conditions as well as number of supernumerary teeth, unilateral-bilateral presence, anatomical localization (maxilla, mandible, anterior-premolar-molar, mesiodens-lateral-canine, parapremolar-paramolar-distomolar shape (rudimentary, supplemental, tuberculate, odontoma, position (palatal-lingual-buccal-labial-central, shortest distance between the tooth and adjacent cortical plate, complications and treatment were assessed. Results: A total of 47 impacted supernumerary teeth in 34 patients were investigated in this study. Of these, 33 (70.2% were unilateral and 14 (29.8% were bilateral. Only 1 supernumerary tooth was found in 27 patients (79.4% whereas 7 patients (20.6% had 2 or more supernumerary teeth. Most of the teeth located in the anterior region (74.4% of the jaws and maxilla (74.4%. Twenty teeth (42.5% were mesiodens, 11 (23.4% were lateral or canine, 14 (29.7% were parapremolar and 2(4.4% were distomolar. Twenty-seven teeth (57.4% were rudimentary, 15 (31.9% were supplemental and 5 (10.7% were odontoma in shape. The shortest distance between the supernumerary tooth and adjacent cortical plate varied between 0 to 2.5 mm with a mean of 0.66 mm. The most common clinical complaint was the non-eruption of permanent teeth (42.5%. All supernumerary teeth were removed under local anesthesia. Orthodontic traction was performed for those impacted permanent teeth if necessary. Conclusion: Impacted supernumerary teeth are usually in close proximity to cortical bone. Although this may facilitate surgical access, there is a risk of

  6. Evaluation of early coronary graft patency after coronary artery bypass graft surgery using multislice computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Raissi Kamal

    2009-12-01

    Full Text Available Abstract Background Coronary artery bypass graft (CABG surgery is the standard of care in the treatment of advanced coronary artery disease, and its long-term results are affected by the failure of bypass grafts. The aim of the present study was to evaluate the early patency rate in coronary bypass grafts. Methods A total of 107 consecutive patients who underwent CABG were included in this study. Early graft patency was evaluated via computed tomography (CT angiography in the first week after surgery. Results There were a total of 366 grafts, comprised of 250 venous grafts and 116 arterial grafts. Multi-slice CT detected acute graft occlusions in 32 (8.7% of all the grafts, including 26 (10% of the 250 venous grafts and 6 (5% of the 116 arterial grafts. The patency rates obtained were 97.3% for the left internal mammary (IMA grafts, 50% for the radial artery grafts, and 50% for the right IMA grafts. Additionally, 107 (96.4% grafts to the left anterior descending artery (LAD were classified as patent, whereas 1 (30% of the 3 grafts in the left circumflex (LCX region and 1 (50% of the 2 grafts in the right coronary artery (RCA territory were found to be occluded. In the venous category, 8 (13.7% of the 58 grafts to LAD were found to be occluded. In the LCX region, 9 (8.5% of the 106 grafts were classified as occluded, while the remaining 97 (91.5% grafts were patent. The venous grafts to RCA were occluded in 9 (10.4% of the 86 grafts. Amongst the multiple preoperative, intraoperative, and postoperative factors, pump time was significantly longer in the patients with occluded grafts than in those with patent grafts (P = 0.04. Conclusion The IMA grafts had the highest early patency rate amongst the coronary bypass grafts. However, the other arterial grafts were associated with a high rate of acute occlusions.

  7. Multislice Computed Tomography Accurately Detects Stenosis in Coronary Artery Bypass Conduits

    Science.gov (United States)

    Duran, Cihan; Sagbas, Ertan; Caynak, Baris; Sanisoglu, Ilhan; Akpinar, Belhhan; Gulbaran, Murat

    2007-01-01

    The aim of this study was to evaluate the accuracy of multislice computed tomography in detecting graft stenosis or occlusion after coronary artery bypass grafting, using coronary angiography as the standard. From January 2005 through May 2006, 25 patients (19 men and 6 women; mean age, 54 ± 11.3 years) underwent diagnostic investigation of their bypass grafts by multislice computed tomography within 1 month of coronary angiography. The mean time elapsed after coronary artery bypass grafting was 6.2 years. In these 25 patients, we examined 65 bypass conduits (24 arterial and 41 venous) and 171 graft segments (the shaft, proximal anastomosis, and distal anastomosis). Compared with coronary angiography, the segment-based sensitivity, specificity, and positive and negative predictive values of multislice computed tomography in the evaluation of stenosis were 89%, 100%, 100%, and 99%, respectively. The patency rate for multislice compu-ted tomography was 85% (55/65: 3 arterial and 7 venous grafts were occluded), with 100% sensitivity and specificity. From these data, we conclude that multislice computed tomography can accurately evaluate the patency and stenosis of bypass grafts during outpatient follow-up. PMID:17948078

  8. Multi-dimensional visualization of coronary aberrancies using multi detector computed tomography

    NARCIS (Netherlands)

    van Ooijen, P; Dorgelo, J; Tukker, W; Willemsen, H; Oudkerk, M; Lewis, BS; Halon, DA; Flugelman, MY; Gensini, GF

    2003-01-01

    The purpose of this study was to evaluate the usefulness of three and four dimensional visualization of multi detector computed tomography datasets for the evaluation of coronary aberrancies. Multi detector computed tomography (MDCT) datasets were obtained in thirteen patients following a standard p

  9. Comparative evaluation of the cadaveric, radiographic and computed tomographic anatomy of the heads of green iguana (Iguana iguana , common tegu ( Tupinambis merianae and bearded dragon ( Pogona vitticeps

    Directory of Open Access Journals (Sweden)

    Banzato Tommaso

    2012-05-01

    Full Text Available Abstract Background Radiology and computed tomography are the most commonly available diagnostic tools for the diagnosis of pathologies affecting the head and skull in veterinary practice. Nevertheless, accurate interpretation of radiographic and CT studies requires a thorough knowledge of the gross and the cross-sectional anatomy. Despite the increasing success of reptiles as pets, only a few reports over their normal imaging features are currently available. The aim of this study is to describe the normal cadaveric, radiographic and computed tomographic features of the heads of the green iguana, tegu and bearded dragon. Results 6 adult green iguanas, 4 tegus, 3 bearded dragons, and, the adult cadavers of : 4 green iguana, 4 tegu, 4 bearded dragon were included in the study. 2 cadavers were dissected following a stratigraphic approach and 2 cadavers were cross-sectioned for each species. These latter specimens were stored in a freezer (−20°C until completely frozen. Transversal sections at 5 mm intervals were obtained by means of an electric band-saw. Each section was cleaned and photographed on both sides. Radiographs of the head of each subject were obtained. Pre- and post- contrast computed tomographic studies of the head were performed on all the live animals. CT images were displayed in both bone and soft tissue windows. Individual anatomic structures were first recognised and labelled on the anatomic images and then matched on radiographs and CT images. Radiographic and CT images of the skull provided good detail of the bony structures in all species. In CT contrast medium injection enabled good detail of the soft tissues to be obtained in the iguana whereas only the eye was clearly distinguishable from the remaining soft tissues in both the tegu and the bearded dragon. Conclusions The results provide an atlas of the normal anatomical and in vivo radiographic and computed tomographic features of the heads of lizards, and this may be

  10. Comparative evaluation of the cadaveric, radiographic and computed tomographic anatomy of the heads of green iguana (Iguana iguana), common tegu (Tupinambis merianae) and bearded dragon (Pogona vitticeps).

    Science.gov (United States)

    Banzato, Tommaso; Selleri, Paolo; Veladiano, Irene A; Martin, Andrea; Zanetti, Emanuele; Zotti, Alessandro

    2012-05-11

    Radiology and computed tomography are the most commonly available diagnostic tools for the diagnosis of pathologies affecting the head and skull in veterinary practice. Nevertheless, accurate interpretation of radiographic and CT studies requires a thorough knowledge of the gross and the cross-sectional anatomy. Despite the increasing success of reptiles as pets, only a few reports over their normal imaging features are currently available. The aim of this study is to describe the normal cadaveric, radiographic and computed tomographic features of the heads of the green iguana, tegu and bearded dragon. 6 adult green iguanas, 4 tegus, 3 bearded dragons, and, the adult cadavers of: 4 green iguana, 4 tegu, 4 bearded dragon were included in the study. 2 cadavers were dissected following a stratigraphic approach and 2 cadavers were cross-sectioned for each species. These latter specimens were stored in a freezer (-20°C) until completely frozen. Transversal sections at 5 mm intervals were obtained by means of an electric band-saw. Each section was cleaned and photographed on both sides. Radiographs of the head of each subject were obtained. Pre- and post- contrast computed tomographic studies of the head were performed on all the live animals. CT images were displayed in both bone and soft tissue windows. Individual anatomic structures were first recognised and labelled on the anatomic images and then matched on radiographs and CT images. Radiographic and CT images of the skull provided good detail of the bony structures in all species. In CT contrast medium injection enabled good detail of the soft tissues to be obtained in the iguana whereas only the eye was clearly distinguishable from the remaining soft tissues in both the tegu and the bearded dragon. The results provide an atlas of the normal anatomical and in vivo radiographic and computed tomographic features of the heads of lizards, and this may be useful in interpreting any imaging modality involving these

  11. The Prognosis of Patients With Nonobstructive Coronary Artery Disease Versus Normal Arteries Determined by Invasive Coronary Angiography or Computed Tomography Coronary Angiography: A Systematic Review.

    Science.gov (United States)

    Huang, Fang-Yang; Huang, Bao-Tao; Lv, Wen-Yu; Liu, Wei; Peng, Yong; Xia, Tian-Li; Wang, Peng-Ju; Zuo, Zhi-Liang; Liu, Rui-Shuang; Zhang, Chen; Gui, Yi-Yue; Liao, Yan-Biao; Chen, Mao; Zhu, Ye

    2016-03-01

    Limited data exist regarding the outcomes of patients with nonobstructive coronary artery disease (CAD) detected by computed tomography coronary angiography (CTCA) or invasive coronary angiography (ICA). Our aim was to compare the prognosis of patients with nonobstructive coronary artery plaques with that of patients with entirely normal arteries. The MEDLINE, Cochrane Library, and Embase databases were searched. Studies comparing the prognosis of individuals with nonobstructive CAD versus normal coronary arteries detected by CTCA or ICA were included. The primary outcome was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, hospitalization due to unstable angina or revascularization. A fixed effects model was chosen to pool the estimates of odds ratios (ORs). Forty-eight studies with 64,905 individuals met the inclusion criteria. Patients in the nonobstructive CAD arm had a significantly higher risk of MACE compared to their counterparts in the normal artery arm (pooled OR, 3.17, 95% confidence interval, 2.77-3.63). When excluding revascularization as an endpoint, hard cardiac composite outcomes were also more frequent among patients with nonobstructive CAD (pooled OR, 2.10; 95%CI, 1.79-2.45). All subgroups (age, sex, follow-up duration, different outcomes, diagnostic modality, and CAD risk factor) consistently showed a poorer prognosis with nonobstructive CAD than with normal arteries. When dividing the studies into a CTCA and ICA group for further analysis based on the indications for diagnostic tests, we also found nonobstructive CAD to be associated with a higher risk of MACE in both stable and acute chest pain. Patients with nonobstructive CAD had a poorer prognosis compared with their counterparts with normal arteries.

  12. Prognostic implications of nonobstructive coronary plaques in patients with non-ST-segment elevation myocardial infarction: a multidetector computed tomography study

    DEFF Research Database (Denmark)

    Kristensen, Thomas S; Kofoed, Klaus F; Kühl, Jørgen T;

    2011-01-01

    We sought to determine whether the amount of noncalcified plaque (NCP) in nonobstructive coronary lesions as detected by multidetector computed tomography (MDCT) was a predictor of future coronary events.......We sought to determine whether the amount of noncalcified plaque (NCP) in nonobstructive coronary lesions as detected by multidetector computed tomography (MDCT) was a predictor of future coronary events....

  13. Neuroblastoma: computed tomographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Choon Sik; Ahn, Chang Su; Kim, Myung Jun; Oh, Ki Keun [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    1994-01-15

    To evaluate the characteristic CT findings of neuroblastoma, we studied neuroblastomas. We analysed CT findings of available 25 cases among pathologically proved 51 neuroblastomas from Jan. 1983 to Sept. 1990. The most frequent site of origin is adrenal gland (40%) and the second is retroperitoneum (32%) and the third ismediastinum (16%). Characteristic CT findings are as follows: Calcifications within the tumor is detected in 86% of abdominal neuroblastomas and 50% of mediastinal origin. Hemorrhagic and necrotic changes within the tumor is noted at 86% in the tumor of abdominal origin and 25% in mediastinal neuroblastomas. Contrast enhanced study showed frequently seperated enhanced appearance with/without solid contrast enhancement. Encasements of major great vessels such as aorta and IVC with/without displacement by metastatic lymph nodes or tumor are frequently seen in 90% of abdominal neuroblastomas. Multiple lymphadenopathy are detected in 95% of abdominal neuroblastomas and 25% of mediastinal neuroblastomas. The most common organ or contiguous direct invasion is kidney in 6 cases and the next one is liver but intraspinal canal invasion is also noted in 2 cases. We concluded that diagnosis of neuroblastoma would be easily obtained in masses of pediatric group from recognition of above characteristic findings.

  14. Quantitative strain analysis in analogue modelling experiments: insights from X-ray computed tomography and tomographic image correlation

    Science.gov (United States)

    Adam, J.; Klinkmueller, M.; Schreurs, G.; Wieneke, B.

    2009-04-01

    deformation. We have adapted our analogue modelling setups for optimal analysis of complex deformation processes using leading-edge volumetric strain monitoring techniques (3D volume DIC, Tomographic DIC). In this study, we apply DIC on X-ray CT images of analogue models. Our first results indicate that DIC can successfully be applied to quantify the 2D and 3D spatial and temporal patterns of strain accumulation. REFERENCES Adam, J., Urai, J.L, Wieneke, B., Oncken, O., Pfeiffer, K., Kukowski, N., Lohrmann, J., Hoth, S. van der Zee, W., and Schmatz, J.; 2005: Shear localisation and strain distribution during tectonic faulting - new insights from granular-flow experiments and high-resolution optical image correlation techniques. Journal of Structural Geology, 27, 283-301. Lohrmann, J., Kukowski, N., Adam, J. & Oncken, O.; 2003: The control of sand wedges by material properties: sensitivity analyses and application to convergent margin mechanics. - Journal of Structural Geology, 25, 1691-1711 Panien, M., Schreurs, G., and Pfiffner, A.; 2006. Mechanical behaviour of granular materials used in analogue modelling: insights from grain characterisation, ring-shear tests and analogue experiments. Journal of Structural Geology, 28, 1710-1724. Schreurs, G., Hänni, R, and Vock, P.; 2002: Analogue modelling of transfer zones in fold and thrust belts: a 4-D analysis. In: Schellart, W.P. and Passchier, C. (eds). Analogue modelling of large-scale tectonic processes. Journal of the Virtual Explorer, 7, 67-73. Schreurs, G., Hänni, R, Panien, M. and Vock, P.; 2003: Analysis of analogue models by helical X-ray computed tomography. In: Mees, F., Swennen, R., Van Geet, M. and Jacobs, P. (eds). Applications of X-ray Computed Tomogaphy in Earth Sciences. Geological Society, London, Special Publications, 215, 213-223.

  15. Pulmonary lymphatic drainage to the mediastinum based on computed tomographic observations of the primary complex of pulmonary histoplasmosis

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Koji; Sasaki, Tomoaki; Nabaa, Basim; Aburano, Tamio (Department of Radiology, Asahikawa Medical University and Hospital, Asahikawa (Japan)), Email: taka1019@asahikawa-med.ac.jp; Beek, Edwin Jr. von (Clinical Research Imaging Centre, Queen' s Medical Research Institute, University of Edinburgh, Edinburgh (United Kingdom)); Stanford, William (Department of Radiology, University of Iowa College of Medicine, Iowa City (United States))

    2012-03-15

    Background. In the primary infection of pulmonary histoplasmosis, pulmonary lesions are commonly solitary and associated with hilar and/or mediastinal nodal diseases, which spontaneously resolve, resulting in calcifications in individuals with normal cellular immunity. Purpose. To assess the lymphatic drainage to the mediastinum from each pulmonary segment and lobe using computed tomographic (CT) observations of a calcified primary complex pulmonary histoplasmosis and predict which patients with N2 disease that would benefit from surgery. Material and Methods. We collected 585 CT studies of patients with primary complex histoplasmosis consisting of solitary calcified pulmonary lesions and calcified hilar and/or mediastinal nodal disease. Using the N stage criteria of non-small cell lung cancer, we assessed the distribution of the involved hilar and mediastinal nodes depending on the pulmonary segment of the lesion, with a focus on skip involvement. We also assessed the correlation between the incidence of N1and skip N2 involvement and the mean number of involved mediastinal nodal stations in the non-skip N2 and skip N2 groups. Results. Skip involvement was common in the apical segment (9/45, 20.0%), posterior segment (7/31, 22.6%), and mediolbasal segment (13/20, 65.0%) in the right lung, and in the apicoposterior segment (7/55, 12.7%), lateral basal segment (6/26, 23.1%), and posterobasal segment (16/47, 34.0%) in the left lung. The incidence of skip involvement in each segment showed a significant inverse correlation with that of N1 involvement (r = -0.51, P <0.05) in both lungs. The mean number of involved mediastinal nodal stations in the non-skip N2 and skip N2 groups in all segments of both lungs were 1.4 (434/301) and 1.2 (93/77), and the former was significantly greater than the latter (P <0.01). Conclusion. Our data showed a predictable pattern of segmental and lobar lymphatic drainage to the mediastinum and suggested that skip involvement could represent

  16. Prevalence of Coronary Artery Intramyocardial Course in a Large Population of Clinical Patients Detected by Multislice Computed Tomography Coronary Angiography

    Energy Technology Data Exchange (ETDEWEB)

    De Rosa, R.; Sacco, M.; Tedeschi, C.; Pepe, R.; Capogrosso, P.; Montemarano, E.; Rotondo, A.; Runza, G.; Midiri, M.; Cademartiri, F. (UO di Radiologia, Ospedale San Gennaro, Napoli (Italy))

