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Sample records for dual-source ct coronary

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

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

    2014-08-15

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

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

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

    2014-08-01

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

  3. Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT

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    Hutt, Antoine; Faivre, Jean-Baptiste; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); Duhamel, Alain; Deken, Valerie [CHRU et Universite de Lille, Department of Biostatistics (EA 2694), Lille (France); Molinari, Francesco [Centre Hospitalier General de Tourcoing, Department of Radiology, Tourcoing (France)

    2016-06-15

    To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening. One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT). Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93-0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = -0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136). Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations. (orig.)

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

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

    2013-10-01

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

  5. Diagnostic accuracy of 128-slice dual-source CT coronary angiography: a randomized comparison of different acquisition protocols

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    Neefjes, Lisan A.; Kate, Gert-Jan R. ten [Erasmus Medical Center, Department of Cardiology, Room Hs 207, P.O. Box 2040, Rotterdam (Netherlands); Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Interuniversity Cardiology Institute of the Netherlands, Utrecht (Netherlands); Rossi, Alexia; Nieman, Koen; Papadopoulou, Stella L.; Dharampal, Anoeshka S.; Dedic, Admir; Feyter, Pim J. de; Mollet, Nico R. [Erasmus Medical Center, Department of Cardiology, Room Hs 207, P.O. Box 2040, Rotterdam (Netherlands); Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Genders, Tessa S.S.; Hunink, M.G.M. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, Rotterdam (Netherlands); Schultz, Carl J. [Erasmus Medical Center, Department of Cardiology, Room Hs 207, P.O. Box 2040, Rotterdam (Netherlands); Weustink, Annick C.; Dijkshoorn, Marcel L.; Straten, Marcel van; Cademartiri, Filippo; Krestin, Gabriel P. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands)

    2013-03-15

    To compare the diagnostic performance and radiation exposure of 128-slice dual-source CT coronary angiography (CTCA) protocols to detect coronary stenosis with more than 50 % lumen obstruction. We prospectively included 459 symptomatic patients referred for CTCA. Patients were randomized between high-pitch spiral vs. narrow-window sequential CTCA protocols (heart rate below 65 bpm, group A), or between wide-window sequential vs. retrospective spiral protocols (heart rate above 65 bpm, group B). Diagnostic performance of CTCA was compared with quantitative coronary angiography in 267 patients. In group A (231 patients, 146 men, mean heart rate 58 {+-} 7 bpm), high-pitch spiral CTCA yielded a lower per-segment sensitivity compared to sequential CTCA (89 % vs. 97 %, P = 0.01). Specificity, PPV and NPV were comparable (95 %, 62 %, 99 % vs. 96 %, 73 %, 100 %, P > 0.05) but radiation dose was lower (1.16 {+-} 0.60 vs. 3.82 {+-} 1.65 mSv, P < 0.001). In group B (228 patients, 132 men, mean heart rate 75 {+-} 11 bpm), per-segment sensitivity, specificity, PPV and NPV were comparable (94 %, 95 %, 67 %, 99 % vs. 92 %, 95 %, 66 %, 99 %, P > 0.05). Radiation dose of sequential CTCA was lower compared to retrospective CTCA (6.12 {+-} 2.58 vs. 8.13 {+-} 4.52 mSv, P < 0.001). Diagnostic performance was comparable in both groups. Sequential CTCA should be used in patients with regular heart rates using 128-slice dual-source CT, providing optimal diagnostic accuracy with as low as reasonably achievable (ALARA) radiation dose. circle 128-slice dual-source CT coronary angiography offers several different acquisition protocols. (orig.)

  6. 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

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    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

  7. High-pitch dual-source CT coronary angiography with low volumes of contrast medium

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    Lembcke, Alexander; Hein, Patrick A.; Knobloch, Gesine; Durmus, Tahir; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); Schwenke, Carsten [SCO:SSiS - Schwenke Consulting, Berlin (Germany); Huppertz, Alexander [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); ISI - Imaging Science Institute Charite, Berlin (Germany)

    2014-01-15

    To assess the effect of lower volumes of contrast medium (CM) on image quality in high-pitch dual-source computed tomography coronary angiography (CTCA). One-hundred consecutive patients (body weight 65-85 kg, stable heart rate ≤65 bpm, cardiac index ≥2.5 L/min/m{sup 2}) referred for CTCA were prospectively enrolled. Patients were randomly assigned to one of five groups of different CM volumes (G{sub 30}, 30 mL; G{sub 40}, 40 mL; G{sub 50}, 50 mL; G{sub 60}, 60 mL; G{sub 70}, 70 mL; flow rate 5 mL/s each, iodine content 370 mg/mL). Attenuation within the proximal and distal coronary artery segments was analysed. Mean attenuation for men and women ranged from 345.0 and 399.1 HU in G{sub 30} to 478.2 and 571.8 HU in G{sub 70}. Mean attenuation values were higher in groups with higher CM volumes (P < 0.0001) and higher in women than in men (P < 0.0001). The proportions of segments with attenuation of at least 300 HU in G{sub 30}, G{sub 40}, G{sub 50}, G{sub 60} and G{sub 70} were 89 %, 95 %, 98 %, 98 % and 99 %. CM volume of 30 mL in women and 40 mL in men proved to be sufficient to guarantee attenuation of at least 300 HU. In selected patients high-pitch dual-source CTCA can be performed with CM volumes of 40 mL in men or 30 mL in women. (orig.)

  8. Diagnostic accuracy of dual-source CT coronary angiography with prospective ECG-triggering on different heart rate patients

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    Sun, Ming-li; Lu, Bin; Han, Lei; Liu, Gang; Yu, Fang-Fang; Hou, Zhi-hui; Gao, Yang; Wang, Hong-yu; Jiang, Shiliang [Peking Union Medical College, Department of Radiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing (China); Wu, Run-ze; Johnson, Laura [CT Research Collaboration, Siemens Healthcare, Shang Hai (China); Yang, Yue-jin; Qiao, Shu-bin [Chinese Academy of Medical Sciences, Peking Union Medical College, Department of Cardiology, Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, Beijing (China)

    2011-08-15

    To evaluate the diagnostic accuracy of dual-source CT (DSCT) prospective ECG-triggering coronary angiography in patients with different heart rate (HR). 103 patients with suspected coronary artery disease underwent DSCT prospective ECG-triggered coronary angiography and invasive coronary angiography (ICA). The patients were grouped by HR during CT scans: low HR ({<=}60 bpm, n = 34); medium HR (60 < HR {<=} 70 bpm, n = 36) and high HR (>70 bpm, n = 33). The sensitivity and specificity of DSCT in detecting {>=}50% stenosis were compared among subgroups where ICA was the gold standard. Image quality was scored using a 4-point scale. A total of 1,580 (95.9%) coronary artery segments were evaluable. Sensitivity and specificity were 82.8% and 98.4%, 88.3% and 98.7%, and 80.3% and 98.6% for different subgroups (all p > 0.05). The overall area under the curve of the receiver-operating characteristic analysis was 0.94. The image quality scores were 3.1 {+-} 0.3, 3.1 {+-} 0.3 and 3.0 {+-} 0.4 for subgroups (p > 0.05). The overall average effective radiation dose was 3.60 {+-} 1.60 mSv. DSCT coronary angiography with prospective ECG-triggering could be just as accurate in patients with medium to high HR compared to those with low HR. (orig.)

  9. Systolic prospectively ECG-triggered dual-source CT angiography for evaluation of the coronary arteries in heart transplant recipients

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    Bastarrika, Gorka [Clinica Universidad de Navarra, Cardiac Imaging Unit, Pamplona (Spain); Clinica Universidad de Navarra, Department of Radiology, Pamplona (Spain); Broncano, Jordi; Arraiza, Maria; Simon-Yarza, Isabel; Pueyo, Jesus C.; Zubieta, Jose L. [Clinica Universidad de Navarra, Department of Radiology, Pamplona (Spain); Azcarate, Pedro M. [Clinica Universidad de Navarra, Cardiac Imaging Unit, Pamplona (Spain); Clinica Universidad de Navarra, Department of Cardiology, Pamplona (Spain); Levy Praschker, Beltran G.; Rabago, Gregorio [Clinica Universidad de Navarra, Department of Cardiovascular Surgery, Pamplona (Spain)

    2011-09-15

    To assess feasibility, image quality, and radiation dose of prospectively ECG-triggered coronary CT angiography (CTA) in orthotopic heart transplant (OHT) recipients. 47 consecutive OHT recipients (40 men, mean age 62.1{+-}10.9 years, mean heart rate 86.3{+-}14.4 bpm) underwent dual-source CTA to rule out coronary allograft vasculopathy in a prospectively ECG-triggered mode with data acquisition during 35% to 45% of the cardiac cycle. Two independent observers blindly assessed image quality on a per-segment and per-vessel basis using a four-point scale (1-excellent, 4-not evaluable). Scores 1-3 were considered acceptable for diagnosis. Multivariate analysis was performed to evaluate differences between image quality scores obtained at different reconstruction intervals. Effective radiation doses were calculated. 671 coronary segments were evaluated. Interobserver agreement on the image quality was {kappa}=0.75. Diagnostic image quality was observed in 93.9%, 95.5% and 93.3% of the segments at 35%, 40% and 45% reconstruction intervals. Mean image quality score was 1.5{+-}0.7 for the entire coronary tree, 1.4{+-}0.7 for the RCA, 1.6{+-}0.8 for the LCA and 1.6{+-}0.7 for the Cx at the best reconstruction interval. Estimated mean radiation dose was 4.5{+-}1.2 mSv. Systolic prospectively ECG-triggered CTA allows diagnostic image quality coronary angiograms in OHT recipients at low radiation doses. (orig.)

  10. Automatic selection of an optimal systolic and diastolic reconstruction windows for dual-source CT coronary angiography

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    Seifarth, H.; Puesken, M.; Wienbeck, S.; Maintz, D.; Heindel, W.; Juergens, K.-U.

    2008-03-01

    Purpose: To assess the performance of a motion map algorithm to automatically determine the optimal systolic and diastolic reconstruction window for coronary CT Angiography using Dual Source CT. Materials and Methods: Dual Source coronary CT angiography data sets (Somatom Definition, Siemens Medical Solutions) from 50 consecutive patients were included in the analysis. Optimal systolic and diastolic reconstruction windows were determined using a motion map algorithm (BestPhase, Siemens Medical Solutions). Additionally data sets were reconstructed in 5% steps throughout the RR-interval. For each major vessel (RCA, LAD and LCX) an optimal systolic and diastolic reconstruction window was manually determined by two independent readers using volume rendering displays. Image quality was rated using a five-point scale (1 = no motion artifacts, 5 = severe motion artifacts over entire length of the vessel). Results: The mean heart rate during the scan was 72.4bpm (+/-15.8bpm). Median systolic and diastolic reconstruction windows using the BestPhase algorithm were at 37% and 73% RR. The median manually selected systolic reconstruction window was 35 %, 30% and 35% for RCA, LAD, and LCX. For all vessels the median observer selected diastolic reconstruction window was 75%. Mean image quality using the BestPhase algorithm was 2.4 +/-0.9 for systolic reconstructions and 1.9 +/-1.1 for diastolic reconstructions. Using the manual approach, the mean image quality was 1.9 +/-0.5 and 1.7 +/-0.8 respectively. There was a significant difference in image quality between automatically and manually determined systolic reconstructions (p<0.01) but there was no significant difference in image quality in diastolic reconstructions. Conclusion: Automatic determination of the optimal reconstruction interval using the BestPhase algorithm is feasible and yields reconstruction windows similar to observer selected reconstruction windows. In diastolic reconstructions overall image quality is similar

  11. Dual-source CT coronary angiography in patients with atrial fibrillation: Comparison with single-source CT

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    Wang Yining [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing (China)], E-mail: yiningpumc@hotmail.com; Zhang Zhuhua [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing (China)], E-mail: yiningpumc@sina.com; Kong Lingyan [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing (China)], E-mail: klyan78@hotmail.com; Song Lan [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing (China)], E-mail: sallysonglan@sina.com; Merges, Reto D. [CT Research Collaboration, Siemens Ltd. (China)], E-mail: reto.merges@siemens.com; Chen Jiuhong [CT Research Collaboration, Siemens Ltd. (China)], E-mail: jiuhong.chen@siemens.com; Jin Zhengyu [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing (China)], E-mail: jin_zhengyu@sina.com

    2008-12-15

    Objective: To evaluate the performance of dual-source computed tomography (DSCT) for the visualization of the coronary arteries in a population with atrial fibrillation (AF) compared to single-source CT (SSCT) and to explore the impact of patients' heart rate (HR) on image quality (IQ) and reconstruction timing. Methods: Thirty consecutive patients (11 male, 19 female; 69.0 {+-} 9.2 years old) with suspected coronary artery disease and permanent AF were examined on a DSCT scanner (120 kV, 400 mAs/rot, 0.33 s rotation time, 64 x 0.6 mm collimation, pitch 0.20-0.28, Siemens Somatom Definition). Patients were divided into two groups: low and medium HR group (HR {<=} 80 bpm, n = 14) and high HR group (HR > 80 bpm, n = 16). Five of the patients also underwent conventional coronary angiography (CAG). The raw data from both tube detector arrays were reconstructed as DSCT data using a routine algorithm (temporal resolution of 83 ms). The raw data from one tube detector array was reconstructed separately on the same system using a routine single source algorithm (temporal resolution of 83-165 ms) and defined as virtual SSCT data. Image quality was assessed using a four-point grading scale from excellent (1) to non-assessable (4). Results: IQ of the DSCT data was significantly better than that of the virtual SSCT data (mean score 1.33 {+-} 0.61 vs. 1.80 {+-} 1.02; Z = -8.755, P = 0.000). 98.6% of the segments shown in DSCT were diagnostic, compared with 89.9% of the segments in virtual SSCT, {chi}{sup 2} = 32.595, P = 0.000. In DSCT group, IQ of low HR group was also better than that of high HR group, although the difference was not as big (mean score 1.25 {+-} 0.52 vs. 1.38 {+-} 0.66; Z = -2.227, P = 0.026). The mean HR of low HR group and high HR group were 67.4 {+-} 8.5 beats per minute (bpm) and 94.2 {+-} 8.8 bpm (t = -8.499, P = 0.000). The range of the variation of HR was higher in high HR group than in low HR group (mean difference between maximum and minimum HR

  12. Critical stenosis of a right ventricle to coronary artery fistula seen at dual-source CT in a newborn with pulmonary atresia and intact ventricular septum.

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    Séguéla, Pierre-Emmanuel; Houyel, Lucile; Loget, Philippe; Piot, Jean-Dominique; Paul, Jean-François

    2011-08-01

    We report the case of a newborn with pulmonary atresia with intact ventricular septum and right ventricle-dependent coronary circulation. He died several weeks after a Blalock-Taussig procedure because of a progressive stenosis of the main coronary artery. We present echocardiographic and dual-source CT images of the stenosis, with autopsy correlation. To our knowledge, CT images of this quality have never been reported in a newborn. This case illustrates the extreme difficulty in prognosticating the outcome for these patients and underlines the need for a detailed neonatal coronary mapping to assess right ventricle-dependent coronary circulation.

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

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

    2009-01-01

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

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

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

    2009-01-15

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

  15. Evaluation of high-pitch dual-source CT angiography for evaluation of coronary and carotid-cerebrovascular arteries

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    Sun, Kai [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Li, Kuncheng, E-mail: cjr.likuncheng@vip.163.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Han, Ruijuan [Department of Cardiology, Chaoyang Hospital, Capital Medical University, Beijing 100020 (China); Li, Wenhuan; Chen, Nan; Yang, Qi; Du, Xiangying; Wang, Chen [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Liu, Guorong; Li, Yuechun [Department of Neurology Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Zhou, Maorong [Department of Radiology, Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Li, Ligang; Heidrun, Endt [CT BM Clinic Marketing, Siemens Healthcare, Beijing 100102 (China)

    2015-03-15

    Objectives: To explore the feasibility and diagnostic accuracy of a combined one-step high-pitch dual-source computed tomography angiography (CTA) technique for evaluation of coronary and carotid-cerebrovascular arteries. Materials and methods: 85 symptomatic patients suspected of coronary artery and cerebrovascular disease referred for simultaneous coronary and carotid-cerebrovascular CTA were included. Additional invasive angiography of the coronary and cerebral arteries was performed within 30 days in 23 and 13 patients, respectively. The objective parameters of image quality, the mean CT attenuations, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. The subjective image quality of vessels was also assessed by 2 independent radiologists blinded to the patients’ medical history and scan protocols. The diagnostic performance of CTA including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection or exclusion of significant artery stenosis was calculated using the chi-squared test of contingency and correlated with the results of invasive angiography representing the standard of reference. Results: Image quality was rated excellent (score 1) in 95.3% (1074/1127), good (score 2) in 3.3% (37/1127), adequate (score 3) in 1.0% (11/1127), and non-diagnostic (score 4) in 0.4% (5/1127) of coronary segments. Image quality of carotid and cerebral vessels was rated mostly excellent (score 1, 95.12% [78/82]; score 2, 3.66% [3/82]; score 3, 1.22% [1/82]). The sensitivity, specificity, PPV and NPV for the detection of coronary stenosis were 92.2% (81.1–97.7%), 95.2% (91.7–97.5%), 79.6% (67.1–89.1%) and 98.3% (95.8–99.5%), respectively. For the detection of carotid and cerebral artery stenosis, CTA demonstrated a sensitivity of 92.8% (80.5–98.4%), a specificity of 93.5% (88.3–96.8%), a PPV of 79.6% (65.6–89.7%) and a NPV of 97.9% (94.1–99.5%). The effective

  16. Accuracy of dual-source CT to identify significant coronary artery disease in patients with uncontrolled hypertension presenting with chest pain: comparison with coronary angiography.

    Science.gov (United States)

    Marwan, Mohamed; Pflederer, Tobias; Schepis, Tiziano; Seltmann, Martin; Klinghammer, Lutz; Muschiol, Gerd; Ropers, Dieter; Daniel, Werner G; Achenbach, Stephan

    2012-06-01

    It has been previously reported that the sensitivity and specificity of multislice CT for detecting significant CAD (coronary artery disease) is high. Chest pain is a common presentation in patients with uncontrolled hypertension. We investigated the sensitivity and specificity of dual-source CT to detect and rule out significant CAD in patients presenting with uncontrolled hypertension accompanied by chest pain. 260 consecutive patients presenting with acute chest pain in the context of stage 2 hypertension (systolic pressure ≥160 and/or diastolic pressure ≥100) were enrolled in the study. After admission, control of blood pressure and risk stratification, 82 patients were excluded due to renal insufficiency, prior coronary revascularisation or refused participation in the study. 90 further patients with low pre-test probability of CAD were also excluded. 88 remaining patients were subjected to CT coronary angiography using dual-source CT (Definition, Siemens Medical Solutions, Forchheim, Germany) within 24 h before invasive coronary angiography. A contrast-enhanced volume dataset was acquired (120 kV, 400 mAs/rot, collimation 2 × 64 × 0.6 mm, retrospective ECG gating). Data sets were evaluated concerning the presence or absence of significant coronary stenoses and validated against invasive coronary angiography. A significant stenosis was assumed if the diameter reduction was ≥50%. 88 patients (mean age 66 ± 11 years, mean heart rate 61 ± 9 bpm) were evaluated regarding the presence or absence of significant CAD (at least one stenosis ≥50% diameter reduction). Mean systolic blood pressure on presentation was 203 ± 20 mmHg and mean diastolic blood pressure was 103 ± 13 mmHg. On a per patient basis, the sensitivity and specificity for dual-source CT to detect significant CAD in vessels >1.5 mm diameter was 100% (36/36, 95% CI 90-100) and 90% (47/52, 95% CI 79-97), respectively with a negative predictive value (NPV) of 100% (47/47, 95% CI 92-100) and a

  17. Congenital coronary artery fistulas: dual-source CT findings from consecutive 6624 patients with suspected or confirmed coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    YUN Hong; ZENG Meng-su; YANG Shan; JIN Hang; YANG Xue

    2011-01-01

    Background Coronary artery fistulas (CAFs) are rare congenital abnormality often unintentionally found in patients with coronary artery disease.Clinical diagnosis of CAFs is difficult due to symptomless or lack of specific symptoms.Dual-source computed tomography (DSCT) might be a useful diagnostic tool for CAFs.The study aimed to retrospectively summarize the imaging features of CAFs delineated at DSCT in 48 CAF patients detected from consecutive 6624 patients with suspected or confirmed coronary artery disease in our institution.Methods Forty-eight patients underwent DSCT angiography by using retrospective electrocardiographic (ECG) gating after infusion of 70 ml of intravenous contrast material during breath hold.Maximum intensity projection (MIP),curved planar reconstruction (CPR),and volume rendering technique (VR) were obtained.Anomalous termination of coronary artery in each subject was evaluated by two radiologists (with more than 10 years experience with cardiovascular imaging),and disagreement between diagnosis readers was settled by a consensus reading.Ten of 48 patients also underwent traditional coronary angiography (CAG) simultaneously.Results In each CAF case,DSCT angiography clearly demonstrated the origin,the termination,the size of abnormal vessel and its course in relation to surrounding great vessels.CAF arising from right coronary artery was the most common type,left circumflex was the least one involved among three coronaries,and pulmonary artery was the most common drainage site.Aneurismal fistulous tract,coronary atherosclerosis,myocardial bridging and anomalous origin of coronary artery were also detected in this group.The demonstration of drainage sites in CAG was consistent with DSCT angiography in 9 patients,and judgment on one anomalous connection in CAG was inconsistent with that in DSCT angiography.Conclusions DSCT angiography could provide accurate delineation of anomalous communications,size and numbers of fistulas in patients with

  18. Attenuation-based characterization of coronary atherosclerotic plaque: Comparison of dual source and dual energy CT with single-source CT and histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Henzler, Thomas, E-mail: Thomas.Henzler@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Porubsky, Stefan [Department of Pathology, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Kayed, Hany [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Harder, Nils [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Department of Pathology, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Krissak, U. Radko; Meyer, Mathias [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Sueselbeck, Tim [1st Department of Medicine University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Marx, Alexander [Department of Pathology, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Michaely, Henrik [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Schoepf, U. Joseph [Department of Radiology and Radiological Science, Medical University of South Carolina, 169 Ashley Avenue, Charleston (United States)

    2011-10-15

    Objective: To compare different CT acquisition techniques regarding for attenuation-based characterization of coronary atherosclerotic plaques using histopathology as the standard of reference. Materials and methods: In a post mortem study 17 human hearts were studied with dual-source CT (DSCT) and dual energy CT (DECT) mode on a DSCT as well as with 16-slice single-source CT (SSCT). At autopsy, atherosclerotic lesions were cut at 5 {mu}m sections. Histopathologic classification of the plaques according to the American Heart Association (AHA) criteria was performed by two pathologists. Attenuation values of all plaques were measured in DSCT, DECT and SSCT studies, respectively and classified based on attenuation according to modified AHA criteria. Results: 58 coronary plaques were identified at autopsy. Regardless of the CT technique only 52/58 plaques were found at CT (sensitivity = 89.6%). There was no significant difference between the mean attenuation values of different plaque types between DSCT, DECT, and SSCT: type IV: 11 HU/8 HU/19 HU; type Va: 44 HU/45 HU/52 HU; type Vb: 1088 HU/966 HU/1079 HU). The sensitivity for correct classification varied depending on the plaque type (type II = 0%, type III = 0%, type IV = 43%, type Va = 58%, Vb = 97%). Conclusion: Independent of the used acquisition technique, SSCT, DSCT and DECT show similar results for attenuation-based characterization of atherosclerotic coronary plaques.

  19. Electrocardiographically triggered CT angiography of the whole aorta and coronary arteries with high-pitch dual-source CT

    Institute of Scientific and Technical Information of China (English)

    张楠

    2013-01-01

    Objective To investigate the feasibility of comprehensive assessment of the whole aorta and coronary arteries(CA)simultaneously with high-pitch128-slice dualsource CT ECG-gated FLASH protocol.Methods A totalof 48 consecutive patients with suspected aortic diseases

  20. Systolic reconstruction in patients with low heart rate using coronary dual-source CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Munemasa, E-mail: radokada@yamaguchi-u.ac.jp [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Nakashima, Yoshiteru; Shigemoto, Youko; Matsunaga, Naofumi [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Miura, Toshiro; Nao, Tomoko [Department of Cardiology, Yamaguchi University Graduate School of Medicine (Japan); Sano, Yuichi; Narazaki, Akiko [Department of Radiology, Yamaguchi University Hospital (Japan); Kido, Shoji [Computer-aided Diagnosis and Biomedical Imaging Research Biomedical Engineering, Applied Medical Engineering Science Graduate School of Medicine, Yamaguchi University (Japan)

    2011-11-15

    Objectives: The purpose of our study was to determine the relationship between the predictive factors and systolic reconstruction (SR) as an optimal reconstruction window in patients with low heart rate (LHR; less than 65 bpm). Methods: 391 patients (262 male and 129 female, mean age; 67.1 {+-} 10.1 years of age) underwent coronary CTA without the additional administration of a beta-blocker. Affecting factors for SR were analyzed in age, gender, body weight (BW), diabetes mellitus (DM), coronary arterial disease (CAD), ejection fraction (EF), systolic and diastolic body pressure (BP) and heart rate variability (HRV) during coronary CTA. Results: In 29 (7.4%) of the 391 patients, SR was needed, but there was no apparent characteristic difference between the systolic and diastolic reconstruction groups in terms of gender, age, BW, DM, CAD and EF. In a multivariate analysis, the co-existence of DM [P < 0.05; OR, 0.27; 95% CI, 0.092-0.80], diastolic BP [P < 0.01; OR, 0.95; 95% CI, 0.92-0.98] and HRV [P < 0.01; OR, 0.98; 95% CI, 0.96-0.99] were found to be the factors for SR. In gender-related analysis, HRV was an important factor regardless of sex, but co-existence of DM affected especially for female and BP for male. Conclusion: Especially in the patients with LHR who had a medication of DM, high HRV or high BP, SR, in addition to DR, was needed to obtain high-quality coronary CTA images.

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

    Science.gov (United States)

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

    2016-10-01

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

  2. Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Lei; Yang, Lin; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); Wang, Yining; Jin, Zhengyu [Chinese Academy of Medical Sciences, Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Zhang, Longjiang; Lu, Guangming [Nanjing University, Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing, Jiangsu (China)

    2013-07-15

    To investigate the feasibility of applying prospectively ECG-triggered sequential coronary CT angiography (CCTA) to patients with atrial fibrillation (AF) and evaluate the image quality and radiation dose compared with a retrospectively ECG-gated helical protocol. 100 patients with persistent AF were enrolled. Fifty patients were randomly assigned to a prospective protocol and the other patients to a retrospective protocol using a second-generation dual-source CT (DS-CT). Image quality was evaluated using a four-point grading scale (1 = excellent, 2 = good, 3 = moderate, 4 = poor) by two reviewers on a per-segment basis. The coronary artery segments were considered non-diagnostic with a quality score of 4. The radiation dose was evaluated. Diagnostic segment rate in the prospective group was 99.4 % (642/646 segments), while that in the retrospective group was 96.5 % (604/626 segments) (P < 0.001). Effective dose was 4.29 {+-} 1.86 and 11.95 {+-} 5.34 mSv for each of the two protocols (P < 0.001), which was a 64 % reduction in the radiation dose for prospective sequential imaging compared with retrospective helical imaging. In AF patients, prospectively ECG-triggered sequential CCTA is feasible using second-generation DS-CT and can decrease >60 % radiation exposure compared with retrospectively ECG-gated helical imaging while improving diagnostic image quality. (orig.)

  3. High-pitch coronary CT angiography in dual-source CT during free breathing vs. breath holding in patients with low heart rates

    Energy Technology Data Exchange (ETDEWEB)

    Bischoff, Bernhard, E-mail: bernhard.bischoff@med.uni-muenchen.de [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Meinel, Felix G. [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Del Prete, Alessandra [Department of Radiology Magrassi-Lanzara, Second University of Naples, Naples (Italy); Reiser, Maximilian F.; Becker, Hans-Christoph [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany)

    2013-12-01

    Background: Coronary CT angiography (CCTA) is usually performed during breath holding to reduce motion artifacts caused by respiration. However, some patients are not able to follow the breathing commands adequately due to deafness, hearing impairment, agitation or pulmonary diseases. The aim of this study was to evaluate the potential of high-pitch CCTA in free breathing patients when compared to breath holding patients. Methods: In this study we evaluated 40 patients (20 free breathing and 20 breath holding patients) with a heart rate of 60 bpm or below referred for CCTA who were examined on a 2nd generation dual-source CT system. Image quality of each coronary artery segment was rated using a 4-point grading scale (1: non diagnostic–4: excellent). Results: Mean heart rate during image acquisition was 52 ±5 bpm in both groups. There was no significant difference in mean image quality, slightly favoring image acquisition during breath holding (mean image quality score 3.76 ± 0.32 in breath holding patients vs. 3.61 ± 0.45 in free breathing patients; p = 0.411). Due to a smaller amount of injected contrast medium, there was a trend for signal intensity to be slightly lower in free breathing patients, but this was not statistically significant (435 ± 123 HU vs. 473 ± 117 HU; p = 0.648). Conclusion: In patients with a low heart rate who are not able to hold their breath adequately, CCTA can also be acquired during free breathing without substantial loss of image quality when using a high pitch scan mode in 2nd generation dual-source CT.