    2008-10-15

    Background: Intramyocardial course, an inborn coronary anomaly, is defined as a segment of a major epicardial coronary artery that runs intramurally through the myocardium; in particular, we distinguish myocardial bridging, in which the vessel returns to an epicardial position after the muscle bridge, and intramyocardial course, which is described as a vessel running and ending in the myocardium. Purpose: To evaluate the prevalence of myocardial bridging and intramyocardial course of coronary arteries as defined by multidetector computed tomography (MDCT) angiography. Material and Methods: The study population consisted of 242 consecutive patients (211 men, 31 women; mean age 59+-6 years) with atypical chest pain admitted to our hospital between December 2004 and September 2006. All MDCT examinations were performed using a 16-detector-row scanner (Aquilion 16 CFX; Toshiba Medical System, Tokyo, Japan). Patients with heart rate above 65 bpm received 50 mg atenolol orally for 3 days prior to the MDCT scan, or they increased their usual therapy with beta-blockers, in order to obtain a prescan heart rate <60 bpm. Curved multiplanar and 3D volume reconstructions were performed to explore coronary anatomy. Results: In 235 patients, the CT scan was successful and images were appropriate for evaluation. The prevalence of myocardial bridging and intramyocardial course of coronary arteries was 18.7% (47 cases) in our patient population. In 30 segments (63.8%), the vessels ran and ended in the myocardium. In the remaining 17 segments (36.2%), the vessels returned to an epicardial position after the muscle bridge. We found no difference in the prevalence of this inborn coronary anomaly when comparing different clinical characteristics of the study population (sex, age, body-mass index [BMI], etc.). The mean length of the subepicardial artery was 7 mm (range 5-12 mm), and the mean depth in the diastolic phase was 1.9 mm (range 1.2-2.3 mm). There was no significant difference of

  17. Clinical feasibility of 3D automated coronary atherosclerotic plaque quantification algorithm on coronary computed tomography angiography: Comparison with intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyung-Bok [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); Myongji Hospital, Division of Cardiology, Cardiovascular Center, Goyang (Korea, Republic of); Lee, Byoung Kwon [Yonsei University College of Medicine, Division of Cardiology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Shin, Sanghoon [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); National Health Insurance Corporation Ilsan Hospital, Division of Cardiology, Goyang (Korea, Republic of); Heo, Ran; Chang, Hyuk-Jae; Chung, Namsik [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); Yonsei University Health System, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of); Arsanjani, Reza [Cedars-Sinai Medical Center, Departments of Imaging and Medicine, Cedars-Sinai Heart Institute, Los Angeles, CA (United States); Kitslaar, Pieter H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical Imaging Systems B.V., Leiden (Netherlands); Broersen, Alexander; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Ahn, Sung Gyun [Yonsei University Wonju Severance Christian Hospital, Division of Cardiology, Wonju (Korea, Republic of); Min, James K. [New York-Presbyterian Hospital, Institute for Cardiovascular Imaging, Weill-Cornell Medical College, New York, NY (United States); Hong, Myeong-Ki; Jang, Yangsoo [Yonsei University Health System, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of)

    2015-10-15

    To evaluate the diagnostic performance of automated coronary atherosclerotic plaque quantification (QCT) by different users (expert/non-expert/automatic). One hundred fifty coronary artery segments from 142 patients who underwent coronary computed tomography angiography (CCTA) and intravascular ultrasound (IVUS) were analyzed. Minimal lumen area (MLA), maximal lumen area stenosis percentage (%AS), mean plaque burden percentage (%PB), and plaque volume were measured semi-automatically by expert, non-expert, and fully automatic QCT analyses, and then compared to IVUS. Between IVUS and expert QCT analysis, the correlation coefficients (r) for the MLA, %AS, %PB, and plaque volume were excellent: 0.89 (p < 0.001), 0.84 (p < 0.001), 0.91 (p < 0.001), and 0.94 (p < 0.001), respectively. There were no significant differences in the mean parameters (all p values >0.05) except %AS (p = 0.01). The automatic QCT analysis showed comparable performance to non-expert QCT analysis, showing correlation coefficients (r) of the MLA (0.80 vs. 0.82), %AS (0.82 vs. 0.80), %PB (0.84 vs. 0.73), and plaque volume (0.84 vs. 0.79) when they were compared to IVUS, respectively. Fully automatic QCT analysis showed clinical utility compared with IVUS, as well as a compelling performance when compared with semiautomatic analyses. (orig.)

  18. Image Quality of Coronary Computed Tomography Angiography with 320-Row Area Detector Computed Tomography in Children with Congenital Heart Disease.

    Science.gov (United States)

    Tada, Akihiro; Sato, Shuhei; Kanie, Yuichiro; Tanaka, Takashi; Inai, Ryota; Akagi, Noriaki; Morimitsu, Yusuke; Kanazawa, Susumu

    2016-03-01

    The objective of this study was to assess factors affecting image quality of 320-row computed tomography angiography (CTA) of coronary arteries in children with congenital heart disease (CHD). We retrospectively reviewed 28 children up to 3 years of age with CHD who underwent prospective electrocardiography (ECG)-gated 320-row CTA with iterative reconstruction. We assessed image quality of proximal coronary artery segments using a five-point scale. Age, body weight, average heart rate, and heart rate variability were recorded and compared between two groups: patients with good diagnostic image quality in all four coronary artery segments and patients with at least one coronary artery segment with nondiagnostic image quality. Altogether, 96 of 112 segments (85.7 %) had diagnostic-quality images. Patients with nondiagnostic segments were significantly younger (10.0 ± 11.6 months) and had lower body weight (5.9 ± 2.9 kg) (each p heart rate and heart rate variability between the two imaging groups were not significant. Receiver operating characteristic analyses for predicting patients with nondiagnostic image quality revealed an optimal body weight cutoff of ≤5.6 kg and an optimal age cutoff of ≤12.5 months. Prospective ECG-gated 320-row CTA with iterative reconstruction provided feasible image quality of coronary arteries in children with CHD. Younger age and lower body weight were factors that led to poorer image quality of coronary arteries.

  19. Automated Computer-Assisted Diagnosis of Obstructive Coronary Artery Disease in Emergency Department Patients Undergoing 256-Slice Coronary Computed Tomography Angiography for Acute Chest Pain.

    Science.gov (United States)

    Hashoul, Sharbell; Gaspar, Tamar; Halon, David A; Lewis, Basil S; Shenkar, Yuval; Jaffe, Ronen; Peled, Nathan; Rubinshtein, Ronen

    2015-10-01

    A 256-slice coronary computed tomography angiography (CCTA) is an accurate method for detection and exclusion of obstructive coronary artery disease (OBS-CAD). However, accurate image interpretation requires expertise and may not be available at all hours. The purpose of this study was to evaluate the usefulness of a fully automated computer-assisted diagnosis (COMP-DIAG) tool for exclusion of OBS-CAD in patients in the emergency department (ED) presenting with chest pain. Three hundred sixty-nine patients in ED without known coronary disease underwent 256-slice CCTA as part of the assessment of chest pain of uncertain origin. COMP-DIAG (CorAnalyzer II) automatically reported presence or exclusion of OBS-CAD (>50% stenosis, ≥1 vessel). Performance characteristics of COMP-DIAG for exclusion and detection of OBS-CAD were determined using expert reading as the reference standard. Seventeen (5%) studies were unassessable by COMP-DIAG software, and 352 patients (1,056 vessels) were therefore available for analysis. COMP-DIAG identified 33% of assessable studies as having OBS-CAD, but the prevalence of OBS-CAD on CCTA was only 18% (66 of 352 patients) by standard expert reading. However, COMP-DIAG correctly identified 61 of the 66 patients (93%) with OBS-CAD with 21 vessels (2%) with OBS-CAD misclassified as negative. In conclusion, compared to expert reading, automated computer-assisted diagnosis using the CorAnalyzer showed high sensitivity but only moderate specificity for detection of obstructive coronary disease in patients in ED who underwent 256-slice CCTA. The high negative predictive value of this computer-assisted algorithm may be useful in the ED setting.

  20. Differentiation of acute total occlusion of coronary artery from chronic total occlusion in coronary computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kwag, Hyon Joo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    To compare the features of coronary computed tomography angiography (CCTA) imaging of the patients with acute total occlusion (ATO) of coronary artery with those of chronic total occlusion (CTO). CCTA of 26 patients with complete interruption of the coronary artery in CCTA and occlusion in conventional coronary angiography, were retrospectively analyzed. Discrimination between the ATO group (n = 11, patients with non ST elevation myocardial infarction or unstable angina) and the CTO group (n = 15, patients with stable angina or nonspecific symptom) was arbitrarily determined by clinical diagnosis. Lesion length, remodeling index (RI), plaque density measured by Hounsfield units (HU), plaque composition, percentage attenuation drop across the lesion, and presence of myocardial thinning were evaluated. Comparisons between the ATO and CTO groups revealed significantly shorter lesion length in the ATO group (0.40 cm vs. 1.87 cm, respectively; p = 0.001), and significantly higher RI (1.56 vs. 1.10, respectively; p = 0.004). Plaque density of the ATO group was lower (37.0 HU vs. 104.7 HU, respectively; p < 0.001) and non calcified plaque was frequently seen in the ATO group (72.7% vs. 26.7%, respectively; p = 0.02). Percentage attenuation drop across the lesion was lower for the ATO group (10.92% vs. 25.44%, respectively; p = 0.005). Myocardial thinning was exclusively observed in the CTO group (seven of 15 patients, p = 0.01). CCTA shows various statistically significant differences between the ATO and CTO groups.

  1. The diagnostic accuracy and outcomes after coronary computed tomography angiography vs. conventional functional testing in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Ortner, Nino; Nørgaard, Bjarne L

    2014-01-01

    AIMS: To systematically review and perform a meta-analysis of the diagnostic accuracy and post-test outcomes of conventional exercise electrocardiography (XECG) and single-photon emission computed tomography (SPECT) compared with coronary computed tomography angiography (coronary CTA) in patients...

  2. Usefulness of preoperative coronary angiography and brain computed tomography in cases of coronary artery disease and cerebrovascular disease undergoing revascularization for arteriosclerosis obliterans

    Energy Technology Data Exchange (ETDEWEB)

    Sakurada, Tall; Shibata, Yoshiki [Southern Tohoku Fukushima Hospital (Japan)

    2003-05-01

    Coronary angiography and brain computed tomography were preoperatively performed to evaluate the clinical condition of coronary artery disease and cerebrovascular disease in 101 patients (mean age, 68.4 years) with revascularization for arteriosclerosis obliterans. Eighty patients had hypertension, 12 had diabetes, and 26 had hyperlipidemia. Seventy-one patients (70.3%) had coronary stenosis. Significant stenoses in major coronary artery branches were confirmed in 35 patients, including 13 patients with old myocardial infarction. Coronary artery bypass grafting and percutaneous coronary angioplasty were performed in 2 and 7 patients with critical stenosis, respectively. Of 57 patients, who underwent brain computed tomography, abnormalities were found in 52 patients (91.2%), including cortical infarction in 9, lacunar infarction in 35, and leukoaraiosis in 27 patients. During the follow-up period 13 patients died (including 3 cases of myocardial infarction and 3 cases of stroke). Actuarial survival rate at 5 years was 80.4%. The influence of ischemic heart disease and cerebrovascular disease on early and late mortality after surgical reconstruction for peripheral occlusive vascular disease is significant. Using visual diagnostic techniques, such as coronary angiography and brain computed tomography, long term survivor should be closely observed for multiple arteriosclerotic vascular diseases. (author)

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  4. Effects of Vessel Tortuosity on Coronary Hemodynamics: An Idealized and Patient-Specific Computational Study.

    Science.gov (United States)

    Vorobtsova, Natalya; Chiastra, Claudio; Stremler, Mark A; Sane, David C; Migliavacca, Francesco; Vlachos, Pavlos

    2016-07-01

    Although coronary tortuosity can influence the hemodynamics of coronary arteries, the relationship between tortuosity and flow has not been thoroughly investigated partly due to the absence of a widely accepted definition of tortuosity and the lack of patient-specific studies that analyze complete coronary trees. Using a computational approach we investigated the effects of tortuosity on coronary flow parameters including pressure drop, wall shear stress, and helical flow strength as measured by helicity intensity. Our analysis considered idealized and patient-specific geometries. Overall results indicate that perfusion pressure decreases with increased tortuosity, but the patient-specific results show that more tortuous vessels have higher physiological wall shear stress values. Differences between the idealized and patient-specific results reveal that an accurate representation of coronary tortuosity must account for all relevant geometric aspects, including curvature imposed by the heart shape. The patient-specific results exhibit a strong correlation between tortuosity and helicity intensity, and the corresponding helical flow contributes directly to the observed increase in wall shear stress. Therefore, helicity intensity may prove helpful in developing a universal parameter to describe tortuosity and assess its impact on patient health. Our data suggest that increased tortuosity could have a deleterious impact via a reduction in coronary perfusion pressure, but the attendant increase in wall shear stress could afford protection against atherosclerosis.

  5. Scanning protocol optimization and dose evaluation in coronary stenosis using multi-slices computed tomography

    Science.gov (United States)

    Huang, Yung-hui; Chen, Chia-lin; Sheu, Chin-yin; Lee, Jason J. S.

    2007-02-01

    Cardiovascular diseases are the most common incidence for premature death in developed countries. A major fraction is attributable to atherosclerotic coronary artery disease, which may result in sudden cardiac failure. A reduction of mortality caused by myocardial infarction may be achieved if coronary atherosclerosis can be detected and treated at an early stage before symptoms occur. Therefore, there is need for an effective tool that allows identification of patients at increased risk for future cardiac events. The current multi-detector CT has been widely used for detection and quantification of coronary calcifications as a sign of coronary atherosclerosis. The aim of this study is to optimize the diagnostic values and radiation exposure in coronary artery calcium-screening examination using multi-slice CT (MSCT) with different image scan protocols. The radiation exposure for all protocols is evaluated by using computed tomography dose index (CTDI) phantom measurements. We chose an optimal scanning protocol and evaluated patient radiation dose in the MSCT coronary artery screenings and preserved its expecting diagnostic accuracy. These changes make the MSCT have more operation flexibility and provide more diagnostic values in current practice.

  6. Computational Fluid Dynamics Analysis of the Effect of Plaques in the Left Coronary Artery

    Directory of Open Access Journals (Sweden)

    Thanapong Chaichana

    2012-01-01

    Full Text Available This study was to investigate the hemodynamic effect of simulated plaques in left coronary artery models, which were generated from a sample patient’s data. Plaques were simulated and placed at the left main stem and the left anterior descending (LAD to produce at least 60% coronary stenosis. Computational fluid dynamics analysis was performed to simulate realistic physiological conditions that reflect the in vivo cardiac hemodynamics, and comparison of wall shear stress (WSS between Newtonian and non-Newtonian fluid models was performed. The pressure gradient (PSG and flow velocities in the left coronary artery were measured and compared in the left coronary models with and without presence of plaques during cardiac cycle. Our results showed that the highest PSG was observed in stenotic regions caused by the plaques. Low flow velocity areas were found at postplaque locations in the left circumflex, LAD, and bifurcation. WSS at the stenotic locations was similar between the non-Newtonian and Newtonian models although some more details were observed with non-Newtonian model. There is a direct correlation between coronary plaques and subsequent hemodynamic changes, based on the simulation of plaques in the realistic coronary models.

  7. Application study of 640-slice computed tomography low dose coronary angiography

    Directory of Open Access Journals (Sweden)

    Ziqiao Lei

    2015-01-01

    Full Text Available Objective: The aim was to explore image quality and radiation dose in patients with different heart rates in 640-slice volume computed tomography (CT coronary angiography by using tube voltage of 100 kV. Materials and Methods: The 220 consecutive patients clinically suspected or confirmed of coronary artery disease were divided into three groups: 67 cases in 1 beat group (heart rate 80 bpm. When scanning was completed, the best phase for coronary arteries would be chosen. Various postprocessing reconstructions of coronary arteries and branches, such as volume reconstruction (VR, maximum density projection, multiplanar reconstruction, curved surface reconstruction, were used. We classified image quality and made statistical analysis according to 4-grades method. We also compared scalability of coronary arterial segments and radiation doses between the groups. Results: There were no significant differences in the scalability of coronary arterial segments between the groups. Effective radiation doses of the three groups were (2.5±0.8 mSv, (8.4±3.1 mSv and (11.2±3.8mSv. The radiation doses between the groups showed statistical difference (P < 0.05. Conclusion: 640-slice volume CT can be adapted to changes during heart rate, and ensure the image quality under the condition of 100 kV, and radiation doses were significantly reduced in patients with heart rate <65 bpm.

  8. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Abildstrom, Steen Z.; Gøtzsche, Ole

    2007-01-01

    coronary artery stenosis in per-segment (19 studies) and per-patients (13 studies) populations were 19 and 57.5% respectively. Accuracy tests with 95% confidence intervals comparing 64-SCTA vs. CCA showed that sensitivity, specificity, positive predictive and negative predictive values for native coronary......% by overall per-segment analysis. CONCLUSION: The high diagnostic accuracy of 64-SCTA validates this non-invasive technique as a potential alternative to CCA in carefully selected populations suspected for coronary stenosis. Udgivelsesdato: 2007-Dec......AIMS: To evaluate the diagnostic accuracy of 64-slice multi-detector computed tomography coronary angiography (64-SCTA) compared with the standard reference conventional coronary angiography (CCA). METHODS AND RESULTS: Based on a systematic search, 27 studies including 1740 patients were eligible...

  9. Performance of computed tomographic urography in diagnosis of upper urinary tract urothelial carcinoma, in patients presenting with hematuria: Systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chlapoutakis, Konstantinos [Department of Radiology, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Theocharopoulos, Nicholas [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Department of Natural Sciences, Technological Education Institute of Crete, P.O. Box 140, 71004 Iraklion, Crete (Greece); Yarmenitis, Spyros [Department of Radiology, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Damilakis, John [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece)], E-mail: damilaki@med.uoc.gr

    2010-02-15

    Computed tomographic urography (CTU) is a relatively new diagnostic imaging technique, which combines the diagnostic advantages introduced by helical tomographic imaging, with the established technique of imaging during the renal excretory phase, into one single examination. Increasing availability of multidetector computed tomography (MDCT) units, further promotes the technique as the 'one-stop-shop' for the imaging investigation of patients with haematuria. We reviewed and meta-analyzed published literature, in order to evaluate the performance of CTU for the detection of upper urinary tract urothelial tumors. CTU proved to be a very sensitive and specific method for the detection of urothelial malignancy, with sensitivity ranging between 88% and 100%, and specificity between 93% and 100%. Pooled sensitivity was 96% (95% CI: 88-100%) and pooled specificity was 99% (95% CI: 98-100%). Direct comparison of the method with intravenous urography (IVU), confirmed the superiority of CTU over IVU in terms of sensitivity and specificity. Major drawbacks of CTU are increased radiation risk, injection of iodinated contrast media which may potentially be accompanied by serious side effects and increased cost, estimated as roughly three times that of IVU. According to our study, CTU is the method of choice for the detection of pathology in 'high risk' haematuria patients, i.e. patients older than 40 years of age presenting with gross haematuria.

  10. Effects of particle size, slice thickness, and reconstruction algorithm on coronary calcium quantitation using ultrafast computed tomography

    Science.gov (United States)

    Tang, Weiyi; Detrano, Robert; Kang, Xingping; Garner, D.; Nickerson, Sharon; Desimone, P.; Mahaisavariya, Paiboon; Brundage, B.

    1994-05-01

    The recent emphasis on early diagnosis of coronary artery disease has stimulated research for a reliable and non-invasive screening method. Radiographically detectable coronary calcium has been shown to predict both pathologic and angiographic findings. Ultrafast computed tomography (UFCT), in quantifying coronary calcium, may become an accurate non-invasive method to evaluate the severity of coronary disease. The currently applied index of UFCT coronary calcium amount is the coronary calcium score of Agatston et al. This score has not been thoroughly evaluated as to its accuracy and dependence on scanning parameters. A potential drawback of the score is its dependence on predetermined CT number thresholds. In this investigation we used a chest phantom to determine the effects of particle size, slice thickness, and reconstruction algorithm on the coronary calcium score, and on the calcium mass estimated with a new method which is not dependent on thresholds.

  11. Computed tomography for the measurement of coronary calcification in asymptomatic risk patients

    Directory of Open Access Journals (Sweden)

    Pichlbauer, Ernest

    2006-05-01

    Full Text Available Background: In 2003 nearly 20% of deaths in Germany were caused by coronary heart disease (CHD. Risk models are used to estimate the ten-year-risk of a coronary event. Coronary calcification may be seen as an additional risk factor. The amount of calcium is correlated with atherosclerotic lesions, but there is no direct correlation with the probability of a plaque rupture. Coronary calcification may be measured either by electron beam computed tomography (EBCT or multi-detector computed tomography (MDCT. Objectives: The aim of this HTA report is to investigate the diagnostic validity and cost effectiveness of computed tomography techniques in measuring coronary calcification of asymptomatic risk patients. Ethical aspects are discussed. Methods: A systematic literature research was performed in 35 international databases which yielded 1080 articles. Overall 43 publications were included for assessment, according to predefined selection criteria. Results: Measuring coronary calcification offers additional information compared with traditional risk factors. Yet at present it cannot be said - according to published literature - which population groups gain most. For determining adequate calcium score thresholds standardisation for age and sex is important. When comparing the reference standard EBCT with MDCT results are inconsistent and depend on the calcium-score value as well as on the scoring method. EBCT as a triage instrument in diagnosing CHD appears to be cost-effective. Yet it is rather not cost-effective as a refinement tool for risk stratification. Discussion: Most of the literature was published in the United States and discusses the use of EBCT as well as (traditional risk stratification by the Framingham Score. Regarding coronary calcification measured by MDCT (which is more widespread in Germany than EBCT and a risk model applicable for European populations clear recommendations based on published literature cannot be made at present

  12. Observer variability in the assessment of CT coronary angiography and coronary artery calcium score: substudy of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

    Science.gov (United States)

    Williams, Michelle C; Golay, Saroj K; Hunter, Amanda; Weir-McCall, Jonathan R; Mlynska, Lucja; Dweck, Marc R; Uren, Neal G; Reid, John H; Lewis, Steff C; Berry, Colin; van Beek, Edwin J R; Roditi, Giles; Newby, David E; Mirsadraee, Saeed

    2015-01-01

    Observer variability can influence the assessment of CT coronary angiography (CTCA) and the subsequent diagnosis of angina pectoris due to coronary heart disease. We assessed 210 CTCAs from the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial for intraobserver and interobserver variability. Calcium score, coronary angiography and image quality were evaluated. Coronary artery disease was defined as none (70%) luminal stenosis and classified as no (70%) coronary artery disease. Post-CTCA diagnosis of angina pectoris due to coronary heart disease was classified as yes, probable, unlikely or no. Patients had a mean body mass index of 29 (28, 30) kg/m(2), heart rate of 58 (57, 60)/min and 62% were men. Intraobserver and interobserver agreements for the presence or absence of coronary artery disease were excellent (95% agreement, κ 0.884 (0.817 to 0.951) and good (91%, 0.791 (0.703 to 0.879)). Intraobserver and interobserver agreement for the presence or absence of angina pectoris due to coronary heart disease were excellent (93%, 0.842 (0.918 to 0.755) and good (86%, 0.701 (0.799 to 0.603)), respectively. Observer variability of calcium score was excellent for calcium scores below 1000. More segments were categorised as uninterpretable with 64-multidetector compared to 320-multidetector CTCA (10.1% vs 2.6%, pcoronary heart disease. NCT01149590.

  13. Reproducibility of coronary atherosclerotic plaque characteristics in populations with low, intermediate, and high prevalence of coronary artery disease by multidetector computer tomography

    DEFF Research Database (Denmark)

    de Knegt, Martina C; Linde, Jesper J; Fuchs, Andreas

    2016-01-01

    To evaluate the interobserver agreement of visual coronary plaque characteristics by 320-slice multidetector computed tomography (MDCT) in three populations with low, intermediate and high CAD prevalence and to identify determinants for the reproducible assessment of these plaque characteristics....... 150 patients, 50 asymptomatic subjects from the general population (low CAD prevalence), 50 symptomatic non-acute coronary syndrome (non-ACS) patients (intermediate CAD prevalence), and 50 ACS patients (high CAD prevalence), matched according to age and gender, were retrospectively enrolled. All...

  14. Coronary Artery Stenosis Flow: Experimental and Computational Investigation

    Science.gov (United States)

    Egelhoff, Carla; Budwig, Ralph; Hansen, Byron; Foster, Jonathan

    2000-11-01

    The effects of symmetry, flowrate, wall roughness and size are investigated using realistic pulsatile waveforms for flow viz and LDV experimental models as well as CFD models using original code. Distal to the stenosis flow is characterized by a high speed jet which is central for symmetric models and attached to the wall for eccentric models. The jet is accompanied by a low speed recirculation zone which persists while lengthening and shortening during most of the cardiac cycle. Of particular note is the downstream onset of flow instability and turbulence for high flow rate conditions in symmetric and eccentric severely occluded stenoses. The location and extent of the unstable flow region continually changes throughout the cycle, which may be a factor contributing to the thrombogenesis which coronary arteries experience.

  15. Diagnostic accuracy of computed tomography coronary angiography according to pre-test probability of coronary artery disease and severity of coronary arterial calcification. The CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) International Multicenter Study

    National Research Council Canada - National Science Library

    Arbab-Zadeh, Armin; Miller, Julie M; Rochitte, Carlos E; Dewey, Marc; Niinuma, Hiroyuki; Gottlieb, Ilan; Paul, Narinder; Clouse, Melvin E; Shapiro, Edward P; Hoe, John; Lardo, Albert C; Bush, David E; de Roos, Albert; Cox, Christopher; Brinker, Jeffrey; Lima, Joăo A C

    2012-01-01

    ...) to detect obstructive coronary artery disease (CAD). The ability of CTA to exclude obstructive CAD in patients of different pre-test probabilities and in presence of coronary calcification remains uncertain. For the CORE-64...

  16. Coronary computed tomography angiography without significant stenosis predicts favourable three-year prognosis

    DEFF Research Database (Denmark)

    Kristiansen, Jeppe Maagaard; Zaremba, Tomas; Johansen, Martin Berg

    2014-01-01

    INTRODUCTION: The objective of this study was to evaluate the incidence of death, cardiovascular events and the use of later non-scheduled imaging for coronary artery disease (CAD) in patients suspected for CAD and discharged without a need for further examination or treatment from an outpatient...... clinic following coronary computed tomography angiography (CCTA). MATERIAL AND METHODS: This was a retrospective cohort study among patients discharged from an outpatient clinic after CCTA at our institution during 2009 and 2010. Follow-up was performed using nationwide Danish registers. RESULTS: A total...... of acute myocardial infarction and no cases of death related to cardiovascular disease. A total of 5.0% of the patients later underwent non-scheduled imaging, predominantly invasive coronary angiography. No patients had revascularisation performed during the study period. CONCLUSION: Patients...

  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. Association between epicardial fat volume and coronary plaques diagnosed by multislice computed tomography

    Directory of Open Access Journals (Sweden)

    José A. Morán Quijada

    2016-01-01

    Full Text Available Introduction: Coronary atherosclerotic disease is a major cause of death in Cuba and elsewhere. The volume of epicardial fat is considered a new cardiovascular risk factor because of its association with coronary atherogenesis.Objective: To determine, by multislice computed tomography, the association between epicardial fat volume and the presence of coronary atherosclerotic plaques.Method: A descriptive study was conducted with a universe of 130 patients with chest pain suggestive of ischemic heart disease, of which 117 were selected by opinion sampling. These patients underwent a calcium score study, a coronary angiography and a measurement of the epicardial fat volume.Results: Male patients predominated (54.7% and those aged 60-69 years (32.5%. A high volume of epicardial fat was found in 51.3% of patients, affecting 52.8% of women; 78.9% of patients with a calcium score between 100 and 399 UH had a high volume of epicardial fat, just as 71.2% of those with plaques and 100% of those with 4 or 5 plaques; 41% of patients had various types of plaque, which were mainly located in the anterior descending artery (88.1%.Conclusions: The measurement of the volume of epicardial fat is a useful tool to estimate the presence of coronary disease. When it was high, it was associated with older age, female gender and the presence of a higher calcium score, more plaques, more injuries and a greater involvement of the anterior descending artery.

  19. Diagnostic performance of computed tomography for detection of concomitant coronary disease in hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Lei; Ma, Xiaohai; Zhang, Chen; Wang, Zhanhong; Fan, Zhanming [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); Ge, Hailong [Capital Medical University, Department of Cardiology, Beijing Anzhen Hospital, Beijing (China); Teraoka, Kunihiko [Tokyo Medical University, Department of Cardiology, Tokyo (Japan)

    2014-10-31

    To evaluate the diagnostic performance of computed tomography (CT) in patients with hypertrophic cardiomyopathy (HCM) and suspected coexistent coronary artery diseases (CADs). Sixty patients were enrolled in this study. Cardiac CT examination included CT coronary angiography (CTCA) and delayed enhancement CT. CT performance in evaluation of the coronary artery was assessed and compared with that of catheter-based coronary angiography (CA). The left ventricle (LV) wall thickness, functional indices and myocardial delayed enhancement (MDE) were measured via cardiac magnetic resonance (CMR) and CT images. Compared with catheter-based CA, CTCA produced a 100 % (24/24) sensitivity, a 94.4 % (34/36) specificity, a 92.3 % (24/26) positive predictive value and a 100 % (34/34) negative predictive value. CT-measured LV wall thickness and functional indices were correlated with those measured via CMR (P < 0.01), though the CT-measured values were smaller than the CMR-measured values. Bland-Altman analysis showed the volume of the focal MDE determined via CT was slightly smaller than that determined using CMR (mean difference: 0.3 cm{sup 3}). For patients with HCM and suspected coexistent CAD, this comprehensive cardiac CT protocol can be helpful in ruling out coronary stenosis and can provide information regarding morphology, function and tissue characterization of the LV myocardium. (orig.)

  20. 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.)

  1. Is there an indication for computed tomography and magnetic resonance imaging in the evaluation of coronary artery bypass grafts?

    NARCIS (Netherlands)

    Dikkers, R.; van der Zaag-Loonen HJ, [No Value; Willems, T.P.; Post, W.J.; Oudkerk, M.

    2009-01-01

    This meta-analysis evaluates the diagnostic accuracy of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for bypass graft occlusion and stenosis detection compared with coronary angiography in post-coronary artery bypass graft patients. The indication for noninvasive

  2. There an Indication for Computed Tomography and Magnetic Resonance Imaging in the Evaluation of Coronary Artery Bypass Grafts?

    NARCIS (Netherlands)

    Dikkers, R.; van der Zaag-Loonen, H. J.; Willems, T. P.; Post, W. J.; Oudkerk, M.

    2009-01-01

    This meta-analysis evaluates tire diagnostic accuracy of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for bypass graft occlusion and stenosis detection compared with coronary angiography in post-coronary artery bypass graft patients. The indication for noninvasive

  3. Computational hemodynamics of an implanted coronary stent based on three-dimensional cine angiography reconstruction.

    Science.gov (United States)

    Chen, Mounter C Y; Lu, Po-Chien; Chen, James S Y; Hwang, Ned H C

    2005-01-01

    Coronary stents are supportive wire meshes that keep narrow coronary arteries patent, reducing the risk of restenosis. Despite the common use of coronary stents, approximately 20-35% of them fail due to restenosis. Flow phenomena adjacent to the stent may contribute to restenosis. Three-dimensional computational fluid dynamics (CFD) and reconstruction based on biplane cine angiography were used to assess coronary geometry and volumetric blood flows. A patient-specific left anterior descending (LAD) artery was reconstructed from single-plane x-ray imaging. With corresponding electrocardiographic signals, images from the same time phase were selected from the angiograms for dynamic three-dimensional reconstruction. The resultant three-dimensional LAD artery at end-diastole was adopted for detailed analysis. Both the geometries and flow fields, based on a computational model from CAE software (ANSYS and CATIA) and full three-dimensional Navier-Stroke equations in the CFD-ACE+ software, respectively, changed dramatically after stent placement. Flow fields showed a complex three-dimensional spiral motion due to arterial tortuosity. The corresponding wall shear stresses, pressure gradient, and flow field all varied significantly after stent placement. Combined angiography and CFD techniques allow more detailed investigation of flow patterns in various segments. The implanted stent(s) may be quantitatively studied from the proposed hemodynamic modeling approach.

  4. Myocardial Perfusion Imaging Versus Computed Tomography Angiography-Derived Fractional Flow Reserve Testing in Stable Patients With Intermediate-Range Coronary Lesions

    DEFF Research Database (Denmark)

    Nørgaard, Bjarne L; Gormsen, Lars C; Bøtker, Hans Erik

    2017-01-01

    BACKGROUND: Data on the clinical utility of coronary computed tomography angiography-derived fractional flow reserve (FFRCT) are sparse. In patients with intermediate (40-70%) coronary stenosis determined by coronary computed tomography angiography, we investigated the association of replacing st...

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  6. Coronary computed tomography angiography: overview of technical aspects, current concepts, and perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Chartrand-Lefebvre, C.; Cadrin-Chenevert, A. [Univ. of Montreal Medical Centre, Radiology Dept., Montreal, Quebec (Canada)]. E-mail: chartrandlef@videotron.ca; Bordeleau, E. [Univ. of Montreal Medical Centre, Radiology Dept., Montreal, Quebec (Canada); Hopital Laval, St. Foy, Quebec (Canada); Ugolini, P.; Ouellet, R. [Montreal Inst. of Cardiology, Montreal, Quebec (Canada); Sablayrolles, J.-L. [Centre Cardiologique du Nord, Paris (France); Prenovault, J. [Univ. of Montreal Medical Centre, Radiology Dept., Montreal, Quebec (Canada)

    2007-04-15

    Multidetector-row electrocardiogram (ECC)-gated cardiac computed tomography (CT) will probably be a major noninvasive imaging option in the near future. Recent developments indicate that this new technology is improving rapidly. This article presents an overview of the current concepts, perspectives, and technical capabilities in coronary CT angiography (CTA). We have reviewed the recent literature on the different applications of this technology; of particular note are the many studies that have demonstrated the high negative predictive value (NPV) of coronary CTA, when performed under optimal conditions, for significant stenoses in native coronary arteries. This new technology's level of performance allows it to be used to evaluate the presence of calcified plaques, coronary bypass graft patency, and the origin and course of congenital coronary anomalies. Despite a high NPV, the robustness of the technology is limited by arrhythmias, the requirement of low heart rates, and calcium-related artifacts. Sonic improvements are needed in the imaging of coronary stents, especially the smaller stents, and in the detection and characterization of noncalcified plaques. Further studies are needed to more precisely determine the role of CTA in various symptomatic and asymptomatic patient groups. Clinical testing of 64-slice scanners has recently begun. As the technology improves, so does the spatial and temporal resolution. To date, this is being achieved through the development of systems with an increased number of detectors and shorter gantry rotation time as well as the development of systems equipped with 2 X-ray tubes and the eventual development of flat-panel technology. Thus further improvement of image quality is expected. (author)

  7. Soil physical and X-ray computed tomographic measurements to investigate small-scale structural differences under strip tillage compared to mulch till and no-till

    Science.gov (United States)

    Pöhlitz, Julia; Rücknagel, Jan; Schlüter, Steffen; Vogel, Hans-Jörg

    2017-04-01

    In recent years there has been an increasing application of conservation tillage techniques where the soil is no longer turned, but only loosened or left completely untilled. Dead plant material remains on the soil surface, which provides environmental and economic benefits such as the conservation of water, preventing soil erosion and saving time during seedbed preparation. There is a variety of conservation tillage systems, e.g. mulch till, no-till and strip tillage, which is a special feature. In strip tillage, the seed bed is divided into a seed zone (strip-till within the seed row: STWS) and a soil management zone (strip-till between the seed row: STBS). However, each tillage application affects physical soil properties and processes. Here, the combined application of classical soil mechanical and computed tomographic methods is used on a Chernozem (texture 0-30 cm: silt loam) to show small-scale structural differences under strip tillage (STWS, STBS) compared to no-till (NT) and mulch till (MT). In addition to the classical soil physical parameters dry bulk density and saturated conductivity (years: 2012, 2014, 2015) at soil depths 2-8 and 12-18 cm, stress-strain tests were carried out to map mechanical behavior. The stress-strain tests were performed for a load range from 5-550 kPa at 12-18 cm depth (year 2015). Mechanical precompression stress was determined on the stress-dry bulk density curves. Further, CT image cross sections and computed tomographic examinations (average pore size, porosity, connectivity, and anisotropy) were used from the same soil samples. For STBS and NT, a significant increase in dry bulk density was observed over the course of time compared to STWS and MT, which was more pronounced at 2-8 cm than at 12-18 cm depth. Despite higher dry bulk density, STBS displayed higher saturated conductivity in contrast to STWS, which can be attributed to higher earthworm abundance. In strip tillage, structural differences were identified

  8. X-Ray Tomographic Reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Bonnie Schmittberger

    2010-08-25

    Tomographic scans have revolutionized imaging techniques used in medical and biological research by resolving individual sample slices instead of several superimposed images that are obtained from regular x-ray scans. X-Ray fluorescence computed tomography, a more specific tomography technique, bombards the sample with synchrotron x-rays and detects the fluorescent photons emitted from the sample. However, since x-rays are attenuated as they pass through the sample, tomographic scans often produce images with erroneous low densities in areas where the x-rays have already passed through most of the sample. To correct for this and correctly reconstruct the data in order to obtain the most accurate images, a program employing iterative methods based on the inverse Radon transform was written. Applying this reconstruction method to a tomographic image recovered some of the lost densities, providing a more accurate image from which element concentrations and internal structure can be determined.