  4. Diagnostic accuracy of dual-source CT coronary angiography: The effect of average heart rate, heart rate variability, and calcium score in a clinical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Long-Jiang Zhang; Zhuo-Li Zhang; Chang-Sheng Zhou; Guang-Ming Lu (Dept. of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing Univ., Nanjing (China)), e-mail: cjr.luguangming@vip.163.com; Sheng-Yong Wu (Medical Imaging Inst. of Tianjin, Tianjin (China)); Jing Wang; Shi-Sen Jiang (Dept. of Cardiology, Jinling Hospital, Clinical School of Medical College, Nanjing Univ., Nanjing (China)); Ying Lu (Dept. of Radiology and Biomedical Imaging, Univ. of California, San Francisco, CA (United States))

    2010-09-15

    Background: Dual-source CT coronary angiography (CTCA) has been used to detect coronary artery disease; however, the factors with potential to affect its diagnostic accuracy remain to be defined. Purpose: To prospectively evaluate the accuracy of dual-source CTCA in diagnosing coronary artery stenosis according to conventional coronary angiography (CAG), and the effect of average heart rate, heart rate variability, and calcium score on the accuracy of CTCA. Material and Methods: A total of 113 patients underwent both dual-source CTCA and CAG. The results were used to evaluate the findings in dual-source CTCA to assess the accuracy in the diagnosis of =50% (significant stenosis) and >75% (severe stenosis) of coronary artery according to those by CAG. Patients were divided into subgroups according to their heart rate (HR), HR variability (HRV), and calcium score, and the accuracy of CTCA was further evaluated. The chi-square test was used to analyze the difference in sensitivity and specificity for the detection of =50% and >75% coronary stenosis among subgroups. The generalized estimation equation method was used in per-vessel analysis to adjust for within-patient correlation. Results: In all, 113 patients had 338 vessels and 1661 segments evaluated by CAG. Dual-source CTCA displayed 1527 segments (91.9%). Among them, 1468 segments (calcium score by CAG score 1, n=1018; score 2, n=270; score 3, n=180) were assessable in CTCA. On a per-patient analysis, the sensitivity and specificity of CTCA were 93.9% and 93.5% for significant stenosis and 86.9% and 98.1% for severe stenosis. On a per-vessel basis, the sensitivity and specificity were 90.2% and 97.1% for significant and 83.3% and 98.1% for severe stenosis. On a per-segment analysis, the sensitivity and specificity were 90.2% and 97.1% for significant and 83.3% and 98.1% for severe stenosis. Average HR had no effect on the sensitivity and specificity of CTCA (P>0.05); whereas HRV and calcium score had some effect on

  5. Screening for coronary artery disease in respiratory patients: comparison of single- and dual-source CT in patients with a heart rate above 70 bpm.

    Science.gov (United States)

    Pansini, Vittorio; Remy-Jardin, Martine; Tacelli, Nunzia; Faivre, Jean-Baptiste; Flohr, Thomas; Deken, Valérie; Duhamel, Alain; Remy, Jacques

    2008-10-01

    To evaluate the assessibility of coronary arteries in respiratory patients with high heart rates. This study was based on the comparative analysis of two paired populations of 54 patients with a heart rate >70 bpm evaluated with dual-source (group 1) and single-source (group 2) CT. The mean heart rate was 89.1 bpm in group 1 and 86.7 bpm in group 2 (P=0.26). The mean number of assessable segments per patient was significantly higher in group 1 compared to group 2 (P bpm, 35.6% for heart rates bpm, 40% for heart rates bpm, and 60% for heart rates bpm in group 1 and 11.3, 12.2, 8.8, and 10% for the corresponding thresholds in group 2 (P<0.05). In both groups of patients, coronary artery imaging was obtained from standard CT angiograms of the chest. The improvement in coronary imaging with dual-source CT suggests that high heart rates should no longer be considered as contraindications for ECG-gated CT angiograms of the chest whenever clinically relevant.

  6. Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Lell, Michael; Anders, Katharina [University of Erlangen, Diagnostic Radiology, Erlangen (Germany); Marwan, Mohamed; Schepis, Tiziano; Pflederer, Tobias; Kuettner, Axel; Ropers, Dieter; Daniel, Werner G.; Achenbach, Stephan [University of Erlangen, Department of Cardiology, Erlangen (Germany); Flohr, Thomas [CT Division, Siemens Healthcare, Forchheim (Germany); Eberhard-Karls-University, Institute of Diagnostic Radiology, Tuebingen (Germany); Allmendinger, Thomas; Thierfelder, Carsten [CT Division, Siemens Healthcare, Forchheim (Germany); Kalender, Willi; Ertel, Dirk [University of Erlangen, Institute of Medical Physics, Erlangen (Germany)

    2009-11-15

    We evaluated radiation exposure and image quality of a new coronary CT angiography protocol, high-pitch spiral acquisition, using dual source CT (DSCT). Coronary CTA was performed in 25 consecutive patients with a stable heart rate of 60 bpm or less after premedication, using 2 x 128 0.6-mm sections, 38.4-mm collimation width and 0.28-s rotation time. Tube settings were 100 kV/320 mAs and 120 kV/400 mAs for patients below and above 100-kg weight, respectively. Data acquisition was prospectively ECG-triggered at 60% of the R-R interval using a pitch of 3.2 (3.4 for the last 10 patients). Images were reconstructed with 75-ms temporal resolution, 0.6-mm slice thickness and 0.3-mm increment. Image quality was evaluated using a four-point scale (1 = excellent, 4 = unevaluable). Mean range of data acquisition was 113 {+-} 22 mm, mean duration was 268 {+-} 23 ms. Of 363 coronary artery segments, 327 had an image quality score of 1, and only 2 segments were rated as ''unevaluable''. Mean dose-length product (DLP) was 71 {+-} 23 mGy cm, mean effective dose was 1.0 {+-} 0.3 mSv (range 0.78-2.1 mSv). For 21 patients with a body weight below 100 kg, mean DLP was 63 {+-} 5 mGy cm (0.88 {+-} 0.07 mSv; range 0.78-0.97 mSv). Prospectively ECG-triggered high-pitch spiral CT acquisition provides high and stable image quality at very low radiation dose. (orig.)

  7. Automated tube voltage selection for radiation dose and contrast medium reduction at coronary CT angiography using 3{sup rd} generation dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Mangold, Stefanie [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Wichmann, Julian L. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Poole, Zachary B.; Varga-Szemes, Akos; De Cecco, Carlo N. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Canstein, Christian [Siemens Medical Solutions, Malvern, PA (United States); Caruso, Damiano [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' , Department of Radiological Sciences, Oncology and Pathology, Rome (Italy); Bamberg, Fabian; Nikolaou, Konstantin [Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2016-10-15

    To investigate the relationship between automated tube voltage selection (ATVS) and body mass index (BMI) and its effect on image quality and radiation dose of coronary CT angiography (CCTA). We evaluated 272 patients who underwent CCTA with 3{sup rd} generation dual-source CT (DSCT). Prospectively ECG-triggered spiral acquisition was performed with automated tube current selection and advanced iterative reconstruction. Tube voltages were selected by ATVS (70-120 kV). BMI, effective dose (ED), and vascular attenuation in the coronary arteries were recorded. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Five-point scales were used for subjective image quality analysis. Image quality was rated good to excellent in 98.9 % of examinations without significant differences for proximal and distal attenuation (all p ≥.0516), whereas image noise was rated significantly higher at 70 kV compared to ≥100 kV (all p <.0266). However, no significant differences were observed in SNR or CNR at 70-120 kV (all p ≥.0829). Mean ED at 70-120 kV was 1.5 ± 1.2 mSv, 2.4 ± 1.5 mSv, 3.6 ± 2.7 mSv, 5.9 ± 4.0 mSv, 7.9 ± 4.2 mSv, and 10.7 ± 4.1 mSv, respectively (all p ≤.0414). Correlation analysis showed a moderate association between tube voltage and BMI (r =.639). ATVS allows individual tube voltage adaptation for CCTA performed with 3{sup rd} generation DSCT, resulting in significantly decreased radiation exposure while maintaining image quality. (orig.)

  8. The influence of body mass index and gender on coronary arterial attenuation with fixed iodine load per body weight at dual-source CT coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xiaomei; Zhu, Yinsu; Xu, Hai; Tang, Lijun; Xu, Yi [Dept. of Radiology, the First Affiliated Hospital of Nanjing Medical Univ., Nanjing, Jiangsu (China)], E-mail: lijun.tang@hotmail.com

    2012-07-15

    Background. Most of current coronary CT angiography protocols are not adapted to body weight (BW) or cardiac output and no literature about influence of gender on coronary attenuation are reported with administration of a fixed iodine load per BW. Purpose. To determine the influence of body mass index (BMI) and gender on coronary arterial attenuation if contrast material dose is linearly adjusted to a patient's BW at dual-source CT coronary angiography (DSCT-CA). Material and Methods. A total of 207 consecutive patients (mean age 60.6 years) undergoing DSCT-CA were included. Contrast material (370 mg I/mL) dose calculation was randomly categorized into two groups (Group1: 1.10 mL/kg for men and women; Group 2: men 1.10 mL/kg, women 0.99 mL/kg) and flow rate was calculated as dose was divided by scan time plus 8 s. Mean arterial attenuations between men and women were compared with respect to attenuations of ascending aorta (AA) above coronary ostia, left main coronary artery (LM), proximal segments of right coronary artery (RCA), left anterior descending (LAD), and left circumflex artery (LCX) in two groups, respectively. Attenuations of coronary arteries were correlated with BW and BMI with simple linear regression. Results. The mean attenuations of AA, LM, RCA, LAD, and LCX were 407.8 {+-} 53.6 HU, 412.6 {+-} 55.4 HU, 411.4 {+-} 64.3 HU, 399.1 {+-} 56.7 HU, and 399.1 {+-} 60.2 HU, respectively, and there were no significant differences between men and women in group 1 (AA, P = 0.571; LM, P = 0.670; RCA, P = 0.737; LAD, P = 0.439, and LCX, P = 0.888). In group 2, the mean attenuations of AA, LM, RCA, LAD, and LCX in men were significantly higher than those in women (AA, P = 0.008; LM, P = 0.025; RCA, P = 0.017; LAD, P = 0.015, and LCX, P = 0.002). Positive linear regression between BW and attenuations of AA (R{sup 2} = 0.047, P = 0.02), LM (R{sup 2} = 0.036, P = 0.04), RCA (R{sup 2} = 0.080, P < 0.01), LAD (R{sup 2} = 0.078, P < 0.01), and LCX (R{sup 2} = 0

  9. Assessment of image quality of 64-row Dual Source versus Single Source CT coronary angiography on heart rate: A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Dikkers, R. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen (Netherlands)], E-mail: r.dikkers@rad.umcg.nl; Greuter, M.J.W. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen (Netherlands)], E-mail: m.j.w.greuter@rad.umcg.nl; Kristanto, W. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen (Netherlands)], E-mail: w.kristanto@rad.umcg.nl; Ooijen, P.M.A. van [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen (Netherlands)], E-mail: p.m.a.van.ooyen@rad.umcg.nl; Sijens, P.E. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen (Netherlands)], E-mail: p.e.sijens@rad.umcg.nl; Willems, T.P. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen (Netherlands)], E-mail: t.p.willems@rad.umcg.nl; Oudkerk, M. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen (Netherlands)], E-mail: m.oudkerk@rad.umcg.nl

    2009-04-15

    Purpose: To assess the influence of temporal resolution on image quality of computed tomographic (CT) coronary angiography by comparing 64-row Dual Source CT (DSCT) and Single Source CT (SSCT) at different heart rates. Methods: An anthropomorphic moving heart phantom was scanned at rest, and at 50 beats per minute (bpm) up to 110 bpm, with intervals of 10 bpm. 3D volume rendered images and curved multi-planar reconstructions (MPRs) were acquired and image quality of the coronary arteries was rated on a 5-points scale (1 = poor image quality with many artefacts, 5 = excellent image quality) for each heart rate and each scanner by 3 observers. Paired sample t-test and Wilcoxon Signed Ranks test were used to assess clinically relevant differences between both modalities. Results: The mean image quality scores at 70, 100 and 110 bpm were significantly higher for DSCT compared to SSCT. The overall mean image quality scores for DSCT (4.2 {+-} 0.6) and SSCT (3.0 {+-} 1.1) also differed significantly (p < 0.001). Conclusion: These initial results show a clinically relevant overall higher image quality for DSCT compared to SSCT, especially at heart rates of 70, 100 and 110 bpm. With its comparatively high image quality and low radiation dose, DSCT appears to be the method of choice in CT coronary angiography at heart rates above 70 bpm.

  10. Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note

    Energy Technology Data Exchange (ETDEWEB)

    Feuchtner, Gudrun [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Innsbruck Medical University, Department of Radiology II, Innsbruck (Austria); Goetti, Robert; Marincek, Borut; Alkadhi, Hatem; Leschka, Sebastian [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Plass, Andre; Wieser, Monika [University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland); Baumueller, Stephan; Stolzmann, Paul; Scheffel, Hans [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland)

    2010-09-15

    To describe prospective ECG-triggered dual-source CT dual-step pulsing (pECG{sub dual-step}) for evaluation of coronary arteries and cardiac function. Fifty-one consecutive patients pre- or post-cardiovascular surgery were examined with adaptive sequential tube current modulated (pECG{sub dual-step}) 128-slice dual-source CT without heart rate control (main padding window: 40% RR interval >65 bpm/70% RR interval <65 bpm). Image quality of coronary arteries was graded (4-point scale), and cardiac function was evaluated. Mean HR was 68 bpm. Thirty-seven patients were in stable sinus rhythm (SR); 14 had arrhythmia. Image quality of coronary arteries was diagnostic in 804/816 (98%) of segments. The number of non-diagnostic segments was higher in patients with arrhythmia as compared to those in SR (4% vs. 0.5%; p = 0.01), and there were fewer segments with excellent image quality (79% vs. 94%; p < 0.001) and more segments with impaired image quality (p < 0.001 and p = 0.002). Global and regional LV function could be evaluated in 41 (80%) and 47 (92%) patients, and valvular function in 48 (94%). In 11/14 of patients with arrhythmia, the second step switched to full mAs, increasing radiation exposure to 8.6 mAs (p < 0.001). The average radiation dose was 3.8 mSv (range, 1.7-7.9) in patients in SR. pECG{sub dual-step}128-slice DSCT is feasible for the evaluation of coronary arteries and cardiac function without heart rate control in patients in stable sinus rhythm at a low radiation dose. (orig.)

  11. Low-dose adaptive sequential scan for dual-source CT coronary angiography in patients with high heart rate: Comparison with retrospective ECG gating

    Energy Technology Data Exchange (ETDEWEB)

    Xu Lei, E-mail: leixu2001@hotmail.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Yang Lin, E-mail: anna7949@163.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Zhang Zhaoqi, E-mail: zhaoqi5000@vip.sohu.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Li Yu, E-mail: athen06@hotmail.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Fan Zhanming, E-mail: fanzm120@tom.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Ma Xiaohai, E-mail: maxi8238@gmail.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Lv Biao, E-mail: biao_lu2007@sina.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Yu Wei, E-mail: yuwei02@gmail.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China)

    2010-11-15

    Purpose: To explore feasibility of dual-source CT (DS-CT) prospective ECG-gated coronary angiography in patients with heart rate (HR) higher than 70 beat per minute (bpm), and evaluate image quality and radiation dose with comparison to retrospective ECG-gated spiral scan. Materials and methods: One hundred patients who underwent DS-CT coronary angiography (DS-CTCA) with mean HR higher than 70 bpm but below 110 bpm were enrolled in the study, 50 were scanned by adaptive sequential scan and another 50 were analyzed by retrospectively gated CT scan. The imaging quality of coronary artery segments in the two groups was evaluated using a four-point grading scale by two independent reviewers. Patient radiation dose was calculated by multiplying dose length product by conversion coefficient of 0.017. Results: There was no significant difference between the two groups for mean HR (p = 0.305), HR variability (p = 0.103), body mass index (p = 0.472), and scan length (p = 0.208). There was good agreement for image quality scoring between the two reviewers (Kappa = 0.72). Coronary evaluability of adaptive sequential scan was 99.7% (608 of 610 segments), while that of retrospective gated scan was 98.7% (614 of 622 segments), showing similar coronary evaluability (p = 0.061). Effective doses of adaptive sequential scan and retrospective gated scan were 5.1 {+-} 1.6 and 11.8 {+-} 4.5 mSv, respectively (p < 0.001), showing that adaptive sequential scan reduced radiation dose by 57% compared with that of retrospective gated scan. Conclusions: In patients with 70-110 bpm HR, DS-CTCA adaptive sequential scan shows similar image quality as retrospective ECG-gated spiral scan with 57% reduction of radiation dose.

  12. 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.

  13. Prospective versus retrospective ECG gating for dual source CT of the coronary stent: Comparison of image quality, accuracy, and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Zhao Lei, E-mail: zhaolei219@sohu.com [Beijing Anzhen Hospital of the Capital University of Medical Sciences (China); Zhang Zhaoqi; Fan Zhanming; Yang Lin; Du Jing [Beijing Anzhen Hospital of the Capital University of Medical Sciences (China)

    2011-03-15

    Objective: To compare image quality, diagnostic accuracy and radiation dose of prospective and retrospective electrocardiogram (ECG) gated dual source computed tomography (DSCT) for the evaluation of the coronary stent, using conventional coronary angiography (CA) as a standard reference. Design, setting and patients: Sixty patients (heart rates {<=}70 bpm) with previous stent implantation who were scheduled for CA were divided in two groups, receiving either prospective or retrospective ECG gated DSCT separately. Two reviewers scored coronary stent image quality and evaluated stent lumen. Results: There was no significant difference in image quality between the two groups. In the prospective group, there were 86.4% (51/59) stents with interpretable images, in the retrospective group, there were 87.5% (49/56) stents with interpretable images. Image quality was not influenced by age, body mass index or heart rate in either group, but heart rate variability had a weak impact on the image quality of the prospective group. Image noise was higher in the prospective group, but this difference reached statistical significance only by using a smooth kernel reconstruction. Per-stent based sensitivity, specificity, and positive and negative predictive value were 100%, 84.1%, 68.2%, and 100%, respectively, in the prospective CT angiography group and 94.4%, 86.8%, 77.3%, and 97.1%, respectively, in the retrospective CT angiography group. There was a significant difference in the effective radiation dose between the two groups, mean effective dose in the prospective and retrospective group was 2.2 {+-} 0.5 mSv (1.5-3.2 mSv) and 14.6 {+-} 3.3 mSv (10.0-20.4 mSv) (p < .001) respectively. Conclusions: Compared with retrospective CT angiography, prospective CT angiography has a similar performance in assessing coronary stent patency, but a lower effective dose in selected patients with regular heart rates {<=}70 bpm.

  14. Prevalence of first-pass myocardial perfusion defects detected by contrast-enhanced dual-source CT in patients with non-ST segment elevation acute coronary syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Schepis, Tiziano; Achenbach, Stephan; Marwan, Mohamed; Muschiol, Gerd; Ropers, Dieter; Daniel, Werner G.; Pflederer, Tobias [University of Erlangen, Department of Internal Medicine 2 (Cardiology), Erlangen (Germany)

    2010-07-15

    To investigate the prevalence and diagnostic value of first-pass myocardial perfusion defects (PD) visualised by contrast-enhanced multidetector computed tomography (MDCT) in patients admitted for a first acute coronary syndrome (ACS). Thirty-eight patients with non-ST segment elevation myocardial infarction (NSTEMI) or unstable angina (UA) and scheduled for percutaneous coronary intervention underwent dual-source CT immediately before catheterisation. CT images were analysed for the presence of any PD by using a 17-segment model. Results were compared with peak cardiac troponin-I (cTnI) and angiography findings. PD were seen in 21 of the 24 patients with NSTEMI (median peak cTnI level 7.07 ng/mL; range 0.72-37.07 ng/mL) and in 2 of 14 patients with UA. PD corresponded with the territory of the infarct-related artery in 20 out of 22 patients. In a patient-based analysis, sensitivity, specificity, negative and positive predictive values of any PD for predicting NSTEMI were 88%, 86%, 80% and 91%. Per culprit artery, the respective values were 86%, 75%, 80% and 83%. In patients with non-ST segment elevation ACS, first-pass myocardial PD in contrast-enhanced MDCT correlate closely with the presence of myocardial necrosis, as determined by increases in cTnI levels. (orig.)

  15. Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison

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    Pflederer, Tobias; Jakstat, Josy; Marwan, Mohamed; Schepis, Tiziano; Bachmann, Sven; Muschiol, Gerd; Ropers, Dieter; Daniel, Werner G.; Achenbach, Stephan [University of Erlangen, Department of Internal Medicine 2, Erlangen (Germany); Kuettner, Axel; Anders, Katharina; Lell, Michael [University of Erlangen, Institute of Diagnostic Radiology, Erlangen (Germany)

    2010-05-15

    To evaluate staged low-dose approaches for coronary CT angiography (CTA) in which a standard sequence was added if the low-dose sequence did not allow reliable rule-out of coronary stenosis. A total of 176 consecutive patients referred for dual-source CTA were randomized to three protocols: group 1 using prospective ECG-triggering (100 kV, 330 mAs), group 2 a retrospectively gated ''MinDose'' sequence (100 kV, 330 mAs) and group 3 a standard spiral sequence (120 kV, 400 mAs). If image quality in low-dose groups 1 or 2 was non-diagnostic, an additional standard CT examination (as in group 3) was performed. Non-diagnostic image quality was found in 11/56, 4/55, and 2/65 patients (46/896, 4/880 and 3/1,040 coronary segments) in groups 1, 2 and 3, respectively. Median (interquartile ranges) volumes of contrast material, CTDI{sub vol}, DLP and effective dose for low-dose groups 1 and 2 and for standard group 3 were 92.5 (11.3), 75.0 (2.5) and 75.0 (9.0) ml; 8.0 (1.4), 16.8 (4.8) and 48.1 (14.2) mGy; 108.0 (27.3), 246.0 (93.0) and 701.0 (207.8) mGy cm; and 1.5 (0.4), 3.4 (1.3) and 9.8 (2.9) mSv, respectively. A staged coronary CTA protocol with an initial low-dose approach and addition of a standard sequence - should image quality be too low - can lead to a substantial reduction in radiation exposure. (orig.)

  16. Diagnostic accuracy of dual-source CT coronary angiography in a population unselected for degree of coronary artery calcification and without heart rate modification

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    Lin, C.-J., E-mail: bcjlin@gmail.co [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Yang-Ming University School of Medicine, Taipei, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Hsu, J.-C. [National Yang-Ming University School of Medicine, Taipei, Taiwan (China); Division of Cardiovascular Medicine, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Lai, Y.-J. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Yang-Ming University School of Medicine, Taipei, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Wang, K.-L. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); Department of Radiological Technology, Yuanpei University, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Lee, J.-Y. [Department of Medical Imaging, Far Eastern Memorial Hospital, Pan-Chiao, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Li, A.-H. [Division of Cardiovascular Medicine, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China); Chu, S.-H. [Division of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, Pan-Chiao City, Taiwan (China); National Taiwan University College of Medicine, Taipei, Taiwan (China)

    2010-02-15

    Aim: To assess the ability of coronary angiography performed using dual-source computed tomography (DSCT) to evaluate coronary artery disease (CAD) in a population with unselected heart rates and extensive coronary calcification. Materials and methods: Forty-four patients at intermediate to high risk for CAD underwent both DSCT coronary angiography and invasive coronary angiography (ICA) within 30 days. No beta blockers were administered prior to imaging. Image quality and quantitatively stenosis of all coronary segments with a diameter >=1.5 mm were accessed. Patients were stratified according to mean heart rate (<70 versus >=70 bpm) and heart rate variability (<10 versus >=10 bpm). DSCT detection of coronary stenosis by segment, vessel, and patient characteristics were compared to the reference standard of ICA. Results: Diagnostic accuracy for all patients was high regarding sensitivity (97%), positive predictive value (PPV, 84.2%), and negative predictive value (NPV, 83.3%) but low regarding specificity (45.5%) with a moderate interobserver agreement (Kappa = 0.50). The accuracy for vessel-based diagnosis was high regarding sensitivity (96.6%), specificity (80.8%), PPV (80.3%), and NPV (96.7%). The segment-based diagnostic results revealed a moderate interobserver agreement for image quality and sensitivity, specificity, PPV and NPV for all segments of 66.9, 97.8, 90.8, and 89.9%, respectively. Conclusion: DSCT coronary angiography has high diagnostic accuracy in assessing CAD among patients at intermediate to high risk without using heart rate-modulating premedication. DSCT is not superior to ICA for diagnosis of calcified segments.

  17. Ultra-low-dose dual-source CT coronary angiography with high pitch: diagnostic yield of a volumetric planning scan and effects on dose reduction and imaging strategy

    Science.gov (United States)

    Hamm, B; Huppertz, A; Lembcke, A

    2015-01-01

    Objective: To evaluate the role of an ultra-low-dose dual-source CT coronary angiography (CTCA) scan with high pitch for delimiting the range of the subsequent standard CTCA scan. Methods: 30 patients with an indication for CTCA were prospectively examined using a two-scan dual-source CTCA protocol (2.0 × 64.0 × 0.6 mm; pitch, 3.4; rotation time of 280 ms; 100 kV): Scan 1 was acquired with one-fifth of the tube current suggested by the automatic exposure control software [CareDose 4D™ (Siemens Healthcare, Erlangen, Germany) using 100 kV and 370 mAs as a reference] with the scan length from the tracheal bifurcation to the diaphragmatic border. Scan 2 was acquired with standard tube current extending with reduced scan length based on Scan 1. Nine central coronary artery segments were analysed qualitatively on both scans. Results: Scan 2 (105.1 ± 10.1 mm) was significantly shorter than Scan 1 (127.0 ± 8.7 mm). Image quality scores were significantly better for Scan 2. However, in 5 of 6 (83%) patients with stenotic coronary artery disease, a stenosis was already detected in Scan 1 and in 13 of 24 (54%) patients with non-stenotic coronary arteries, a stenosis was already excluded by Scan 1. Using Scan 2 as reference, the positive- and negative-predictive value of Scan 1 was 83% (5 of 6 patients) and 100% (13 of 13 patients), respectively. Conclusion: An ultra-low-dose CTCA planning scan enables a reliable scan length reduction of the following standard CTCA scan and allows for correct diagnosis in a substantial proportion of patients. Advances in knowledge: Further dose reductions are possible owing to a change in the individual patient's imaging strategy as a prior ultra-low-dose CTCA scan may already rule out the presence of a stenosis or may lead to a direct transferal to an invasive catheter procedure. PMID:25710210

  18. Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control

    Energy Technology Data Exchange (ETDEWEB)

    Scheffel, Hans; Alkadhi, Hatem; Desbiolles, Lotus; Frauenfelder, Thomas; Schertler, Thomas; Husmann, Lars; Marincek, Borut; Leschka, Sebastian [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Plass, Andre; Vachenauer, Robert; Grunenfelder, Juerg; Genoni, Michele [Clinic for Cardiovascular Surgery, Zurich (Switzerland); Gaemperli, Oliver; Schepis, Tiziano [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Center for Integrative Human Physiology, Zurich (Switzerland)

    2006-12-15

    The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1{+-}11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14{+-}9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter {>=}1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3{+-}3.9 kg/m{sup 2} (range 22.4-36.3 kg/m{sup 2}), mean heart rate during CT was 70.3{+-}14.2 bpm (range 47-102 bpm), and mean Agatston score was 821{+-}904 (range 0-3,110). Image quality was diagnostic (scores 1-3) in 98.6% (414/420) of segments (mean image quality score 1.68{+-}0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control. (orig.)

  19. Diagnostic accuracy and its affecting factors of dual-source CT for assessment of coronary stents patency and in-stent restenosis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xing-hua; YANG Li; WU Jian; JU Hai-yue; ZHANG Fan; HE Bin; CHEN Yun-dai

    2012-01-01

    Background In-stent restenosis is a common complication after stent implantation.However,the assessment of stent lumen in computed tomography (CT) coronary angiography is limited by multiple factors.Our study aimed to evaluate the accuracy and the suspected affecting factors in diagnosing coronary in-stent restenosis by dual-source CT (DSCT) compared with coronary angiography.Methods One hundred and fifteen stents in 50 patients were evaluated with DSCT before coronary angiography for the detection of coronary in-stent restenosis (≥ 50% luminal narrowing).Patency of each stent was analyzed by two independent expert radiologists blinded to the results of coronary angiography.The relationship between diagnostic accuracy and the suspected factors including age,body mass index (BMI),heart rate,variation of heart rate,radiation dose,image quality,location and stent characteristics (type,material,diameter,length and strut thickness) was assessed wilh both univariate and multivariate analysis.The fitting of a Logistic regression model was evaluated using a receiver operating characteristic (ROC) curve.Results Mean stent diameter was (2.9±0.4) mm.Sensitivity,specificity,positive and negative predictive values and accuracy of DSCT in detection of in-stent restenosis were 69.2%,91.2%,50.0%,95.9%,and 88.7%,respectively.In a subgroup of stents with a diameter ≥3.0 mm,sensitivity,specificity,positive and negative predictive values and accuracy were 100.0%,96.5%,75.0%,100.0%+ and 96.8%,respectively.Stent diameter <3.0 mm and poor image quality were associated with poor diagnostic accuracy (P <0.05).The area under curve of ROC was 0.79.Conclusion DSCT can provide high accuracy for the assessment of in-stent restenosis in stents with a diameter ≥3.0mm,and can play an important role in ruling out in-stent restenosis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-08-15

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

  1. Correlation between Coronary Artery Stenosis and Plaque Nature Dual-Source Computed Tomography for Coronary Angiography%双源 CT 对冠状动脉狭窄及斑块性质的应用价值

    Institute of Scientific and Technical Information of China (English)

    柏辉; 李国晖

    2015-01-01

    目的:探讨双源CT对冠状动脉狭窄及不同性质冠状动脉斑块的诊断价值。方法:对50例临床确诊及拟诊冠心病患者行双源CT冠状动脉成像(CCTA)检查及冠状动脉造影(CCA),以CCA结果为参考标准,评估双源CT对不同性质斑块所致冠状动脉狭窄的特异度、敏感度、阳性预测值、阴性预测值及准确性,分析狭窄程度与斑块成分间的相关性。结果:与CCA对照,50例患者中,双源CT对诊断冠状动脉狭窄的特异度、敏感度、阳性预测值、阴性预测值依次如下:轻度狭窄分别为98.9%、46.7%、77.8%、95.8%;中度狭窄分别为97.6%、71.0%、84.6%、94.8%;重度狭窄分别为96.6%、96.4%、96.4%、98.6%。误诊冠状动脉狭窄共20支,诊断符合率为89.8%。对非钙化性斑块所致管腔狭窄的诊断符合率达84.3%,高于钙化性斑块(76.9%)。结论:双源CT冠状动脉成像能够有效判断冠状动脉狭窄程度及斑块成分。%Objective: To discuss the diagnosis value for coronary artery of different components of plaque and stenosis by dual-source computed tomography coronary artery imaging.Method:A total of 50 pa-tients diagnosed with coronary heart disease underwent dual-source computed tomography coronary artery ( CCTA) imaging and coronary angiography( CCA) .The specificity,sensitivity, positive predictive value,neg-ative predictive value,and accuracy for the quantitative detection of stenosis assessed.Result:In the 50 pa-tients,The specificity,sensitivity, positive predictive value,negative predictive value and accuracy for the de-tection of coronary artery stenosis assessed with dual-source CT were respectively:for<50 stenosis,98.9%, 46.7%,77.8%,95.8%;for 50 ~74 stenosis,97.6%,71.0%,84.6%,94.8%;for≥75 stenosis,96.6%、96. 4%、96.4%、98.6%.Comparing with CCA,misdiagnosis was observed in 20 of 196 arteries with dual-source CT

  2. Application of 70 kV Third-generation High-pitch Dual-source Coronary CT Angiography in Patients with Different Body Mass Index.