  9. Micro-Computed Tomographic Evaluation of Hard Tissue Debris Removal after Different Irrigation Methods and Its Influence on the Filling of Curved Canals.

    Science.gov (United States)

    Freire, Laila Gonzales; Iglecias, Elaine Faga; Cunha, Rodrigo Sanches; Dos Santos, Marcelo; Gavini, Giulio

    2015-10-01

    The aim of this study was to compare the efficacy of passive ultrasonic irrigation (PUI) and the EndoVac (EV) System (Discus Dental, Culver City, CA) in hard tissue debris removal and its influence on the quality of the root canal filling with the aid of micro-computed tomographic scanner. Twenty-four mandibular molars were subjected to 4 microtomographic scannings (ie, before and after instrumentation, after final irrigation, and after obturation) using the SkyScan 1176 X-ray microtomograph (Bruker microCT, Kontich, Belgium) at a resolution of 17.42 μm. Mesial canals were prepared using R25 Reciproc instruments (VDW GmbH, Munich, Germany) and divided into 2 groups according to the final irrigation method: the PUI group (n = 12) and the EV group (n = 12). All specimens were filled with the continuous wave of condensation technique. CTAn and CTvol software (Bruker microCT) were used for volumetric analysis and 3-dimensional model reconstruction of the root canals, hard tissue debris, and the filling material. Data were statistically analyzed using the Student t test. Analysis of the micro-computed tomographic scans revealed debris accumulated inside the root canals, occupying an average of 3.4% of the canal's volume. Irrigation with PUI and the EV system reduced the volume of hard tissue debris in 55.55% and 53.65%, respectively, with no statistical difference between them (P > .05). Also, there was no difference among the groups with regard to the volume of filling material and voids (P > .05). PUI and the EV system were equally efficient in the removal of hard tissue debris and the quality of root canal filling was similar in both groups, with no influence from the irrigation method. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Comparative validity and reproducibility study of various landmark-oriented reference planes in 3-dimensional computed tomographic analysis for patients receiving orthognathic surgery.

    Directory of Open Access Journals (Sweden)

    Hsiu-Hsia Lin

    Full Text Available Three-dimensional computed tomographic imaging has become popular in clinical evaluation, treatment planning, surgical simulation, and outcome assessment for maxillofacial intervention. The purposes of this study were to investigate whether there is any correlation among landmark-based horizontal reference planes and to validate the reproducibility and reliability of landmark identification.Preoperative and postoperative cone-beam computed tomographic images of patients who had undergone orthognathic surgery were collected. Landmark-oriented reference planes including the Frankfort horizontal plane (FHP and the lateral semicircular canal plane (LSP were established. Four FHPs were defined by selecting 3 points from the orbitale, porion, or midpoint of paired points. The LSP passed through both the lateral semicircular canal points and nasion. The distances between the maxillary or mandibular teeth and the reference planes were measured, and the differences between the 2 sides were calculated and compared. The precision in locating the landmarks was evaluated by performing repeated tests, and the intraobserver reproducibility and interobserver reliability were assessed.A total of 30 patients with facial deformity and malocclusion--10 patients with facial symmetry, 10 patients with facial asymmetry, and 10 patients with cleft lip and palate--were recruited. Comparing the differences among the 5 reference planes showed no statistically significant difference among all patient groups. Regarding intraobserver reproducibility, the mean differences in the 3 coordinates varied from 0 to 0.35 mm, with correlation coefficients between 0.96 and 1.0, showing high correlation between repeated tests. Regarding interobserver reliability, the mean differences among the 3 coordinates varied from 0 to 0.47 mm, with correlation coefficients between 0.88 and 1.0, exhibiting high correlation between the different examiners.The 5 horizontal reference planes were

  11. Assessment Of Coronary Artery Aneurysms Using Transluminal Attenuation Gradient And Computational Modeling In Kawasaki Disease Patients

    Science.gov (United States)

    Grande Gutierrez, Noelia; Kahn, Andrew; Shirinsky, Olga; Gagarina, Nina; Lyskina, Galina; Fukazawa, Ryuji; Owaga, Shunichi; Burns, Jane; Marsden, Alison

    2015-11-01

    Kawasaki Disease (KD) can result in coronary artery aneurysms (CAA) in up to 25% of patients, putting them at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines recommend CAA diameter >8 mm as the arbitrary criterion for initiating systemic anticoagulation. KD patient specific modeling and flow simulations suggest that hemodynamic data can predict regions at increased risk of thrombosis. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length and has been proposed as a non-invasive method for characterizing coronary stenosis from CT Angiography. We hypothesized that CAA abnormal flow could be quantified using TAG. We computed hemodynamics for patient specific coronary models using a stabilized finite element method, coupled numerically to a lumped parameter network to model the heart and vascular boundary conditions. TAG was quantified in the major coronary arteries. We compared TAG for aneurysmal and normal arteries and we analyzed TAG correlation with hemodynamic and geometrical parameters. Our results suggest that TAG may provide hemodynamic data not available from anatomy alone. TAG represents a possible extension to standard CTA that could help to better evaluate the risk of thrombus formation in KD.

  12. Male Gender and Arterial Hypertension are Plaque Predictors at Coronary Computed Tomography Angiography

    Science.gov (United States)

    Oliveira, Joselina Luzia Menezes; Hirata, Mario Hiroyuki; Sousa, Amanda Guerra de Moraes Rego; Gabriel, Fabíola Santos; Hirata, Thiago Dominguez Crespo; Tavares, Irlaneide da Silva; Melo, Luiza Dantas; Dória, Fabiana de Santana; Sousa, Antônio Carlos Sobral; Pinto, Ibraim Masciarelli Francisco

    2015-01-01

    Background Systemic Arterial Hypertension (SAH) is one of the main risk factors for Coronary Artery Disease (CAD), in addition to male gender. Differences in coronary artery lesions between hypertensive and normotensive individuals of both genders at the Coronary Computed Tomography Angiography (CCTA) have not been clearly determined. Objective To Investigate the calcium score (CS), CAD extent and characteristics of coronary plaques at CCTA in men and women with and without SAH. Methods Prospective cross-sectional study of 509 patients undergoing CCTA for CAD diagnosis and risk stratification, from November 2011 to December 2012, at Instituto de Cardiologia Dante Pazzanese. Individuals were stratified according to gender and subdivided according to the presence (HT +) or absence (HT-) of SAH. Results HT+ women were older (62.3 ± 10.2 vs 57.8 ± 12.8, p = 0.01). As for the assessment of CAD extent, the HT+ individuals of both genders had significant CAD, although multivessel disease is more frequent in HT + men. The regression analysis for significant CAD showed that age and male gender were the determinant factors of multivessel disease and CS ≥ 100. Plaque type analysis showed that SAH was a predictive risk factor for partially calcified plaques (OR = 3.9). Conclusion Hypertensive men had multivessel disease more often than women. Male gender was a determinant factor of significant CAD, multivessel disease, CS ≥ 100 and calcified and partially calcified plaques, whereas SAH was predictive of partially calcified plaques. PMID:25861034

  13. Risk stratification of coronary artery disease in asymptomatic diabetic subjects using multidetector computed tomography.

    Science.gov (United States)

    Shimabukuro, Michio; Saito, Taro; Higa, Toru; Nakamura, Keita; Masuzaki, Hiroaki; Sata, Masataka

    2015-01-01

    Patients with type 2 diabetes mellitus (T2DM) show a greater risk for coronary artery disease (CAD), but the risk stratification in asymptomatic CAD patients has not been established. This study investigated the prevalence and severity for asymptomatic CAD and predictors in T2DM patients. In a multiclinic group, diabetic patients (320 men, 186 women) without known symptoms suggestive of CAD were recruited for multidetector computed tomography (MDCT). Patients were categorized according to severity of coronary atherosclerosis: Grade 1 (normal findings), Grade 2 (mild atherosclerosis without significant stenosis), Grade 3 (moderate stenosis/atherosclerosis, 50-74% stenosis), Grade 4 (moderate stenosis/atherosclerosis, 75-89% stenosis), Grade 5 (severe stenosis/atherosclerosis, ≥90% stenosis). The trend for severity grade of CAD was slightly higher in men than women (P=0.054). For critical lesions (combined Grades 3-5), the prevalence was almost equal (men 44% vs. women 37%; P=0.113). Multivariate models showed that in men, HbA1c≥7.4%, dyslipidemia, duration of diabetes, retinopathy, and other type of cardiovascular diseases were predictors of critical lesions and in women, duration of diabetes and retinopathy were predictors. The prevalence and severity of asymptomatic CAD are comparably high in men and women with T2DM. Risk stratification by using MDCT might be useful to predict asymptomatic coronary lesions requiring coronary revascularization.

  14. Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

    Science.gov (United States)

    Seitun, Sara; Clemente, Alberto; La Grutta, Ludovico; Toia, Patrizia; Runza, Giuseppe; Midiri, Massimo; Maffei, Erica

    2017-01-01

    During the last decade coronary computed tomography angiography (CTA) has become the preeminent non-invasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging. Myocardial CTP imaging can be performed with a single static scan during first pass of the contrast agent, with monoenergetic or dual-energy acquisition, or as a dynamic, time-resolved scan during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson). A number of CTP techniques are available, which can assess myocardial perfusion in both a qualitative, semi-quantitative or quantitative manner. Once used primarily as research tools, these modalities are increasingly being used in routine clinical practice. All these techniques offer the substantial advantage of combining anatomical and functional evaluation of flow-limiting coronary stenosis in the same examination that would be beneficial for clinical decision-making. This review focuses on the state-of the-art and future trends of these evolving imaging modalities in the field of cardiology for the physiologic assessments of CAD. PMID:28540209

  15. Multislice computed tomography: angiographic emulation versus standard assessment for detection of coronary stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Schnapauff, Dirk; Hamm, Bernd; Dewey, Marc [Humboldt-Universitaet zu Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin, Chariteplatz 1, P.O. Box 10098, Berlin (Germany); Duebel, Hans-Peter; Baumann, Gert [Charite - Universitaetsmedizin Berlin, Department of Cardiology, Berlin (Germany); Scholze, Juergen [Charite - Universitaetsmedizin Berlin, Charite Outpatient Centre, Berlin (Germany)

    2007-07-15

    The present study investigated angiographic emulation of multislice computed tomography (MSCT) (catheter-like visualization) as an alternative approach of analyzing and visualizing findings in comparison with standard assessment. Thirty patients (120 coronary arteries) were randomly selected from 90 prospectively investigated patients with suspected coronary artery disease who underwent MSCT (16-slice scanner, 0.5 mm collimation, 400 ms rotation time) prior to conventional coronary angiography for comparison of both approaches. Sensitivity and specificity of angiographic emulation [81% (26/32) and 93% (82/88)] were not significantly different from those of standard assessment [88% (28/32) and 99% (87/88)], while the per-case analysis time was significantly shorter for angiographic emulation than for standard assessment (3.4 {+-} 1.5 vs 7.0 {+-} 2.5 min, P < 0.001). Both interventional and referring cardiologists preferred angiographic emulation over standard curved multiplanar reformations of MSCT coronary angiography for illustration, mainly because of improved overall lucidity and depiction of sidebranches (P < 0.001). In conclusion, angiographic emulation of MSCT reduces analysis time, yields a diagnostic accuracy comparable to that of standard assessment, and is preferred by cardiologists for visualization of results. (orig.)

  16. Relationship between glycemic control and coronary artery disease severity, prevalence and plaque characteristics by computed tomography coronary angiography in asymptomatic type 2 diabetic patients.

    Science.gov (United States)

    Tavares, C A F; Rassi, C H R E; Fahel, M G; Wajchenberg, B L; Rochitte, C E; Lerario, A C

    2016-10-01

    Evaluate whether glycemic control in type 2 diabetes (DM2) asymptomatic for coronary artery disease (CAD) affects not only the presence and magnitude of CAD but also the characteristics of plaque vulnerability using multidetector row computed coronary tomography (MDCT). Acute coronary syndrome (ACS) is frequently observed in asymptomatic DM2 patients. Positive vessel remodeling (PR) and low-attenuation plaques (LAP) identified by MDCT have been demonstrated to be characteristics of subsequent culprit lesions of ACS. However, little is known regarding plaque characteristics in asymptomatic diabetic patients and their relationship with glycemic control. Ninety asymptomatic DM2 patients, aged 40-65 years old, underwent MDCT. The presence of atherosclerotic obstruction, defined as coronary stenosis ≥50 %, and plaque characteristics were compared between two groups of patients with A1c patients, 38 (42.2 %) presented with coronary atherosclerotic plaques, 11 had A1c patients had significant lumen obstruction higher than 50 %: 3 in the A1c patients, the simultaneous presence of two vulnerability plaque characteristics (PR and LAP) were observed more frequently in the A1c ≥ 7 group (n = 8) than in the A1c patients with A1c ≥ 7 % have a higher frequency of CAD and a higher proportion of vulnerable atherosclerotic coronary plaque by MDCT compared to patients with DM2 with A1c < 7 in our study.

  17. A head-to-head comparison of the coronary calcium score by computed tomography with myocardial perfusion imaging in predicting coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Mansour Almoudi; Zhong-Hua Sun

    2012-01-01

    Objectives The coronary artery calcium (CAC) score has been shown to predict future cardiac events. However the extent to which the added value of a CAC score to the diagnostic performance of myocardial perfusion imaging (MPI) by single photon emission computed tomography (SPECT) is unclear. The purpose of this study is to investigate the correlation between CAC score and SPECT in patients with suspected coronary artery disease. Methods A retrospective review of the CAC scores by use of the Agatston calcium scoring method and cardiac SPECT diagnostic reports was conducted in 48 patients, who underwent both coronary computed tomography (CT) and SPECT examinations due to suspected coronary artery disease. A Pearson correlation test was used to determine the relation between CAC scores and MPI-SPECT assessments with regard to the evaluation of the extent of disease. Results Forty-seven percent of the patients had CAC scores more than 100, while 42% of these patients demonstrated abnormal, or probably abnormal, MPI-SPECT. Of the 23% of patients with a zero CAC score, only 7% had normal MPI-SPECT findings. No significant correlation was found between the CAC scores and MPISPECT assessments (r value ranged from 0.012 to 0.080), regardless of the degree of coronary calcification. Conclusions There is a lack of correlation between the CAC scores and the MPI-SPECT findings in the assessment of the extent of coronary artery disease. CAC scores and MPI-SPECT should be considered complementary approaches in the evaluation of patients with suspected coronary artery disease.

  18. Assessment of coronary artery disease and calcified coronary plaque burden by computed tomography in patients with and without diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Maffei, Erica; Seitun, Sara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Nieman, Koen; Weustink, Annick C.; Mollet, Nico R. [Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Martini, Chiara [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Guaricci, Andrea Igoren [Azienda Ospedaliero-Universitaria di Foggia, Department of Cardiology, Foggia (Italy); Tedeschi, Carlo [Ospedale San Gennaro, Department of Cardiology, Naples (Italy); Berti, Elena; Grilli, Roberto [Regione Emilia-Romagna, Healthcare and Social Agency, Bologna (Italy); Messalli, Giancarlo [SDN Foundation, IRCCS, Naples (Italy); Cademartiri, Filippo [Azienda Ospedaliero-Universitaria di Parma, Department of Radiology and Cardiology, Parma (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Azienda Ospedaliero-Universitaria - Parma, Department of Radiology, Parma (Italy)

    2011-05-15

    To compare the coronary atherosclerotic burden in patients with and without type-2 diabetes using CT Coronary Angiography (CTCA). 147 diabetic (mean age: 65 {+-} 10 years; male: 89) and 979 nondiabetic patients (mean age: 61 {+-} 13 years; male: 567) without a history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined and each diseased segment was classified as showing obstructive lesion (luminal narrowing >50%) or not. Coronary calcium scoring (CCS) was assessed too. Diabetics showed a higher number of diseased segments (4.1 {+-} 4.2 vs. 2.1 {+-} 3.0; p < 0.0001); a higher rate of CCS > 400 (p < 0.001), obstructive CAD (37% vs. 18% of patients; p < 0.0001), and fewer normal coronary arteries (20% vs. 42%; p < 0.0001), as compared to nondiabetics. The percentage of patients with obstructive CAD paralleled increasing CCS in both groups. Diabetics with CCS {<=} 10 had a higher prevalence of coronary plaque (39.6% vs. 24.5%, p = 0.003) and obstructive CAD (12.5% vs. 3.8%, p = 0.01). Among patients with CCS {<=} 10 all diabetics with obstructive CAD had a zero CCS and one patient was asymptomatic. Diabetes was associated with higher coronary plaque burden. The present study demonstrates that the absence of coronary calcification does not exclude obstructive CAD especially in diabetics. (orig.)

  19. Computed tomographic scanning in neurosurgery, 3. Application of ACTA 200-FS scanner to neurosurgical disease in the first half year of 1980

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Y. (Kansai Medical School, Moriguchi, Osaka (Japan))

    1981-03-01

    Computed tomographic scannings were performed in overall 727 scans, including 133 enhanced scans, of neurosurgical cases from January 1, 1980 to June 30, 1980 at Kansai Medical University. The computed tomography scanner was not only helpful in screening of neurosurgical disease at outpatient clinics, but of most value in emergency with the rapidity and the abundance of its information. It also gave surgeons the indication and the direction of operations exactly. In this respect, Metrizamide cisternography offered a new development of diagnosis especially in studies of posterior fossa tumor and circulation of cerebrospinal fluid. Moreover, the correlations of periventricular lucency with ventricular size and slit-like ventricles associated with peritoneoventricular shunt were studied. These studies revealed that periventricular lucency and ventricular size reflected function of shunt well and slit-like ventricle was an unfavorable state, although being asymptomatic. Numbers of mainly scanned neurosurgical disease reached at 192 (27.1%) in intracranial tumors, 107 (14.7%) in head injuries, 83 (11.4%) in intracranial hemorrhages and 69 (9.5%) in so called hydrocephalus respectively. About 6.9% of all scans were screening and follow up scans of cerebrovascular diseases. This report showed the usefulness of computed tomography in neurosurgery and the present state of its utilization in our institute.

  20. Computed tomographic findings of X-linked deafness: a spectrum from child to mother, from young to old, from boy to girl, from mixed to sudden hearing loss.

    Science.gov (United States)

    Saylisoy, Suzan; Incesulu, Armagan; Gurbuz, Melek Kezban; Adapinar, Baki

    2014-01-01

    Congenital mixed hearing loss associated with fixed stapes footplate is a rare disorder transmitted through X-linked inheritance. The purpose of this study was to report the radiologic findings of X-linked deafness with middle ear anomalies in affected children and young patients and in carrier women. The computed tomographic and audiometric findings of 7 subjects (4 affected children and young patients, 1 of whom is a girl; 2 carrier mothers; and a man who presented with sudden hearing loss) from different families were analyzed. Computed tomography showed bulbous dilatation of the fundi of the internal auditory canals, incomplete bony separation between the basal turn of the cochleas and the lateral ends of the internal auditory canal, deficiency of the modiolus, enlarged first part of the facial nerve, and dilatation of the superior and the inferior vestibular nerve canal and the singular canal. Besides these characteristic findings, dilatation of the vestibular aqueduct was seen except in the man. Middle ear anomalies including oval and/or round window and/or stapes abnormalities were also detected in three affected patients. The carrier mothers had milder forms of some characteristic findings. Because of the risks of stapes surgery in X-linked deafness, recognition of the characteristic imaging features of these disorders is important. Especially in young patients with mixed hearing loss, temporal bone computed tomography should be performed before stapes surgery to avoid the complication of stapes gusher. Middle ear anomalies might be highly associated with X-linked deafness.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-05-15

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

  2. Transient cortical blindness after coronary angiography.

    Science.gov (United States)

    Alp, B N; Bozbuğa, N; Tuncer, M A; Yakut, C

    2009-01-01

    Transient cortical blindness is rarely encountered after angiography of native coronary arteries or bypass grafts. This paper reports a case of transient cortical blindness that occurred 72 h after coronary angiography in a 56-year old patient. This was the patient's fourth exposure to contrast medium. Neurological examination demonstrated cortical blindness and the absence of any focal neurological deficit. A non-contrast-enhanced computed tomographic scan of the brain revealed bilateral contrast enhancement in the occipital lobes and no evidence of cerebral haemorrhage, and magnetic resonance imaging of the brain showed no pathology. Sight returned spontaneously within 4 days and his vision gradually improved. A search of the current literature for reported cases of transient cortical blindness suggested that this is a rarely encountered complication of coronary angiography.

  3. Myocardial CT perfusion imaging and SPECT for the diagnosis of coronary artery disease

    DEFF Research Database (Denmark)

    George, Richard T; Mehra, Vishal C; Chen, Marcus Y

    2014-01-01

    ). Sensitivity and specificity were calculated with use of prespecified cutoffs. The reference standard was a stenosis of at least 50% at coronary angiography as determined with quantitative methods. RESULTS: CAD was diagnosed in 229 of the 381 patients (60%). The per-patient sensitivity and specificity......PURPOSE: To compare the diagnostic performance of myocardial computed tomographic (CT) perfusion imaging and single photon emission computed tomography (SPECT) perfusion imaging in the diagnosis of anatomically significant coronary artery disease (CAD) as depicted at invasive coronary angiography...... or pharmacologic stress SPECT before and within 60 days of coronary angiography. Images from CT perfusion imaging, SPECT, and coronary angiography were interpreted at blinded, independent core laboratories. The primary diagnostic parameter was the area under the receiver operating characteristic curve (Az...

  4. Computer-aided detection for computed tomographic colonography screening: a prospective comparison of a double-reading paradigm with first-reader computer-aided detection against second-reader computer-aided detection.

    Science.gov (United States)

    Iussich, Gabriella; Correale, Loredana; Senore, Carlo; Hassan, Cesare; Segnan, Nereo; Campanella, Delia; Bert, Alberto; Galatola, Giovanni; Laudi, Cristiana; Regge, Daniele

    2014-03-01

    The objective of this study was to prospectively compare diagnostic performance and time efficiency of a double-reading paradigm in which a first-reader computer-aided detection (CAD) is followed by a fast 2-dimensional review (DR FR-CAD) with those of a double reading with second-reader CAD (SR CAD). The local ethical committee approved this study. Consecutive immunological patients who have positive results for fecal immunological test who were scheduled for colonoscopy were enrolled for a 10-month period. Computed tomographic colonography studies were read with CAD (CAD COLON-1.20; im3D, Turin, Italy) by using both SR CAD (applied after unassisted interpretation primary 2-dimensional) and DR FR-CAD (CAD-prompts evaluation followed by a fast 2-dimensional review) in randomized order with the radiologist for each reading paradigm masked to the other reader's results.Per-patient sensitivity and specificity of unassisted and CAD-assisted readings for detecting 6-mm adenomas or larger were calculated by using unblinding colonoscopy as reference standard. Reporting times were also calculated. Pairwise comparisons were performed. A total of 182 participants (median age, 65 years; range, 58-76) were included in the final analysis. Of these, 93 (51%) had at least 1 cancer or a 6-mm adenoma or larger. At the 6-mm threshold, sensitivity of unassisted reading (79.6%; 95% confidence interval [CI], 69.9-87.2) increased significantly with the use of both SR CAD (86.0%; 95% CI, 77.3%-92.3%) and DR FR-CAD (89.2%; 95% CI, 81.1%-94.7%), without differences between CAD readings (P = 0.500). No significant differences in specificity among the 3 paradigms were observed. Double reading with first-reader CAD required less reading time than that for SR CAD (378 vs 496; Δ118 seconds; P reader CAD is followed by a fast 2-dimensional review improves the adenoma detection rate to the same level achieved by a second-reader CAD while decreasing reporting times.

  5. Nonrigid registration-based coronary artery motion correction for cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Bhagalia, Roshni; Pack, Jed D.; Miller, James V.; Iatrou, Maria [GE Global Research, Niskayuna, New York 12309 (United States); GE Healthcare, Hoboken, New Jersey 07030 (United States)

    2012-07-15

    Purpose: X-ray computed tomography angiography (CTA) is the modality of choice to noninvasively monitor and diagnose heart disease with coronary artery health and stenosis detection being of particular interest. Reliable, clinically relevant coronary artery imaging mandates high spatiotemporal resolution. However, advances in intrinsic scanner spatial resolution (CT scanners are available which combine nearly 900 detector columns with focal spot oversampling) can be tempered by motion blurring, particularly in patients with unstable heartbeats. As a result, recently numerous methods have been devised to improve coronary CTA imaging. Solutions involving hardware, multisector algorithms, or {beta}-blockers are limited by cost, oversimplifying assumptions about cardiac motion, and populations showing contraindications to drugs, respectively. This work introduces an inexpensive algorithmic solution that retrospectively improves the temporal resolution of coronary CTA without significantly affecting spatial resolution. Methods: Given the goal of ruling out coronary stenosis, the method focuses on 'deblurring' the coronary arteries. The approach makes no assumptions about cardiac motion, can be used on exams acquired at high heart rates (even over 75 beats/min), and draws on a fast and accurate three-dimensional (3D) nonrigid bidirectional labeled point matching approach to estimate the trajectories of the coronary arteries during image acquisition. Motion compensation is achieved by employing a 3D warping of a series of partial reconstructions based on the estimated motion fields. Each of these partial reconstructions is created from data acquired over a short time interval. For brevity, the algorithm 'Subphasic Warp and Add' (SWA) reconstruction. Results: The performance of the new motion estimation-compensation approach was evaluated by a systematic observer study conducted using nine human cardiac CTA exams acquired over a range of average heart

  6. Reproducibility of coronary atherosclerotic plaque characteristics in populations with low, intermediate, and high prevalence of coronary artery disease by multidetector computer tomography: a guide to reliable visual coronary plaque assessments.

    Science.gov (United States)

    de Knegt, Martina C; Linde, Jesper J; Fuchs, Andreas; Nordestgaard, Børge G; Køber, Lars V; Hove, Jens D; Kofoed, Klaus F

    2016-10-01

    To evaluate the interobserver agreement of visual coronary plaque characteristics by 320-slice multidetector computed tomography (MDCT) in three populations with low, intermediate and high CAD prevalence and to identify determinants for the reproducible assessment of these plaque characteristics. 150 patients, 50 asymptomatic subjects from the general population (low CAD prevalence), 50 symptomatic non-acute coronary syndrome (non-ACS) patients (intermediate CAD prevalence), and 50 ACS patients (high CAD prevalence), matched according to age and gender, were retrospectively enrolled. All coronary segments were evaluated for overall image quality, evaluability, presence of CAD, coronary stenosis, plaque composition, plaque focality, and spotty calcification by four readers. Interobserver agreement was assessed using Fleiss' Kappa (κ) and intra-class correlation (ICC). Widely used clinical parameters (overall scan quality, presence of CAD, and determination of coronary stenosis) showed good agreement among the four readers, (ICC = 0.66, κ = 0.73, ICC = 0.74, respectively). When accounting for heart rate, body mass index, plaque location, and coronary stenosis above/below 50 %, interobserver agreement for plaque composition, presence of CAD, and coronary stenosis improved to either good or excellent, (κ = 0.61, κ = 0.81, ICC = 0.78, respectively). Spotty calcification was the least reproducible parameter investigated (κ = 0.33). Across subpopulations, reproducibility of coronary plaque characteristics generally decreased with increasing CAD prevalence except for plaque composition, (limits of agreement: ±2.03, ±1.96, ±1.79 for low, intermediate and high CAD prevalence, respectively). 320-slice MDCT can be used to assess coronary plaque characteristics, except for spotty calcification. Reproducibility estimates are influenced by heart rate, body size, plaque location, and degree of luminal stenosis.

  7. Impaired exercise-related myocardial uptake of technetium-99m-tetrofosmin in relation to coronary narrowing and diabetic state: assessment with quantitative single photon emission computed tomography.

    Science.gov (United States)

    Sasao, H; Nakata, T; Tsuchihashi, K; Wakabayashi, T; Nakaihara, N; Doi, A; Hashimoto, A; Kobayashi, H; Shimamoto, K

    2001-01-01

    Despite the diagnostic efficacy of stress myocardial perfusion imaging, the correlation between the actual perfusion tracer activity and diseased state of a coronary artery has not been studied in detail. We estimated exercise-related perfusion augmentation in relation to disease states of a coronary artery in diabetic and non-diabetic patients by a newly developed quantitative technetium (Tc)-99m-tetrofosmin myocardial imaging technique. Tc-99m-tetrofosmin tomographic imaging with an exercise-rest protocol was performed in 26 stable coronary patients and in 8 age-matched controls. Percent increase (%IR) in myocardial count during symptom-limited submaximal exercise-stress was calculated in 16 non-infarcted polar map segments and in each coronary territory by a subtraction technique with corrections for physical decay and injected tracer doses, and the results were compared with those of angiographically quantified coronary diameter stenosis (%DS). Percent IR and peak heart rate during exercise showed a positive linear correlation both in coronary territories with significant stenosis (%DS > or = 75%) and in control or nonstenotic (%DS more was identified by a %IR cutoff value of 40% with 77% sensitivity, 70% specificity, and an accuracy of 72%. In coronary territories with a %DS of less than 75%, %IR in diabetic patients was significantly lower (46+/-15%) than that in nondiabetic patients (61+/-25%). Thus, blunted exercise-related augmentation of myocardial uptake of Tc-99m-tetrofosmin correlates with the severity of coronary narrowing and diabetic state.

  8. Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial.

    Science.gov (United States)

    Liu, Ting; Maurovich-Horvat, Pál; Mayrhofer, Thomas; Puchner, Stefan B; Lu, Michael T; Ghemigian, Khristine; Kitslaar, Pieter H; Broersen, Alexander; Pursnani, Amit; Hoffmann, Udo; Ferencik, Maros

    2017-08-12

    Semi-automated software can provide quantitative assessment of atherosclerotic plaques on coronary CT angiography (CTA). The relationship between established qualitative high-risk plaque features and quantitative plaque measurements has not been studied. We analyzed the association between quantitative plaque measurements and qualitative high-risk plaque features on coronary CTA. We included 260 patients with plaque who underwent coronary CTA in the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) II trial. Quantitative plaque assessment and qualitative plaque characterization were performed on a per coronary segment basis. Quantitative coronary plaque measurements included plaque volume, plaque burden, remodeling index, and diameter stenosis. In qualitative analysis, high-risk plaque was present if positive remodeling, low CT attenuation plaque, napkin-ring sign or spotty calcium were detected. Univariable and multivariable logistic regression analyses were performed to assess the association between quantitative and qualitative high-risk plaque assessment. Among 888 segments with coronary plaque, high-risk plaque was present in 391 (44.0%) segments by qualitative analysis. In quantitative analysis, segments with high-risk plaque had higher total plaque volume, low CT attenuation plaque volume, plaque burden and remodeling index. Quantitatively assessed low CT attenuation plaque volume (odds ratio 1.12 per 1 mm(3), 95% CI 1.04-1.21), positive remodeling (odds ratio 1.25 per 0.1, 95% CI 1.10-1.41) and plaque burden (odds ratio 1.53 per 0.1, 95% CI 1.08-2.16) were associated with high-risk plaque. Quantitative coronary plaque characteristics (low CT attenuation plaque volume, positive remodeling and plaque burden) measured by semi-automated software correlated with qualitative assessment of high-risk plaque features.

  9. Influence of different path length computation models and iterative reconstruction algorithms on the quality of transmission reconstruction in Tomographic Gamma Scanning

    Science.gov (United States)

    Han, Miaomiao; Guo, Zhirong; Liu, Haifeng; Li, Qinghua

    2017-07-01

    This paper studies the influence of different path length computation models and iterative reconstruction algorithms on the quality of transmission reconstruction in Tomographic Gamma Scanning. The research purpose is to quantify and to localize heterogeneous matrices while investigating the recovery of linear attenuation coefficients (LACs) maps in 200 liter drums. Two different path length computation models so called ;point to point (PP); model and ;point to detector (PD); model are coupled with two different transmission reconstruction algorithms - Algebraic Reconstruction Technique (ART) with non-negativity constraint, and Maximum Likelihood Expectation Maximization (MLEM), respectively. Thus 4 modes are formed: ART-PP, ART-PD, MLEM-PP, MLEM-PD. The inter-comparison of transmission reconstruction qualities of these 4 modes is taken into account for heterogeneous matrices in the radioactive waste drums. Results illustrate that transmission-reconstructed qualities of MLEM algorithm are better than ART algorithm to get the most accurate LACs maps in good agreement with the reference data simulated by Monte Carlo. Moreover, PD model can be used to assay higher density waste drum and has a greater scope of application than PP model in TGS.

  10. Helical computed tomographic dacryocystography and its role in the diagnosis and management of lacrimal drainage system blocks and medial canthal masses

    Directory of Open Access Journals (Sweden)

    Udhay Priti

    2008-01-01

    Full Text Available Aim: To study the indications, technique and diagnostic utility of helical computed tomographic dacryocystography (CTDCG. Materials and Methods: Retrospective analysis of 13 patients who underwent CTDCG with subsequent surgical intervention, during the period January 2003 to December 2005, was done. Axial plain computed tomography (CT scan was performed, followed by administration of water-soluble contrast in the conjunctival cul de sac or by cannulation of the lacrimal passages. Thin-slice helical CT with two-dimensional (2D and three-dimensional (3D coronal and sagittal reformation was done. Results: Four patients were males and 9 were females. Age range was 5 to 62 years. Seven patients presented with watering and 6 patients with a medial canthal mass. Three patients had history of trauma. CTDCG was performed by instillation technique in 10 patients and by cannulation in 3 patients. CTDCG showed mass lesion displacing the sac in 5 cases, nasolacrimal duct obstruction in 6 cases and mucocele in 2 cases. Based on the findings on CTDCG, 5 patients underwent mass excision, 7 underwent dacryocystorhinostomy and 1 patient underwent primary silicone tube intubation. Conclusion: Helical CTDCG is a safe and useful diagnostic tool for the lacrimal surgeon. Instillation technique is a physiological and convenient method, and cannulation is needed only in cases where adequate visualization is not achieved.

  11. Comparative evaluation of the cadaveric and computed tomographic features of the coelomic cavity in the green iguana (Iguana iguana), black and white tegu (Tupinambis merianae) and bearded dragon (Pogona vitticeps).

    Science.gov (United States)

    Banzato, T; Selleri, P; Veladiano, I A; Zotti, A

    2013-12-01

    Contrast-enhanced computed tomographic studies of the coelomic cavity in four green iguanas, four black and white tegus and four bearded dragons were performed using a conventional CT scanner. Anatomical reference cross sections were obtained from four green iguana, four black and white tegu and six bearded dragon cadavers; the specimens were stored in a -20°C freezer for 24 h then sliced into 5-mm intervals. The frozen sections were cleaned with water and photographed on both sides. The individual anatomical structures were identified by means of the available literature; these were labelled first on the anatomical images and then matched to the corresponding computed tomography images. The results provide an atlas of the normal cross-sectional and computed tomographic anatomy of the coelomic cavity in the green iguana, the black and white tegu and the bearded dragon, which is useful in the interpretation of any imaging modality. © 2013 Blackwell Verlag GmbH.

  12. Transluminal attenuation gradient in coronary computed tomography angiography for determining stenosis severity of calcified coronary artery: a primary study with dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Minwen; Wei, Mengqi; Wen, Didi; Zhao, Hongliang; Liu, Ying; Li, Jian [Fourth Military Medical University, Department of Radiology, Xijing Hospital, Xi' an, Shaanxi Province (China); Li, Jiayi [Fourth Military Medical University, Department of Cardiology, Xijing Hospital, Xi' an, Shaanxi Province (China)

    2015-05-01

    To evaluate the diagnostic accuracy of transluminal attenuation gradient (TAG) for stenosis severity of calcified lesions assessed by coronary computed tomography angiography (CCTA). One hundred seven patients who underwent CCTA and coronary angiography (CAG) were enrolled. TAGs of 309 major epicardial coronary arteries were measured. The impact of plaque composition, Agatston scores, and lesion length ratio on TAG were analyzed. Diagnostic performance vs. CAG of TAG, CCTA, and combined TAG/CCTA were evaluated, and incremental value of TAG for reclassification of CCTA stenosis severity in calcified lesions was also analyzed. TAG decreased consistently with stenosis severity. TAG was significantly lower in coronary arteries with calcification scores >300 and lesion length ratios >2/3. TAG improved diagnostic accuracy of CCTA (c-statistic =0.982 vs. 0.942, P = 0.0001) in calcified lesions, and the sensitivity, specificity, positive, and negative predictive values of TAG cutoff ≤ -11.33 were 72 %, 91 %, 88 %, and 78 %, respectively. The addition of TAG to CCTA resulted in significant reclassification (NRI =0.093, P = 0.022) in calcified vessels. Measurement of TAG may improve diagnostic performance and reclassification of CCTA in coronary stenosis caused by calcified lesions. (orig.)