    Science.gov (United States)

    Yi, Yan; Cao, Jian; Lin, Lu; Kong, Lingyan; Jiang, Shu; Li, Xiao; Liu, Peijun; Wang, Ming; Wang, Man; Wang, Yun; Jin, Zhengyu; Wang, Yining

    2017-02-20

    Objective  To investigate the optimized range of body mass index (BMI) selection for patients undergoing 70 kV high-pitch dual-source coronary CT angiography (CCTA) on the third-generation dual-source CT (DSCT). Methods  Patients undergoing prospective high-pitch ultra-low contrast media (CM) CCTA on the third-generation DSCT using the automatic tube voltage selection at 70 kV were included and divided into three groups:group A,with BMI≤24 kg/m(2);group B,with 24 kg/m(2)image quality results,and effective dose (ED) were evaluated and compared. Results  No significant difference was found in age (H=2.36,P=0.78),heart rate (H=3.51,P=0.80),and ED(H=1.77,P=0.12) among three groups. The noise of the aortic root in group A was (21.66±4.00)HU,which was significantly lower than that in group C [(23.61±4.20)HU](F=2.05,P=0.03). The signal to noise ratio of aortic root in group A (18.61±5.28) was significantly better than that in group C (14.75±2.58) (F=5.31,P=0.02). No other significant difference in quantitative image quality were found among the three groups (all P >0.05). Subjective image quality in group A(Z=2.91,P=0.004) and B(Z=2.27,P=0.021) were both significantly better than that in group C. Conclusion  The ultra-low tube voltage (70 kV) combined with ultra-low CM CCTA protocol on third-generation high-pitch DSCT may be better for patients with BMI<28 kg/m2 than those with BMI ≥28 kg/m(2) in China.

  3. Radiation dose for thoracic and coronary step-and-shoot CT using a 128-slice dual-source machine in infants and small children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Paul, Jean-Francois; Rohnean, Adela; Elfassy, Eric; Sigal-Cinqualbre, Anne [Radiology-Centre Chirurgical Marie Lannelongue, Plessis-Robinson (France)

    2011-02-15

    For coronary artery visualization, retrospective ECG-gated acquisition by dual-source computed tomography (DSCT) was superior to spiral non-ECG-gated acquisition in a paediatric population of congenital heart disease (CHD) patients. However, retrospective cardiac CT is associated with substantial radiation doses to the patient. Recently, DSCT with end-systolic reconstruction was found to be robust for imaging the coronary arteries in patients with high heart rates. To evaluate step-and-shoot DSCT with end-systolic reconstruction for evaluating the heart, coronary arteries and other thoracic structures in young children with CHD. All neonates and children younger than 6 years of age who were referred to our institution for CHD evaluation between September and October 2009 were included in the study. ECG-gated DSCT was performed in sequential prospective mode centred on the systolic phase identified by ECG analysis. To assess the radiation dose, we recorded the dose-length product (DLP) in mGy.cm and the effective dose in mSv estimated from the DLP. Overall image quality was evaluated using a 5-grade scoring system and was assessed by looking at cardiac and vascular structures. The image quality for the proximal and middle segments of the right and left coronary arteries was also evaluated using a 5-grade scale. Images of diagnostic quality (grade {>=} 3) were obtained in all 30 children with a mean image quality grade of 4.7 {+-} 0.6 (range, 3-5). Mean DLP was 5.7 {+-} 4.8 mGy*cm (range, 1-22 mGy cm) and mean effective radiation dose was 0.26 {+-} 0.16 mSv (range, 0.05-0.8 mSv). Prospective ECG-gated thoracic DSCT at end-systole usually provides adequate thoracic and coronary artery image quality in neonates, infants and young children with CHD, independent of heart rate. This new method is associated with lower radiation doses compared to previous literature (mean effective dose, 0.26 mSv). (orig.)

  4. Clinical Value of Dual Source CT in the Diagnosis of Coronary Artery Stenosis%双源CT诊断不同程度冠状动脉狭窄的临床价值

    Institute of Scientific and Technical Information of China (English)

    高振兴; 佟晖

    2015-01-01

    Objective To investigate the clinical value of dual source CT in the diagnosis of coronary artery stenosis.MethodsThirty-six patients with clinicaly suspected coronary heart disease in our hospital received with dual source CT and conventional coronary angiography.Results Dual source CT findings and coronary angiography results were compared and the diagnosis of coronary artery stenosis sensitivity for 94.7%,specificity of diagnosis of 95.5%,the positive predictive value for 83.4%,the negative predictive value was 98.78%. The diagnostic accuracy rate was 95.3%. Dual source CT in the diagnosis of severe stenosis diagnostic sensitivity was significantly lower than that of mild stenosis,moderate stenosis diagnosis sensitivity, he difference had statistical significance(P< 0.05).Conclusion With the traditional coronary artery stenosis diagnosis coronary angiography were compared with and dual source CT scan with rapid scanning,high accuracy in the diagnosis and noninvasive clinical advantage.%目的:探讨双源CT诊断不同程度冠状动脉狭窄的临床价值。方法选取来我院因临床拟诊冠心病而接受双源CT和传统冠状动脉造影检查的患者36例。结果双源CT检查结果与冠状动脉造影检查结果相比,其冠状动脉狭窄诊断的敏感度为94.7%、诊断特异性为95.5%、阳性预测值为83.4%、阴性预测值为98.78%,诊断准确率为95.3%。双源CT检查对重度狭窄诊断敏感度低于轻度狭窄和中度狭窄的诊断敏感度,比较差异具有统计学意义(P<0.05)。结论与传统冠状动脉狭窄诊断方式冠状动脉造影相比,双源CT扫描具有扫描迅速、诊断准确率较高,无创伤等临床优势。

  5. Impact of an advanced image-based monoenergetic reconstruction algorithm on coronary stent visualization using third generation dual-source dual-energy CT: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Mangold, Stefanie [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Cannao, Paola M. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Milan, Scuola di Specializzazione in Radiodiagnostica, Milan (Italy); Schoepf, U.J. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Wichmann, Julian L. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Canstein, Christian [Siemens Medical Solutions, Malvern, PA (United States); Fuller, Stephen R.; Varga-Szemes, Akos [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Muscogiuri, Giuseppe; De Cecco, Carlo N. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' , Department of Radiological Sciences, Oncology and Pathology, Rome (Italy); Nikolaou, Konstantin [Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2016-06-15

    To evaluate the impact of an advanced monoenergetic (ME) reconstruction algorithm on CT coronary stent imaging in a phantom model. Three stents with lumen diameters of 2.25, 3.0 and 3.5 mm were examined with a third-generation dual-source dual-energy CT (DECT). Tube potential was set at 90/Sn150 kV for DE and 70, 90 or 120 kV for single-energy (SE) acquisitions and advanced modelled iterative reconstruction was used. Overall, 23 reconstructions were evaluated for each stent including three SE acquisitions and ten advanced and standard ME images with virtual photon energies from 40 to 130 keV, respectively. In-stent luminal diameter was measured and compared to nominal lumen diameter to determine stent lumen visibility. Contrast-to-noise ratio was calculated. Advanced ME reconstructions substantially increased lumen visibility in comparison to SE for stents ≤3 mm. 130 keV images produced the best mean lumen visibility: 86 % for the 2.25 mm stent (82 % for standard ME and 64 % for SE) and 82 % for the 3.0 mm stent (77 % for standard ME and 69 % for SE). Mean DLP for SE 120 kV and DE acquisitions were 114.4 ± 9.8 and 58.9 ± 2.2 mGy x cm, respectively. DECT with advanced ME reconstructions improves the in-lumen visibility of small stents in comparison with standard ME and SE imaging. (orig.)

  6. Prospectively ECG-triggered high-pitch coronary angiography with third-generation dual-source CT at 70 kVp tube voltage: feasibility, image quality, radiation dose, and effect of iterative reconstruction.

    Science.gov (United States)

    Hell, Michaela M; Bittner, Daniel; Schuhbaeck, Annika; Muschiol, Gerd; Brand, Michael; Lell, Michael; Uder, Michael; Achenbach, Stephan; Marwan, Mohamed

    2014-01-01

    Low tube voltage reduces radiation exposure in coronary CT angiography (CTA). Using 70 kVp tube potential has so far not been possible because CT systems were unable to provide sufficiently high tube current with low voltage. We evaluated feasibility, image quality (IQ), and radiation dose of coronary CTA using a third-generation dual-source CT system capable of producing 450 mAs tube current at 70 kVp tube voltage. Coronary CTA was performed in 26 consecutive patients with suspected coronary artery disease, selected for body weight Image noise was lower in IR vs FBP (60 ± 10 HU vs 74 ± 8 HU; P < .001). In patients <100 kg and with a regular heart rate <60 beats/min, third-generation dual-source CT using high-pitch spiral acquisition and 70 kVp tube voltage is feasible and provides both robust IQ and very low radiation exposure. Copyright © 2014 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  7. Diagnostic accuracy of coronary CT angiography using 3{sup rd}-generation dual-source CT and automated tube voltage selection: Clinical application in a non-obese and obese patient population

    Energy Technology Data Exchange (ETDEWEB)

    Mangold, Stefanie [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Wichmann, Julian L. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Caruso, Damiano [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' , Department of Radiological Sciences, Oncology and Pathology, Rome (Italy); Tesche, Christian [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Heart Centre Munich-Bogenhausen, Department of Cardiology, Munich (Germany); Steinberg, Daniel H.; Bayer, Richard R. [Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Varga-Szemes, Akos; Stubenrauch, Andrew C.; Biancalana, Matthew; De Cecco, Carlo N. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Nikolaou, Konstantin [Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2017-06-15

    To investigate diagnostic accuracy of 3{sup rd}-generation dual-source CT (DSCT) coronary angiography in obese and non-obese patients. We retrospectively analyzed 76 patients who underwent coronary CT angiography (CCTA) and invasive coronary angiography. Prospectively ECG-triggered acquisition was performed with automated tube voltage selection (ATVS). Patients were dichotomized based on body mass index in groups A (<30 kg/m{sup 2}, n = 37) and B (≥30 kg/m{sup 2}, n = 39) and based on tube voltage in groups C (<120 kV, n = 46) and D (120 kV, n = 30). Coronary arteries were assessed for significant stenoses (≥50 % luminal narrowing) and diagnostic accuracy was calculated. Per-patient overall sensitivity, specificity, positive predictive value, negative predictive value (NPV) and accuracy were 96.9 %, 95.5 %, 93.9 %, 97.7 % and 96.1 %, respectively. Sensitivity and NPV were lower in groups B and D compared to groups A and C, but no statistically significant differences were observed (group A vs. B: sensitivity, 100.0 % vs. 93.3 %, p = 0.9493; NPV, 100 % vs. 95.5 %, p = 0.9812; group C vs. D: sensitivity, 100.0 % vs. 92.3 %, p = 0.8462; NPV, 100.0 % vs. 94.1 %, p = 0.8285). CCTA using 3{sup rd}-generation DSCT and (ATVS) provides high diagnostic accuracy in both non-obese and obese patients. (orig.)

  8. Utility of virtual endoscopy in coronary dual-source CT angiography: initial experience%仿真内镜用于双源CT冠状动脉成像的初步经验

    Institute of Scientific and Technical Information of China (English)

    何卫红; 陈伟; 周晖

    2011-01-01

    目的 初步探讨双源CT冠状动脉成像时利用仿真内镜诊断冠状动脉疾病的潜在价值.方法 使用Fly-through软件对40例双源CT冠状动脉成像病例行仿真内镜观察,并与CT冠状动脉成像常规方法和传统冠状动脉造影术进行比较.结果 40例患者共120支冠状动脉中,92%(110/120)的冠状动脉可行仿真内镜成像;仿真内镜判断有意义的冠状动脉狭窄正确率为85%( 41/48);常规CT冠状动脉成像不能判断的9处严重钙化,仿真内镜显示为显著或高度狭窄;4枚冠状动脉支架内和3支桥血管仿真内镜显示通畅.结论 仿真内镜可立体显示正常和病变冠状动脉腔内情况,是CT冠状动脉成像后处理方法的的重要补充.%[Objective] To explore the potential clinical value of virtual endoscopy in detecting coronary artery lesions. [Methods] Forty patients underwent dual-source CT coronary angiography. Virtual endoscopies were simulated in 120 coronary arteries using the Fly-through software, with routine imaging post-processing methods of CT coronary angiography and conventional coronary angiography as the reference standard. [Results] Virtual endo- scopies of 92% (110/120) major coronary artery were successfully performed with good image quality, and the accuracy of virtual coronary angioscopy was 85% (41/48) for detecting hemodynamically significant stenoses confirmed by conventional coronary angiography. Using virtual coronary angioscopy, 9 severe calcified coronary arteries were identified as significant or severe stenoses, while unable to estimate by routine CT coronary angiography. Virtual endoscopies of intracoronary stents (n=4) or bypass grafts (n=4) were patency. [Conclusions] Endoscopy of coronary arteries using dual-source CT allows comprehensive 3-dimensional delineation of the vessel lumen, and can be used as an important complement to the routine post-processing methods of CT coronary angiography in some cases.

  9. Intravenous Contrast Material Administration at High-pitch Dual-source CT Coronary Angiography: Bolus-tracking Technique with Shortened Time of Respiratory Instruction Versus Test Bolus Technique

    Institute of Scientific and Technical Information of China (English)

    Kai Sun; Guo-rong Liu; Yue-chun Li; Rui-juan Han; Li-fang Cui; Li-jun Ma; Li-gang Li; Chang-yong Li

    2012-01-01

    Objective To investigate the feasibility of acquiring the similar homogeneous enhancement using bolus-tracking techniques with shortened respiratory time in prospectively electrocardiogram-gated high-pitch spiral acquisition mode (Flash mode) coronary computed tomography angiography (CCTA) compared with test bolus technique.Methods One hundred and eighty-four consecutive patients with mean heart rate ≤65 beats per minute undergoing CCTA were prospectively included in this study.The patients were randomly divided into two groups.Patients in the group A (n=92) instructed to shorten respiratory time received CCTA using bolus-tracking technique with high-pitch spiral acquisition mode (Flash mode),while those in the group B (n=92) underwent CCTA with test bolus technique.The attenuation in the ascending aorta,image noise,contrast-to-noise ratio and radiation doses of the two groups were assessed.Results There were no significant differences in the mean attenuation values in the ascending aorta (483.18±59.07 HU vs.498.7±83.51 HU,P=0.183),image noise (21.4±4.5 HU vs.20.9±4.3 HU,P=0.414),contrast-to-noise ratio (12.1±4.2 vs.13.8±5.1,P=0.31) between the groups A and B.There were no significant differences in the radiation dose of dynamic monitoring scans (0.056±0.026 mSv vs.0.062±0.018 mSv,P=0.068) and radiation dose of angiography (0.94±0.07 mSv vs.0.96±0.15 mSv,P=0.926) between the two groups,while 15 mL less contrast material volume was administered in the group A than the group B.Conclusion Bolus-tracking technique with shortened time of respiratory in Flash mode of dual-source CT yields the similar homogeneous enhancement with less contrast material in comparison to the test bolus technique.

  10. The culprit lesion and its consequences: combined visualization of the coronary arteries and delayed myocardial enhancement in dual-source CT: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H.; Bruners, Philipp [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital, Aachen (Germany); RWTH Aachen University, Applied Medical Engineering, Helmholtz Institute, Aachen (Germany); Friman, Ola; Hennemuth, Anja [Fraunhofer MEVIS, Bremen (Germany)

    2010-12-15

    To assess combined analysis of coronary arteries and delayed myocardial contrast enhancement based on co-registration of coronary CT angiography and late-phase CT and automatic segmentation. Co-registration and late enhancement segmentation were applied to coronary CT angiography and late-phase CT images from six pigs with acute myocardial infarction (MI) and six patients with chronic MI. MI size was quantified by manual delineation, the established 3SD method, and a new mixture model approach. Correspondence between coronary artery lesions and MI was assessed visually from fused segmentation results. Co-registration was successful in all cases. There was substantial agreement in the number of segments diagnosed with MI, comparing manual delineation and the mixture model for animal ({kappa} = 0.839) and patient studies ({kappa} = 0.770). There were no significant differences between the two methods (P > 0.05). In patients there was a discrepancy between the segmental distribution of MI and empirical coronary artery perfusion in 10/96 segments when compared with the true coronary branching pattern. The mixture model approach is well suited for automated assessment of MI size from late-phase cardiac CT. Fusion imaging eliminates the need for empirical knowledge of the anatomical relationship between the coronary artery lesion and the area of myocardial ischaemia. (orig.)

  11. 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.)

  12. Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Moez Ben; Rohnean, Adela; Sigal-Cinqualbre, Anne; Adler, Ghazal; Paul, Jean-Francois [CC Marie Lannelongue, Radiology Department, Plessis-Robinson (France)

    2009-07-15

    There are only a few reports on the diagnostic accuracy, and the technical and clinical feasibility, of multidetector CT (MDCT) in infants with congenital heart disease (CHD). To evaluate the image quality and radiation dose of DSCT in babies with CHD. From November 2006 to November 2007, 110 consecutive infants with CHD referred for pre- or postoperative CT evaluation were included. All these infants had a spiral angiothoracic DSCT scan after injection of 300 mg/ml iopromide at 0.5-1 ml/s with a power injector using a low-dose protocol (80 kVp and 10 mAs/kg). Of these infants, 34 also underwent an ECG-gated coronary CT scan for evaluation of the course of the coronary arteries. No serious adverse events were recorded. The mean dose-length product was 8{+-}6 mGy.cm (effective dose 0.5{+-}0.2 mSv) and 21{+-}9 mGy.cm (effective dose 1.3{+-}0.6 mSv) during the non-ECG-gated spiral acquisition and ECG-gated acquisition, respectively. Diagnostic quality images were achieved with the spiral acquisition in 89% of cases. Compared to the spiral mode, ECG-gated acquisition significantly improved the visualization of the coronary arteries, with a diagnostic rate of 91% and 84% for the left and right coronary arteries, respectively. DSCT together with iopromide at 300 mg/ml is a valuable tool for the routine clinical evaluation of infants with CHD. ECG-gated acquisition provides reliable visualization of the course of the coronary arteries. (orig.)

  13. Thoracic applications of dual-source CT technology.

    Science.gov (United States)

    Boroto, Kahimano; Remy-Jardin, Martine; Flohr, Thomas; Faivre, Jean-Baptiste; Pansini, Vittorio; Tacelli, Nunzia; Schmidt, Bernhard; Gorgos, Andrei; Remy, Jacques

    2008-12-01

    Among the various imaging modalities available, CT has remained over time the core imaging technique for the evaluation of respiratory disorders. The recent advent of dual-source CT offers innovative approaches to investigate thoracic diseases, based on the use of one or two tubes as well as single or dual energy to scan the entire thorax. Two major options can be used in clinical practice with promising results. Dual source, single-energy scanning allows scanning of the entire thorax with ultra-high temporal resolution which opens the field of integrated cardiothoracic imaging without ECG gating as well as optimized evaluation of pediatric and adult patients with limited ability to cooperate. Dual-source, dual-energy acquisitions represent another very innovative means of investigating respiratory disorders, adding tissue characterization and functional analysis to morphological evaluation. The purpose of this review article is to provide results on preliminary experiences with the above-mentioned scanning conditions with dual-source CT and to envisage potential forthcoming applications in the field of thoracic imaging.

  14. The utilization of dual source CT in imaging of polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Nicolaou, S. [University of British Columbia, Vancouver General Hospital, Department of Radiology, 899 West 12th Avenue, Vancouver, British Columbia, V5Z1M9 (Canada)], E-mail: savvas.nicolaou@vch.ca; Eftekhari, A.; Sedlic, T.; Hou, D.J.; Mudri, M.J.; Aldrich, John; Louis, L. [University of British Columbia, Vancouver General Hospital, Department of Radiology, 899 West 12th Avenue, Vancouver, British Columbia, V5Z1M9 (Canada)

    2008-12-15

    Despite the growing role of imaging, trauma remains the leading cause of death in people below the age of 45 years in the western industrialized countries. Trauma has been touted as the largest epidemic in the 20th century. The advent of MDCT has been the greatest advance in trauma care in the last 25 years. However, there are still challenges in CT imaging of the polytrauma individual including time restraints, diagnostic errors, radiation dose effects and bridging the gap between anatomy and physiology. This article will analyze these challenges and provide possible solutions offered by the unique design of the dual source CT scanner.

  15. Diagnostic value of dual-source CT in Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    CHAO Bao-ting; WANG Xi-ming; WU Le-bin; CHEN Jie; CHENG Zhao-ping; WU Da-wei; DUAN Yan-hua

    2010-01-01

    Background Doppler color echocardiography is a common method for detecting coronary artery lesions in patients with Kawasaki disease(KD).However,the diagnostic accuracy for the whole coronary artery lesions is limited.The purpose of this study was to compare the diagnostic value of dual-source computed tomography (DSCT) and Doppler color echocardiography for the assessment of coronary artery lesions caused by KD.Methods Sixteen patients,12 with typical KD and 4 with atypical KD,underwent DSCT and Doppler color echocardiography.The position and internal diameter of each coronary artery lesion was measured.Correlation analysis was used to compare the diagnostic value of the two imaging modalities.Results ln the typical KD group, seven patients did not have any coronary artery Iesion as confirmed by both DSCT scans and Doppler color echocardiography;in four patients proximal coronary artery injuries were identified by both modalities;in one patient an aneurysm in the middle and distal segments of the coronary artery was detected by DSCT but was negative in Doppler color echocardiography.In the atypical KD group,three cases showed the same results with both modalities,while one case with coronary artery stenosis in the middle segment was identified by DSCT but not detected by Doppler color echocardiography.There was a good correlation between the two imaging modalities(Kappa value,0.768(≥0.75)).Conclusion DSCT coronary artery angiography is an accurate,non-invasive,and valuable technique for detecting and following up coronary artery lesions in patients with KD.

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

    Science.gov (United States)

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

    2007-11-01

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

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

    Science.gov (United States)

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

    2010-04-01

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

  18. Prospectively Electrocardiogram-Gated High-Pitch Spiral Acquisition Mode Dual-Source CT Coronary Angiography in Patients with High Heart Rates: Comparison with Retrospective Electrocardiogram-Gated Spiral Acquisition Mode

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Kai; Ma, Rui; Wang, Li Jun [Dept. of Radiology, Baotou Central Hospital, Baotou (China); Li, Li Gang; Chen, Jiu Hong [CT BM Clinic Marketing, Siemens Healthcare, Beijing (China)

    2012-11-15

    To assess the image quality and effective radiation dose of prospectively electrocardiogram (ECG)-gated high-pitch spiral acquisition mode (flash mode) of dual-source CT (DSCT) coronary angiography (CTCA) in patients with high heart rates (HRs) as compared with retrospectively ECG-gated spiral acquisition mode. Two hundred and sixty-eight consecutive patients (132 female, mean age: 55 {+-} 11 years) with mean HR > 65 beats per minute (bpm) were prospectively included in this study. The patients were divided into two groups. Collection was performed in group A CTCA using flash mode setting at 20-30% of the R-R interval, and retrospectively ECG-gated spiral acquisition mode in group B. The image noise, contrast-to-noise ratio (CNR), image quality scores, effective radiation dose and influencing factors on image quality between the two groups were assessed. There were no significant differences in image quality scores and proportions of non-diagnostic coronary artery segments between two groups (image quality scores: 1.064 {+-} 0.306 [group A] vs. 1.084 {+-} 0.327 [group B], p = 0.063; proportion of non-diagnostic coronary artery segments: segment-based analysis 1.52% (group A) vs. 1.74% (group B), p = 0.345; patient-based analysis 7.5% (group A) vs. 6.7% (group B), p = 0.812). The estimated radiation dose was 1.0 {+-} 0.16 mSv in group A and 7.1 {+-} 1.05 mSv in group B (p = 0.001). In conclusion, in patients with HRs > 65 bpm without cardiac arrhythmia, the prospectively high-pitch spiral-acquisition mode with image-acquired timing set at 20-30% of the R-R interval provides a similar image quality and low rate of non-diagnostic coronary segments to the retrospectively ECG-gated low-pitch spiral acquisition mode, with significant reduction of radiation exposure.

  19. Feasibility and Diagnostic Accuracy for Assessment of Coronary Artery Stenosis of Prospectively Electrocardiogram-gated High-pitch Spiral Acquisition Mode Dual-source CT Coronary Angiography in Patients with Relatively Higher Heart Rates:in Comparison wit

    Institute of Scientific and Technical Information of China (English)

    Kai Sun; Rui-juan Han; Li-fang Cui; Rui-ping Zhao; Li-jun Ma; Li-jun Wang; Li-gang Li; Chang-yong Li

    2012-01-01

    Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography coronary angiography (CTCA) in patients with relatively higher heart rates (HR) compared with catheter coronary angiography (CCA).Methods Forty-seven consecutive patients with relatively higher HR (>65 and < 100 bpm) (20 male,27 female; age 55 ± 10 years) who both underwent dual-source CTCA and CCA were prospectively included in this study.All patients were performed CTCA using high pitch mode setting at 20%-30% of the R-R interval for the image acquisition.All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a three-point scale (1:excellent to 3:non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%).Considered CCA as the standard of reference,the sensitivity,specificity,positive predictive value and negative predictive value were calculated.Radiation dose values were calculated using the dose-length product.Results Image quality was rated as being score 1 in 92.4% of segments,score 2 in 6.1% of segments and score 3 in 1.5% of segments.The average image quality score per segment was 1.064±0.306.The HR variability of patients with image score 1,2 and 3 were 2.29± 1.06 bpm,5.17± 1.37 bpm,8.88± 1.53 bpm,respectively.The average HR variability of patients with different image scores were significantly different (F=170.402,P=0.001).The sensitivity,specificity,positive and negative predictive values were 92.6%,97.0%,87.6%,98.3%,respe ctively,per segment and 90.0%,95.2%,85.3%,96.9%,respectively,per vessel and 100%,63.6%,90.0%,100%,respectively,per patient.The effective radiation dose was on average 0.86±0.16 mSv.Conclusion In patients with HR more than 65 bpm and below 100 bpm without cardiac arrhythmia

  20. Clinical application of dual-source CT in the diagnosis of ALCAPA

    Institute of Scientific and Technical Information of China (English)

    程召平

    2014-01-01

    Objective To explore the clinical usefulness of anomalous origin of left coronary artery from the pulmonary artery(ALCAPA)by dual-source CT(DSCT)angiography.Methods A total of 10 patients(mean age5.1±5.0 yrs,age range 0.2-15 yrs;male 5)withALCAPA who underwent DSCT angiography and echocardiography were retrospectively included.Surgery was performed in 7 patients,and conventional cardiac angiography(CCA)in 4 patients.The subjective image quality was evaluated on a

  1. Correlation of radiation dose and heart rate in dual-source computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Laspas, Fotios; Roussakis, Arkadios; Kritikos, Nikolaos; Efthimiadou, Roxani; Kehagias, Dimitrios; Andreou, John (CT and MRI Dept., Hygeia Hospital, Athens (Greece)), e-mail: fotisdimi@yahoo.gr; Tsantioti, Dimitra (Statistician, Hygeia Hospital, Athens (Greece))

    2011-04-15

    Background: Computed tomography coronary angiography (CTCA) has been widely used since the introduction of 64-slice scanners and dual-source CT technology, but the relatively high radiation dose remains a major concern. Purpose: To evaluate the relationship between radiation exposure and heart rate (HR), in dual-source CTCA. Material and Methods: Data from 218 CTCA examinations, performed with a dual-source 64-slices scanner, were statistically evaluated. Effective radiation dose, expressed in mSv, was calculated as the product of the dose-length product (DLP) times a conversion coefficient for the chest (mSv = DLPx0.017). Heart rate range and mean heart rate, expressed in beats per minute (bpm) of each individual during CTCA, were also provided by the system. Statistical analysis of effective dose and heart rate data was performed by using Pearson correlation coefficient and two-sample t-test. Results: Mean HR and effective dose were found to have a borderline positive relationship. Individuals with a mean HR >65 bpm observed to receive a statistically significant higher effective dose as compared to those with a mean HR =65 bpm. Moreover, a strong correlation between effective dose and variability of HR of more than 20 bpm was observed. Conclusion: Dual-source CT scanners are considered to have the capability to provide diagnostic examinations even with high HR and arrhythmias. However, it is desirable to keep the mean heart rate below 65 bpm and heart rate fluctuation less than 20 bpm in order to reduce the radiation exposure

  2. 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.)

  3. 心电编辑对提高双源CT冠脉图像质量的初步研究%Preliminary application of ECG-editing technique in improving image quality of dual-source CT coronary angiography

    Institute of Scientific and Technical Information of China (English)

    杨立民; 刘成磊; 徐凯

    2012-01-01

    目的:探讨心电编辑在改善双源CT冠脉图像质量中的作用.方法:以冠脉分支为单位,回顾性分析60例心率变异过大或心律失常患者双源CT冠脉成像编辑前后的图像质量,总结不同类型的心电编辑方法.结果:60例心率变异过大或心律失常患者,心率范围为55~269次/min,平均心率(92.8±31.9)次/min,冠脉图像编辑前后的图像质量总评分分别为2.26±1.03、3.5±0.61(t=-17.85,P=0.001);表明编辑前后图像质量的评分有统计学意义,编辑后图像质量明显改善.结论:心电编辑技术可以明显改善心率变异过大或心律失常患者双源CT冠脉成像的图像质量.%Objective:To evaluate the effect of ECG-editing technique on dual-source CT coronary angiography. Methods: Based on per-segment analysis, image quality before and after ECG editing were retrospectively analyzed in 60 patients with heart rate variability or arrhythmia. Different types of ECG editing methods were summarized. Results:In 60 patients without stable sinus rhythm,the heart rate was (55~269) bpm/min. And mean heart rate was (92. 8±31. 9) bpm/min. The over all mean image quality scores before and after ECG editing were (2. 26±1. 03) and (3. 50±0. 61), respectively. There was statistical difference in pre-editing and post-editing reconstructed images quality, suggesting ECG editing significantly improving the image quality ( P <0. 01). Conclusion: ECG editing technique significantly improves image quality of coronary artery in patients with heart rate variability or arrhythmia.