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  14. Computer-aided diagnosis system for coronary artery stenosis using a neural network

    Science.gov (United States)

    Suzuki, Kenji; Horiba, Isao; Sugie, Noboru; Nanki, Michio

    2001-07-01

    We have developed a new computer-aided diagnosis system for coronary artery stenosis, which can learn medical doctors' clinical experiences and medical knowledge. In order to develop such a system, we have employed a multilayer neural network (NN). The NN has the capability to learn experts' experiences and knowledge. The proposed system consists of (a) automatic vessel tracking, (b) automatically extraction of the edges of the vessel, and (c) estimation of stenosis based on the NN. In order to evaluate the performance of the proposed system, two experiments with the phantoms and clinical images were performed. The stenoses estimated by the proposed system agreed well with not only the stenoses based on the actual measurement of the phantoms but also those diagnosed by a medical specialist from coronary arteriograms. The experimental results have shown that the proposed system has the capability to learn medical doctors' clinical experiences and medical knowledge. The proposed system has been proved to be useful to aid to diagnose coronary artery stenosis.

  15. Drug delivery patterns for different stenting techniques in coronary bifurcations: a comparative computational study.

    Science.gov (United States)

    Cutrì, Elena; Zunino, Paolo; Morlacchi, Stefano; Chiastra, Claudio; Migliavacca, Francesco

    2013-08-01

    The treatment of coronary bifurcation lesions represents a challenge for the interventional cardiologists due to the lower rate of procedural success and the higher risk of restenosis. The advent of drug-eluting stents (DES) has dramatically reduced restenosis and consequently the request for re-intervention. The aim of the present work is to provide further insight about the effectiveness of DES by means of a computational study that combines virtual stent implantation, fluid dynamics and drug release for different stenting protocols currently used in the treatment of a coronary artery bifurcation. An explicit dynamic finite element model is developed in order to obtain realistic configurations of the implanted devices used to perform fluid dynamics analysis by means of a previously developed finite element method coupling the blood flow and the intramural plasma filtration in rigid arteries. To efficiently model the drug release, a multiscale strategy is adopted, ranging from lumped parameter model accounting for drug release to fully 3-D models for drug transport to the artery. Differences in drug delivery to the artery are evaluated with respect to local drug dosage. This model allowed to compare alternative stenting configurations (namely the Provisional Side Branch, the Culotte and the Inverted Culotte techniques), thus suggesting guidelines in the treatment of coronary bifurcation lesions and addressing clinical issues such as the effectiveness of drug delivery to lesions in the side branch, as well as the influence of incomplete strut apposition and overlapping stents.

  16. Recurrence of Takotsubo Cardiomyopathy: Role of Multi- Detector Computed Tomography Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Yaser Jenab

    2015-10-01

    Full Text Available Takotsubo cardiomyopathy (TCM, also known as stress-induced cardiomyopathy, is a clinical syndrome of transient left ventricular (LV apical wall motion abnormality with relative preservation of the basal heart segments in the absence of any significant atherosclerosis. Recurrence of this condition is rare. We report a postmenopausal woman, who experienced two episodes of TCM within 4 months following emotional and physical stress. In the first episode, she was admitted due to severe dyspnea, accompanied by sudden-onset, prolonged, burning chest pain and palpitation. Transthoracic echocardiography revealed akinesia of the LV, with the exception of the basal regions. Coronary angiography demonstrated no significant coronary artery disease, and follow-up echocardiography showed normalization of the LV wall motion abnormalities. In the second episode, she experienced similar symptoms and echocardiography revealed similar changes. Multi-detector computed tomography revealed normal coronary arteries. After 9 days, she was discharged in good condition; and at 3 months’ follow- up, she was symptom-free with normal echocardiography.

  17. Non-cardiac findings on coronary computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc; Schnapauff, Dirk; Teige, Florian; Hamm, Bernd [Charite-Universitaetsmedizin Berlin, Humboldt-Universitaet zu Berlin, Department of Radiology, Chariteplatz 1, P.O. Box 10098, Berlin (Germany)

    2007-08-15

    Both multislice computed tomography (CT) and magnetic resonance imaging (MRI) are emerging as methods to detect coronary artery stenoses and assess cardiac function and morphology. Non-cardiac structures are also amenable to assessment by these non-invasive tests. We investigated the rate of significant and insignificant non-cardiac findings using CT and MRI. A total of 108 consecutive patients suspected of having coronary artery disease and without contraindications to CT and MRI were included in this study. Significant non-cardiac findings were defined as findings that required additional clinical or radiological follow-up. CT and MR images were read independently in a blinded fashion. CT yielded five significant non-cardiac findings in five patients (5%). These included a pulmonary embolism, large pleural effusions, sarcoid, a large hiatal hernia, and a pulmonary nodule (>1.0 cm). Two of these significant non-cardiac findings were also seen on MRI (pleural effusions and sarcoid, 2%). Insignificant non-cardiac findings were more frequent than significant findings on both CT (n = 11, 10%) and MRI (n = 7, 6%). Incidental non-cardiac findings on CT and MRI of the coronary arteries are common, which is why images should be analyzed by radiologists to ensure that important findings are not missed and unnecessary follow-up examinations are avoided. (orig.)

  18. Effect of age and plaque morphology on diagnostic accuracy of dual source multidetector computed tomography coronary angiography

    Institute of Scientific and Technical Information of China (English)

    Hamza Sunman; Giray Kabak; Lale Tokgzolu; Ali Oto; Kudret Aytemir; Hikmet Yorgun; Uur Canpolat; Ali Taher; Edis Demiri; Tuncay Hazrolan; Leventahiner; Ergn B.Kaya

    2014-01-01

    Background Multidetector computed tomography (MDCT) coronary angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. The purpose of this study is to investigate the effect of age and coronary plaque calcification on diagnostic accuracy of MDCT. Methods The patients were examined by using dual-source MDCT and conventional coronary angiography. MDCT results were analyzed with regard to the severity (>50%stenosis) and morphology (non-calcified, mixed, or calcified) of coronary atherosclerotic plaques evaluated in a 16-segment model. Results In total, 181 patients (94 men and 87 women) with 2,687 coronary artery segments were examined with MDCT. Ninety three patients were older than 65 years of age (group A, 42 men) and 88 were younger (group B, 52 men). Two-hundred nine coronary artery segments (7.2%) were ex-cluded because of small distal coronary vessel segments and/or motion artifacts. The overall number of segments with non-diagnostic image quality was similar in both groups of patients. Of the 2,687 evaluated segments, 157 (5.8%) were significantly diseased, and 144 of them were correctly detected by MDCT. Diagnostic evaluation showed that the sensitivity, positive predictive value, specificity, and negative pre-dictive value were 89.5%, 62.5%, 96.0%, and 99.2%, respectively in group A, and 95.2%, 64.8%, 97.5%, and 99.8%in group B, respectively. In addition, detailed segment-based analyses in coronary segments with non-calcified, mixed and calcified plaques in both groups were simi-lar diagnostic accuracy. Conclusions Very high diagnostic accuracy observed in this study suggests that MDCT coronary angiography could be a suitable diagnostic tool for not only younger patients but also for older patients.

  19. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Girinsky, Theodore, E-mail: girinsky.theodore@orange.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); M’Kacher, Radhia [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Lessard, Nathalie [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Koscielny, Serge [Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif (France); Elfassy, Eric; Raoux, François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France); Carde, Patrice [Department of Hematology, Institut Gustave Roussy, Villejuif (France); Santos, Marcos Dos [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Margainaud, Jean-Pierre [Department of Head and Neck Surgery, Institut Gustave Roussy, Villejuif (France); Sabatier, Laure [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Ghalibafian, Mithra [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Paul, Jean-François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France)

    2014-05-01

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.

  20. Tomographic imaging with polarized light.

    Science.gov (United States)

    Soloviev, Vadim Y; Zacharakis, Giannis; Spiliopoulos, George; Favicchio, Rosy; Correia, Teresa; Arridge, Simon R; Ripoll, Jorge

    2012-06-01

    We report three-dimensional tomographic reconstruction of optical parameters for the mesoscopic light scattering regime from experimentally obtained datasets by using polarized light. We present a numerically inexpensive approximation to the radiative transfer equation governing the polarized light transport. This approximation is employed in the reconstruction algorithm, which computes two optical parameters by using parallel and perpendicular polarizations of transmitted light. Datasets were obtained by imaging a scattering phantom embedding highly absorbing inclusions. Reconstruction results are presented and discussed.

  1. Development of a computer-generated model for the coronary arterial tree based on multislice CT and morphometric data

    Science.gov (United States)

    Fung, George S. K.; Segars, W. Paul; Taguchi, Katsuyuki; Fishman, Elliot K.; Tsui, Benjamin M. W.

    2006-03-01

    A detailed four-dimensional model of the coronary artery tree has great potential in a wide variety of applications especially in biomedical imaging. We developed a computer generated three-dimensional model for the coronary arterial tree based on two datasets: (1) gated multi-slice computed tomography (MSCT) angiographic data obtained from a normal human subject and (2) statistical morphometric data obtained from porcine hearts. The main coronary arteries and heart structures were segmented from the MSCT data to define the initial segments of the vasculature and geometrical details of the boundaries. An iterative rule-based computer generation algorithm was then developed to extend the coronary artery tree beyond the initial segmented branches. The algorithm was governed by the following factors: (1) the statistical morphometric measurements of the connectivities, lengths, and diameters of the arterial segments, (2) repelling forces from other segments and boundaries, and (3) optimality principles to minimize the drag force at each bifurcation in the generated tree. Using this algorithm, the segmented coronary artery tree from the MSCT data was optimally extended to create a 3D computational model of the largest six orders of the coronary arterial tree. The new method for generating the 3D model is effective in imposing the constraints of anatomical and physiological characteristics of coronary vasculature. When combined with the 4D NCAT phantom, a computer model for the human anatomy and cardiac and respiratory motions, the new model will provide a unique tool to study cardiovascular characteristics and diseases through direct and medical imaging simulation studies.

  2. Comparative Micro-computed Tomographic Evaluation of the Sealing Quality of ProRoot MTA and MTA Angelus Apical Plugs Placed with Various Techniques.

    Science.gov (United States)

    Sisli, Selen Nihal; Ozbas, Hakan

    2017-01-01

    This study compared the effects of different mixing and placement techniques on sealing of ProRoot MTA (Dentsply Maillefer, Ballaigues, Switzerland) and MTA Angelus (Soluçoes Odontologicas, Londrina, Brazil) apical plugs using micro-computed tomographic (micro-CT) imaging. Standardized divergent open apex models were created using 120 extracted maxillary incisors and divided into 8 groups (n = 15). ProRoot MTA and MTA Angelus were mixed manually or mechanically and introduced to form apical plugs by hand condensation or indirect ultrasonic activation for 10 seconds. The samples were scanned using micro-CT imaging, and volumetric analysis of the voids between the dentin walls and the apical plugs and the porosity inside MTA was performed. Irrespective of the mixing and placement techniques used, the voids between the dentin walls and the apical plugs in the MTA Angelus groups were greater than those in the ProRoot MTA groups (P MTA than combined manual mixing and hand condensation (P MTA, both mixed and placed manually, was greater than for MTA Angelus (P  .05). ProRoot MTA showed better marginal adaptation than MTA Angelus. Mechanically mixed products had better handling characteristics than the manually mixed product. Indirect ultrasonic activation did improve the adaptation of manually mixed MTA Angelus to the dentin walls. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  3. Qualitative and quantitative assessment of smoking-related lung disease: effect of iterative reconstruction on low-dose computed tomographic examinations.

    Science.gov (United States)

    Hague, Cameron J; Krowchuk, Natasha; Alhassan, Donya; Ho, Kevin; Leipsic, Jonathon; Sin, Don D; Mayo, John R; Coxson, Harvey O

    2014-11-01

    The purpose of this research is to examine the role that differing levels of adaptive statistical iterative reconstruction (ASIR) have on the qualitative and quantitative assessment of smoking-related lung disease. Institutional board review approval was obtained. A total of 52 patients undergoing clinically indicated low-dose computed tomographic (CT) examinations of the chest (100 kVp, 65 mAs, mean radiation dose 1.0±0.12 mSv), with reconstruction of data with different levels of blended ASIR (0%, 40%, and 100%), were consented. Qualitative assessment of CT data sets was performed by 2 trained thoracic radiologists blinded to clinical history, spirometry, and quantitative data for the presence of emphysema (%/lung zone) and the degree of respiratory bronchiolitis. Quantitative analysis was performed (Apollo Image analysis, VIDA Diagnostics) to assess emphysema and airway measures of chronic obstructive pulmonary disease. The application of ASIR results in alterations in both qualitative and quantitative assessment of smoking-related lung disease. As levels of ASIR increased, both readers scored more respiratory bronchiolitis (Pqualitative and quantitative assessment of smoking-related lung disease. Although a powerful tool to allow dose reduction, caution must be exercised when iterative reconstruction techniques are utilized when evaluating CT examinations for findings of chronic obstructive pulmonary disease.

  4. A unique case of Turner syndrome accompanying prolactinoma and unexpected elongated styloid process: Clinical and cone-beam computed tomographic features

    Science.gov (United States)

    Tatli, Ufuk; Yazicioglu, Iffet; Evlice, Ahmet; Oztunc, Haluk

    2013-01-01

    Turner syndrome (TS) is one of the most common chromosomal abnormalities, with an estimated frequency among female live births of 1/2,000-3,000. The syndrome is characterized by the partial or complete absence of one X chromosome (45,X karyotype). We reported a unique case of a 40-year-old woman with TS accompanying unexpected elongated styloid process specific to Eagle syndrome (ES) and followed up-prolactinoma. The present article is the first report to define the cone-beam computed tomographic (CBCT) features of TS accompanying ES. Patients with TS carry various risks that make treatment more complicated; thus advanced imaging techniques for proper treatment and follow-up are extremely important. In the light of CBCT examination, craniofacial abnormalities specific to TS and accompanying syndromes such as the crowding of teeth especially in the maxillary anterior region caused by maxillary narrowness, micrognatic maxilla and mandible, relative mandibular retrusion, malocclusion, open-bite, and an elongated styloid process (length of 32.7 mm) on the right side were illustrated in detail. PMID:23807938

  5. How will you need me, how will you read me, when I'm 64 (or more!)?: volume computed tomographic scanning and information overload in the emergency department.

    Science.gov (United States)

    Chason, David P; Anderson, Jon A; Stephens, Jason S; Suss, Richard A; Guild, Jeffrey B; Blackburn, Timothy J; Champine, Julie G; Lane, Thomas J

    2010-01-01

    Computed tomographic (CT) scanning technology now employs up to 320 detector rows of 0.5-mm width and allows rapid acquisition of isotropic volume datasets over the entire body. Data from a single CT acquisition can be reconstructed into image series that would formerly have required multiple acquisitions. Small isotropic voxels permit scan parameters to be general while reconstruction algorithms remain specific to anatomy. While this results in more efficient operation in the Emergency Department, it necessitates new ways of displaying, interpreting, and archiving the information. Critical decisions include how much of the patient to scan and how to time contrast injections when imaging multiple organs. These choices must be made in light of dose considerations to the patient and the general population of patients. The technical basis of high-density CT scanning is discussed, including detector configurations and reconstruction techniques. Volumetric scanning in the Emergency Department can improve patient care but requires a change of technical habits. 2010 Mosby, Inc. All rights reserved.

  6. Cone Beam Computed Tomographic Analyses of the Position and Course of the Mandibular Canal: Relevance to the Sagittal Split Ramus Osteotomy

    Directory of Open Access Journals (Sweden)

    Ahmet Ercan Sekerci

    2014-01-01

    Full Text Available Purpose. The aim of this study was to document the position and course of the mandibular canal through the region of the mandibular angle and body in dental patients, using cone beam computed tomographic imaging. Methods. The position and course of the mandibular canal from the region of the third molar to the first molar were measured at five specific locations in the same plane: at three different positions just between the first and second molars; between the second and third molars; and just distal to the third molar. Results. The study sample was composed of 500 hemimandibles from 250 dental patients with a mean age of 26.32. Significant differences were found between genders, distances, and positions. B decreased significantly from the anterior positions to the posterior positions in both females and males. The mean values of S and CB increased significantly from the posterior positions to the anterior positions in both females and males. Conclusion. Because the sagittal split ramus osteotomy is a technically difficult procedure, we hope that the findings of the present study will help the surgeon in choosing the safest surgical technique for the treatment of mandibular deformities.

  7. A unique case of Turner syndrome accompanying prolactinoma and unexpected elongated styloid process: Clinical and cone-beam computed tomographic features

    Energy Technology Data Exchange (ETDEWEB)

    Evlice, Burcu; Tatli, Ufuk; Yazicioglu, Iffet; Oztunc, Haluk [Faculty of Dentistry, Cukurova University, Adana (Turkey); Evlice, Ahmet [Faculty of Medicine, Cukurova University, Adana (Turkey)

    2013-06-15

    Turner syndrome (TS) is one of the most common chromosomal abnormalities, with an estimated frequency among female live births of 1/2,000-3,000. The syndrome is characterized by the partial or complete absence of one X chromosome (45,X karyotype). We reported a unique case of a 40-year-old woman with TS accompanying unexpected elongated styloid process specific to Eagle syndrome (ES) and followed up-prolactinoma. The present article is the first report to define the cone-beam computed tomographic (CBCT) features of TS accompanying ES. Patients with TS carry various risks that make treatment more complicated; thus advanced imaging techniques for proper treatment and follow-up are extremely important. In the light of CBCT examination, craniofacial abnormalities specific to TS and accompanying syndromes such as the crowding of teeth especially in the maxillary anterior region caused by maxillary narrowness, micrognatic maxilla and mandible, relative mandibular retrusion, malocclusion, open-bite, and an elongated styloid process (length of 32.7 mm) on the right side were illustrated in detail.