  4. 双源CT冠状动脉造影在心律失常患者的临床应用%Clinical Application of Dual-source CT Coronary Angiography in Patients with Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    胡春峰; 徐凯; 袁莹莹; 汪秀玲; 李绍东; 程广军; 谢丽响

    2012-01-01

    Purpose: To study the clinical application value of dual-source CT coronary angiography (DSCT-CA) in patients with arrhythmia. Methods: Seventy-three patients with arrhythmia (29 patients with ventricular extrasystoles, 25 with atrial extrasystoles, 19 with atrial fibrillation) underwent DSCT-CA in this study. Retrospective gating technique and ECG editing technique were used. Coronary segment image quality was evaluated by four-grade method. Average heart rate and heart rate variability between ECG-editing group and no ECG- editing group and the image quality of pre-editing and post-editing in ECG-editing group were compared respectively. Results: In 73 patients, ECG-editing was not needed in 14 patients, and ECG-editing was needed in 59 patients. The average heart rate and heart rate variability between ECG-editing group and no ECG-editing group was with significant difference (P< 0.05 ). The image quality in every segment of ECG-editing group between pre-editing and post-editing was also with significant difference ( P < 0.05 ). After ECG-editing, 11 segments did not reach diagnosis requirements. Conclusion: DSCT-CA can be used in patients with arrhythmia. The image quality of coronary artery could be significantly improved with ECG-editing in patients with arrhythmia, but the key to improve the quality of image is to control heart rate and heart rate variability.%目的:探讨双源CT冠状动脉造影(DSCT-CA)在心律失常患者中的临床应用价值.方法:行DSCT-CA的心律失常患者共73例(室性期前收缩29例,房性期前收缩25例,心房纤颤19例),采用回顾性心电门控重建图像及心电编辑技术,对各段血管图像质量分级,比较无需编辑组与需编辑组的平均心率及心率波动、需编辑组各段冠状动脉编辑前后的图像质量.结果:73例中14例为无需编辑组,59例为需编辑组.无需编辑组的平均心率、心率波动均明显低于需编辑组(P<0.05).心电编辑后各段冠状动脉

  5. Bachmann束及其血供的双源CT冠状动脉成像表现%Imaging findings of Bachmann bundle and its arterial supply on dual-source CT coronary angiography

    Institute of Scientific and Technical Information of China (English)

    彭泽华; 蒲红; 白林; 印隆林; 陈加源; 蒋瑾; 李刚

    2011-01-01

    Objective To investigate the morphologic features of Bachmann bundle (BB) and its vascular supply on dual-source CT coronary angiography(DSCTCA) in healthy volunteers and patients with coronary artery lesion (CAL). Methods Clinical histories, electrocardiograms (ECGs), and images of DSCTCA of 106 patients ( CAL group) and 100 healthy volunteers ( Control group) were reviewed. All 106 patients underwent conventional coronary angiography ( CCA ). The Gensini scoring system was used to assess the results of CCA. The patients were divided into three groups according to their Gensini scores. The length, width and superoinferior diameter, CT value, and vascular supply of BB were studied. Rank sum test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results ( 1 ) BB visualization rate of control group was higher than CAL group [86.0% (86/100) vs 51.9%(55/106), x2 = 27.726, P < 0.01]. The higher the Gensini score of CAL subgroup, the lower the visualization rate of its BB [80.0% ( 28/35 ), 55.6% ( 20/36 ), 20.0% ( 7/35 ), x2 = 25.530, P < 0.01].(2)The median of measurements of length,width and superoinferior diameter of control and CAL group were 13.0 vs 13.8,5.0 vs 5.2 and 5.9 vs 6.2 mm, respectively ( P > 0.05 ). (3) The CT value of the BB region in control group( median :42.6 HU ) was higher than that of CAL group( median: 13.0 HU) ( Z = - 7.061, P <0.01). The CT values of BB regions in patients with nonvisualized BB (median: -16.0 HU) were lower. The CT values of the BB regions in CAL group were negatively-correlated with Gensini scores( median:19.0) (r = -0.553, P <0.01 ). (4)The blood supply of BB and BB region was provided by right sinuatrial node artery ( SNA, 58.7%, 121/206 ), left SNA ( 35.9%, 74/206 ) or both SNAs ( 5.3%, 11/206 ).Conclusions DSCTCA could can show the anatomical characteristics of BB and its arterial supply. The serious the degree of CAL , the lower the BB display rate, and the

  6. Applied anatomy of myocardial bridge-mural coronary artery by dual-source CT%心肌桥-壁冠状动脉临床应用解剖的双源CT研究

    Institute of Scientific and Technical Information of China (English)

    虞康惠; 成官迅; 刘国顺; 阎静

    2012-01-01

    Objective To study the morphologic features of myocardial bridge-mural coronary (MB-MCA) by dual-source CT (DSCT), and improve the understanding of it on clinical diagnosis value. Methods 3709 patients were involved in this study. MB-MCAs were located accurately according to the guideline of the American Heart Association, and the length, depth, compression of MB-MCA and concomitant atheromatous changes were evaluated. Results 638 cases had MB-MCA in overall 3709 patients by DSCT, getting the prevalence of 17.20%. 654 MB-MCA were detected including 426 in segment 7, 72 in segment 8 and 56 in segment 6, the rest distributing in segment 2, 3, 4, 9, 11, 12,13 and 16. Of 654 MB-MCA, the mean length was (20.52± 9.84 )mm and the mean thickness was (1.27± 0.93 )mm. The lumen of MCA showed no significant stenosis or mild to moderate stenosis, and a rare severe stenosis. 92 patients with MB-MCA had atherosclerotic plaque. Conclusions DSCT not only may directly demonstrate the dissection shape of MB-MCA, but might also dynamically evaluate the change of MB-MCA in the entire cardiac cycle, supplying the clinical significance research of MB-MCA for valuable information.%目的 研究心肌桥-壁冠状动脉(MB-MCA)的双源CT(DSCT)形态学特征,以提高对MB-MCA临床诊断价值的认识.方法 分析3709例冠状动脉CTA病人,根据美国心脏病协会的冠状动脉16段分段法对检出的MB-MCA进行准确定位,对其长度、深度、收缩期管腔压缩程度及其伴随的粥样硬化情况进行评估.结果 3709例病人中发现MB-MCA 638例,检出率约17.20%,共检出654支MB-MCA,其中426支位于7段(S7)、72支位于8段(S8)、56支位于6段(S6),其余分别分布于2段(S2)、3段(S3)、4段(S4)、9段(S9)、11段(S11)、12段(S12)、13段(S13)及16段(S16);MB-MCA平均长度为( 20.52±9.84 )mm,平均深度为(1.27±0.93 )mm;收缩期时MCA管腔呈现不同程度的狭窄,但重度狭窄罕见;92例MB-MCA患者

  7. 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

  8. High-pitch dual-source CT angiography of the whole aorta without ECG synchronisation: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Beeres, Martin; Schell, Boris; Mastragelopoulos, Aristidis; Kerl, Josef Matthias; Gruber-Rouh, Tatjana; Lee, Clara; Siebenhandl, Petra; Bodelle, Boris; Zangos, Stephan; Vogl, Thomas J.; Jacobi, Volkmar; Bauer, Ralf W. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Herrmann, Eva [Clinic of the Goethe University, Department of Biostatistics, Frankfurt (Germany)

    2012-01-15

    To investigate the feasibility, image quality and radiation dose for high-pitch dual-source CT angiography (CTA) of the whole aorta without ECG synchronisation. Each group of 40 patients underwent CTA either on a 16-slice (group 1) or dual-source CT device with conventional single-source (group 2) or high-pitch mode with a pitch of 3.0 (group 3). The presence of motion or stair-step artefacts of the thoracic aorta was independently assessed by two readers. Subjective and objective scoring of motion and artefacts were significantly reduced in the high-pitch examination protocol (p < 0.05). The imaging length was not significantly different, but the imaging time was significantly (p < 0.001) shorter in the high-pitch group (12.2 vs. 7.4 vs. 1.7 s for groups 1, 2 and 3). The ascending aorta and the coronary ostia were reliably evaluable in all patients of group 3 without motion artefacts as well. High-pitch dual-source CT angiography of the whole aorta is feasible in unselected patients. As a significant advantage over regular pitch protocols, motion-free imaging of the aorta is possible without ECG synchronisation. Thus, this CT mode bears potential to become a standard CT protocol before trans-catheter aortic valve implantation (TAVI). (orig.)

  9. Initial experience of dual-energy lung perfusion CT using a dual-source CT system in children

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-09-15

    Initial experience of dual-source dual-energy (DE) lung perfusion CT in children is described. In addition to traditional identification of pulmonary emboli, the assessment of lung perfusion is technically feasible with dual-source DE CT in children with acceptable radiation dose. This article describes how to perform dual-source DE lung perfusion CT in children, including the optimization of intravenous injection method and CT dose parameters. How to produce weighted-average CT images for the assessment of pulmonary emboli and colour-coded perfusion maps for the assessment of regional lung perfusion is also detailed. Lung perfusion status can then be evaluated on perfusion maps by means of either qualitative or quantitative analysis. Potential advantages and disadvantages of this emerging CT technique compared to lung perfusion scintigraphy and cardiac MRI are discussed. (orig.)

  10. 双源CT临床应用新进展%Dual-source CT clinical application of new progress

    Institute of Scientific and Technical Information of China (English)

    黄远彬

    2014-01-01

    双源CT进行2种不同能量的X线同步扫描,可获得双能量图像,具有成像速度快,辐射剂量低,图像质量高的优点。双源CT进行冠状动脉成像,图像质量不再受患者心率过快、不规则以及屏气困难的影响,能获得可靠的冠状动脉图像,是目前无创性左室功能检查评价最具价值的检查方法之一。双源CT扫描时间缩短辐射剂量降低,有效克服部分患者移动伪影及呼吸伪影,适用于儿童患者及躁动患者的检查,为急性胸痛患者快速诊断提供安全有效手段。双源CT双能量虚拟平扫在头部、胸部、腹部疾病检查中已得到良好运用。双源CT在两种不同能量状态下的数据采集可对物质成分进行定性分析,拓宽了CT的应用范围,具有较好临床价值。%Dual source CT for 2 different energy X-ray scanning, can obtain the dual energy images, has fast imaging speed, low radiation dose, the advantages of high image quality. Dual source CT coronary artery imaging, image quality is not affected by the patient’s heart rate too fast, irregular and breath dififcult, can obtain the coronary artery image reliable;it is one of the current inspection method without evaluation and examination of the left ventricular function most value. Dual source CT scan can reduce the time of radiation dose, effectively overcome some patients moving artifact and respiratory artifacts, suitable for children patients and agitation of patients, to provide safe, effective method for the rapid diagnosis and emergency classiifcation of patients with acute chest pain. Dual energy CT virtual scan has been well used in the head, chest, abdominal disease examination. Dual source CT for qualitative analysis of components in two different energy state of the data acquisition, and widen the application range of CT, with good clinical application.

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  12. 双源CT非心率控制自适应前瞻性心电门控序列扫描冠状动脉成像%CT coronary angiography without heart rate control with adaptive cardio sequence prospective ECG-gated using the second generation dual-source CT

    Institute of Scientific and Technical Information of China (English)

    王小琴; 钱农; 潘昌杰; 薛跃君; 王涛; 靳激扬

    2012-01-01

    Objective To explore the feasibility of improving image quality of low dose scanning using adaptive cardio sequence prospective ECG-gated without heart rate control by the second generation dual-source CT coronary angiography (CTCA). Methods Ninety-four consecutive patients were collected prospectively and underwent prospective ECG-gated a-daptive cardio sequence dual-source CTCA without heart rate control. Two experienced radiologists double-blindly assessed image quality of 15 segments of coronary arteries with five-score scale. Images with no less than 3 scores were usable for diagnosis. Correlation between image quality and heart rate, as well as with heart rate variability were analyzed. The intra-observer agreement for image quality was assessed. CT dose index of volume (CTDIvol) and effective dose (ED) were measured. Results The mean heart rate during scanning was (87. 24 13. 76) beats percent minute in all 94 patients. Totally 1410 segments of coronary arteries were included, and images useful for diagnosis (≥3 scores) were obtained in 1334 segments (94. 61%) of the coronary artery segments, while 76 segments (5. 39%) had non-assessable image quality. The mean image quality score for the whole coronary tree was 4. 25 0. 93. No correlation was observed between the mean heart rate (r= 0. 17, P = 0. 11) or heart rate variability (r=0. 10, P = 0. 32) and image quality. The Kappa value between two radiologists was 0.90 on image quality (P<0.001). CTDIvol and ED was (11.84+ 1.76)mGy and (2. 19 + 0. 45)mSv, respectively. Conclusion Using prospective ECG-gated adaptive cardio sequence, assessable image quality of coronary artery can be acquired with dual-source CT without heart rate control, and radiation dose can be obviously reduced.%目的 探讨双源CT非心率控制低剂量自适应前瞻性心电门控序列扫描冠状动脉成像的可行性.方法 前瞻性收集94例患者进行双源CT非心率控制自适应前瞻性心电门控序列扫

  13. Dual-source computed tomography: Estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ketelsen, Dominik [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)], E-mail: dominik.ketelsen@med.uni-tuebingen.de; Thomas, Christoph; Werner, Matthias; Luetkhoff, Marie H. [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Buchgeister, Markus [Departments of Radiotherapy and Radiooncology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Tsiflikas, Ilias; Reimann, Anja [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Burgstahler, Christof [Department of Cardiology, University Hospital Tuebingen, Ottfried-Mueller-Strasse 10, 72076 Tuebingen (Germany); Brodoefel, Harald; Kopp, Andreas F.; Claussen, Claus D.; Heuschmid, Martin [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)

    2010-02-15

    Purpose: The aim of the study was to estimate radiation exposure of coronary calcium scoring and angiography using ECG-gated and ECG-triggered dual-source computed tomography. Materials and methods: An Alderson Rando phantom equipped with thermoluminescent dosimeters was used for all dose measurements. Effective dose was calculated according to ICRP 103. Radiation exposure was performed on a dual-source computed tomography (DSCT) scanner with standard protocols for calcium scoring (DSCT-Ca) and coronary angiography (DSCTA) at different heart rates (40-100 beats/min). Furthermore, a scanning protocol with ECG-triggering as well as a standard chest CT scan were evaluated. Results: Depending on gender, heart rate and ECG-pulsing, the effective dose of a complete cardiac DSCT (DSCT-Ca and DSCTA) scan varies from 10.2 to 32.6 mSv. The effective radiation dose increased significantly with lower heart rates (p < 0.035). ECG-pulsing reduced the radiation exposure significantly in DSCTA (p < 0.001). Due to breast tissue in the primary scan range, females' doses showed an increase up to 69.9% compared to males in scan protocols without ECG-pulsing. Prospective ECG-triggered DSCTA resulted in estimated effective doses from 2.8 mSv (males) to 4.1 mSv (females). Conclusion: The ECG-pulsing technique has proven its effectiveness to reduce effective dose in coronary CT angiography and is recommended for all patients with regular heart rates. The patient's heart rate influences the radiation exposure with a significant decrease at higher heart rates. Due to its lower dose, ECG-triggered DSCTA should be implemented for special indications, i.e. for diagnosis of pathologies of the aortic root and the ascending aorta.

  14. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-01-15

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

  16. 双源CT的临床应用进展%Development and Clinical Application of Dual-Source CT

    Institute of Scientific and Technical Information of China (English)

    徐辉; 殷信道; 吴旻

    2014-01-01

    In 2005 and 2008, Siemens launched the 昀rst and second generation Dual Source CT system. This paper reviews the basic structure, characteristics, advantages and application of Dual Source CT system.%2005年、2008年西门子相继推出第一代双源CT Definition(Dual Source Computed Tomography, DSCT)、第二代双源CT(SOMATOM De昀nition Flash),本文主要就双源CT的基本结构、特点、优势以及在临床应用方面的进展作一综述。

  17. Application of flash dual-source CT at low radiation dose and low contrast medium dose in triple-rule-out (tro) examination.

    Science.gov (United States)

    Chen, Hong-Liang; Chen, Tian-Wu; Qiu, Li-Hua; Diao, Xian-Ming; Zhang, Chao; Chen, Li

    2015-01-01

    To evaluate the clinical imaging capacity of FLASH dual-source CT at low radiation dose and low contrast medium dose in thoracic aorta, pulmonary artery & vein and coronary artery. One hundred and eight patients of thoracalgia were randomly divided into two groups; 60 cases (group A) received dual-source CT scan in flash model at 100 KV and contrast medium dose of 74 ml combined with digital subtraction angiography (DSA) examination; 48 cases (group B) received retrospectively. ECG-triggered high-pitch spiral acquisition at 120 KV and contrast medium dose of 101 ml. Several image reconstruction techniques were adopted for coronary artery, pulmonary artery and aorta. The imaging quality and the diagnostic value of this technique were evaluated. Coronary artery stenosis of group A was compared against the results of DSA examination. The scan time in group A was obviously shorter than that of group B, i.e., t=0.7±0.1 s in group A and t=7.7±1.7 s in group A. The image reconstruction phase of coronary artery was 70.4±15.6% in group A, and the systolic phase accounted for 13.3% of the optimal reconstruction phase. Compared with group B, the radiation dose of group A decreased obviously, i.e. ED=2.7±0.7 mSv for group A and ED=21.6±6.0 mSv for group B. Moreover, less contrast agent was consumed in group A than in group B, which was 74 ml in group A and 101 ml in group B. The image quality of aorta and pulmonary artery & vein was grade 1 for all cases in group A, which was the same as with group B. The coronary artery images of group A had better quality, with score of 2.9±0.1. Of 780 segments, only 2 segments could be effectively diagnosed, showing no statistically significant differences from group B (P>0.05). The coronary artery stenosis revealed by dual-source CT for group A was not significantly different from that by DSA (P>0.05). FLASH dual-source CT scan at reduced radiation dose and reduced contrast medium dose used for triple-rule-out (TRO) examination

  18. Cardiac electrical mechanical coupling and flash dual-source CT coronary angiography in patients with high heart rates%心脏电机械偶联与Flash双源CT冠状动脉成像在高心率患者中的应用

    Institute of Scientific and Technical Information of China (English)

    韩瑞娟; 孙凯; 李立刚; 陈九宏

    2011-01-01

    Objective To assess the image quality and effective radiation dose of prospectively e -lectrocardiogram-triggered high-pitch spiral acquisition (flash spiral mode)dual-source CT coronary angiogra-phy in patients with high heart rate(HR).Methods From 1321 consecutive patients,seventy patients with HR≥70 bpm (group A) and seventy patients with HR <70 bpm (group B) underwent CT angiography and were prospectively included in this study .The start phase for image acquisition of the most cranial slice was selected at 20%-30% of the R-R interval for group A and at 60% of the RR interval for group B.Assessed the image quality and effective radiation dose of two group .Results (1)There were no significant differ-ences in age,sex,BMI and scan time between the two groups.(2)Image qualities:The segments with non-di-agnostic image quality occurred (i.e.score 3) had no significant difference between group A and group B (2.1% vs.1.5%,P=0.48).Non-diagnostic image quality was most often found in the RCA and LCX in both groups.(3)The estimated radiation dose was on average (1.00 ±0.15) mSv(0.7-1.82 mSv) in group A and (1.01 ±0.16)mSv (0.65-1.82 mSv) in group B.Conclusions Patients with high heart rates can be performed CTCA with high-pitch spiral acquisition mode.20%-30% of the R-R interval window for data ac-quisition for high-pitch dual-source CTCA may probably obtain good image quality with low doses .The high-est HRs are 100 bpm with good image quality.HR variability is a great effect factor of image quality .The esti-mated radiation dose is about 1 mSv.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  20. Comparison of low-dose sequences of dual-source CT and echocardiography for preoperative evaluation of aortic valve disease

    Institute of Scientific and Technical Information of China (English)

    FENG Juan; WANG Xi-ming; JI Xiao-peng; LI Hai-ou; LI Qiao; GUO Wen-bin; WANG Zheng-jun

    2013-01-01

    Background Accurate evaluation of coronary artery,aortic valve annulus diameter (AVAD),and cardiac function in patients with aortic valve disease is of great significance for surgical strategy.In this study,we explored the preoperative evaluation of low-dose sequence (MinDose sequence) scan of dual-source CT (DSCT) for those patients.Methods Forty patients suspected for aortic valve disease (the experimental group) underwent MinDose sequence of DSCT to observe coronary artery,AVAD,and left ventricular ejection fraction (LVEF).Another 33 subjects suspected for coronary artery disease (the control group) underwent conventional retrospective electrocardiographically-gated sequence of DSCT.Two-dimensional transthoracic echocardiography (2D-TTE) and four-dimensional transthoracic echocardiography (4D-TTE) were applied in the experimental group to measure AVAD and LVEF and compared with MinDose-DSCT.Results There was a strong correlation between LVEFs measured by 2D-TTE and MinDose-DSCT (r=0.87,P <0.01),as well as between 4D-TTE and MinDose-DSCT (r=0.90,P <0.01).AVAD measured by MinDose-DSCT was in good agreement with corresponding measurements by 2D-TTE (r=0.90,P <0.01).The effective dose in the experimental group was 63.54% lower than that in the control group.Conclusions MinDose sequence of DSCT with a low radiation dose serving as a one-stop preoperative evaluation makes effective assessment of the coronary artery,AVAD,and LVEF for patients with aortic valve disease.

  1. High-pitch dual-source CT angiography of the aortic valve-aortic root complex without ECG-synchronization

    Energy Technology Data Exchange (ETDEWEB)

    Karlo, Christoph; Leschka, Sebastian; Goetti, Robert Paul; Feuchtner, Gudrun; Desbiolles, Lotus; Stolzmann, Paul; Marincek, Borut; Baumueller, Stephan [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Plass, Andre; Falk, Volkmar [University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Massachusetts General Hospital, Harvard Medical School, Cardiac MR PET CT Group, Boston, MA (United States)

    2011-01-15

    To compare image quality and radiation dose of high-pitch computed tomography angiography(CTA) of the aortic valve-aortic root complex with and without prospective ECG-gating compared to a retrospectively ECG-gated standard-pitch acquisition. 120 patients(mean age 68 {+-} 13 years) were examined using a 128-slice dual-source CT system using prospectively ECG-gated high-pitch(group A; n = 40), non-ECG-gated high-pitch(group B; n = 40) or retrospectively ECG-gated standard-pitch(C; n = 40) acquisition techniques. Image quality of the aortic root, valve and ascending aorta including the coronary ostia was assessed by two independent readers. Image noise was measured, radiation dose estimates were calculated. Interobserver agreement was good({kappa} = 0.64-0.78). Image quality was diagnostic in 38/40 patients(group A), 37/40(B) and 38/40(C) with no significant difference in number of patients with diagnostic image quality among all groups (p = 0.56). Significantly more patients showed excellent image quality in group A compared to groups B and C(each, p < 0.01). Average image noise was significantly different between all groups(p < 0.05). Mean radiation dose estimates in groups A and B(each; 2.4 {+-} 0.3 mSv) were significantly lower compared to group C(17.5 {+-} 4.4 mSv; p < 0.01). High-pitch dual-source CTA provides diagnostic image quality of the aortic valve-aortic root complex even without ECG-gating at 86% less radiation dose when compared to a standard-pitch ECG-gated acquisition. (orig.)

  2. 双源CT大螺距前瞻心电触发血管成像评价全主动脉及冠状动脉%Electrocardiographically triggered CT angiography of the whole aorta and coronary arteries with high-pitch dual-source CT

    Institute of Scientific and Technical Information of China (English)

    张楠; 李宇; 吕元; 赵龙; 耿薇; 范占明

    2013-01-01

    Objective To investigate the feasibility of comprehensive assessment of the whole aorta and coronary arteries (CA) simultaneously with high-pitch 128-slice dual-source CT ECG-gated FLASH protocol.Methods A total of 48 consecutive patients with suspected aortic diseases underwent CTA examination of the whole aorta and CA using a ECG-gated FLASH CT protocol (pitch =3.2) without heart rate (HR) control.Aorta,aortic valves and CA were shown with different post-processing modalities.The image quality of the aorta,aortic valves and CA was evaluated and compared according to HR (low HR group ≤ 65 bpm,high HR group > 65 bpm).The scan time,effective dose and contrast medium volume were recorded.Inter-observer differences were calculated by Kappa test.Differences between groups were analyzed by Mann-Whitney test with count data and variance test with measurement data.Results All examinations were completed successfully.The image quality was acceptable in the aorta,aortic valve (100%,48/48) and CA (94.0%,551/586).Percentage of diagnostic quality images was slightly higher in low HR group (94.7%,232/245,93.5%,319/341,Z =-2.504,P < 0.05).Inter-reader reproducibility was 95.8% (46/48) in the aorta and aortic valve,96.6% (566/586) in CA,yielded good agreement (Kappa =0.81 and 0.89).The mean attenuation of aorta and CA were higher than 300 HU,especially in low HR group (357.0-446.0) HU.Except proximal segment of right CA,the CNR of whole aorta and coronary arteries were significantly higher in the low HR group (24.5-29.0) than that in the high HR group (20.0-23.1,P <0.05).SNR of the whole aorta was higher in the low HR group (13.7-17.9) than the high HR group (11.5-13.9,P < 0.05).The mean scan time was (1.56 ± 0.08) s,effective dose was (4.12 ± 1.23) mSv (2.77-6.77 mSv),and contrast medium volume was (72.8 ± 2.1) ml.Conclusions CT angiography of whole aorta and coronary arteries could be performed simultaueously within 2 seconds with CT ECG-gated FLASH

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  5. The Research and Solution Scheme on Relationship between Dual-Source CT Coronary Artery CTA Artifact and Heart Rate Change%双源CT冠状动脉CTA伪影与心率变化关系探讨和解决对策

    Institute of Scientific and Technical Information of China (English)

    冀舒文; 巢惠民; 高斌; 陈旺

    2011-01-01

    目的:研究双源CT成像质量和错层伪影出现原因,探讨成像质量不佳的原因和解决方法。方法:回顾性分析自2010年2月至2010年6月70例临床疑似冠心病人双源CT冠状动脉CTA图像和心电监测资料。比较出现错层伪影和无错层伪影的病人的平均心率、心率波动、心率变异和平均R-R间期的差异。结果:出现错层伪影和无错层伪影病人的平均心率、心率波动、心率变异和平均R-R间期没有显著性差异。结论:在双源CT使用中,平均心率、心率波动、心率变异、平均R-R间期等参数不是直接或主要导致图像质量不佳和错层伪影的主要原因,这与双源CT的设备性能和数据采集方式有关。导致图像伪影的原因是心律不齐、扫描过程中的体位移动,出现伪影后进行心电编辑重新发现和选择不同心动周期心脏运动相位相同的重建时间窗可以纠正错层伪影。%Purpose:The reason of imaging quality and wrong layer artifact of coronary arteries CTA with Dual-source CT and heart rate and to discuss the reason of poor imaging quality and the solution.Method:70 cases of coronary arteries CTA imaging and ECG data of patients with suspected coronary artery disease from February 2010 to July 2010 were retrospectively analyzed.The difference of average heart rate,fluctuation of heart rate,variation of heart rate and average R-R period between the patients who has artifact and no artifact was compared.Results:Average heart rate,fluctuation of heart rate,variation of heart rate and average R-R period between the patients who has artifact and no artifact is no significant difference.Conclusion:Use in the double source CT in,average heart rate,heart rate motion,heart rate variation and average R-R expect to etc.parameter to isn't direct or mainly cause picture quality poor and wrong layer false shadow of main reason,this and double equipments function and data of the source CT

  6. Alternative technique using dual source CT imaging for assessment of myocardial perfusion

    Directory of Open Access Journals (Sweden)

    Amgad S. Abdel-Rahman

    2015-06-01

    Conclusion: We propose that comprehensive evaluation of coronary artery morphology and myocardial perfusion in patients with CAD could be achieved by single reproducible non-invasive contrast enhanced CT acquisition using DSCT scanners while operated in single energy mode with high sensitivity, specificity and diagnostic accuracy, it also has the potential to be the first, independent and stand out imaging choice in such field.

  7. Optimization of kV Selection on Third-generation High-pitch Dual-source Coronary CT Angiography Using Ultra-low Contrast Media Protocols in Patients with Body Mass Index between 20-30 kg/m(2) under Automatic Tube Voltage Selection.

    Science.gov (United States)

    Wang, Ming; Yi, Yan; Cao, Jian; Wang, Yining; Qi, Bing; Ma, Shuo; Wang, Yun

    2017-02-20

    Objective To investigate the application of automatic tube voltage selection (CARE-kV)coronary CT angiography (CCTA)using ultra-low contrast media (CM)protocols in patients with body mass index (BMI)between 20 kg/m(2) and 30 kg/m(2) on third-generation dual-source CT (DSCT). Methods We prospectively included 134 consecutive patients with BMI between 20 kg/m(2) and 30 kg/m(2)who underwent CARE-kV prospective high-pitch CCTA on third-generation DSCT using the ultra-low CM protocols and divided them into two groups according to the CARE-kV results:70 kV group(n=91):65 patients with normal BMI(20 kg/m(2)≤BMI≤25 kg/m(2))and 26 patients with high BMI(25 kg/m(2)image quality (IQ),and results of patients in each group and subgroup were evaluated and compared.ResultsThe ED of 70 kV group was(0.24±0.04)mSv,which was 53% lower(H=3.37,P=0.02)than that of 80 kV group [(0.51±0.05)mSv]. No significant difference of CNR and SNR had been found in normal BMI patients(H=1.81,P=0.23)and high BMI patients (H=0.91,P=0.84)among 70 kV group and 80 kV group,as well as the subjective IQ in normal BMI patients(Z=0.79,P=0.76)and high BMI patients (Z=0.77,P=0.81)among 70 kV group and 80 kV group. Conclusion sWhen patients with BMI between 20 kg/m(2) and 30 kg/m(2) receive CARE-kV prospective high-pitch CCTA on third-generation DSCT,the CARE-kV results for a portion of patients may be higher than other patients with the same BMI level,so as to guarantee the equivalent IQ. The CARE-kV can help to select the patients' optimal tube voltage value more accurately and reasonably.

  8. Assessment of radiation exposure on a dual-source computed tomography-scanner performing coronary computed tomography-angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kirchhoff, S., E-mail: sonja.kirchhoff@med.uni-muenchen.d [Institute of Clinical Radiology, University Hospital Munich - Grosshadern, Ludwig Maximilians-Universitaet Muenchen, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich (Germany); Herzog, P., E-mail: peter.herzog@med.uni-muenchen.d [Institute of Clinical Radiology, University Hospital Munich - Grosshadern, Ludwig Maximilians-Universitaet Muenchen, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich (Germany); Johnson, T., E-mail: Thorsten.johnson@med.uni-muenchen.d [Institute of Clinical Radiology, University Hospital Munich - Grosshadern, Ludwig Maximilians-Universitaet Muenchen, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich (Germany); Boehm, H., E-mail: holger.boehm@med.uni-muenchen.d [Institute of Clinical Radiology, University Hospital Munich - Grosshadern, Ludwig Maximilians-Universitaet Muenchen, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich (Germany); Nikolaou, K., E-mail: konstantin.nikolaou@med.uni-muenchen.d [Institute of Clinical Radiology, University Hospital Munich - Grosshadern, Ludwig Maximilians-Universitaet Muenchen, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich (Germany); Reiser, M.F., E-mail: maximilian.reiser@med.uni-muenchen.d [Institute of Clinical Radiology, University Hospital Munich - Grosshadern, Ludwig Maximilians-Universitaet Muenchen, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich (Germany); Becker, C.H., E-mail: christoph.becker@med.uni-muenchen.d [Institute of Clinical Radiology, University Hospital Munich - Grosshadern, Ludwig Maximilians-Universitaet Muenchen, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich (Germany)

    2010-06-15

    Objective: The radiation exposure of a dual-source-64-channel multi-detector-computed-tomography-scanner (Somatom-Defintion, Siemens, Germany) was assessed in a phantom-study performing coronary-CT-angiography (CTCA) in comparison to patients' data randomly selected from routine scanning. Methods: 240 CT-acquisitions of a computed tomography dose index (CTDI)-phantom (PTW, Freiburg, Germany) were performed using a synthetically generated Electrocardiography (ECG)-signal with variable heart rates (30-180 beats per minute (bpm)). 120 measurements were acquired using continuous tube-output; 120 measurements were performed using ECG-synchronized tube-modulation. The pulsing window was set at minimum duration at 65% of the cardiac cycle between 30 and 75 bpm. From 90-180 bpm the pulsing window was set at 30-70% of the cardiac cycle. Automated pitch adaptation was always used. A comparison between phantom CTDI and two patient groups' CTDI corresponding to the two pulsing groups was performed. Results: Without ECG-tube-modulation CDTI-values were affected by heart-rate-changes resulting in 85.7 mGray (mGy) at 30 and 45 bpm, 65.5 mGy/60 bpm, 54.7 mGy/75 bpm, 46.5 mGy/90 bpm, 34.2 mGy/120 bpm, 27.0 mGy/150 bpm and 22.1 mGy/180 bpm equal to effective doses between 14.5 mSievert (mSv) at 30/45 bpm and 3.6 mSv at 180 bpm. Using ECG-tube-modulation these CTDI-values resulted: 32.6 mGy/30 bpm, 36.6 mGy/45 bpm, 31.4 mGy/60 bpm, 26.8 mGy/75 bpm, 23.7 mGy/90 bpm, 19.4 mGy/120 bpm, 17.2 mGy/150 bpm and 15.6 mGy/180 bpm equal to effective doses between 5.5 mSv at 30 bpm and 2.6 mSv at 180 bpm. Significant CTDI-differences were found between patients with lower/moderate and higher heart rates in comparison to the phantom CTDI-results. Conclusions: Dual source CTCA is particularly dose efficient at high heart rates when automated pitch adaptation, especially in combination with ECG-based tube-modulation is used. However in clinical routine scanning for patients with higher

  9. Efficacy of a dynamic collimator for overranging dose reduction in a second- and third-generation dual source CT scanner

    NARCIS (Netherlands)

    R. Booij (Ronald); M.L. Dijkshoorn (Marcel); M. van Straten (Marcel)

    2017-01-01

    textabstractObjectives: The purpose of this study was to assess the efficacy of the renewed dynamic collimator in a third-generation dual source CT (DSCT) scanner and to determine the improvements over the second-generation scanner. Methods: Collimator efficacy is defined as the percentage overrangi

  10. Radiation dose levels in pediatric chest CT: experience in 499 children evaluated with dual-source single-energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Martine, Remy-Jardin; Colas, Lucie; Jean-Baptiste, Faivre; Remy, Jacques [CHU Lille (EA 2694) University of Lille, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Santangelo, Teresa [CHU Lille (EA 2694) University of Lille, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Bambino Gesu Children' s Hospital, Department of Imaging, Rome (Italy); Duhamel, Alain [University of Lille (EA 2694), Department of Biostatistics, CHU Lille, Lille (France); Deschildre, Antoine [CHU Lille - University of Lille, Department of Pediatric Pulmonology, Lille (France)

    2017-02-15

    The availability of dual-source technology has introduced the possibility of scanning children at lower kVp with a high-pitch mode, combining high-speed data acquisition and high temporal resolution. To establish the radiation dose levels of dual-source, single-energy chest CT examinations in children. We retrospectively recorded the dose-length product (DLP) of 499 consecutive examinations obtained in children <50 kg, divided into five weight groups: group 1 (<10 kg, n = 129); group 2 (10-20 kg, n = 176); group 3 (20-30 kg, n = 99), group 4 (30-40 kg, n = 58) and group 5 (40-49 kg, n = 37). All CT examinations were performed with high temporal resolution (75 ms), a high-pitch mode and a weight-adapted selection of the milliamperage. CT examinations were obtained at 80 kVp with a milliamperage ranging between 40 mAs and 90 mAs, and a pitch of 2.0 (n = 162; 32.5%) or 3.0 (n = 337; 67.5%). The mean duration of data acquisition was 522.8 ± 192.0 ms (interquartile range 390 to 610; median 490). In the study population, the mean CT dose index volume (CTDIvol{sub 32}) was 0.83 mGy (standard deviation [SD] 0.20 mGy; interquartile range 0.72 to 0.94; median 0.78); the mean DLP{sub 32} was 21.4 mGy.cm (SD 9.1 mGy.cm; interquartile range 15 to 25; median 19.0); and the mean size-specific dose estimate (SSDE) was 1.7 mGy (SD 0.4 mGy; interquartile range 1.5 to 1.9; median 1.7). The DLP{sub 32}, CTDI{sub vol32} and SSDE were found to be statistically significant in the five weight categories (P < 0.0001). This study establishes the radiation dose levels for dual-source, single-kVp chest CT from a single center. In the five weight categories, the median values varied 15-37 mGy.cm for the DLP{sub 32}, 0.78-1.25 mGy for the CTDI{sub vol32} and 1.6-2.1 mGy for the SSDE. (orig.)

  11. Assessment of thoracic aortic elasticity: a preliminary study using electrocardiographically gated dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ning; Guo, Lijun; Sun, Haitao; Gao, Fei; Liu, Cheng [Shandong University, Shandong Medical Imaging Research Institute, Jinan (China); Beck, Thomas [Siemens AG, Healthcare Sector, Imaging and IT Division, Computed Tomography, Forchheim (Germany); Chen, Jiuhong [Siemens Ltd., China, Healthcare, No.7, Wangjing Zhonghuan Nanlu, Beijing (China); Biermann, Christina [Siemens AG, Siemens Healthcare Consulting, Erlangen (Germany)

    2011-07-15

    To gain a new insight into the elastic properties of the thoracic aorta in patients without aortic diseases using electrocardiographically (ECG)-gated dual-source (DS) CT. 56 subjects with no cardiovascular disease, selected from 2,700 people undergoing ECG-gated DSCT examination, were divided into three groups according to their age. CT data were reconstructed in 5% step throughout the RR interval. Diameter and area were measured at the curve of the ascending aorta (AA) and at the same level of the descending aorta (DA). The pulsation and elasticity of the aorta were evaluated. Aortic diameter changes were noted throughout the cardiac cycle. The maximum average diameter was seen at an RR interval of 24.02 {+-} 4.99% for the AA and 25.63 {+-} 4.77% for the DA. The minimum was at 93.5 {+-} 4.04% for the AA and 96.6 {+-} 4.58% for the DA. There was an age-dependent decrease in elasticity, while different correlation coefficients were found between various age groups and different elastic parameters. The properties of aortic pulsation and wall elasticity could be well shown by ECG-gated DSCT. The new findings regarding segment difference and age relevance were significant and should be taken into account in clinical trials and treatments for the elasticity related cardiovascular diseases. (orig.)

  12. 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.

  13. Intensity distribution and impact of scatter for dual-source CT

    Science.gov (United States)

    Kyriakou, Yiannis; Kalender, Willi A.

    2007-12-01

    Apart from forward scatter, which is given for all CT scanners, dual-source CT (DSCT) is also affected by cross-scatter photons from the second tube-detector system arranged at 90°. We investigated the magnitude and distribution of scatter for DSCT and its impact on image quality. Simulations and measurements of homogeneous and anthropomorphic phantoms were conducted for a DSCT scanner (SOMATOM Definition, Siemens Medical Solutions, Forchheim, Germany) at tube voltages of 80 and 120 kV. The simulations of forward scatter were carried out using combined analytical and Monte Carlo simulation methods for a collimation of 19.2 mm for both tube-detector systems. Measurements of cross scatter were performed by switching one tube off, still reading out the corresponding detector. The relative scatter fractions and the distribution of cross scatter were registered for various imaging conditions. Additionally, a detailed noise analysis with respect to the correction of cross-scatter artifacts is provided to evaluate the performance of correction algorithms. The forward-scatter fraction increased with increasing phantom diameter from 0.02 up to 0.11 for PMMA phantoms of 80 to 400 mm diameter. For cross scatter, the mean intensity was equivalent to forward scatter for small phantoms but was larger for increased phantom size and resulted in severe artifacts in the reconstructed images. The outer dimensions and shape of the object are decisive for the cross-scatter intensity distribution whereas the influence of the degree of inhomogeneity of the respective phantom appears to be negligible. Scatter correction suppressed cross-scatter artifacts but increased noise as a function of the cross-scatter fraction. The magnitude of scatter is not negligible for DSCT systems and dedicated corrections are necessary for the assurance of unimpaired image quality.

  14. Preliminary study on ultra low tube voltage (70kV)sequential scan with low-volume contrast media protocol for dual-source CT coronary angiography%70 kV超低管电压低对比剂用量冠状动脉CTA研究

    Institute of Scientific and Technical Information of China (English)

    曹剑; 王少华; 张龙江; 卢光明; 金征宇; 易妍; 王怡宁; 林路; 王明; 孔令燕; 薛华丹; 宋兰; 王志伟

    2014-01-01

    Objective:To investigate the application of ultra low tube voltage (70kV)for coronary artery CT angiog-raphy (CCTA)with low-volume contrast media and low inj ection rate on dual-source CT (DSCT)equipment with integrat-ed circuit (IC)detector.Methods:Fifty patients with body mass index (BMI)not more than 25kg/m2 were scanned with a prospectively ECG-triggering sequential CCTA protocol on DSCT.All patients were randomly divided into two groups:the injection rate and volume of contrast in Group A was 4.0ml/s and 32mL (350mg I/mL);those in Group B were 4.0mL/s and 50mL (350mg I/mL),respectively.Tube voltage of both groups was 70kV.The raw data were reconstructed with sino-gram affirmed iterative reconstruction (SAFIRE)technique.The differences of age,BMI,heart rate,background noise,sig-nal-to-noise ratio (SNR)and radiation dose between the two Groups were compared.Besides,the CT value and CNR of the aortic root and each segment of coronary arteries were compared.And Image quality (1~4,excellent to non-assessable)be-tween the two Groups was compared segment-based.Results:There were no significant differences in age,BMI,heart rate, background noise,SNR or radiation dose between the two Groups (all P>0.05),and the mean ED was about 0.90mSv.The CT value of the distal segment of each coronary arteries in Group B was higher than Group A,while there were no signifi-cant differences in the proximal and median segments between the two groups.However,the CNR of each segment of coro-nary arteries in Group B were higher than Group A (all P<0.01).Mean segment-based image quality scores showed no sig-nificant difference between the two Groups reconstructed with SAFIRE (Group A,1.16±0.18,Group B,1.18±0.18;P=0.75).The percentage of assessable segments in each Group were more than 98%.Conclusion:For patients with normal BMI,the use of tube voltage as 70kV with SAFIRE technique in DSCT equipped IC detector is feasible.And both the con-trast injection rate and volume can be much lower

  15. Adenosine-stress dynamic myocardial perfusion imaging using 128-slice dual-source CT: optimization of the CT protocol to reduce the radiation dose.

    Science.gov (United States)

    Kim, Sung Mok; Kim, Yoo Na; Choe, Yeon Hyeon

    2013-04-01

    The aim of this study was to compare the radiation dose and image quality of different adenosine-stress dynamic myocardial perfusion CT protocols using a 128-slice dual-source computed tomography (DSCT) scanner. We included 330 consecutive patients with suspected coronary artery disease. Protocols employed the following dynamic scan parameters: protocol I, a 30-s scan with a fixed tube current (FTC, n = 172); protocol II, a 30-s scan using an automatic tube current modulation (ATCM) technique (n = 108); protocol III, a 14-s scan using an ATCM (n = 50). To determine the scan interval for protocol III, we analyzed time-attenuation curves of 26 patients with myocardial perfusion who had been scanned using protocol I or II. The maximum attenuation difference between normal and abnormal myocardium occurred at 18.0 s to 30.3 s after initiation of contrast injection. Myocardial perfusion images of FTC and ATCM were of diagnostic image quality based on visual analysis. The mean radiation dose associated with protocols I, II, and III was 12.1 ± 1.6 mSv, 7.7 ± 2.5 mSv, and 3.8 ± 1.3 mSv, respectively (p < 0.01). Use of a dose-modulation technique and a 14-s scan duration for adenosine-stress CT enables significant dose reduction while maintaining diagnostic image quality.

  16. Quantitative assessment of left ventricular function with dual-source CT in comparison to cardiac magnetic resonance imaging: initial findings

    Energy Technology Data Exchange (ETDEWEB)

    Busch, S.; Johnson, T.R.C.; Wintersperger, B.J.; Minaifar, N.; Bhargava, A.; Rist, C.; Reiser, M.F.; Becker, C.; Nikolaou, K. [University of Munich, Department of Clinical Radiology, Munich (Germany)

    2008-03-15

    Cardiac magnetic resonance imaging and echocardiography are currently regarded as standard modalities for the quantification of left ventricular volumes and ejection fraction. With the recent introduction of dual-source computedtomography (DSCT), the increased temporal resolution of 83 ms should also improve the assessment of cardiac function in CT. The aim of this study was to evaluate the accuracy of DSCT in the assessment of left ventricular functional parameters with cardiac magnetic resonance imaging (MRI) as standard of reference. Fifteen patients (two female, 13 male; mean age 50.8 {+-} 19.2 years) underwent CT and MRI examinations on a DSCT (Somatom Definition; Siemens Medical Solutions, Forchheim, Germany) and a 3.0-Tesla MR scanner (Magnetom Trio; Siemens Medical Solutions), respectively. Multiphase axial CT images were analysed with a semiautomatic region growing algorithms (Syngo Circulation; Siemens Medical Solutions) by two independent blinded observers. In MRI, dynamic cine loops of short axis slices were evaluated with semiautomatic contour detection software (ARGUS; Siemens Medical Solutions) independently by two readers. End-systolic volume (ESV), end-diastolic volume (EDV), ejection fraction (EF) and stroke volume (SV) were determined for both modalities, and correlation coefficient, systematic error, limits of agreement and inter-observer variability were assessed. In DSCT, EDV and ESV were 135.8 {+-} 41.9 ml and 54.9 {+-} 29.6 ml, respectively, compared with 132.1 {+-} 40.8 ml EDV and 57.6 {+-} 27.3 ml ESV in MRI. Thus, EDV was overestimated by 3.7 ml (limits of agreement -46.1/+53.6), while ESV was underestimated by 2.6 ml (-36.6/+31.4). Mean EF was 61.6 {+-} 12.4% in DSCT and 57.9 {+-} 9.0% in MRI, resulting in an overestimation of EF by 3.8% with limits of agreement at -14.7 and +22.2%. Rank correlation rho values were 0.81 for EDV (P = 0.0024), 0.79 for ESV (P = 0.0031) and 0.64 for EF (P = 0.0168). The kappa value of inter

  17. Study of dual-source CT coronary angiography using low tube voltage setting in patients with low body mass index%低体质量指数患者双源CT低管电压冠状动脉成像的应用研究

    Institute of Scientific and Technical Information of China (English)

    曹建新; 王鹏; 王一民; 杨诚; 王帅

    2013-01-01

    Objective To explore the feasibility of dual-source CT coronary angiography (CTCA) using 80 kV tube voltage setting in patients with low body mass index (BMI).Methods A total of 240 patients with suspected coronary artery disease (BMI range 18.6-21.5 kg/m2) underwent dual-source CTCA.They were randomly assigned to group A (120 kV tube voltage),B (100 kV tube voltage) and C (80 kV tube voltage) based on a random number table.The contrast media dose,volume CT dose index (CTDIvol),dose length product (DLP),and effective dose (ED) were evaluated for each patient.Image noise,CT value,contrast,signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) and figure of merit (FOM) of coronary artery were all evaluated.Tie image quality of coronary artery was assessed with a threepoint scale (3 points:excellent,2 points:general,1 point:poor).Scan length,CTDIvol,DLP,ED,and contrast media dose for patients,image noise,CT value,contrast,SNR,CNR,and FOM of coronary artery were all analyzed using one-way ANOV4 analysis for 3 groups.Time windows of ECG-pulsing protocol were analyzed using x2 test,and the image quality scores of coronary artery were analyzed using Kruskal-Wallis test.Results There were no differences in scan length and Time windows of ECG-pulsing protocol among 3 groups (scan length F =2.58,P > 0.05,Time windows of ECG-pulsing protocol x2 =0.77,P > 0.05).The average contrast media doses were (82.0 ± 6.4),(76.8 ± 6.1),and (59.1 ± 3.5) ml,the average CTDIvol were(27.5 ±6.2),(18.7 ±4.4),and(11.4 ±2.4)mGy,the average DLPs were (427.7 ±92.4),(295.4 ± 77.1),and (183.9 ± 41.3) mGy · cm,and the average EDs were (6.1 ± 1.3),(4.1 ± 1.1),and (2.6 ± 0.6) msy for group A,B and C,respectively.There were statistical differences in contrast media dose,CTDIvoI,DLP,and ED among 3 groups (the F values for contrast media dose,CTDIvol,DLP,and ED were 383.08,248.13,221.05,and 234.81,respectively,all P <0.01).Compared to group A and B,the contrast media dose in group C

  18. Efficacy of a dynamic collimator for overranging dose reduction in a second- and third-generation dual source CT scanner

    OpenAIRE

    Booij, Ronald; Dijkshoorn, Marcel; Straten, Marcel

    2017-01-01

    textabstractObjectives: The purpose of this study was to assess the efficacy of the renewed dynamic collimator in a third-generation dual source CT (DSCT) scanner and to determine the improvements over the second-generation scanner. Methods: Collimator efficacy is defined as the percentage overranging dose in terms of dose–length product (DLP) that is blocked by the dynamic collimator relative to the total overranging dose in case of a static collimator. Efficacy was assessed at various pitch...

  19. 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.

  20. 双源CT冠状动脉血管成像中降低团注追踪触发监测频率的可行性研究%Feasibility of reducing bolus-tracking monitor frequency in coronary CT angiology with dual-source CT

    Institute of Scientific and Technical Information of China (English)

    韩宇欣; 王辉; 汤漪凡; 王涛; 吕蓉; 于长路; 刘金梦

    2016-01-01

    Objective To investigate the feasibility of reducing bolus⁃tracking monitor frequency in coronary CT angiography (CTA). Methods This prospective study including 120 patients with suspected coronary artery disease (CAD). According to the examination registration order, the patients were divided into groups A, B and C (n=40 for each group). All patients underwent coronary CTA with bolus⁃tracking technology, and were monitored at 10 s after the injection of contrast. The monitoring frequency of bolus⁃tracking for Group A was every 1.14 s, that for Group B was every 1.47 s , and for Group C was every 2.00 s, while the trigger threshold was set as 100 HU. To evaluate the image quality, the objective evaluation included signal noise ratio (SNR) and contrast noise ratio (CNR) of aorta (AO), CNR of left main coronary artery (LM) and right coronary artery (RCA), and the subjective score was recorded for each coronary artery segment. The monitoring times when CT density of the region of interest (ROI) reached the threshold, the CT value and the effective dose (ED) in the 3 groups were recorded. Objective image quality, monitoring parameters and radiation dose were compared using analysis of variance method, subjective image quality was compared withχ2 tests. Results There was no significant difference in AO (SNR and CNR), LM (CNR) and RCA (CNR) among the 3 groups, respectively (P>0.05). Subjective image quality scores of groups A, B, C were (1.879±0.042), (1.876±0.042), (1.881±0.042 ), with no significant difference (χ2=0.003,P>0.05). The monitoring times of to reach the threshold in groups A, B, C were (4.78±2.37), (3.76±1.39), (2.77±0.99), and ED were (0.058±0.031),(0.031±0.011), (0.021±0.007) mSv, with the significant difference (F=9.009, 31.998, respectively, P0.05)。A、B、C组的图像质量评分分别为(1.879±0.042)、(1.876±0.042)、(1.881±0.042)分,差异无统计学意义(χ2=0.003,P>0.05)。A、B、C组达到阈值

  1. Correlation Between Dual-energy and Perfusion CT in Patients with Focal Liver Lesions Using Third-generation Dual-source CT Scanner.

    Science.gov (United States)

    Xu, Jia; Zheng, Yongchang; Wang, Xuan; Xue, Huadan; Wang, Shitian; Liang, Jixiang; Jin, Zhengyu

    2017-02-20

    Objective To compare measurements of dual-energy CT iodine map parameters and liver perfusion CT parameters in patients with focal liver lesions using a third-generation dual-source CT scanner. Methods Between November 2015 and August 2016,33 patients with non-cystic focal lesions of liver were enrolled in this study. CT examinations were performed with a third-generation dual-source CT. The study CT protocol included a perfusion CT and dual-energy arterial and portal venous scans,with a time interval of 15 minutes. Iodine attenuation was measured at five region of interests including areas of high,medium,and low density within the lesion,as well as right and left liver parenchyma from the iodine map,while arterial liver perfusion (ALP),portal venous liver perfusion (PVP),and hepatic perfusion index (HPI) at the same location were measured from perfusion CT. The Pearson product-moment correlation coefficient was used to evaluate the relationship between iodine attenuation and perfusion parameters. Results The iodine attenuation at arterial phase showed significant intra-individual correlation with ALP (r=0.812,95% CI=0.728-0.885,Pperfusion CT [(14.53±0.45)mSv](t=25.212,P<0.001). Conclusion Iodine attenuation from arterial phase of dual energy CT demonstrates significant correlation with ALP and PVP,and iodine attenuation from portal venous phase demonstrates significant correlation with PVP.

  2. [The value of dual-source dual-energy CT with iodine overlay in the diagnosis of acute necrotizing pancreatitis].

    Science.gov (United States)

    Yuan, Yuan; Huang, Zi-Xing; Li, Zhen-Lin; Song, Bin; Deng, Li-Ping

    2012-07-01

    To investigate the clinical value of dual-source computed tomography dual-energy Iodine overlay technique in the imaging diagnosis of acute necrotizing pancreatitis. The imaging data were retrospectively analyzed in 67 cases of acute necrotizing pancreatitis underwent contrast-enhanced dual-source dual-energy CT in portal venous phase. The CT imaging parameters, including the difference of CT value between pancreatic parenchyma and necrotic lesion, contrast-to-noise ratio of pancreatic parenchyma-to-necrosis, area of pancreatic necrosis and score of subjective diagnosis, were measured and assessed on CT images of 80 kV, 140 kV, weighted-average 120 kV as well as Iodine overlay. The differences of CT value between pancreatic parenchyma and necrosis in the images of 80 kV, 140 kV, weighted-average 120 kV and Iodine overlay were (67.40 +/- 20.82) HU, (42.87 +/- 14.99) HU, (48.69 +/- 15.82) HU, (33.01 +/- 10.26) HU, respectively; contrast-to-noise ratios of pancreatic parenchyma-to-necrosis of each group were 8.36 +/- 3.58, 5.85 +/- 2.65, 7.68 +/- 3.51, 10.60 4.34; area of pancreatic necrosis of each group was (3.78 +/- 2.68) cm2, (3.28 +/- 2.59) cm2, (3.37 +/- 2.46) cm2, (2.42 +/- 1.98) cm2; the score of subjective diagnosis of each group was 3.88 +/- 0.33, 3.31 +/- 0.80, 3.58 +/- 0.66, 2.81 +/- 0.76, respectively. The four indexes in the images of Iodine overlay were significantly different from those of another three groups (P overlay was significantly higher than that of another three groups, while the difference of CT value, area of pancreatic necrosis and score of subjective diagnosis were lower. CONCLUSION; Dual-source CT dual-energy Iodine overlay is not helpful to improve subjective judgment in the diagnosis of pancreatic necrosis, but contributes to the display of hypoperfusion area around the necrosis.

  3. Detection of significant coronary artery stenosis with cardiac dual-source computed tomography angiography in heart transplant recipients.

    Science.gov (United States)

    von Ziegler, Franz; Rümmler, Janine; Kaczmarek, Ingo; Greif, Martin; Schenzle, Jan; Helbig, Susanne; Becker, Christoph; Meiser, Bruno; Becker, Alexander

    2012-10-01

    Present study evaluates clinical feasibility of cardiac dual-source computed tomography angiography (DSCTA) to detect significant coronary stenosis because of chronic allograft vasculopathy (CAV) after heart transplantation (HTX). An overall of 51 consecutive heart transplant recipients (43 men, 8 women, mean age: 52.3 ± 13.6 years) underwent DSCTA 1 ± 2 days before annual routine invasive coronary angiography (ICA). Three patients were excluded from further analysis. Total 714/717 (99.6%) segments in remaining 48 patients were depicted in diagnostic image quality by DSCTA with three vessel segments in two patients being additionally excluded because of motion artefacts. On a segment-based analysis, sensitivity, specificity, and diagnostic accuracy (DA) for detection of significant stenosis were calculated as 100%, 98.9% and 98.9% respectively. On a patient-based evaluation, sensitivity, specificity and DA were 100%, 86.0% and 93.0% respectively for remaining 46 patients. Negative predictive value (NPV) was 100%. DSCTA enables diagnosis and especially the exclusion of significant coronary artery stenosis in patients after HTX with a high NPV. The low rate of excluded vessel segments compared with former studies indicates improvement in image acquisition and robustness of latest scanner technology and thus may make subsequent annual invasive coronary angiography unnecessary. © 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.

  4. Dual energy with dual source CT and kVp switching with single source CT: a comparison of dual energy performance

    Science.gov (United States)

    Grasruck, M.; Kappler, S.; Reinwand, M.; Stierstorfer, K.

    2009-02-01

    Stimulated by the introduction of clinical dual source CT, the interest in dual energy methods has been increasing in the past years. Whereas the potential of material decomposition by dual energy methods is known since the early 1980ies, the realization of dual energy methods is a wide field of today's research. Energy separation can be achieved with energy selective detectors or by varying X-ray source spectra. This paper focuses on dual energy techniques with varying X-ray spectra. These can be provided by dual source CT devices, operated with different kVp settings on each tube. Excellent spectral separation is the key property for use in clinical routine. The drawback of higher cost for two tubes and two detectors leads to an alternative realization, where a single source CT yields different spectra by fast kVp switching from reading to reading. This provides access to dual-energy methods in single source CT. However, this technique comes with some intrinsic limitations. The maximum X-ray flux is reduced in comparison to the dual source system. The kVp rise and fall time between each reading reduces the spectral separation. In comparison to dual source CT, for a constant number of projections per energy spectrum the temporal resolution is reduced; a reasonable trade of between reduced numbers of projection and limited temporal resolution has to be found. The overall dual energy performance is the guiding line for our investigations. We present simulations and measurements which benchmark both solutions in terms of spectral behavior, especially of spectral separation.

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

    Directory of Open Access Journals (Sweden)

    Zhonghua Sun

    2016-06-01

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

  6. Spatial Distribution of Iron Within the Normal Human Liver Using Dual-Source Dual-Energy CT Imaging.

    Science.gov (United States)

    Abadia, Andres F; Grant, Katharine L; Carey, Kathleen E; Bolch, Wesley E; Morin, Richard L

    2017-05-29

    Explore the potential of dual-source dual-energy (DSDE) computed tomography (CT) to retrospectively analyze the uniformity of iron distribution and establish iron concentration ranges and distribution patterns found in healthy livers. Ten mixtures consisting of an iron nitrate solution and deionized water were prepared in test tubes and scanned using a DSDE 128-slice CT system. Iron images were derived from a 3-material decomposition algorithm (optimized for the quantification of iron). A conversion factor (mg Fe/mL per Hounsfield unit) was calculated from this phantom study as the quotient of known tube concentrations and their corresponding CT values. Retrospective analysis was performed of patients who had undergone DSDE imaging for renal stones. Thirty-seven patients with normal liver function were randomly selected (mean age, 52.5 years). The examinations were processed for iron concentration. Multiple regions of interest were analyzed, and iron concentration (mg Fe/mL) and distribution was reported. The mean conversion factor obtained from the phantom study was 0.15 mg Fe/mL per Hounsfield unit. Whole-liver mean iron concentrations yielded a range of 0.0 to 2.91 mg Fe/mL, with 94.6% (35/37) of the patients exhibiting mean concentrations below 1.0 mg Fe/mL. The most important finding was that iron concentration was not uniform and patients exhibited regionally high concentrations (36/37). These regions of higher concentration were observed to be dominant in the middle-to-upper part of the liver (75%), medially (72.2%), and anteriorly (83.3%). Dual-source dual-energy CT can be used to assess the uniformity of iron distribution in healthy subjects. Applying similar techniques to unhealthy livers, future research may focus on the impact of hepatic iron content and distribution for noninvasive assessment in diseased subjects.