  8. Differences in clinical features and computed tomographic findings between embolic and non-embolic acute ischemic stroke. A quantitative differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Takano, Kentaro; Yamaguchi, Takenori; Minematsu, Kazuo; Sawada, Tohru; Omae, Teruo [National Cardiovascular Center, Suita, Osaka (Japan)

    1998-02-01

    A diagnosis based on the presumed mechanism of stroke onset is useful for management strategies in acute ischemic stroke. Ninety-two patients with embolic (cardiac or artery-to-artery) and 107 with non-embolic (thrombotic or hemodynamic) stroke were diagnosed on strict cerebral angiographic criteria alone. To clearly discriminate between these two groups, the neurological and computed tomographic (CT) findings were then compared. Rapidity of onset, vomiting, urinary incontinence, level of consciousness, cervical bruit, anisocoria, tongue deviation, sensory disturbance, and CT findings (location of hypodense area, findings of brain edema and hemorrhagic transformation) were discriminatory factors between the two groups (p<0.01). According to these 11 items, we prepared a numerical table for quantitative differential diagnosis. A diagnostic accuracy of 98.9% for embolic and 87.9% for non-embolic stroke in internal verification, and 90.0% and 82.9%, respectively, in external verification was observed. The differences in clinical features and CT findings between embolic and non-embolic stroke may reflect the pathophysiological mechanisms of the occlusive process of cerebral artery as well as the extent and severity of ischemia. (author)

  9. Evaluation of the Efficacy of TRUShape and Reciproc File Systems in the Removal of Root Filling Material: An Ex Vivo Micro-Computed Tomographic Study.

    Science.gov (United States)

    de Siqueira Zuolo, Arthur; Zuolo, Mario Luis; da Silveira Bueno, Carlos Eduardo; Chu, Rene; Cunha, Rodrigo Sanches

    2016-02-01

    The purpose of this study was to evaluate the efficacy of TRUShape (Dentsply Tulsa Dental Specialties, Tulsa, OK) compared with the Reciproc file (VDW, Munich, Germany) in the removal of filling material from oval canals filled with 2 different sealers and differences in the working time. Sixty-four mandibular canines with oval canals were prepared and divided into 4 groups (n = 16). Half of the specimens were filled with gutta-percha and pulp canal sealer (PCS), and the remainders were filled with gutta-percha and bioceramic sealer (BCS). The specimens were retreated using either the Reciproc or TRUShape files. A micro-computed tomographic scanner was used to assess filling material removal, and the time taken for removal was also recorded. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. The mean volume of the remaining filling material was similar when comparing both files (P ≥ .05). However, in the groups filled with BCS, the percentage of remaining filling material was higher than in the groups filled with PCS (P material when comparing both files system; however, Reciproc was faster than TRUShape. BCS groups exhibited significantly more remaining filling material in the canals and required more time for retreatment. Remaining filling material was observed in all samples regardless of the technique or sealer used. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. MULTIDETECTOR COMPUTED TOMOGRAPHIC AND LOW-FIELD MAGNETIC RESONANCE IMAGING ANATOMY OF THE QUADRIGEMINAL CISTERN AND CHARACTERIZATION OF SUPRACOLLICULAR FLUID ACCUMULATIONS IN DOGS.

    Science.gov (United States)

    Bertolini, G; Ricciardi, M; Caldin, M

    2016-05-01

    Focal fluid accumulations in the supracollicular region are commonly termed quadrigeminal cysts and may be either subclinical or associated with neurologic deficits in dogs. Little published information is available on normal imaging anatomy and anatomic relationships for the canine quadrigeminal cistern. Objectives of this observational, cross-sectional study were to describe normal quadrigeminal cistern anatomy and determine the prevalence and characteristics of supracollicular fluid accumulations in dogs. Normal descriptions were accomplished using computed tomographic (CT) cisternography in one canine cadaver, and CT and magnetic resonance imaging (MRI) studies of the brain in four prospectively recruited dogs with no evidence of intracranial disease. Prevalence and characteristics descriptions were accomplished using a retrospective review of brain CT or MRI studies performed during the period of 2005-2015. The normal quadrigeminal cistern consistently exhibited a complex H shape and was separated from the third ventricle by a thin membrane. Prevalence of supracollicular fluid accumulations (SFAs) was 2.19% among CT studies (n = 4427) and 2.2% among MRI studies (n = 626). Dogs with SFA were significantly younger than control dogs (P dogs were predisposed (P dogs with SFAs, the following three patterns were defined: (1) third ventricle (49.54%), (2) quadrigeminal cistern (13.51%), and (3) both third ventricle and quadrigeminal cistern (36.93%). Authors recommend that the term supracollicular fluid accumulation (SFA) should be used rather than the term quadrigeminal cyst to describe these focal fluid accumulations in dogs.

  11. Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

    Energy Technology Data Exchange (ETDEWEB)

    Spada, Cristiano; Barbaro, Federico; Petruzziello, Lucio [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Stoker, Jaap; Haan, Margriet C. de [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Alarcon, Onofre [Universidad de La Laguna, Department of Gastroenterology, Hospital Universitario de Canarias, Facultad de Medicina, La Laguna, Tenerife (Spain); Bellini, Davide; Laghi, Andrea [Sapienza University of Rome, I.C.O.T. Hospital, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Bretthauer, Michael [Oslo University Hospital, Department of Health Economy and Health Management, University of Oslo, and Department of Transplantation Medicine, Gastroenterology Unit, Oslo (Norway); Dumonceau, Jean-Marc [Gedyt Endoscopy Center, Buenos Aires (Argentina); Ferlitsch, Monika [Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna (Austria); Halligan, Steve; Helbren, Emma; Plumb, Andrew; Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); Hellstrom, Mikael [Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Department of Radiology, Gothenburg (Sweden); Kuipers, Ernst J. [Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam (Netherlands); Lefere, Philippe [Virtual Colonoscopy Teaching Centre, Hooglede (Belgium); AZ Delta, Roeselare (Belgium); Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Neri, Emanuele [University of Pisa, Diagnostic and Interventional Radiology, Pisa (Italy); Regge, Daniele [Institute for Cancer Research and Treatment, Candiolo-Torino (Italy); Hassan, Cesare [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Ospedale Nuovo Regina Margherita, Department of Gastroenterology, Rome (Italy)

    2014-10-03

    Colorectal cancer (CRC) is a major cause of morbidity and mortality [1, 2]. CRC screening by fecal occult blood testing (FOBT) has been shown to reduce CRC mortality [3, 4], and is currently used in several European countries. Colonoscopy is highly effective for detecting advanced neoplasia, and endoscopic polypectomy reduces subsequent CRCspecific incidence and mortality [5]. In Europe, colonoscopy is mainly used to investigate FOBT-positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk [6]. Computed tomographic colonography (CTC) is a minimally invasive imaging technique that is highly accurate for detecting colorectal cancer (CRC) and adenomatous polyps. The technique is standardized [7], and CTC is more easily performed than barium enema. Evidence-based data suggest that CTC is the natural replacement for barium enema and a complementary rather than an alternative examination to colonoscopy. However, the clinical scenarios for which CTC is indicated remain unclear. To address this uncertainty - 20 years after the first presentation of CTC at a radiological meeting [8] - the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) decided to produce a common guideline regarding indications for CTC in clinical practice. Technical and quality issues of CTC have been deliberately excluded from this work as these have already been discussed separately [7].

  12. Correlation of coronary artery stenosis evaluation with left heart structure and function by multi-slice computed tomography.

    Science.gov (United States)

    Song, L N; Cao, A D; Niu, Y J; Liu, N

    2014-08-07

    The aim of this study was to determine the impact of multi-slice computed tomography (MSCT) evaluation of coronary artery stenosis on left heart structure and systolic function. Coronary artery CT angiography was performed in 200 patients diagnosed with coronary heart disease, and then according to the AHA coronary artery 17-segment fractionation method, the Gensini score (GS) was determined for every narrow segment, and one-stop assessment of the correlation between left heart structure and function was performed. After the grouping of GS quartiles from low to high, there were differences between different patients with regard to LVDD, LADD, LVEDV, LVESV, MM, LVEF, and FS, while no difference in SV and CO. GS showed linear negative correlation with LVEF and FS, and linear positive correlation with LVDD, LADD, LVEDV, LVESV, and MM, while no correlation with SV and CO. That is, GS of coronary artery stenosis was negatively correlated with left ventricular systolic function and positively correlated with myocardial mass. The narrower the coronary artery, the worse the cardiac function and the higher the myocardial hypertrophy. Coronary artery stenosis was one of the important causes of the decrease in left ventricular systolic function and cardiac remodeling.

  13. The impact of scaled boundary conditions on wall shear stress computations in atherosclerotic human coronary bifurcations.

    Science.gov (United States)

    Schrauwen, Jelle T C; Schwarz, Janina C V; Wentzel, Jolanda J; van der Steen, Antonius F W; Siebes, Maria; Gijsen, Frank J H

    2016-05-15

    The aim of this study was to determine if reliable patient-specific wall shear stress (WSS) can be computed when diameter-based scaling laws are used to impose the boundary conditions for computational fluid dynamics. This study focused on mildly diseased human coronary bifurcations since they are predilection sites for atherosclerosis. Eight patients scheduled for percutaneous coronary intervention were imaged with angiography. The velocity proximal and distal of a bifurcation was acquired with intravascular Doppler measurements. These measurements were used for inflow and outflow boundary conditions for the first set of WSS computations. For the second set of computations, absolute inflow and outflow ratios were derived from geometry-based scaling laws based on angiography data. Normalized WSS maps per segment were obtained by dividing the absolute WSS by the mean WSS value. Absolute and normalized WSS maps from the measured-approach and the scaled-approach were compared. A reasonable agreement was found between the measured and scaled inflows, with a median difference of 0.08 ml/s [-0.01; 0.20]. The measured and the scaled outflow ratios showed a good agreement: 1.5 percentage points [-19.0; 4.5]. Absolute WSS maps were sensitive to the inflow and outflow variations, and relatively large differences between the two approaches were observed. For normalized WSS maps, the results for the two approaches were equivalent. This study showed that normalized WSS can be obtained from angiography data alone by applying diameter-based scaling laws to define the boundary conditions. Caution should be taken when absolute WSS is assessed from computations using scaled boundary conditions.

  14. A comparison of echocardiographic and electron beam computed tomographic assessment of aortic valve area in patients with valvular aortic stenosis

    NARCIS (Netherlands)

    Piers, Lieuwe H.; Dikkers, Riksta; Tio, Rene A.; van den Berg, Maarten P.; Willems, Tineke P.; Zijlstra, Felix; Oudkerk, Matthijs

    2007-01-01

    The purpose of this study was to compare electron beam computed tomography (EBT) with transthoracic echocardiography (TTE) in determining aortic valve area (AVA). Thirty patients (9 females, 21 males) underwent a contrast-enhanced EBT scan (e-Speed, GE, San Francisco, CA, USA) and TTE within 17 +/-

  15. Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320 row detector computed tomography

    DEFF Research Database (Denmark)

    Vavere, Andrea L; Simon, Gregory G; George, Richard T

    2013-01-01

    Multidetector coronary computed tomography angiography (CTA) is a promising modality for widespread clinical application because of its noninvasive nature and high diagnostic accuracy as found in previous studies using 64 to 320 simultaneous detector rows. It is, however, limited in its ability...... to detect myocardial ischemia. In this article, we describe the design of the CORE320 study ("Combined coronary atherosclerosis and myocardial perfusion evaluation using 320 detector row computed tomography"). This prospective, multicenter, multinational study is unique in that it is designed to assess...... the diagnostic performance of combined 320-row CTA and myocardial CT perfusion imaging (CTP) in comparison with the combination of invasive coronary angiography and single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI). The trial is being performed at 16 medical centers located in 8...

  16. Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Michiel A. de; Boogers, Mark J.; Veltman, Caroline E. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); The Interuniversity Cardiology Institute of The Netherlands, Utrecht (Netherlands); El-Naggar, Heba M.; Bax, Jeroen J.; Delgado, Victoria [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Broersen, Alexander; Kitslaar, Pieter H.; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Kroft, Lucia J. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Younis, Imad Al [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands); Reiber, Johan H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical imaging systems B.V., Leiden (Netherlands); Scholte, Arthur J. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands)

    2013-08-15

    Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT). Included in the study were 40 patients (mean age 58.2 {+-} 10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS {>=}2) on gated myocardial perfusion SPECT. Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41-24.7, p < 0.001, and OR 1.07, 95 % CI 1.00-1.45, p = 0.032, respectively) after correcting for clinical variables and visually assessed significant stenosis. The addition of quantitatively assessed significant stenosis ({chi} {sup 2} = 20.7) and lesion length ({chi} {sup 2} = 26.0) to the clinical variables and the visual assessment ({chi} {sup 2} = 5.9) had incremental value in the association with myocardial ischaemia. Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have

  17. Transmural myocardial perfusion gradients in relation to coronary artery stenoses severity assessed by cardiac multidetector computed tomography

    DEFF Research Database (Denmark)

    Linde, Jesper James; Kühl, Jørgen Tobias; Hove, Jens Dahlgaard

    2015-01-01

    To assess the relationship between epicardial coronary artery stenosis severity and the corresponding regional transmural perfusion at rest and during adenosine stress, using multidetector computed tomography (MDCT). We evaluated the relationship between the severity of coronary artery diameter...... = stress - PI/rest - PI), and the transmural perfusion ratio (TPR = subendocardium/subepicardium) were calculated. A coronary artery stenosis ≥50 % was present in 49 patients (25 %). Rest-PI and rest-TPR values were similar in patients with and without a coronary artery stenosis ≥50 %, whereas stress...... stenosis assessed by MDCT angiography and semi-quantitative myocardial MDCT perfusion in 200 symptomatic patients. The perfusion index (PI = mean myocardial attenuation density/mean left ventricular lumen attenuation density) at rest and during adenosine stress, the myocardial perfusion reserve (MPR...

  18. Correlative multiple porosimetries for reservoir sandstones with adoption of a new reference-sample-guided computed-tomographic method

    Science.gov (United States)

    Jin, Jae Hwa; Kim, Junho; Lee, Jeong-Yil; Oh, Young Min

    2016-07-01

    One of the main interests in petroleum geology and reservoir engineering is to quantify the porosity of reservoir beds as accurately as possible. A variety of direct measurements, including methods of mercury intrusion, helium injection and petrographic image analysis, have been developed; however, their application frequently yields equivocal results because these methods are different in theoretical bases, means of measurement, and causes of measurement errors. Here, we present a set of porosities measured in Berea Sandstone samples by the multiple methods, in particular with adoption of a new method using computed tomography and reference samples. The multiple porosimetric data show a marked correlativeness among different methods, suggesting that these methods are compatible with each other. The new method of reference-sample-guided computed tomography is more effective than the previous methods when the accompanied merits such as experimental conveniences are taken into account.

  19. Correlative multiple porosimetries for reservoir sandstones with adoption of a new reference-sample-guided computed-tomographic method.

    Science.gov (United States)

    Jin, Jae Hwa; Kim, Junho; Lee, Jeong-Yil; Oh, Young Min

    2016-07-22

    One of the main interests in petroleum geology and reservoir engineering is to quantify the porosity of reservoir beds as accurately as possible. A variety of direct measurements, including methods of mercury intrusion, helium injection and petrographic image analysis, have been developed; however, their application frequently yields equivocal results because these methods are different in theoretical bases, means of measurement, and causes of measurement errors. Here, we present a set of porosities measured in Berea Sandstone samples by the multiple methods, in particular with adoption of a new method using computed tomography and reference samples. The multiple porosimetric data show a marked correlativeness among different methods, suggesting that these methods are compatible with each other. The new method of reference-sample-guided computed tomography is more effective than the previous methods when the accompanied merits such as experimental conveniences are taken into account.

  20. Transoesophageal ultrasound and computer tomographic assessment of the equine cricoarytenoid dorsalis muscle: Relationship between muscle geometry and exercising laryngeal function.

    Science.gov (United States)

    Kenny, M; Cercone, M; Rawlinson, J J; Ducharme, N G; Bookbinder, L; Thompson, M; Cheetham, J

    2017-05-01

    Early detection of recurrent laryngeal neuropathy (RLN) is of considerable interest to the equine industry. To describe two imaging modalities, transoesophageal ultrasound (TEU) and computed tomography (CT) with multiplanar reconstruction to assess laryngeal muscle geometry, and determine the relationship between cricoarytenoid dorsalis (CAD) geometry and function. Two-phase study evaluating CAD geometry in experimental horses and horses with naturally occurring RLN. Equine CAD muscle volume was determined from CT scan sets using volumetric reconstruction with LiveWire. The midbody and caudal dorsal-ventral thickness of the CAD muscle was determined using a TEU in the same horses; and in horses with a range of severity of RLN (n = 112). Transoesophageal ultrasound was able to readily image the CAD muscles and lower left:right CAD thickness ratios were observed with increasing disease severity. Computed tomography based muscle volume correlated very closely with ex vivo muscle volume (R(2) = 0.77). Computed tomography reconstruction can accurately determine intrinsic laryngeal muscle geometry. A relationship between TEU measurements of CAD geometry and laryngeal function was established. These imaging techniques could be used to track the response of the CAD muscle to restorative surgical treatments such as nerve muscle pedicle graft, nerve anastomosis and functional electrical stimulation. © 2016 EVJ Ltd.

  1. Central tarsal bone fractures in horses not used for racing: Computed tomographic configuration and long-term outcome of lag screw fixation.

    Science.gov (United States)

    Gunst, S; Del Chicca, F; Fürst, A E; Kuemmerle, J M

    2016-09-01

    There are no reports on the configuration of equine central tarsal bone fractures based on cross-sectional imaging and clinical and radiographic long-term outcome after internal fixation. To report clinical, radiographic and computed tomographic findings of equine central tarsal bone fractures and to evaluate the long-term outcome of internal fixation. Retrospective case series. All horses diagnosed with a central tarsal bone fracture at our institution in 2009-2013 were included. Computed tomography and internal fixation using lag screw technique was performed in all patients. Medical records and diagnostic images were reviewed retrospectively. A clinical and radiographic follow-up examination was performed at least 1 year post operatively. A central tarsal bone fracture was diagnosed in 6 horses. Five were Warmbloods used for showjumping and one was a Quarter Horse used for reining. All horses had sagittal slab fractures that began dorsally, ran in a plantar or plantaromedial direction and exited the plantar cortex at the plantar or plantaromedial indentation of the central tarsal bone. Marked sclerosis of the central tarsal bone was diagnosed in all patients. At long-term follow-up, 5/6 horses were sound and used as intended although mild osteophyte formation at the distal intertarsal joint was commonly observed. Central tarsal bone fractures in nonracehorses had a distinct configuration but radiographically subtle additional fracture lines can occur. A chronic stress related aetiology seems likely. Internal fixation of these fractures based on an accurate diagnosis of the individual fracture configuration resulted in a very good prognosis. © 2015 EVJ Ltd.