  7. Evaluation of combined coronary CT angiography and dual-energy myocardial perfusion imaging for detection of acute myocardial infarction via second-generation dual-source CT:an experimental study in a porcine phantom model%第二代双源CT冠状动脉成像结合双能量心肌灌注评价猪急性心肌梗死的实验研究

    Institute of Scientific and Technical Information of China (English)

    孙凯; 李坤成; 韩瑞娟; 白栓成; 王君艳; 钱毅东; 刘智慧

    2015-01-01

    Objective To evaluate the diagnostic accuracy of dual-energy “one-step” combined CT coronary angiography ( CCTA ) and myocardial perfusion imaging ( MPI ) for the detection of acute myocardial infarction via second-generation dual-source CT compared with histopathological and conventional coronary angiography (CAG) findings in a porcine phantom. Methods Seven minipigs underwent transcatheter embolization of the coronary arteries by using gelatin sponge to produce acute myocardial infarction. CAG, dual-energy CCTA, and MPI were performed 20 min before, immediately after, and 24 h following the modeling procedure, respectively. A color-coded iodine map was used to evaluate the myocardial perfusion defects on the 17-segment model. In consensus, two radiologists interpreted all iodine map imaging results from MPI and CCTA. Considering CAG and pathological staining as gold standards, the sensibility and specificity of the CCTA and iodine maps from MPI were evaluated using dual-energy CT. Results Following coronary embolization, dual-energy CT iodine maps showed 45 infarcted segments and 40 non-infarcted segments. Per-segment analysis indicated the sensitivity, specificity, positive predictive value and negative predictive value as 93%, 95%, 95% and 93%, respectively. The corresponding values obtained by per-territory analysis were 100%, 86%, 89%and 100%, with CAG and histopathological findings as reference standards. The effective radiation dose of each dual-energy scan was 3.07±0.85 mSv(2.21-4.49 mSv). Conclusions Dual-energy “one-step” combined CCTA and MPI iodine maps for the detection of acute myocardial infarction via second-generation dual-source CT showed enhanced diagnostic accuracy with CAG and histopathology as gold standards.%目的:通过建立猪急性心肌梗死模型,以组织病理学和冠状动脉造影(CAG)结果为金标准,评价第二代双源CT双能量“一站式”冠状动脉CT血管造影(CCTA)结合心

  8. Energy Limits in Second Generation High-pitch Dual Source CT - Comparison in an Upper Abdominal Phantom

    Directory of Open Access Journals (Sweden)

    Martin Beeres

    2015-01-01

    Full Text Available Objectives: The aim of our study was to find out how much energy is applicable in second-generation dual source high-pitch computed tomography (CT in imaging of the abdomen. Materials and Methods: We examined an upper abdominal phantom using a Somatom Definition Flash CT-Scanner (Siemens, Forchheim, Germany. The study protocol consisted of a scan-series at 100 kV and 120 kV. In each scan series we started with a pitch of 3.2 and reduced it in steps of 0.2, until a pitch of 1.6 was reached. The current was adjusted to the maximum the scanner could achieve. Energy values, image noise, image quality, and radiation exposure were evaluated. Results: For a pitch of 3.2 the maximum applicable current was 142 mAs at 120 kV and in 100 kV the maximum applicable current was 114 mAs. For conventional abdominal imaging, current levels of 200 to 260 mAs are generally used. To achieve similar current levels, we had to decrease the pitch to 1.8 at 100 kV - at this pitch we could perform our imaging at 204 mAs. At a pitch of 2.2 in 120 kV we could apply a current of 206 mAs. Conclusion: We conclude our study by stating that if there is a need for a higher current, we have to reduce the pitch. In a high-pitch dual source CT, we always have to remember where our main focus is, so we can adjust the pitch to the energy we need in the area of the body that has to be imaged, to find answers to the clinical question being raised.

  9. Assessment of left ventricular function and mass in dual-source computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Christoph J., E-mail: c.jensen@contilia.d [Department of Cardiology and Angiology, Elisabeth Hospital, Essen (Germany); Jochims, Markus [Department of Cardiology and Angiology, Elisabeth Hospital, Essen (Germany); Hunold, Peter; Forsting, Michael; Barkhausen, Joerg [Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Essen (Germany); Sabin, Georg V.; Bruder, Oliver [Department of Cardiology and Angiology, Elisabeth Hospital, Essen (Germany); Schlosser, Thomas [Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Essen (Germany)

    2010-06-15

    Purpose: To quantify left ventricular (LV) function and mass (LVM) derived from dual-source computed tomography (DSCT) and the influence of beta-blocker administration compared to cardiac magnetic resonance imaging (CMR). Methods: Thirty-two patients undergoing cardiac DSCT and CMR were included, where of fifteen received metoprolol intravenously before DSCT. LV parameters were calculated by the disc-summation method (DSM) and by a segmented region-growing algorithm (RGA). All data sets were analyzed by two blinded observers. Interobserver agreement was tested by the intraclass correlation coefficient. Results.: 1. Using DSM LV parameters were not statistically different between DSCT and CMR in all patients (DSCT vs. CMR: EF 63 {+-} 8% vs. 64 {+-} 8%, p = 0.47; EDV 136 {+-} 36 ml vs. 138 {+-} 35 ml, p = 0.66; ESV 52 {+-} 21 ml vs. 52 {+-} 22 ml, p = 0.61; SV 83 {+-} 22 ml vs. 87 {+-} 19 ml, p = 0.22; CO 5.4 {+-} 0.9 l/min vs. 5.7 {+-} 1.2 l/min, p = 0.09, LVM 132 {+-} 33 g vs. 132 {+-} 33 g, p = 0.99). 2. In a subgroup of 15 patients beta-blockade prior to DSCT resulted in a lower ejection fraction (EF), stroke volume (SV), cardiac output (CO) and increase in end systolic volume (ESV) in DSCT (EF 59 {+-} 8% vs. 62 {+-} 9%; SV 73 {+-} 17 ml vs. 81 {+-} 15 ml; CO 5.7 {+-} 1.2 l/min vs. 5.0 {+-} 0.8 l/min; ESV 52 {+-} 27 ml vs. 57 {+-} 24 ml, all p < 0.05). 3. Analyzing the RGA parameters LV volumes were not significantly different compared to DSM, whereas LVM was higher using RGA (177 {+-} 31 g vs. 132 {+-} 33 g, p < 0.05). Interobserver agreement was excellent comparing DSM values with best agreement between RGA calculations. Conclusion: Left ventricular volumes and mass can reliably be assessed by DSCT compared to CMR. However, beta-blocker administration leads to statistically significant reduced EF, SV and CO, whereas ESV significantly increases. DSCT RGA reliably analyzes LV function, whereas LVM is overestimated compared to DSM.

  10. Quantitative assessment of pure aortic valve regurgitation with dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Li, Z., E-mail: lzlcd01@126.com [Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Huang, L.; Chen, X.; Xia, C.; Yuan, Y.; Shuai, T. [Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China)

    2012-07-15

    Aim: To assess the severity of pure aortic regurgitation by measuring regurgitation volumes (RV) and fractions (RF) with dual-source computed tomography (DSCT) as compared to magnetic resonance imaging (MRI) and echocardiography. Materials and methods: Thirty-eight patients (15 men, 23 women; mean age 46 {+-} 11 years) with isolated aortic valve regurgitation underwent retrospectively electrocardiogram (ECG)-gated DSCT, echocardiography, and MRI. Stroke volumes of the left and right ventricles were measured at DSCT and MRI. Thus, RVs and RFs were calculated and compared. The agreement between DSCT and MRI was tested by intraclass correlation coefficient and Bland-Altman analyses. Spearman's rank order correlation and weighted {kappa} tests were used for testing correlations of AR severity between DSCT results and corresponding echocardiographic grades. Results: The RV and RF measured by DSCT were not significantly different from those measured using MRI (p = 0.71 and 0.79). DSCT correlated well with MRI for the measurement of RV (r{sub I} = 0.86, p<0.001) and calculation of the RF (r{sub I} =0.90, p<0.001). Good agreement between the techniques was obtained by using Bland-Altman analyses. The severity of regurgitation estimated by echocardiography correlated well with DSCT (r{sub s} = 0.95, p<0.001) and MRI (r{sub s} = 0.95, p<0.001). Inter-technique agreement between DSCT and two-dimensional transthoracic echocardiography (2DTTE) regarding the grading of the severity of AR was excellent ({kappa} = 0.90), and good agreement was also obtained between MRI and 2DTTE assessments of the severity of AR ({kappa} = 0.87). Conclusion: DSCT using a volume approach can be used to quantitatively determine the severity of pure aortic regurgitation when compared with MRI and echocardiography.

  11. Assessment of aortic stenosis after aortic valve replacement. Comparative evaluation of dual-source CT and echocardiography; Quantitative Evaluation der Aortenklappenoeffnungsflaeche mit der Dual-Source-CT und Korrelation mit der 2D-Echokardiografie. Initiale Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Saam, T.; Minaifar, N.; Becker, C.; Reiser, M.; Nikolaou, K. [Ludwig-Maximilians-Univ. Muenchen (Germany). Inst. fuer Klinische Radiologie; Oberhoffer, M.; Rist, C.; Vogt, F.; Reichart, B. [Ludwig-Maximilians-Univ. Muenchen (Germany). Herzchirurgische Klinik und Poliklinik

    2008-06-15

    Purpose: To prospectively evaluate whether planimetric measurements of aortic valve area (AVA) with dual-source computed tomography (DSCT) correlate with measurements obtained by echocardiography and to correlate the amount of calcification of the aortic valve with AVA in a group of patients after aortic valve replacement. Materials and Method: 23 patients underwent dual-source computed tomography (DSCT) of the heart (Somatom Definition, Siemens Medical Solutions, Forchheim, Germany), without heart rate control (heart rate 52-113 beats/minute). All patients had undergone aortic valve replacement (homografts, mean time after surgery: 7{+-}3 years). The AVA of the transplanted aortic valve graft was measured planimetrically by means of DSCT and compared with echocardiography as a standard of reference, to exclude post-surgical restenosis of the valve. Maximum AVA in systole planimetrically measured with CT was compared with calculated AVA values determined with the continuity equation, using transvalvular pressure gradients. The amount of calcification of the aortic valve was quantified and correlated (Spearman's R) with the AVA. To assess intra- and inter-reader reproducibility, the DCST data was re-analyzed by two readers 4 weeks after the initial review. Results: All DSCT datasets were of diagnostic image quality concerning valve depiction. The mean AVA as measured by DSCT was 2.7{+-}0.9 cm{sup 2} compared to 1.8{+-}0.5 cm{sup 2} by echocardiography (p<0.05). The planimetric evaluation of the CT data as compared to results of echocardiography showed a significant correlation of the results (Pearson's correlation coefficient R=0.78, p<0.001). Intra- and inter-reader reproducibility was good with intra-class correlation coefficients of 0.86 and 0.81, respectively (p<0.001). There was a significant negative correlation between the amount of aortic valve calcification and AVA as measured by echocardiography (R=-0.42; p<0.05) and as measured by DSCT (R=-0

  12. Automated attenuation-based tube voltage selection for body CTA: Performance evaluation of 192-slice dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Winklehner, Anna; Gordic, Sonja; Lauk, Eliane; Frauenfelder, Thomas; Alkadhi, Hatem; Husarik, Daniela B. [University Hospital Zurich, Institute for Diagnostic and Interventional Radiology, Zurich (Switzerland); Leschka, Sebastian [University Hospital Zurich, Institute for Diagnostic and Interventional Radiology, Zurich (Switzerland); Division of Radiology and Nuclear Medicine, St. Gallen (Switzerland)

    2015-08-15

    To assess radiation dose and image quality in body CT-angiography (CTA) with automated attenuation-based tube voltage selection (ATVS) on a 192-slice dual-source CT (DSCT). Forty patients (69.5 ± 9.6 years) who had undergone body CTA with ATVS (ref.kVp 100, ref.mAs 90) using a 2x192-slice CT in single-source mode were retrospectively included. All patients had undergone prior CTA with a 2x128-slice CT and ATVS with identical imaging and contrast media protocols, serving for comparison. Images were reconstructed with iterative reconstruction at similar strength levels. Radiation dose was determined. Image quality was assessed semi-quantitatively (1:excellent, 5:non-diagnostic), aortic attenuation, noise and CNR were determined. As compared to 128-slice DSCT, 192-slice DSCT selected tube voltages were lower in 30 patients (75 %), higher in 3 (7.5 %), and similar in 7 patients (17.5 %). CTDI{sub vol} was lower with 192-slice DSCT (4.7 ± 1.9 mGy vs. 5.8 ± 2.1 mGy; p < 0.001). Subjective image quality, mean aortic attenuation (342 ± 67HU vs. 268 ± 67HU) and CNR (9.8 ± 2.5 vs. 8.2 ± 2.9) were higher with 192-slice DSCT (all p < 0.01), all datasets being diagnostic. Our study suggests that ATVS of 192-slice DSCT for body CTA is associated with an improved image quality and further radiation dose reduction of 19 % compared to 128-slice DSCT. (orig.)

  13. Clinical utility of ultra high pitch dual source thoracic CT imaging of acute pulmonary embolism in the emergency department: Are we one step closer towards a non-gated triple rule out?

    Energy Technology Data Exchange (ETDEWEB)

    Hou, Daniel J., E-mail: danieljameshou@gmail.com; Tso, David K., E-mail: david.k.tso@gmail.com; Davison, Chris, E-mail: chrisdavison100@gmail.com; Inacio, Joao, E-mail: joao.r.inacio@gmail.com; Louis, Luck J., E-mail: lucklouis@gmail.com; Nicolaou, Savvakis, E-mail: savvas.nicolaou@vch.ca; Reimann, Anja J., E-mail: anja.reimann@gmx.de

    2013-10-01

    Objectives/Purpose: Aim of this study was to retrospectively compare the image quality and the radiation dose of an ultra high pitch CT scan for the evaluation of pulmonary embolism and visualization of cardiac structures in comparison to our institution's standard pulmonary embolism protocol. Method and materials: The study cohort consisted of 115 consecutive patients, 57 underwent CT pulmonary angiography on a dual source 128 slice scanner (Siemens Somatom Definition FLASH) via an ultra high pitch mode (Pitch 2.8) while 58 were scanned on a dual source 64 slice scanner (Siemens Somatom Definition Dual Source) with standard pitch (Pitch 0.9). Qualitative image assessment was determined by two blinded radiologists with 3 and 15 years’ experience in chest and cardiac CT. Quantitative image assessment was determined by the signal to noise ratio (SNR) and contrast to noise ratio (CNR). Effective radiation dose was calculated via the product of the dose length product. Results: For the ultra high pitch protocol, 14% (8/57) were positive for pulmonary embolus compared to 13.7% (8/58) for the standard pitch group. 98.2% of the ultra high pitch scans were diagnostic for pulmonary embolus vs. 94.8% of the standard protocol. Visualization of cardiac structures was significantly improved with the ultra high pitch protocol (p < 0.0001). Significantly more lung parenchymal motion was observed on the standard protocol (p < 0.0001). The mean pulmonary vessel attenuation, SNR, and CNR were not significantly different. The mean effective dose was lower for the ultra high pitch studies (4.09 mSv ± 0.78 vs. 7.72 mSv ± 2.60, p < 0.0001). Conclusion: Ultra high pitch CT imaging for pulmonary embolus is a technique which has potential to assess motion free evaluation of most cardiac structures and proximal coronary arteries at lower radiation doses.

  14. Dual energy virtual CT colonoscopy with dual source computed tomography. Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Karcaaltincaba, M.; Karaosmanoglu, D.; Akata, D.; Sentuerk, S.; Oezmen, M. [Dept. of Radiology, Hacettepe Univ. School of Medicine (Turkey); Alibek, S. [Dept. of Radiology, Hacettepe Univ. School of Medicine (Turkey); Radiology Inst., Univ. of Erlangen (Germany)

    2009-09-15

    Purpose: To describe the technique of DE MDCT colonoscopy and to assess its feasibility. Materials and Methods: 8 patients were scanned with DSCT with a DE scan protocol and dose modulation software. Analysis was performed using dedicated DE software. Prone non-contrast images and DE supine images after contrast injection were obtained. Results: DE colonoscopic images were successfully obtained in 7 patients, but the FOV did not cover all colonic segments in 1 patient, thus resulting in a technical success rate was 87.5%. Streak artifacts were present in the pelvic region in 2 patients. Virtual unenhanced images and iodine map images were obtained for all patients. In 1 patient a polypoid non-enhancing structure was noted on the iodine map, and conventional colonoscopy revealed impacted stool. Enhancing rectal cancer in 1 patient was correctly shown on the iodine map. Iodine maps helped to differentiate stool fragments/retained fluid by the absence of enhancement when compared to prone CT images. The major advantage of DE colonoscopy was the lack of misregistration. Conclusion: DE MDCT colonoscopy is technically feasible and may obviate the need for unenhanced prone images. It may be possible to perform noncathartic DECT colonoscopy. The major limitation is the limited FOV of tube B. The dose should be optimized to reduce streak artifacts in the pelvic region. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-15

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

  16. Dual-Source CT Angiography of Peripheral Arterial Stents: In Vitro Evaluation of 22 Different Stent Types

    Directory of Open Access Journals (Sweden)

    Michael Köhler

    2011-01-01

    Full Text Available Purpose. To test different peripheral arterial stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation and image noise in dual-source multidetector row CT (DSCT in vitro. Methods and Materials. 22 stents (nitinol, steel, cobalt-alloy, tantalum, platinum alloy were examined in a vessel phantom. All stents were imaged in axial orientation with standard parameters. Image reconstructions were obtained with four different convolution kernels. To evaluate visualization characteristics of the stent, the lumen diameter, intraluminal density and noise were measured. Results. The mean percentage of the visible stent lumen diameter from the nominal stent diameter was 74.5% ± 5.7 for the medium-sharp kernel, 72.8% ± 6.4 for the medium, 70.8% ± 6.4 for the medium-smooth and 67.6% ± 6.6 for the smooth kernel. Mean values of lumen attenuation were 299.7HU ± 127 (medium-sharp, 273.9HU ± 68 (medium, 270.7HU ± 53 (medium-smooth and 265.8HU ± 43. Mean image noise was: 54.6 ± 6.3, 20.5 ± 1.7, 16.3 ± 1.7, 14.0 ± 2 respectively. Conclusion. Visible stent lumen diameter varies depending on stent type and scan parameters. Lumen diameter visibility increases with the sharpness of the reconstruction kernel. Smoother kernels provide more realistic density measurements inside the stent lumen and less image noise.

  17. Reproducibility of semi-automatic coronary plaque quantification in coronary CT angiography with sub-mSv radiation dose

    DEFF Research Database (Denmark)

    Øvrehus, Kristian Altern; Schuhbaeck, Annika; Marwan, Mohamed

    2015-01-01

    or response to medical therapies. The reproducibility from repeated assessment of such quantitative measurements from low-radiation dose coronary CTA has not been previously assessed. Purpose: To evaluate the interscan, interobserver and intraobserver reproducibility for coronary plaque volume assessment...... using semi-automatic plaque analyses algorithm in low radiation dose coronary CTA. Methods: In 50 consecutive patients undergoing two 128-slice dual source CT scans within 12 days with a mean radiation dose of 0.7 mSv per coronary CTA, the interscan, interobserver and intraobserver reproducibility.......6% and +/- 32.1%, respectively. Conclusion: A semi-automatic plaque assessment algorithm in repeated low radiation dose coronary CTA allows for high reproducibility of coronary plaque characterization and quantification measures. (C) 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc...

  18. The use of dual source CT in diagnosis of carotid body tumors%双源CT在颈动脉体瘤诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    曹罡; 郭婷; 周长圣; 张森林; 孟昭业; 杨震; 董震; 徐金科; 毛钊

    2011-01-01

    Objective To evaluate the value of dual source CT in diagnosis and treatment of carotid body tumors.Methods Between Sep, 2007 and April 2010, a total of 5 patients who were planed to be diagnosed as carotid body underwent dual source CT.The relationship of the tumour and the near vessels, and the character of the tumor were identified by analysis of clinical signs and imaging results.The risk factors and feasibility of operations were evaluated before done.The tumors were resected.Results The clear edge mass of soft tissue was shown in all 5 patients in dual source CT images at the bifurcation of the common carotid artery.The minors presented obviously enhanced high-density after contrast media administration.The tumors have plenty blood supply.4 patients with small tumor in only one side show especially “cup-sign”.One female patient with bilateral tumors didn't have“ cup-sign” and significant narrow blood vessel, however the tumors were much bigger.5 patients were all diagnosed by dual source CT.The tumonrs were resected and reserved common carotid artery and internal carotid artery.Couclusion Dual source CT is convenience, non-trauma.Its information can be composited.It can offer overall image information of the blood vessel disease such as CBT, which is very important for diagnosis, typing, evaluation the risk of the operation of CBT.So, dual source CT can be the first choice in the diagnosis of carotid body tumor.%目的 评价双源CT(dual source CT,DSCT)在颈动脉体瘤(carotid body tumor,CBT)诊断、治疗中的价值.方法 2007年9月至2010年4月对临床拟诊CBT的5例行颈部双源CT检查,根据临床体征及影像学检查确定肿瘤的性质及其与颈总、颈内、颈外动脉的关系,评估手术的风险及可行性.结果 5例DSCT检查结果均显示颈总动脉分叉处界线清晰的软组织实性肿块.增强扫描后病灶均呈明显强化,瘤体血供丰富.4例单侧瘤体较小CBT呈现典型的"高脚杯"征.1例双

  19. Assessment of Acute Chest Pain with Dual-Source CT%双源CT对急性胸痛的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李宇; 范占明; 余婧; 耿冀; 叶红; 晏子旭; 张兆琪

    2011-01-01

    Objective To assess the accuracy of triple rule out protocol for acute chest pain with dual-source CT in emergency department. Methods 56 consecutive patients with acute chest pain were examined with triple rule out protocol on a dual-source scanner (Siemens) at a temporal resolution of 83 ms using a body-mass-adapted contrast material injection. The scanning range included the whole chest from the first ribs to the diaphragm. The level of the carina was defined as the trigger point where the second tube was switched on additionally. The tri-phase injection protocol was used to get enough enhancement of coronary arteries,pulmonary arteries and aortas. One patient was excluded because he was unable to hold breath during scanning. The remaining subjects underwent more than 30 days follow-up. Results All examinations showed an adequate contrast enhancement of the pulmonary arteries, coronary arteries and aortas. The mean volume of contrast medium was (88±5 ) ml. The median radiation exposure was 11.6 mSy (95 %CI 6.9-13.1 ). 14 patients showed coronary arteries atherosclerosis, including coronary arterial stenosis more than 50% in 13 and 12 patients underwent the coronary stent implantation. 11 patients suffered from aortic dissection(Stanford type A), and 11 patients with pulmonary embolism (PE). In brief, the reasons of the chest pain were complex. 7 of the patients suffered from several kinds of chest diseases. The sensitivity and specificity in diagnosing acute chest pain were 98% and 96% ,respectively with CTA. There were no adverse outcomes follow-up for 30 days in this group. Conclusion Triple rule out coronary CT angiography in evaluation of the patients with acute chest pain presented to the emergency department is very helpful, safety and effective way.%目的 评价双源CT胸痛三联扫描计划对急诊胸痛诊断的准确性.方法 按照入选标准连续选取急性胸痛患者56例,采用西门子双源CT扫描仪胸痛三联扫描计划

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-15

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

  1. Third-generation dual-source 70-kVp chest CT angiography with advanced iterative reconstruction in young children: image quality and radiation dose reduction

    Energy Technology Data Exchange (ETDEWEB)

    Rompel, Oliver; Janka, Rolf; Lell, Michael M.; Uder, Michael; Hammon, Matthias [University Hospital Erlangen, Department of Radiology, Erlangen (Germany); Gloeckler, Martin; Dittrich, Sven [University Hospital Erlangen, Department of Pediatric Cardiology, Erlangen (Germany); Cesnjevar, Robert [University Hospital Erlangen, Department of Pediatric Cardiac Surgery, Erlangen (Germany)

    2016-04-15

    Many technical updates have been made in multi-detector CT. To evaluate image quality and radiation dose of high-pitch second- and third-generation dual-source chest CT angiography and to assess the effects of different levels of advanced modeled iterative reconstruction (ADMIRE) in newborns and children. Chest CT angiography (70 kVp) was performed in 42 children (age 158 ± 267 days, range 1-1,194 days). We evaluated subjective and objective image quality, and radiation dose with filtered back projection (FBP) and different strength levels of ADMIRE. For comparison were 42 matched controls examined with a second-generation 128-slice dual-source CT-scanner (80 kVp). ADMIRE demonstrated improved objective and subjective image quality (P <.01). Mean signal/noise, contrast/noise and subjective image quality were 11.9, 10.0 and 1.9, respectively, for the 80 kVp mode and 11.2, 10.0 and 1.9 for the 70 kVp mode. With ADMIRE, the corresponding values for the 70 kVp mode were 13.7, 12.1 and 1.4 at strength level 2 and 17.6, 15.6 and 1.2 at strength level 4. Mean CTDI{sub vol}, DLP and effective dose were significantly lower with the 70-kVp mode (0.31 mGy, 5.33 mGy*cm, 0.36 mSv) compared to the 80-kVp mode (0.46 mGy, 9.17 mGy*cm, 0.62 mSv; P <.01). The third-generation dual-source CT at 70 kVp provided good objective and subjective image quality at lower radiation exposure. ADMIRE improved objective and subjective image quality. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Weintraub Nealw F

    2009-04-01

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

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

    Science.gov (United States)

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

    2009-04-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  5. Application of fusion of coincidence PET/CT image and dual source CT image in diagnosis of tumors%经济型PET/CT与双源CT异机融合在肿瘤诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    苏雪娟; 鲍红梅; 刘帆; 李运奇; 高琼

    2012-01-01

    Objective To explore the value of fusion of coincidence PET/CT image and dual source CT image in comparison of fused imaging quality. Methods Integration of coincidence PET/CT PET images with dual source CT images was performed in 29 cases with suspected tumor or tumor recurrence or metastasis, and the image quality was compared with that of PET/CT in fused images. Results Forty-six primary or metastic tumors were detected by both methods. The image quality in fused imaging of stand-alone coincidence PET/CT with dual source CT was better than that of coincidence PET/CT in fused images (X2 = 14. 743, P<0. 001). Conclusion The integration of stand-alone coincidence PET/CT and dual source CT is convenient and practical,having complementary advantages, which may improve image quality and help clinical diagnosis and treatment of tumors.%目的 通过对比分析经济型PET/CT与双源CT异机融合的图像质量,探讨异机融合的临床应用价值.方法 对29例可疑肿瘤或肿瘤复发转移患者行经济型PET/CT的PET与双源CT图像融合,并与同机融合图像质量进行对比分析.结果 两种方法均检出原发灶和转移灶共46个,异机融合图像质量优于同机融合(x2=14.743,P<0.001).结论 双源CT与经济型PET/CT异机融合,方便实用,优势互补,可提高图像质量,对临床诊断和治疗肿瘤有重要价值.

  6. Single- and dual-energy CT of the abdomen: comparison of radiation dose and image quality of 2nd and 3rd generation dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Wichmann, Julian L. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Hardie, Andrew D.; Felmly, Lloyd M.; Perry, Jonathan D.; Varga-Szemes, Akos; De Cecco, Carlo N. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Schoepf, U.J. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Mangold, Stefanie [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Caruso, Damiano [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' , Department of Radiological Sciences, Oncological and Pathological Sciences, Latina (Italy); Canstein, Christian [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Siemens Medical Solutions USA, Malvern, PA (United States); Vogl, Thomas J. [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany)

    2017-02-15

    To compare single-energy (SECT) and dual-energy (DECT) abdominal CT examinations in matched patient cohorts regarding differences in radiation dose and image quality performed with second- and third-generation dual-source CT (DSCT). We retrospectively analysed 200 patients (100 male, 100 female; mean age 61.2 ± 13.5 years, mean body mass index 27.5 ± 3.8 kg/m{sup 2}) equally divided into four groups matched by gender and body mass index, who had undergone portal venous phase abdominal CT with second-generation (group A, 120-kV-SECT; group B, 80/140-kV-DECT) and third-generation DSCT (group C, 100-kV-SECT; group D, 90/150-kV-DECT). The radiation dose was normalised for 40-cm scan length. Dose-independent figure-of-merit (FOM) contrast-to-noise ratios (CNRs) were calculated for various organs and vessels. Subjective overall image quality and reader confidence were assessed. The effective normalised radiation dose was significantly lower (P < 0.001) in groups C (6.2 ± 2.0 mSv) and D (5.3 ± 1.9 mSv, P = 0.103) compared to groups A (8.8 ± 2.3 mSv) and B (9.7 ± 2.4 mSv, P = 0.102). Dose-independent FOM-CNR peaked for liver, kidney, and portal vein measurements (all P ≤ 0.0285) in group D. Subjective image quality and reader confidence were consistently rated as excellent in all groups (all ≥1.53 out of 5). With both DSCT generations, abdominal DECT can be routinely performed without radiation dose penalty compared to SECT, while third-generation DSCT shows improved dose efficiency. (orig.)

  7. Evaluation the Stability of Coronary Plaque by Combining 64-section Dual Source CT with Inflammatory Mediators in Aged Type 2 Diabetics with Coronary Artery Disease%64层双源螺旋CT结合血清学标志物评价老年2型糖尿病合并冠心病患者冠脉斑块的稳定性

    Institute of Scientific and Technical Information of China (English)

    何燕; 杨莉; 杨文慧; 魏云鸿; 叶秋芳; 杨永丽

    2014-01-01

    目的 应用64层双源螺旋CT冠状动脉成像(dual-source CT,DSCT)检查方法评价老年糖尿病合并冠心病患者冠脉斑块性质,同时分析老年糖尿病合并冠心病患者血清学标志物的变化,为预测急性冠脉事件风险、早期识别易损斑块患者提供诊断依据.方法 选取2010年12月至2013年10月期间在昆明医科大学附属延安医院老年科和心内科住院,临床疑诊冠心病的老年患者,经行64层双源螺旋CT检查、冠脉造影检查诊断明确为冠心病共129例,根据有无2型糖尿病(T2DM)病史分为:老年冠心病组(n=69)和老年T2DM合并冠心病组(n=60).采用酶联免疫法测定C反应蛋白(CRP)、血浆粘附分子-1(VCAM1)、基质金属蛋白酶9(MMP-9)、白细胞介素6(IL-6)和同型半胱氨酸(Hcy).评价64-DSCT对老年冠心病患者冠脉斑块性质及血清学标志物等方面的差异.结果 老年T2DM合并冠心病与老年冠心病组比较冠脉斑块构成有差别,老年T2DM合并冠心病组软斑较老年冠心病组所占比例高(P<0.05).老年T2DM合并冠心病组IL-6、VCAM1、MMP-9、Hcy表达均高于老年冠心病组,非钙化斑块组血清学标志物CRP、IL-6、VCAM1、Hcv比钙化斑块组高,2组间比较差异均有统计学意义(P<0.05).结论 64-DSCT能够对冠状动脉粥样斑块进行初步定性分析,老年糖尿病合并冠心病患者冠脉斑块以软斑和混合斑为主,血清学标志物CRP、IL-6、VCAM1、Hcv可作为预测斑块稳定性的指标.

  8. CT diagnosis of dual source for pulmonary embolism%肺动脉栓塞的炫速双源CT诊断

    Institute of Scientific and Technical Information of China (English)

    邢漠

    2015-01-01

    Objective: To investigae and analyze the CT diagnostic performance of dual source for pulmonary embolism.Methods: he records of 35 cases with pulmonary embolism from August 2012 to April 2015 were retrospectively analyzed by prior implementation of Hyun-speed dual-source CT scan followed by the elbow injection omnipaque or ultravist,the implementation of the second scan was delayed by 30 s.Finally,the results of diagnosis were observed and analyzed.Results: Hyun-speed dual-source CT scan examination diagnosed: 18 patients with markings sparse,16 patients of pulmonary infarction form,5 patients with pulmonary hypertension,11 patients with pleural effusion and 6 patients with pleural thickening.After enhanced scan,the majority of patients with arterial filling defect tiny face.Conclusion: Hyun-speed dual-source CT scanning for diagnosis of pulmonary embolism has advantage of being fast with good image clarity providing timely scan with safety and clear scannings.It can depict variety of small lesions.%目的:探讨分析肺动脉栓塞的炫速双源CT诊断效果.方法:采取回顾性分析法,抽取2012年8月—2015年4月经临床确诊的35例肺动脉栓塞患者,事先实施炫速双源CT平扫,而后经肘注射欧乃派克或者优维显,延迟30 s后实施第2次扫描,观察分析检查诊断结果.结果:经炫速双源CT平扫检查,有18例患者肺纹理稀疏,16例患者肺梗死灶形成,5例患者肺动脉高压,11例患者胸腔积液,6例患者胸膜肥厚.经增强扫描检查后,大部分患者充盈缺损与动脉面细小.结论:采用炫速双源CT扫描诊断肺动脉栓塞,速度快且图像清晰,可及时扫描并观察各种小病灶,安全有效.

  9. Triple-rule-out dual-source CT angiography of patients with acute chest pain: Dose reduction potential of 100 kV scanning

    Energy Technology Data Exchange (ETDEWEB)

    Krissak, Radko, E-mail: radko.krissak@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany); Henzler, Thomas; Prechel, Anne; Reichert, Miriam [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany); Gruettner, Joachim; Sueselbeck, Tim [1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany); Schoenberg, Stefan O.; Fink, Christian [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany)

    2012-12-15

    Purpose: To investigate the dose reduction potential of low kV triple-rule-out dual-source CT angiography (TRO-CTA) in non-obese (BMI ≤ 25 kg/m{sup 2}) patients with acute chest pain. Materials and methods: Sixty consecutive patients were randomly assigned to two different retrospectively ECG-gated TRO-CTA protocols in this prospective trial: Thirty patients were examined with a 120-kV standard protocol (320 reference mAs with automatic tube current modulation, automatically adapted pitch and ECG-pulsing) and served as the control group (group 1), an otherwise identical 100 kV protocol was used in the other thirty patients (group 2) for a radiation dose reduction. Subjective image quality was assessed on a 5 point scale (1: excellent, 5: non-diagnostic) by two blinded observers. Quantitative image analysis assessed vascular attenuation, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in different vascular segments. The effective dose was calculated from the dose length product (DLP) using a conversion coefficient of 0.017 mSv mGy{sup −1} cm{sup −1}. Results: There was no significant difference of age, BMI, heart rate, pitch or scan length between both patient groups. Subjective image quality was rated similar in both groups (group 1: 1.2 ± 0.4, group 2: average score = 1.3 ± 0.5). Vessel attenuation was significantly higher in group 2 than in group 1 (ascending aorta: 456 ± 83 HU vs. 370 ± 78 HU, p < 0.001; pulmonary artery: 468 ± 118 HU vs. 411 ± 91 HU, p = 0.03; left coronary artery: 437 ± 110 HU vs. 348 ± 89 HU, p < 0.001), however, there was no significant difference in SNR (13.2 ± 7.6 vs. 14.5 ± 7.5, p = 0.49) or CNR (13.8 ± 6.6 vs. 15.9 ± 7.7, p = 0.25). The effective radiation dose of the 100 kV protocol was significantly lower (9.6 ± 3.2 mSv vs. 18.1 ± 9.4 mSv, p < 0.0001). Conclusion: TRO-CTA with 100 kV is feasible in non-obese patients and results in diagnostic image quality and significantly reduced radiation dose.

  10. Next generation coronary CT angiography: in vitro evaluation of 27 coronary stents

    Energy Technology Data Exchange (ETDEWEB)

    Gassenmaier, Tobias; Bley, Thorsten A. [University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Petri, Nils; Voelker, Wolfram [University Hospital Wuerzburg, Department of Internal Medicine I, Wuerzburg (Germany); Allmendinger, Thomas; Flohr, Thomas [Siemens Healthcare, Forchheim (Germany); Maintz, David [University of Cologne, Department of Radiology, Cologne (Germany)

    2014-11-15

    To evaluate in-stent lumen visibility of 27 modern and commonly used coronary stents (16 individual stent types, two stents at six different sizes each) utilising a third-generation dual-source CT system. Stents were implanted in a plastic tube filled with contrast. Examinations were performed parallel to the system's z-axis for all stents (i.e. 0 ) and in an orientation of 90 for stents with a diameter of 3.0 mm. Two stents were evaluated in different diameters (2.25 to 4.0 mm). Examinations were acquired with a collimation of 96 x 0.6 mm, tube voltage of 120 kVp with 340 mAs tube current. Evaluation was performed using a medium-soft (Bv40), a medium-sharp (Bv49) and a sharp (Bv59) convolution kernel optimised for vascular imaging. Mean visible stent lumen of stents with 3.0 mm diameter ranged from 53.3 % (IQR 48.9 - 56.7 %) to 73.9 % (66.7 - 76.7 %), depending on the kernel used at 0 , and was highest at an orientation of 90 with 80.0 % (75.6 - 82.8 %) using the Bv59 kernel, strength 4. Visible stent lumen declined with decreasing stent size. Use of third-generation dual-source CT enables stent lumen visibility of up to 80 % in metal stents and 100 % in bioresorbable stents. (orig.)

  11. Coronary CT in Acute Cardiac Care

    NARCIS (Netherlands)

    A. Dedic (Admir)

    2016-01-01

    markdownabstractCoronary CT angiography is a well-established diagnostic modality for stable angina pectoris. It provides an angiographic, non-invasive alternative for the diagnosis of coronary artery disease, exceeding in the ability to exclude important coronary artery disease. Having the ability

  12. Systematic review of the accuracy of dual-source cardiacct for detection of arterial stenosis in difficult to image patient groups

    NARCIS (Netherlands)

    M. Westwood (Marie); H. Raatz (Heike); K. Misso (Kate); L.T. Burgers (Laura); W.K. Redekop (Ken); S.K. Lhachimi (Stefan); N. Armstrong (Nigel); J. Kleijnen (Jos)

    2013-01-01

    textabstractPurpose: To assess the diagnostic performance of dual-source cardiac (DSC) computed tomography (CT) newer-generation CT instruments for identifying anatomically significant coronary artery disease (CAD) in patients who are difficult to image by using 64-section CT. Materials and Methods:

  13. Imaging the Parasinus Region with a Third-Generation Dual-Source CT and the Effect of Tin Filtration on Image Quality and Radiation Dose.

    Science.gov (United States)

    Lell, M M; May, M S; Brand, M; Eller, A; Buder, T; Hofmann, E; Uder, M; Wuest, W

    2015-07-01

    CT is the imaging technique of choice in the evaluation of midface trauma or inflammatory disease. We performed a systematic evaluation of scan protocols to optimize image quality and radiation exposure on third-generation dual-source CT. CT protocols with different tube voltage (70-150 kV), current (25-300 reference mAs), prefiltration, pitch value, and rotation time were systematically evaluated. All images were reconstructed with iterative reconstruction (Advanced Modeled Iterative Reconstruction, level 2). To individually compare results with otherwise identical factors, we obtained all scans on a frozen human head. Conebeam CT was performed for image quality and dose comparison with multidetector row CT. Delineation of important anatomic structures and incidental pathologic conditions in the cadaver head was evaluated. One hundred kilovolts with tin prefiltration demonstrated the best compromise between dose and image quality. The most dose-effective combination for trauma imaging was Sn100 kV/250 mAs (volume CT dose index, 2.02 mGy), and for preoperative sinus surgery planning, Sn100 kV/150 mAs (volume CT dose index, 1.22 mGy). "Sn" indicates an additional prefiltration of the x-ray beam with a tin filter to constrict the energy spectrum. Exclusion of sinonasal disease was possible with even a lower dose by using Sn100 kV/25 mAs (volume CT dose index, 0.2 mGy). High image quality at very low dose levels can be achieved by using a Sn100-kV protocol with iterative reconstruction. The effective dose is comparable with that of conventional radiography, and the high image quality at even lower radiation exposure favors multidetector row CT over conebeam CT. © 2015 by American Journal of Neuroradiology.

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

    Directory of Open Access Journals (Sweden)

    Anja Hagen

    2012-04-01

    Full Text Available Scientific background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive computed tomography (CT coronary angiography are used in the diagnosis of coronary heart disease (CHD. Research questions: The present report aims to evaluate the clinical efficacy, diagnostic accuracy, prognostic value cost-effectiveness as well as the ethical, social and legal implications of CT coronary angiography versus invasive coronary angiography in the diagnosis of CHD. Methods: A systematic literature search was conducted in electronic data bases (MEDLINE, EMBASE etc. in October 2010 and was completed with a manual search. The literature search was restricted to articles published from 2006 in German or English. Two independent reviewers were involved in the selection of the relevant publications. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography as the reference standard and on diagnostic studies with intracoronary pressure measurement as the reference standard. Study results were combined in a meta-analysis with 95 % confidence intervals (CI. Additionally, data on radiation doses from current non-systematic reviews were taken into account. A health economic evaluation was performed by modelling from the social perspective with clinical assumptions derived from the meta-analysis and economic assumptions derived from contemporary German sources. Data on special indications (bypass or in-stent-restenosis were not included in the evaluation. Only data obtained using CT scanners with at least 64 slices were considered. Results: No studies were found regarding the clinical efficacy or prognostic value of CT coronary angiography versus conventional invasive coronary angiography in the diagnosis of CHD. Overall, 15 systematic reviews with data from 44 diagnostic studies using invasive coronary angiography as the reference standard (identification of obstructive

  15. Xenon ventilation CT using dual-source and dual-energy technique in children with bronchiolitis obliterans: correlation of xenon and CT density values with pulmonary function test results

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Yang, Dong Hyun; Seo, Joon Beom; Chae, Eun Jin; Lee, Jeongjin [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Songpa-gu, Seoul (Korea); Hong, Soo-Jong; Yu, Jinho; Kim, Byoung-Ju [University of Ulsan College of Medicine, Department of Pediatrics, Asan Medical Center, Seoul (Korea); Krauss, Bernhard [Siemens Medical Solutions AG-Computed Tomography, Forchheim (Germany)

    2010-09-15

    Xenon ventilation CT using dual-source and dual-energy technique is a recently introduced, promising functional lung imaging method. To expand its clinical applications evidence of additional diagnostic value of xenon ventilation CT over conventional chest CT is required. To evaluate the usefulness of xenon ventilation CT using dual-source and dual-energy technique in children with bronchiolitis obliterans (BO). Seventeen children (age 7-18 years; 11 boys) with BO underwent xenon ventilation CT using dual-source and dual-energy technique. Xenon and CT density values were measured in normal and hyperlucent lung regions on CT and were compared between the two regions. Volumes of hyperlucent regions and ventilation defects were calculated with thresholds determined by visual and histogram-based analysis. Indexed volumes of hyperlucent lung regions and ventilation defects were correlated with pulmonary function test results. Effective doses of xenon CT were calculated. Xenon (14.6 {+-} 6.4 HU vs 26.1 {+-} 6.5 HU; P < 0.001) and CT density (-892.8 {+-} 25.4 HU vs -812.3 {+-} 38.7 HU; P < 0.001) values were significantly lower in hyperlucent regions than in normal lung regions. Xenon and CT density values showed significant positive correlation for the entire lung in 16 children ({gamma} = 0.55 {+-} 0.17, P < 0.001 or =0.017) and for hyperlucent regions in 13 children ({gamma} = 0.44 {+-} 0.16, P < 0.001 or =0.001-0.019). Indexed volumes and volume percentages of hyperlucent lung regions and ventilation defects showed strong negative correlations with forced expiratory volume [FEV1, ({gamma} = -0.64-0.85, P {<=} 0.006)], FEV1/forced vital capacity [FVC, ({gamma} = -0.63-0.84, P {<=} 0.008)], and forced midexpiratory flow rate [FEF{sub 25-75}, ({gamma} = -0.68-0.88, P {<=} 0.002). Volume percentages of xenon ventilation defects (35.0 {+-} 16.4%)] were not significantly different from those of hyperlucent lung regions (38.2 {+-} 18.6%). However, mismatches between the

  16. Application of dual-source CT in diagnosis of common atrioventricular canal%双源CT在共同房室通道诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    冯越; 刘铁; 翟利浩

    2012-01-01

    目的 探讨双源CT(DSCT)在共同房室通道(CAC)诊断中的应用价值.方法 选取9例CAC患儿,采用DSCT心电门控下对比增强完成心脏检查,并在图像工作站完成多平面(MPR)、最大密度投影(MIP)和三维容积漫游(VR)处理.同期所有患儿均完成超声心动图检查.比较两种检查方法的诊断结果.结果 DSCT均作出CAC诊断,共发现合并畸形29处;超声心动图亦均作出CAC诊断,共发现合并畸形16处.结论 DSCT可以对CAC患儿作出准确诊断,较之超声心动图能发现更多合并畸形,有助于临床手术方案的制定与完善.%Objective To evaluate the clinical values of dual-source CT (DSCT) in diagnosis of common atrioventricular canal. Methods Nine children aged 135 days to 6 y with common atrioventricular canal (CAC) underwent dual-source cardiac CT scan. Two- and three-dimensional images were processed by means of MPR (coronal, sagital and oblique), MIP and VR. E-chocardiography was performed in all cases at same time; and 2 cases received surgical treatment. Results DSCT confirmed diagnosis of CAC in all 9 cases. DSCT revealed 29 concomitant anomalies and echocardiography revealed 16 in all 9 cases. Conclusion DSCT can confirm diagnosis of common atrioventricular canal, which contributes to the planning of operation and better surgical outcomes of patients.

  17. Clinical application of dual-source CT in the evaluation of patients with lung cancer: correlation with perfusion scintigraphy and pulmonary function tests.

    Science.gov (United States)

    Fraioli, F; Serra, G; Liberali, S; Fiorelli, A; Liparulo, V; Zaccagna, F; Ciccariello, G; Catalano, C; Passariello, R

    2011-09-01

    This study was done to assess the diagnostic potential of dual-source computed tomography (DSCT) in the functional evaluation of lung cancer patients undergoing surgical resection. The CT data were compared with pulmonary perfusion scintigraphy and pulmonary function tests (PFTs). All patients were evaluated with DSCT, scintigraphy and PFTs. The DSCT scan protocol was as follows: two tubes (80 and 140 kV; Care Dose protocol); 70 cc of contrast material (5 cc/s); 5- to 6-s scan time; 0.6 mm collimation. After the automatic calculation of lung perfusion with DSCT and quantification of air volumes and emphysema with dedicated software applications, the perfusional CT studies were compared with scintigraphy using a visual score for perfusion defects; CT air volumes and emphysema were compared with PFTs. The values of accuracy, sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of DSCT compared with perfusion scintigraphy as the reference standard were: 0.88, 0.84, 0.90, 0.93 and 0.88, respectively. The McNemar test did not identify significant differences either between the two imaging techniques (p=0.07) or between CT and PFTs (p=0.09). DSCT is a robust and promising technique that provides important and accurate information on lung function.

  18. 双源 CT 在诊断右室双出口中的应用%Application of dual source CT in the diagnosis of double outlet right ventricle

    Institute of Scientific and Technical Information of China (English)

    吴健; 马延贺; 张洪

    2015-01-01

    Objective:To investigate the value of dual source CT in the diagnosis of double outlet right ventricle (DORV)and anatomic deformities of complex congenital heart disease.Methods:The clinical materials of 17 patients with double outlet right ventricle diagnosed by dual source CT and confirmed by angiocardiography or surgery were analyzed ret-rospectively.The relationship between visceral and atrium,atrium ventricle connection,ventricular vascular connection based on the section analysis were studied.The DORV were classified and the anatomic deformities were identified,which were compared with echocardiography findings.Results:All of the 17 cases of DORV were all diagnosed by dual source CT accu-rately,while only 14 cases were accurately diagnosed by echocardiography.17 cases were classified by dual source CT and echocardiography as subaotic type (10 cases and 8 cases respectively),subpulmonary type (4 cases and 3 cases respective-ly),subpulmonary and subaortic type (one case and one case respectively),abnormality distal to great arteries (2 cases and 2 cases respectively).47 concomitant anatomic deformities of 15 kinds were diagnosed by dual source CT and only 2 were missed with atrial septal defect and patent ductus arteriosus for one case each.Treatment of 11 patients included surgical operation or trans-catheter closure via cardioangiography.Conclusion:Accurate diagnosis and classification of DORV could be obtained by dual source CT,which can provid important guidance for surgical treatment.%目的:探讨双源 CT 对右室双出口(DORV)的诊断价值及对复杂先心病解剖畸形的确诊价值。方法:回顾性分析17例经双源 CT 诊断并经心血管造影、手术等确认为右室双出口的病例资料。通过节段分析法分析内脏-心房关系、心房-心室连接、心室-大血管连接等内容,对 DORV 进行分型并确定解剖畸形,并与超声心动图进行对比。结果:17例DORV 均经双源 CT

  19. Radiation dose considerations by intra-individual Monte Carlo simulations in dual source spiral coronary computed tomography angiography with electrocardiogram-triggered tube current modulation and adaptive pitch

    Energy Technology Data Exchange (ETDEWEB)

    May, Matthias S.; Kuettner, Axel; Lell, Michael M.; Wuest, Wolfgang; Scharf, Michael; Uder, Michael [University of Erlangen, Department of Radiology, Erlangen (Germany); Deak, Paul; Kalender, Willi A. [University of Erlangen, Department of Medical Physics, Erlangen (Germany); Keller, Andrea K.; Haeberle, Lothar [University of Erlangen, Department of Medical Informatics, Biometry and Epidemiology, Erlangen (Germany); Achenbach, Stephan; Seltmann, Martin [University of Erlangen, Department of Cardiology, Erlangen (Germany)

    2012-03-15

    To evaluate radiation dose levels in patients undergoing spiral coronary computed tomography angiography (CTA) on a dual-source system in clinical routine. Coronary CTA was performed for 56 patients with electrocardiogram-triggered tube current modulation (TCM) and heart-rate (HR) dependent pitch adaptation. Individual Monte Carlo (MC) simulations were performed for dose assessment. Retrospective simulations with constant tube current (CTC) served as reference. Lung tissue was segmented and used for organ and effective dose (ED) calculation. Estimates for mean relative ED was 7.1 {+-} 2.1 mSv/100 mAs for TCM and 12.5 {+-} 5.3 mSv/100 mAs for CTC (P < 0.001). Relative dose reduction at low HR ({<=}60 bpm) was highest (49 {+-} 5%) compared to intermediate (60-70 bpm, 33 {+-} 12%) and high HR (>70 bpm, 29 {+-} 12%). However lowest ED is achieved at high HR (5.2 {+-} 1.5 mSv/100 mAs), compared with intermediate (6.7 {+-} 1.6 mSv/100 mAs) and low (8.3 {+-} 2.1 mSv/100 mAs) HR when automated pitch adaptation is applied. Radiation dose savings up to 52% are achievable by TCM at low and regular HR. However lowest ED is attained at high HR by pitch adaptation despite inferior radiation dose reduction by TCM. circle Monte Carlo simulations allow for individual radiation dose calculations. (orig.)

  20. Unenhanced third-generation dual-source chest CT using a tin filter for spectral shaping at 100 kVp

    Energy Technology Data Exchange (ETDEWEB)

    Haubenreisser, Holger, E-mail: holger.haubenreisser@medma.uni-heidelberg.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany); Meyer, Mathias; Sudarski, Sonja [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany); Allmendinger, Thomas [Siemens Healthcare Sector, CT Division, Forchheim (Germany); Schoenberg, Stefan O.; Henzler, Thomas [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany)

    2015-08-15

    Highlights: • Spectral shaping can be done using an additional tin filter. • Spectral shaping can lead to a significantly lower dose for non-contrast CT. • The low dose protocol maintains sufficient image quality for diagnosis. • The protocol used should be used for non-contrast enhanced chest CT when possible. - Abstract: Objective: To prospectively investigate image quality and radiation dose of 100 kVp spectral shaping chest CT using a dedicated tin filter on a 3rd generation dual-source CT (DSCT) in comparison to standard 100 kVp chest CT. Methods: Sixty patients referred for a non-contrast chest on a 3rd generation DSCT were prospectively included and examined at 100 kVp with a dedicated tin filter. These patients were retrospectively matched with patients that were examined on a 2nd generation DSCT at 100 kVp without tin filter. Objective and subjective image quality was assessed in various anatomic regions and radiation dose was compared. Results: Radiation dose was decreased by 90% using the tin filter (3.0 vs 0.32 mSv). Soft tissue attenuation and image noise was not statistically different for both examination techniques (p > 0.05), however image noise was found to be significantly higher in the trachea when using the additional tin filter (p = 0.002). SNR was found to be statistically similar in pulmonary tissue, significantly lower when measured in air and significantly higher in the aorta for the scans on the 3rd generation DSCT. Subjective image quality with regard to overall quality and image noise and sharpness was not statistically significantly different (p > 0.05). Conclusion: 100 kVp spectral shaping chest CT by means of a tube-based tin-filter on a 3rd generation DSCT allows 90% dose reduction when compared to 100 kVp chest CT on a 2nd generation DSCT without spectral shaping.

  1. 炫速双源CT的客观测量在诊断冠状动脉支架内再狭窄中的应用%Usefulness of flash dual-source computed tomography for evaluation of coronary artery in-stent restenosis

    Institute of Scientific and Technical Information of China (English)

    章盈; 毛萍; 王欢; 杜常青; 王亚利; 汤益民; 唐礼江

    2016-01-01

    Objective To investigate the value of flash dual- source computed tomography (CT) angiography in the evaluation of coronary artery in- stent restenosis (ISR). Methods 101 patients with 167 coronary stents underwent dual- source CT angiography for re- examination. CT values of different segments of vessels with stents were measured for evaluation of ISR and compared with the results of elective coronary angiography performed during fol owing 60 days. The accuracy and cut- off value of dual- source CT in the diagnosis of ISR were calculated. Results The CT image quality of 151 stents (90.5%) was suitable for evaluation. The diameter of stent was a main factor influencing CT image quality. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of dual- source CT for the diagnosis of ISR were 83.8%, 82.8%, 77.0%, 88.2%and 83.2%, respectively. The cutoff points of a difference in CT value from aortic root to the vessel 5~10mm proximal to the stent, proximal end of the stent, in- stent lumen, distal end of the stent, and the vessel 5~10mm distal to the stent for diagnosing ISR were 7.5Hu, 16.0Hu, 42.5Hu, 47.5Hu and 56.0Hu, respectively. Conclusion The in- stent lumen of coronary artery can be imaged clearly by dual- source CT, which could provide higher diagnostic accuracy of ISR.%目的:探讨炫速双源CT在诊断冠状动脉支架内再狭窄(ISR)中的应用。方法对101例患者植入的167枚冠脉支架行炫速双源CT血管显像复查,测量支架段各部位的CT值评价支架内再狭窄,并与随后60d内所做的选择性冠状动脉造影结果对比,计算炫速双源CT诊断ISR的准确程度及诊断ISR的CT临界值。结果炫速双源CT显示151枚(90.5%)支架的影像质量适于诊断,支架直径是主要影响因素。炫速双源CT评价冠状动脉ISR的敏感度、特异度、阳性预测值、阴性预测值和符合率分别为83.8%、82.8%、77.0%、88.2%和83.2%。诊断ISR

  2. 双源CT与冠状动脉造影评估冠状动脉支架内再狭窄%Dual-Source Computed Tomography and Coronary Angiography in Evaluation of In-Stent Restenosis

    Institute of Scientific and Technical Information of China (English)

    王联发; 纪勤炯; 朱有志; 侯勇; 黄猛珣; 顾磊

    2012-01-01

    目的 对比分析双源CT( dual-source CT,DSCT)与冠状动脉造影(coronary angiography,CAG)评估支架内再狭窄( in stent restenosis,ISR)的结果,探讨支架所在部位及支架大小对DSCT评估冠状动脉ISR的影响.方法 106例同期行DSCT及SCAG检查的支架术后的患者,以SCAG结果为标准,比较DSCT评估不同部位及大小支架ISR的敏感性、特异性及准确性.结果 173枚支架中有156枚支架DSCT显影良好.DSCT显示有ISR的支架33枚,CAG证实存在ISR的支架38枚,DSCT诊断ISR的敏感度和特异度分别为78.9%和97.5%,阳性预测值90.9%,阴性预测值93.5%,一致率为92.9%.DSCT对近心端支架再狭窄的检出率优于远心端支架;直径≥3.0 mm支架的ISR检出率优于直径<3.0mm支架.结论 支架内径大小及所在部位影响DSCT图像的显示.DSCT在评估ISR方面,可基本取代SCAG作为冠脉近端支架及大直径支架(支架直径≥3 mm)通畅情况的评估方式.%Objective To compare the results of dual-source CT(DSCT) and coronary angiography (CAG) in the diagnosis of in-stent restenosis ( ISR) , and discuss the influence of the positions and size of stents on the evaluation results of ISR by DSCT. Methods The 106 patients in the same period underwent DSCT and CAG were included in the study, analysis and comparison ISR of DSCT diagnostic sensitivity, specificity and accuracy to detect in-stent restenosis was evaluated referring to coronary angiography. ISR was defined as a lesion demonstrating stenosis greater than 50%. Results In all 173 stents, 156 stents could be assessed by DSCT. 33 stents could be detected ISR by DSCT.38 stents with ISR indicated by CAG. The sensitivity,specificity,positive and negative predictive value and accuracy to identify ISR was 78.9% ,97.5% ,90.9% and 93.5% ,92.9% .respectively. DSCT coronary artery proximal in-stent restenosis detection rate were superior to the distal stent. The detection with DSCT in-stent restenosis of positive

  3. Coronary artery visibility in free-breathing young children on non-gated chest CT: impact of temporal resolution

    Energy Technology Data Exchange (ETDEWEB)

    Bridoux, Alexandre; Hutt, Antoine; Faivre, Jean-Baptiste; Pagniez, Julien; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), 59037 Lille Cedex (France); Flohr, Thomas [Siemens Healthcare, Department of Research and Development in CT, Forchheim (Germany); Duhamel, Alain [Universite de Lille, Department of Biostatistics, Lille (France)

    2015-11-15

    Dual-source CT allows scanning of the chest with high pitch and high temporal resolution, which can improve the detection of proximal coronary arteries in infants and young children when scanned without general anesthesia, sedation or beta-blockade. To compare coronary artery visibility between higher and standard temporal resolution. We analyzed CT images in 93 children who underwent a standard chest CT angiographic examination with reconstruction of images with a temporal resolution of 75 ms (group 1) and 140 ms (group 2). The percentage of detected coronary segments was higher in group 1 than in group 2 when considering all segments (group 1: 27%; group 2: 24%; P = 0.0004) and proximal segments (group 1: 37%; group 2: 32%; P = 0.0006). In both groups, the highest rates of detection were observed for the left main coronary artery (S1) (group 1: 65%; group 2: 58%) and proximal left anterior descending coronary artery (S2) (group 1: 43%; group 2: 42%). Higher rates of detection were seen in group 1 for the left main coronary artery (P = 0.03), proximal right coronary artery (P = 0.01), proximal segments of the left coronary artery (P = 0.02) and proximal segments of the left and right coronary arteries (P = 0.0006). Higher temporal resolution improved the visibility of proximal coronary arteries in pediatric chest CT. (orig.)

  4. 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

  5. Initial results of a new generation dual source CT system using only an in-plane comb filter for ultra-high resolution temporal bone imaging

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Mathias; Haubenreisser, Holger; Schoenberg, Stefan O.; Henzler, Thomas [Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Raupach, Rainer; Schmidt, Bernhard; Leidecker, Christianne; Allmendinger, Thomas; Flohr, Thomas [Siemens Healthcare, Imaging and Therapy Division, Forchheim (Germany); Lietzmann, Florian; Schad, Lothar R. [Heidelberg University, Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany)

    2015-01-15

    To prospectively evaluate radiation dose and image quality of a third generation dual-source CT (DSCT) without z-axis filter behind the patient for temporal bone CT. Forty-five patients were either examined on a first, second, or third generation DSCT in an ultra-high-resolution (UHR) temporal bone-imaging mode. On the third generation DSCT system, the tighter focal spot of 0.2 mm{sup 2} removesthe necessity for an additional z-axis-filter, leading to an improved z-axis radiation dose efficiency. Images of 0.4 mm were reconstructed using standard filtered-back-projection or iterative reconstruction (IR) technique for previous generations of DSCT and a novel IR algorithm for the third generation DSCT. Radiation dose and image quality were compared between the three DSCT systems. The statistically significantly highest subjective and objective image quality was evaluated for the third generation DSCT when compared to the first or second generation DSCT systems (all p < 0.05). Total effective dose was 63 %/39 % lower for the third generation examination as compared to the first and second generation DSCT. Temporal bone imaging without z-axis-UHR-filter and a novel third generation IR algorithm allows for significantly higher image quality while lowering effective dose when compared to the first two generations of DSCTs. (orig.)