  2. Computational fluid dynamics comparisons of wall shear stress in patient-specific coronary artery bifurcation using coronary angiography and optical coherence tomography

    Science.gov (United States)

    Poon, Eric; Thondapu, Vikas; Chin, Cheng; Scheerlinck, Cedric; Zahtila, Tony; Mamon, Chris; Nguyen, Wilson; Ooi, Andrew; Barlis, Peter

    2016-11-01

    Blood flow dynamics directly influence biology of the arterial wall, and are closely linked with the development of coronary artery disease. Computational fluid dynamics (CFD) solvers may be employed to analyze the hemodynamic environment in patient-specific reconstructions of coronary arteries. Although coronary X-ray angiography (CA) is the most common medical imaging modality for 3D arterial reconstruction, models reconstructed from CA assume a circular or elliptical cross-sectional area. This limitation can be overcome with a reconstruction technique fusing CA with intravascular optical coherence tomography (OCT). OCT scans the interior of an artery using near-infrared light, achieving a 10-micron resolution and providing unprecedented detail of vessel geometry. We compared 3D coronary artery bifurcation models generated using CA alone versus OCT-angiography fusion. The model reconstructed from CA alone is unable to identify the detailed geometrical variations of diseased arteries, and also under-estimates the cross-sectional vessel area compared to OCT-angiography fusion. CFD was performed in both models under pulsatile flow in order to identify and compare regions of low wall shear stress, a hemodynamic parameter directly linked with progression of atherosclerosis. Supported by ARC LP150100233 and VLSCI VR0210.

  3. Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Geluk, Christiane A.; Perik, Patrick J.; Tio, Rene A.; Goette, Marco J.W.; Hillege, Hans L.; Zijlstra, Felix [University Medical Center Groningen, Thoraxcenter, Department of Cardiology, Groningen (Netherlands); Dikkers, Riksta; Vliegenthart, Rozemarijn; Houwers, Janneke B.; Willems, Tineke P.; Oudkerk, Matthijs [University Medical Center Groningen, Department of Radiology, Groningen (Netherlands)

    2008-02-15

    We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients were enrolled in a screening protocol including CCS by electron beam computed tomography (Agatston score), and exercise testing. Decision-making was based on CCS. When CCS{>=}400, coronary angiography (CAG) was recommended. When CCS<10, patients were discharged. Exercise tests were graded as positive, negative or nondiagnostic. The combined endpoint was defined as coronary event or obstructive CAD at CAG. During 12{+-}4 months, CCS{>=}400, 10-399 and <10 were found in 42, 103 and 159 patients and the combined endpoint occurred in 24 (57%), 14 (14%) and 0 patients (0%), respectively. In 22 patients (7%), myocardial perfusion scintigraphy was performed instead of exercise testing due to the inability to perform an exercise test. A positive, nondiagnostic and negative exercise test result was found in 37, 76 and 191 patients, and the combined endpoint occurred in 11 (30%), 15 (20%) and 12 patients (6%), respectively. Receiver-operator characteristics analysis showed that the area under the curve of 0.89 (95% CI: 0.85-0.93) for CCS was superior to 0.69 (95% CI: 0.61-0.78) for exercise testing (P<0.0001). In conclusion, measurement of CCS is an appropriate initial screening test in a well-defined low-risk population with suspected CAD. (orig.)

  4. Advances in tomographic PIV

    NARCIS (Netherlands)

    Novara, M.

    2013-01-01

    This research deals with advanced developments in 3D particle image velocimetry based on the tomographic PIV technique (Tomo-PIV). The latter is a relatively recent measurement technique introduced by Elsinga et al. in 2005, which is based on the tomographic reconstruction of particle tracers in thr

  5. Radiographic and Computed Tomographic Configuration of Incomplete Proximal Fractures of the Proximal Phalanx in Horses Not Used for Racing.

    Science.gov (United States)

    Brünisholz, Hervé P; Hagen, Regine; Fürst, Anton E; Kuemmerle, Jan M

    2015-10-01

    To characterize the configuration of incomplete proximal fractures of the proximal phalanx (P1) in horses not used for racing and compare radiographic with computed tomography (CT) findings. Historical cohort. Twenty-four horses with incomplete fractures of P1. Medical records of horses not used for racing diagnosed with an incomplete proximal fracture of P1 based on clinical and radiographic examination and confirmed by CT between 2008 and 2013 were retrieved. Radiographs and CT studies of these horses were analyzed using a subjective grading system and by measuring variables that characterized fracture configuration. Twenty-four horses were included (20 Warmbloods) with a mean age of 9.5 years and mean body weight of 574 kg. Fourteen forelimbs and 10 hind limbs were affected. Mean duration of lameness was 8.7 weeks. Computed tomography was superior to radiography in both identifying the fracture and determining fracture size and location. On CT, 92% of fractures were located in the mid-sagittal plane. Mean proximodistal length of the fracture was 13 mm. Fractures were frequently not bicortical. Fractures in forelimbs were located significantly more dorsally than fractures in hind limbs. A distinct fracture pattern with 2 subchondral lines running parallel in close proximity to each other was identified in 54% of cases. Incomplete proximal fractures of P1 have significant variation in their configurations, especially their dorsopalmar/-plantar location. Computed tomography examination allowed clear identification of the fracture configurations and was superior to radiography. © Copyright 2015 by The American College of Veterinary Surgeons.

  6. Micro-computed tomographic analysis of progression of artificial enamel lesions in primary and permanent teeth after resin infiltration.

    Science.gov (United States)

    Ozgul, Betul Memis; Orhan, Kaan; Oz, Firdevs Tulga

    2015-09-01

    We investigated inhibition of lesion progression in artificial enamel lesions. Lesions were created on primary and permanent anterior teeth (n = 10 each) and were divided randomly into two groups with two windows: Group 1 (window A: resin infiltration; window B: negative control) and Group 2 (window A: resin infiltration + fluoride varnish; window B: fluoride varnish). After pH cycling, micro-computed tomography was used to analyze progression of lesion depth and changes in mineral density. Resin infiltration and resin infiltration + fluoride varnish significantly inhibited progression of lesion depth in primary teeth (P 0.05). Resin infiltration is a promising method of inhibiting progression of caries lesions.

  7. Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions

    DEFF Research Database (Denmark)

    Gaur, Sara; Øvrehus, Kristian Altern; Dey, Damini

    2016-01-01

    tomography angiography (CTA)-derived fractional flow reserve (FFRCT), and lesion-specific ischaemia identified by FFR in a substudy of the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). METHODS AND RESULTS: Coronary CTA stenosis, plaque volumes, FFRCT, and FFR were assessed...... the receiver-operating characteristics curve (AUC) analysis. Ischaemia was defined by FFR or FFRCT ≤0.80. Plaque volumes were inversely related to FFR irrespective of stenosis severity. Relative risk (95% confidence interval) for prediction of ischaemia for stenosis >50%, NCP ≥185 mm(3), LD-NCP ≥30 mm(3), CP...

  8. Two- and three-dimensional computed tomographic anatomy of the enamel, infundibulae and pulp of 126 equine cheek teeth. Part 1: Findings in teeth without macroscopic occlusal or computed tomographic lesions.

    Science.gov (United States)

    Windley, Z; Weller, R; Tremaine, W H; Perkins, J D

    2009-05-01

    Dental disorders are of major clinical importance in equine practice; however, the knowledge of normal dental anatomy, especially that of the pulp remains incomplete. Computed tomography (CT) is being used increasingly in the diagnosis of dental disease, although the normal 2- (2D) and 3-dimensional (3D) CT anatomy has not yet been fully described. To describe the 2D and 3D CT appearance of the enamel, infundibulae and pulp of normal equine cheek teeth. One-hundred-and-twenty-six cadaveric cheek teeth with eruption ages of 0.5-19 years were evaluated; CT scans of each tooth were performed after occlusal surface examination with a dental probe. Three-dimensional reconstructions of the enamel, infundibulae and pulp were created from the CT scans using greyscale thresholding and subsequent polynomial meshing. Each tooth was sectioned coronally or axially into serial slices using a band saw and the sections compared to the corresponding CT images. The CT reconstructions enabled the systematic description of the pulpar anatomy of the mandibular and maxillary cheek teeth in 3D, which has not been described in detail previously. The number of interpulpar communications between pulp horns and the pulpar volume of each tooth was shown to decrease with increasing age. The interpulpar communications of the maxillary cheek teeth were found to be of greater complexity and variety in comparison to their mandibular counterparts. Mandibular and maxillary cheek teeth showed different, but consistent patterns in their pulpar and enamel morphology. The detailed description of the normal 2D and 3D CT appearance of equine cheek teeth provides a reference basis for the diagnosis of dental disease with CT. Additionally, in depth knowledge of the pulpar anatomy of the equine cheek teeth is an essential prerequisite if endodontic therapy is to develop further in the future.

  9. Time-Resolved C-Arm Computed Tomographic Angiography Derived From Computed Tomographic Perfusion Acquisition: New Capability for One-Stop-Shop Acute Ischemic Stroke Treatment in the Angiosuite.

    Science.gov (United States)

    Yang, Pengfei; Niu, Kai; Wu, Yijing; Struffert, Tobias; Dorfler, Arnd; Schafer, Sebastian; Royalty, Kevin; Strother, Charles; Chen, Guang-Hong

    2015-12-01

    Multimodal imaging using cone beam C-arm computed tomography (CT) may shorten the delay from ictus to revascularization for acute ischemic stroke patients with a large vessel occlusion. Largely because of limited temporal resolution, reconstruction of time-resolved CT angiography (CTA) from these systems has not yielded satisfactory results. We evaluated the image quality and diagnostic value of time-resolved C-arm CTA reconstructed using novel image processing algorithms. Studies were done under an Institutional Review Board approved protocol. Postprocessing of data from 21 C-arm CT dynamic perfusion acquisitions from 17 patients with acute ischemic stroke were done to derive time-resolved C-arm CTA images. Two observers independently evaluated image quality and diagnostic content for each case. ICC and receiver-operating characteristic analysis were performed to evaluate interobserver agreement and diagnostic value of this novel imaging modality. Time-resolved C-arm CTA images were successfully generated from 20 data sets (95.2%, 20/21). Two observers agreed well that the image quality for large cerebral arteries was good but was more limited for small cerebral arteries (distal to M1, A1, and P1). receiver-operating characteristic curves demonstrated excellent diagnostic value for detecting large vessel occlusions (area under the curve=0.987-1). Time-resolved CTAs derived from C-arm CT perfusion acquisitions provide high quality images that allowed accurate diagnosis of large vessel occlusions. Although image quality of smaller arteries in this study was not optimal ongoing modifications of the postprocessing algorithm will likely remove this limitation. Adding time-resolved C-arm CTAs to the capabilities of the angiography suite further enhances its suitability as a one-stop shop for care for patients with acute ischemic stroke. © 2015 American Heart Association, Inc.

  10. 非典型心绞痛人群冠心病诊断评分方案的创建及冠状动脉CT检查对其的影响%Establishment of a scoring scheme for diagnosis of coronary heart disease in patients with atypical angina and effect of coronary computerized tomographic scanning on it

    Institute of Scientific and Technical Information of China (English)

    吴贵军; 韩雅玲; 荆全民; 王效增; 李毅; 邓捷; 张磊; 霍勇; 张岩

    2012-01-01

    Objectives To establish an efficient diagnostic scoring system to predict prevalence of coronary heart disease (CHD) in patients with atypical angina. Methods By retrospectively studing a database of 3 420 patients with atypical angina and with suspected CHD, risk factors were selected from clinical factors examined through multivariate logistic analysis and were assigned according to odds ratio (OR). Risk points are calculated and ascoring system for diagnosis of CHD with atypical angina was established. Correlations between risk score and prevalence of CHD as well as between risk score and coronary artery lesion severity were analyzed. Application efficiency of diagnostic scoring scheme was tested by calculating area under the receiver operating characteristic (ROC) curve. Coronary computerized tomographic scanning (CT) was conducted a risk factor analysis and assigned according to OR. Considering coronary CT was as one of the factors for diagnostic scoring scheme, the new area under the ROC curve was calculated to examine the application efficiency of new scheme. Results Prevalence of CHD is 63.68% in this study. Age, male, smoking, hypertension, diabetes mellitus and dyslipidemia were 6 risk factors for diagnostic scoring system named as "ABCDDS". Area under the ROC curve of diagnostic scoring scheme was 0.723 and standard error was 0.010. Range of risk score in diagnostic scoring scheme was from 0 to 11. The higher the score in the diagnostic scoring scheme was, the higher potentiality of CHD in a patient with atypical angina, and the more serious the coronary artery disease was. Score of coronary CT was 7. Area under the ROC curve of diagnostic scoring scheme increased to 0.832 when coronary CT was included. Conclusions Diagnostic scoring scheme is simple and practical for efficiently predicting probability of CHD in patients with atypical angina, and its application can be improved by coronary CT.%目的 建立预测非典型心绞痛冠状动脉粥样硬

  11. Prognostic importance of scintigraphic left ventricular cavity dilation during intravenous dipyridamole technetium-99m sestamibi myocardial tomographic imaging in predicting coronary events.

    Science.gov (United States)

    McClellan, J R; Travin, M I; Herman, S D; Baron, J I; Golub, R J; Gallagher, J J; Waters, D; Heller, G V

    1997-03-01

    Left ventricular (LV) cavity dilation during stress myocardial perfusion imaging has been associated with multivessel disease, and may be an independent prognostic marker in addition to perfusion defects. The present study examines the predictive value for future cardiac events of transient or fixed LV dilation during dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) imaging. The study included 512 consecutive patients who underwent SPECT imaging with Tc-99m sestamibi after dipyridamole infusion. Transient LV dilation was seen in 70 patients (14%) and 74 had fixed cavity dilation (14%); cavity size was normal in 368 patients (72%). Each perfusion scan was classified as normal or abnormal, and if abnormal, defects were categorized as transient or fixed, and as small, medium, or large (depending upon the number of abnormal vascular territories). Events during a mean follow-up of 12.8 +/- 6.8 months were tabulated by direct review of hospital charts and death certificates. The cardiac event rate (cardiac death or nonfatal infarction) was 1.9% in patients with normal cavity size, 11.4% with transient LV dilation, and 13.5% with fixed LV dilation (p < 0.01). Compared with patients with normal cavity size, those with transient LV dilation were more likely to sustain a myocardial infarction (p < 0.01) and those with fixed dilation more frequently suffered cardiac death (p < 0.01) and hospitalization for heart failure (p < 0.01). The group with the highest risk had both a large perfusion defect and cavity dilation. By Cox proportional hazard regression analysis, both transient and fixed LV dilation were strong independent predictors of cardiac events. Transient or fixed LV dilation are commonly seen during dipyridamole Tc-99m sestamibi SPECT imaging (14% incidence for each) and are useful predictors of cardiac events.

  12. Computed tomographic features predictive of local recurrence in patients with early stage lung cancer treated with stereotactic body radiation therapy.

    Science.gov (United States)

    Halpenny, Darragh; Ridge, Carole A; Hayes, Sara; Zheng, Junting; Moskowitz, Chaya S; Rimner, Andreas; Ginsberg, Michelle S

    2015-01-01

    The objective of this study is to identify computed tomography (CT) features of local recurrence (LR) after stereotactic body radiation therapy (SBRT) for lung cancer. Two hundred eighteen patients underwent SBRT for lung cancer from January 1st, 2006 to March 1st, 2011. Signs of LR recorded: opacity with new bulging margin, opacification of air bronchograms, enlarging pleural effusion, new or enlarging mass, and increased lung density at the treatment site. A new bulging margin at the treatment site was the only feature significantly associated with LR (P<.005). Most CT features classically associated with LR following conventional radiation therapy are unreliable for predicting LR following SBRT. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. A rare case of maxillary first molar with single root and single canal diagnosed using spiral computed tomographic scan

    Directory of Open Access Journals (Sweden)

    Ajay Saxena

    2014-01-01

    Full Text Available Variations in dental anatomy and canal morphology are found in all teeth. Knowledge of these variations, particularly the location and treatment of all canals, plays a key role in the success of endodontic therapy. The presence of extra canals, apical ramification, or lateral canals is commonly encountered, and their incidence and significance have been well-documented. However, the clinician should also be aware of the possibility of the existence of fewer root and/or canal numbers. Here is a case report of left maxillary first permanent molar with a single root and single canal. The goal of this clinical article is to report a maxillary molar with single root and single canal and to highlight the role of spiral computed tomography (SCT as a method to confirm the three-dimensional (3D anatomy of teeth.

  14. COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE THYROID GLANDS IN EIGHT HYPERTHYROID CATS PRE- AND POSTMETHIMAZOLE TREATMENT COMPARED WITH SEVEN EUTHYROID CATS.

    Science.gov (United States)

    Bush, Jennifer L; Nemanic, Sarah; Gordon, Jana; Bobe, Gerd

    2017-03-01

    Hyperthyroidism is the most common feline endocrinopathy; thyroid computed tomography (CT) may improve disease detection and methimazole dose selection. Objectives of this experimental pre-post with historical case-control study were to perform thyroid CT imaging in awake or mildly sedated hyperthyroid cats, compare thyroid gland CT appearance in euthyroid and hyperthyroid cats pre- and postmethimazole treatment, and determine whether thyroid size or attenuation correlate with methimazole dose needed for euthyroidism. Premethimazole treatment, eight hyperthyroid cats received CT scans from the head to heart, which were compared to CT of seven euthyroid cats. Total thyroxine levels were monitored every 3-4 weeks. Postmethimazole CT was performed 30 days after achieving euthyroid status. Computed tomography parameters recorded included thyroid length, width, height, attenuation, and heterogeneity. Median time between CT was 70 days (53-213 days). Mild sedation was needed in five hyperthyroid cats premethimazole, and none postmethimazole. Thyroid volume was significantly larger in hyperthyroid cats compared to euthyroid cats (785.0 mm(3) vs. 154.9 mm(3) ; P = 0.002) and remained unchanged by methimazole treatment (-4.5 mm3; P = 0.50). Thyroid attenuation and heterogeneity decreased with methimazole treatment (96.1 HU vs. 85.9 HU; P = 0.02. 12.4 HU vs. 8.1 HU; P = 0.009). Methimazole dose ranged from 2.5 to 10 mg daily with a positive correlation between pretreatment thyroid gland volume and dose needed to achieve euthyroidism (P = 0.03). Euthyroid and hyperthyroid cats are easily imaged awake or mildly sedated with CT. Methimazole in hyperthyroid cats significantly lowers thyroid attenuation and heterogeneity, but not size. © 2016 American College of Veterinary Radiology.

  15. Data on analysis of coronary atherosclerosis on computed</