  6. 双源 CT 对主动脉瓣狭窄的诊断价值%Assessment of aortic stenosis with dual-source CT

    Institute of Scientific and Technical Information of China (English)

    王朴飞; 吕梁; 王罡; 杨利鹏; 佘波; 安鸿飞; 周子煜

    2014-01-01

    Objective To discuss the feasibility and accuracy of dual-source CT ( DSCT) in the evaluation of aortic stenosis ( AS) with transthoracic echocardiography ( TTE) as reference.Methods A total of 53 patients who underwent both DSCT and TTE were prospectively evaluated.All of them were assessed by TTE for aortic stenosis.Maximum aortic valve area ( AVA) in systolic phase was measured with DSCT , and was compared to that index obtained from the continuity equation on TTE.The severity of AS was graded as mild , moderate , or severe according to the AVA.Linear regression analysis and Bland-Altman plots were used to compare the AVA measured by using CT and TTE.Agreement on semi-quantitative grades of AS severity between the two methods was tested by using Kappa statistics.Results The mean AVA using DSCT was (1.45 ±0.35 ) cm2 compared to the mean AVA of ( 1.33 ±0.36 ) cm2 using TTE, with a significant correlation between them (r=0.92,P<0.01).Bland-Altman analysis demonstrated good inter-modality consistency between DSCT and TTE.However , DSCT demonstrated a slight overestimation of the AVA compared to TTE.As identified by TTE, there were 53 patients with AS, 13 with mild AS, 21 with moderate AS , and 19 with severe AS.In 3 patients DSCT showed no AS , TTE detected mild AS.In 6 cases, TTE had graded the stenosis as moderate , but the stenosis degree was graded as mild using DSCT.Kappa analysis showed a good agreement between the two methods on semi -quantitative grades of aortic stenosis severity (Kappa=0.75,P<0.01).Conclusion AVA measurements using DSCT is feasible and reasonably accurate for those patients with moderate to severe aortic stenosis.%目的:以经胸心脏超声(TTE)为对照,探讨双源CT(DSCT)评估主动脉瓣狭窄(AS)的可行性及准确性。方法回顾性分析53例行DSCT冠状动脉成像及TTE检查,经TTE诊断均为AS的患者。 DSCT面积法测量收缩期最大主动脉瓣口面积(AVA),TTE采用连续性方程计

  7. Diagnostic value of quantitative stenosis predictors with coronary CT angiography compared to invasive fractional flow reserve

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Rui [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Renker, Matthias [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231 Bad Nauheim (Germany); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Wichmann, Julian L. [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Fuller, Stephen R.; Rier, Jeremy D.; Bayer, Richard R.; Steinberg, Daniel H. [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); De Cecco, Carlo N. [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Departments of Radiological Sciences, Oncology, and Pathology, University of Rome “Sapienza”-Polo Pontino, Latina, Viale Regina Elena, 324-00161 Roma (Italy); Baumann, Stefan [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); First Department of Medicine, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany)

    2015-08-15

    Highlights: • Evaluation of the diagnostic performance of CCTA predictors for coronary stenosis. • TAG was unable to detect hemodynamically significant coronary lesions. • CT-FFR, LL/MLD{sup 4} and CCO provide enhanced diagnostic performance over CCTA. • CT-FFR was the best parameter. - Abstract: Objective: To evaluate the diagnostic performance of CCTA-derived stenosis predictors including CT-FFR for the detection of ischemia-inducing stenosis compared to invasive FFR. Materials and methods: Stenosis parameters were assessed using dual-source CT (DSCT). All patients underwent both CCTA and invasive FFR within 3 months and were retrospectively analyzed. Observers visually assessed all CCTA studies and performed multiple lesion measurements. Lesion length/minimal luminal diameter{sup 4} (LL/MLD{sup 4}), transluminal attenuation gradient (TAG), corrected coronary attenuation (CCO) and CT-FFR were calculated. Results: The cohort included 32 patients (58 ± 12 years, 66%male). Among 32 coronary lesions, 8 (25%) were considered hemodynamically significant with an FFR <0.80. Compared to invasive FFR, the per-vessel sensitivity and specificity of CCTA, CT-FFR, LL/MLD{sup 4}, CCO and TAG for detecting hemodynamically significant lesions were 100% and 54%, 100% and 91%, 85% and 92%, 66% and 88%, 37% and 58%, respectively. Receiver operating characteristics analysis resulted in an area under the curve of 0.91 for CT-FFR (p = 0.0005), 0.88 for LL/MLD{sup 4} (p < 0.0001), 0.85 for CCO (p < 0.0001). TAG with an AUC of 0.67 (p = 0.152) was unable to discriminate between vessels with or without hemodynamically significant lesions. Conclusion: CT-FFR, LL/MLD{sup 4} and CCO provide enhanced diagnostic performance over CCTA analysis alone for discrimination of hemodynamically significant coronary stenosis.

  8. Initial results of a new generation dual source CT system using only an in-plane comb filter for ultra-high resolution temporal bone imaging.

    Science.gov (United States)

    Meyer, Mathias; Haubenreisser, Holger; Raupach, Rainer; Schmidt, Bernhard; Lietzmann, Florian; Leidecker, Christianne; Allmendinger, Thomas; Flohr, Thomas; Schad, Lothar R; Schoenberg, Stefan O; Henzler, Thomas

    2015-01-01

    To prospectively evaluate radiation dose and image quality of a third generation dual-source CT (DSCT) without z-axis filter behind the patient for temporal bone CT. Forty-five patients were either examined on a first, second, or third generation DSCT in an ultra-high-resolution (UHR) temporal bone-imaging mode. On the third generation DSCT system, the tighter focal spot of 0.2 mm(2) removes the necessity for an additional z-axis-filter, leading to an improved z-axis radiation dose efficiency. Images of 0.4 mm were reconstructed using standard filtered-back-projection or iterative reconstruction (IR) technique for previous generations of DSCT and a novel IR algorithm for the third generation DSCT. Radiation dose and image quality were compared between the three DSCT systems. The statistically significantly highest subjective and objective image quality was evaluated for the third generation DSCT when compared to the first or second generation DSCT systems (all p generation examination as compared to the first and second generation DSCT. Temporal bone imaging without z-axis-UHR-filter and a novel third generation IR algorithm allows for significantly higher image quality while lowering effective dose when compared to the first two generations of DSCTs. • Omitting the z-axis-filter allows a reduction in radiation dose of 50% • A smaller focal spot of 0.2 mm (2) significantly improves spatial resolution • Ultra-high-resolution temporal-bone-CT helps to gain diagnostic information of the middle/inner ear.

  9. Coronary CT angiography in symptomatic patients

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-02-01

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

  10. Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Zhaoping; Wang, Ximing; Duan, Yanhua; Wu, Lebin; Wu, Dawei; Chao, Baoting; Liu, Cheng; Xu, Zhuodong [Shandong University, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Li, Hongxin; Liang, Fei [Shandong Provincial Hospital, Department of Cardiovascular Surgery, Jinan, Shandong (China); Xu, Jian; Chen, Jiuhong [Siemens. Ltd. China, CT Research Collaboration, Beijing (China)

    2010-10-15

    To explore the clinical value of low-dose prospective ECG-triggering dual-source CT (DSCT) angiography in infants and children with complex congenital heart disease (CHD) compared with transthoracic echocardiography (TTE). Thirty-five patients (mean age: 16 months, range: 2 months to 6 years; male 15; mean weight: 12 kg) underwent low-dose prospective ECG-triggering DSCT angiography and TTE. Surgeries were performed in 29 patients, and conventional cardiac angiography (CCA) was performed in 8 patients. The accuracy was calculated based on the surgical and/or CCA findings. The overall imaging quality was evaluated on a five-point scale. A total of 146 separate cardiovascular deformities were confirmed. DSCT missed three atrial septal defects and a patent ductus arteriosus. The accuracy of DSCT angiography and TTE was 97.3% (142/146) and 92.5% (135/146), respectively. Overall test parameters for DSCT angiography and TTE were similar (sensitivity, 97.3% vs 92.5%; specificity, 99.8% vs 99.8%). The average subjective image quality score was 4.3 {+-} 0.7. The mean effective dose was 0.38 {+-} 0.09 mSv. Prospective ECG-triggering DSCT angiography with a very low effective radiation dose allows the accurate diagnosis of anomalies in infants and children with complex CHD compared with TTE. It has great promise to become a commonly used second-line technique for complex CHD. (orig.)

  11. Virtual monochromatic imaging in dual-source and dual-energy CT for visualization of acute ischemic stroke

    CERN Document Server

    Hara, Hidetake; Matsuzawa, Hiroki; Inoue, Toshiyuki; Abe, Shinji; Satoh, Hitoshi; Nakajima, Yasuo

    2015-01-01

    We have recently developed a phantom that simulates acute ischemic stroke. We attempted to visualize acute-stage cerebral infarction by applying virtual monochromatic images to this phantom using dual-energy CT (DECT). Virtual monochromatic images were created using DECT from 40 to 100 keV at every 10 keV and from 60 to 80 keV at every 1 keV, under three energy conditions of tube voltages with thin (Sn) filters. Calculation of the CNR values allowed us to evaluate the visualization of acute-stage cerebral infarction. The CNR value of a virtual monochromatic image was the highest at 68 keV under 80 kV / Sn 140 kV, at 72 keV under 100 kV / Sn 140 kV, and at 67 keV under 140 kV / 80 kV. The CNR values of virtual monochromatic images between 65 and 75 keV were significantly higher than those obtained for all other created energy images. Therefore, optimal conditions for visualizing acute ischemic stroke were achievable.

  12. Post-mortem CT-coronary angiography

    DEFF Research Database (Denmark)

    Pøhlsgaard, Camilla; Leth, Peter Mygind

    2007-01-01

    post-mortem coronary angiography and computerized tomography.  We describe how to prepare and inject the contrast medium, and how to establish a CT-protocol that optimizes spatial resolution, low contrast resolution and noise level. Testing of the method on 6 hearts, showed that the lumen...

  13. Application Progress of Dual-source CT and Craniocervical CTA%双源CT头颈部CTA的应用进展

    Institute of Scientific and Technical Information of China (English)

    金欣; 韩淑祯; 张晓光

    2014-01-01

    目前双源CT是当今世界上最先进的CT设备,头颈部CTA作为一种无创性检查方法对头颈动脉血管狭窄及斑块的诊断有重要价值和帮助,其优点为检查时间短、成功率高、费用相对低廉、并发症少、安全无创等,可以作为头颈部动脉血管检查的首选和重要方法。头颈部血管病变是脑血管疾病的主要发病原因之一,尽早发现头颈部动脉病变,通过发现“罪犯血管”进行及时干预治疗和二级预防,可显著降低脑血管疾病的发病率、致残率、死亡率。%Dual-source CT is currently the most advanced CT equipment in the world. Craniocervical CTA as a noninvasive method, has significant value and assistance for the diagnosis of head and neck artery stenosis and plaque, its advantages including short time, high success rate, relatively low cost, fewer complications, safety and noninvasiveness, and can serve as a preferred and important method for head and neck arteries inspection. Craniocervical vascular disease is one of the major causes of cerebrovascular diseases, early detection of head and neck artery disease, finding“culprit vessels”and timely carrying out intervention treatment and secondary prevention, can significantly reduce the incidence of cerebrovascular diseases.

  14. 双源计算机断层扫描在永存动脉干诊断中的应用%Clinical application of dual-source CT in diagnosis of persistent truncus arteriosus

    Institute of Scientific and Technical Information of China (English)

    冯越; 刘铁; 翟利浩

    2012-01-01

    Objectives To explore the clinical values of dual - source computed tomography ( CT) in diagnosis of persistent truncus arteriosus(PTA). Methods Seven patients (aged 7 days to 8 years, middle age 3.4 years) diagnosed as PTA by echocardiography underwent cardiac CT with dual-source CT machine. Two- and three-dimensional images were reformated by multiple planar reformation (coronal, sagital and oblique), maximum intensity projection and volume rendering. Of the 7 patients, 4 underwent angiocardiography. Results Qualitative and classification diagnosis were made through Dual-source CT in all the 7 cases. Dual-source CT visualized 28 concomitant anomalies while echocardiography visualized 24 in all the 7 cases. Conclusions Qualitalive and classification diagnosis can be made through Dual-source CT which contributes to the strategies and improvement of operations.%目的 探讨双源计算机断层扫面(computed tomography,CT)在永存动脉干诊断中的应用价值.方法 选择7例经超声心动图诊断为永存动脉干患者,年龄7d~8岁,中位年龄3.4岁.采用双源CT,心电门控下对比增强完成心脏检查,并在图像工作站完成多平面(MPR)、最大密度投影(MIP)和三维容积漫游(VR)处理.其中有4例进行心导管检查.结果 双源CT对7例永存动脉干均作出定性诊断和分型诊断,共发现合并畸形28处.超声心动图共显示24处.结论 双源CT可以对永存动脉干患者作出准确诊断及分型,并有助于临床手术方案的制订与完善.

  15. 双源CT对主动脉病变的诊断价值%Diagnostic Value of Dual Source CT Angiography in Aortic Disease

    Institute of Scientific and Technical Information of China (English)

    朱建国; 郭亮

    2015-01-01

    Objective To explore the value of the dual-source CT angiography (DSCT) in diagnosis of aortic disease. Methods 90 patients were suspected aortic disease with CTA, raw data were dealt with multiplanar reformation (MPR), curved planar reformation (CPR), maximum intensity projection (MIP) and volume rendering (VR). Results The aortic disease in 90 cases included aortic dissection 27 cases, aortic aneurysm 14 cases, takayasu arteritis 3 cases, atherosclerotic 15 cases, aortic ulcer 5 cases, aortic intramural hematoma 5 cases, aortic coarctation 1 case, aortic variations 1 case, portal spongy degeneration 1 case, Budd-Chiari Syndrome 1 case, superior mesenteric arterial thrombosis 2 cases, portal thrombosis 1 case, left renal artery aneurysms 1 case, splenic artery aneurysms 1 case, pulmonary embolism 4 cases, renal cancer 1 case, normal aortic 7 cases. All the image quality is excellent, and the average effective radiation dose was 3.14 mSv. Conclusion Dual-source CT angiography is significant in diagnosing aortic disease, and can reduce radiation dose.%目的:探讨双源CT扫描血管成像对主动脉病变的诊断价值。方法对临床可疑主动脉病变的90例患者采用双源CT血管造影(CTA)检查,并对原始数据采用多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)和容积再现(VR)后处理技术进行重建。结果90例患者中共检出主动脉夹层27例,主动脉瘤14例,大动脉炎3例,主动脉粥样硬化15例,主动脉壁溃疡5例,主动脉壁内血肿5例,主动脉缩窄1例,主动脉变异1例,门静脉海绵样变性1例,布加氏综合征1例,肠系膜上动脉血栓2例,门静脉血栓1例,左肾动脉瘤1例,脾动脉瘤1例,肺动脉血栓4例,肾癌1例,正常7例。所有图像质量优良,有效射线剂量平均约3.14 mSv。结论双源CT扫描对主动脉病变的诊断具有重要意义,并能降低辐射剂量。

  16. Image quality and radiation dose of 128-slice dual-source CT venography using low kilovoltage combined with high-pitch scanning and automatic tube current modulation.

    Science.gov (United States)

    Park, Chan Kue; Choo, Ki Seok; Jeon, Ung Bae; Baik, Seung Kug; Kim, Yong Woo; Kim, Tae Un; Kim, Chang Won; Jeong, Yeon Ju; Jeong, Dong Wook; Lim, Soo Jin

    2013-06-01

    To compare vascular enhancement, image quality, and radiation dose of 128-slice dual-source CT venography (CTV) between an imaging setting of 120 kVp with low pitch, and a setting of 100 kVp combined with high pitch and automatic tube current modulation. A total of 100 patients with suspected deep vein thrombosis and varicose veins were divided into two groups: Group 1 [50 patients, 120 kVp, low pitch (0.6), and fixed 120 mA) and Group 2 (50 patients, 100 kVp, high pitch (3.0), and automatic tube current modulation]. Two radiologists, who were blinded to the image protocol, assessed vascular enhancement and image noise in the inferior vena cava (IVC), femoral vein, and popliteal vein. They also assigned an image quality score independently using a 5-point visual scale. Effective dose was estimated using the dose-length product (DLP). Group demographics, radiation dose, vascular enhancement, image noise, and image quality in the two groups were analyzed. Mean vascular enhancement of the IVC, femoral vein, and popliteal vein was significantly higher in group 2 than in group 1, and images in group 2 had significantly higher image noise. However, there were no significant differences in subjective image quality score of the IVC, femoral vein, and popliteal vein. The mean DLP in group 2 (402.10 ± 94.29 mGy cm) was significantly lower than that in group 1 (973.36 ± 63.20 mGy cm) (P enhancement with acceptable image quality and low radiation dose.

  17. 双源 CT 双能量技术在泌尿系结石诊断中的应用价值%Application value of dual energy technique of dual source CT in the diagnosis of urinary calculi

    Institute of Scientific and Technical Information of China (English)

    高江晖; 马洪宇; 郭文伟; 于庆康

    2016-01-01

    目的:探讨双源 CT 双能量技术在尿路结石组成分析中的预测价值。方法对30例泌尿系统结石患者行双源 CT 双能量扫描,对结石组成成份进行分析,将结果与红外光谱法分析的结石组成相比,计算双源 CT 分析尿酸盐结石、非尿酸盐结石的特异度与灵敏度,判断预测结石的准确性。结果30例泌尿系结石中尿酸盐类结石10例,非尿酸盐类结石20例,尿酸盐结石、非尿酸盐结石在140 kV 能量下 CT 值分别为(312.5±55.5)HU、(650.6±255.5)HU,在100 kV 能量下 CT 值分别为(328.5±50.5)HU、(960.8±180.5)HU,尿酸盐结石、非尿酸盐结石在两种能量下的差值分别为(16.5±5.1)HU、(310.2±26.7)HU,比值分别为(1.05±0.01)HU、(1.47±0.02) HU,尿酸盐结石差值、比值明显低于非尿酸盐结石(P <0.05),双源 CT 可切确辨别尿酸盐类结石与非尿酸盐类结石,其灵敏度、特异度分别为90%、95%。结论双源 CT 双能量成像技术能在尿路结石治疗前对其组成进行分析,对认识结石的成因及预防结石形成有很大帮助。%Objective To investigate the clinical value of dual source dual energy CT( DS-DECT)in predict chemical component of urinary calculi. Methods Selected 30 cases with urinary cal-culi underwent dual source Flash CT,analysed the component of the calculi,compared the results and in-frared spectroscopy analysis of calculi composition,calculated the specificity and sensitivity of urate cal-culi,non urate calculus by dual source CT analysis,and judged the forecasting accuracy of the calculi. Results Among the 30 urinary calculi patients,10 cases had uric acid calculi and 20 cases had non-u-ric acid calculi. Uric acid calculi and non-uric acid calculi under 140 kV energy:CT values were (312. 5 ± 55. 5)HU,(650. 6 ± 255. 5)HU;under 100 kV energy:CT values were(328. 5 ± 50. 5) HU,(960. 8 ± 180. 5)HU;the difference of acid

  18. 急性主动脉夹层诊断中双源CT检查的应用价值评述%Comment on the Application Value of Dual Source CT in Diagnosis of Acute Aortic Dissection

    Institute of Scientific and Technical Information of China (English)

    陈说

    2015-01-01

    目的:探析双源CT检查在急性主动脉夹层诊断中的运用价值。方法选择120例急性主动脉夹层患者为研究对象,回顾性分析其临床资料。结果双源CT诊断急性主动脉夹层的特异度和敏感度均为100%;同时MPR与VR和MIP在综合显示能力方面比较差异有统计学意义(P<0.05)。结论双源CT诊断急性主动脉夹层具有较高的准确率。%Objective To explore dual-source CT examination in the diagnosis of acute aortic dissection using value. Methods 120 cases of patients with acute aortic dissection were chosen as the research object, the clinical data were retrospectively analyzed. Results The degree of dual-source CT in the diagnosis of acute aortic dissection of the specific and sensitivity was 100%, meanwhile MPR and VR and MIP in the aspect of the comprehensive ability was statistically signiifcant (P<0.05). Conclusion Dual-source CT in the diagnosis of acute aortic dissection has higher accuracy.

  19. Diagnosis of pulmonary artery embolism. Comparison of single-source CT and 3{sup rd} generation dual-source CT using a dual-energy protocol regarding image quality and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Petritsch, Bernhard; Kosmala, Aleksander; Gassenmeier, Tobias; Weng, Andreas Max; Veldhoen, Simon; Kunz, Andreas Steven; Bley, Thorsten Alexander [Univ. Hospital Wuerzburg (Germany). Inst. of Diagnostic and Interventional Radiology

    2017-06-15

    To compare radiation dose, subjective and objective image quality of 3 rd generation dual-source CT (DSCT) and dual-energy CT (DECT) with conventional 64-slice single-source CT (SSCT) for pulmonary CTA. 180 pulmonary CTA studies were performed in three patient cohorts of 60 patients each. Group 1: conventional SSCT 120 kV (ref.); group 2: single-energy DSCT 100 kV (ref.); group 3: DECT 90/Sn150 kV. CTDIvol, DLP, effective radiation dose were reported, and CT attenuation (HU) was measured on three central and peripheral levels. The signal-to-noise-ratio (SNR) and contrast-to-noise-ratio (CNR) were calculated. Two readers assessed subjective image quality according to a five-point scale. Mean CTDIvol and DLP were significantly lower in the dual-energy group compared to the SSCT group (p < 0.001 [CTDIvol]; p < 0.001 [DLP]) and the DSCT group (p = 0.003 [CTDIvol]; p = 0.003 [DLP]), respectively. The effective dose in the DECT group was 2.79 ± 0.95 mSv and significantly smaller than in the SSCT group (4.60 ± 1.68 mSv, p < 0.001) and the DSCT group (4.24 ± 2.69 mSv, p = 0.003). The SNR and CNR were significantly higher in the DSCT group (p < 0.001). Subjective image quality did not differ significantly among the three protocols and was rated good to excellent in 75 % (135/180) of cases with an inter-observer agreement of 80 %. Dual-energy pulmonary CTA protocols of 3 rd generation dual-source scanners allow for significant reduction of radiation dose while providing excellent image quality and potential additional information by means of perfusion maps. Dual-energy CT with 90/Sn150 kV configuration allows for significant dose reduction in pulmonary CTA. Subjective image quality was similar among the three evaluated CT-protocols (64-slice SSCT, single-energy DSCT, 90/Sn150 kV DECT) and was rated good to excellent in 75% of cases. Dual-energy CT provides potential additional information by means of iodine distribution maps.

  20. Dual-source dual-energy CT angiography with virtual non-enhanced images and iodine map for active gastrointestinal bleeding: Image quality, radiation dose and diagnostic performance

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Hao, E-mail: sunhao_robert@126.com [Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing 100730 (China); Hou, Xin-Yi, E-mail: hxy_pumc@126.com [Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing (China); Xue, Hua-Dan, E-mail: bjdanna95@hotmail.com [Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing 100730 (China); Li, Xiao-Guang, E-mail: xglee88@126.com [Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing 100730 (China); Jin, Zheng-Yu, E-mail: zhengyu_jin@126.com [Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing 100730 (China); Qian, Jia-Ming, E-mail: qjiaming57@gmail.com [Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing (China); Yu, Jian-Chun, E-mail: yu-jch@163.com [Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing (China); Zhu, Hua-Dong, E-mail: huadongzhu@hotmail.com [Department of Emergency, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing (China)

    2015-05-15

    Highlights: • GIB is a common gastrointestinal emergency with a high mortality rate. • Detection and localization of GIB source are important for imaging modality. • DSDECTA using a dual-phase scan protocol is clinically feasible. • DSDECTA with VNE and iodine map images can diagnose the active GIB source accurately. • DSDECTA can reduce radiation dose compared with conventional CT examination in GIB. - Abstract: Objectives: To evaluate the clinical feasibility of dual-source dual-energy CT angiography (DSDECTA) with virtual non-enhanced images and iodine map for active gastrointestinal bleeding (GIB). Methods: From June 2010 to December 2012, 112 consecutive patients with clinical signs of active GIB underwent DSDECTA with true non-enhanced (TNE), arterial phase with single-source mode, and portal-venous phase with dual-energy mode (100 kVp/230 mAs and Sn 140 kVp/178 mAs). Virtual non-enhanced CT (VNE) image sets and iodine map were reformatted from ‘Liver VNC’ software. The mean CT number, noise, signal to noise ratio (SNR), image quality and radiation dose were compared between TNE and VNE image sets. Two radiologists, blinded to clinical data, interpreted images from DSDECTA with TNE (protocol 1), and DSDECTA with VNE and iodine map (protocol 2) respectively, with discordant interpretation resolved by consensus. The standards of reference included digital subtraction angiography, endoscopy, surgery, or final pathology reports. Receiver–operating characteristic (ROC) analysis was undertaken and the area under the curve (AUC) calculated for CT protocols 1 and 2, respectively. Results: There was no significant difference in mean CT numbers of all organs (including liver, pancreas, spleen, kidney, abdominal aorta, and psoas muscle) (P > 0.05). Lower noise and higher SNR were found on VNE images than TNE images (P < 0.05). Image quality of VNE was lower than that of TNE without significant difference (P > 0.05). The active GIB source was identified

  1. Low concentration contrast medium for dual-source computed tomography coronary angiography by a combination of iterative reconstruction and low-tube-voltage technique: Feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Minwen, E-mail: zhengmw2007@163.com; Liu, Ying, E-mail: yingyinglyly@126.com; Wei, Mengqi, E-mail: weimengqi2008@163.com; Wu, Yongjie, E-mail: wu18291988526@163.com; Zhao, Hongliang, E-mail: zhaohl1980@163.com; Li, Jian, E-mail: xjyylj@yeah.net

    2014-02-15

    Objectives: To assess the impact of low-concentration contrast medium on vascular enhancement, image quality and radiation dose of coronary CT angiography (cCTA) by using a combination of iterative reconstruction (IR) and low-tube-voltage technique. Materials and methods: One hundred patients were prospectively randomized to two types of contrast medium and underwent prospective electrocardiogram-triggering cCTA (Definition Flash, Siemens Healthcare; collimation: 128 mm × 0.6 mm; tube current: 300 mA s). Fifty patients received Iopromide 370 were scanned using the conventional tube setting (100 kVp or 120 kVp if BMI ≥ 25 kg/m{sup 2}) and reconstructed with filtered back projection (FBP). Fifty patients received Iodixanol 270 were scanned using the low-tube-voltage (80 kVp or 100 kVp if BMI ≥ 25 kg/m{sup 2}) technique and reconstructed with IR. CT attenuation was measured in coronary artery and other anatomical regions. Noise, image quality and radiation dose were compared. Results: Compared with two Iopromide 370 subgroups, Iomeprol 270 subgroups showed no significant difference in CT attenuation (576.63 ± 95.50 vs. 569.51 ± 118.93 for BMI < 25 kg/m{sup 2}, p = 0.647 and 394.19 ± 68.09 vs. 383.72 ± 63.11 for BMI ≥ 25 kg/m{sup 2}, p = 0.212), noise (in various anatomical regions of interest) and image quality (3.5 vs. 4.0, p = 0.13), but significantly (0.41 ± 0.17 vs. 0.94 ± 0.45 for BMI < 25 kg/m{sup 2}, p < 0.001 and 1.14 ± 0.24 vs. 2.37 ± 0.69 for BMI ≥ 25 kg/m{sup 2}, p < 0.001) lower radiation dose, which reflects dose saving of 56.4% and 51.9%, respectively. Conclusions: Combined IR with low-tube-voltage technique, a low-concentration contrast medium of 270 mg I/ml can still maintain the contrast enhancement without impairing image quality, as well as significantly lower the radiation dose.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

  3. 双源CT增强扫描检查对肠梗阻患者梗阻部位和梗阻病因的诊断意义%Diagnostic Value of Dual Source CT Enhanced Scan of Intestinal Obstruction

    Institute of Scientific and Technical Information of China (English)

    易琳; 芮军; 相运勇; 袁鑫鑫

    2016-01-01

    Objective To analyze the obstruction site,etiology,diagnosis by dual source CT scan significance. Methods From January 2015 to January 2016 in our hospital to receive treatment for intestinal obstruction in 32 patients for the study,patients admit ed to hospital,administering dual-source CT enhanced scan,clinical data,the inspection process,the diagnosis of patients,etc. were retrospel tively and analyzed. Results The di-agnosis of obstruction,the dual-source CT scan diagnosis entirely consistent with fiber endoscopy findings and surgical results,the site of obstruction diagnosed as 100%in the diagnosis of obstructive reasons,only one case was misdiagnosed as Crohn's disease intestinal tuberculosis,other reasons are consistent with the results of fiber endoscopy and surgical results,cause of obstruction diagnosis was 96. 9%. Conclusion The dual-source CT applied to the site of obstruction and to diagnose the cause can improve the diagnosis rate,to provide a reliable reference for the development of clinical programs.%目的:分析在肠梗阻部位、病因诊断中应用双源CT增强扫描的意义。方法选择2015年1月至2016年1月接收治疗的肠梗阻患者32例为研究对象,患者入院时,施予双源CT增强扫描检查,对患者临床资料、检查过程、诊断结果等进行回顾性分析。结果在梗阻部位的诊断中,双源CT增强扫描诊断结果与纤维镜检查结果和手术结果完全一致,梗阻部位确诊率为100.0%,在梗阻原因的诊断中,仅有1例克罗恩病被误诊为肠结核,其他原因均与纤维镜检查结果和手术结果一致,梗阻原因确诊率为96.9%。结论将双源CT应用到肠梗阻部位及原因的诊断中可提高确诊率,为临床治疗方案的制定提供可靠参考。

  4. Impact of iterative reconstruction on CT coronary calcium quantification

    DEFF Research Database (Denmark)

    Kurata, Akira; Dharampal, Anoeshka; Dedic, Admir;

    2013-01-01

    We evaluated the influence of sinogram-affirmed iterative reconstruction (SAFIRE) on the coronary artery calcium (CAC) score by computed tomography (CT).......We evaluated the influence of sinogram-affirmed iterative reconstruction (SAFIRE) on the coronary artery calcium (CAC) score by computed tomography (CT)....

  5. Clinical eraluation of dual-source CT enterography using dual-energy rirtual non-enhanced technique%双源 CT 小肠造影双能量虚拟平扫的临床评估

    Institute of Scientific and Technical Information of China (English)

    邓丽萍; 史晓喆; 章士正; 张峭巍

    2014-01-01

    目的:探讨64排双源 CT 小肠造影双能量虚拟平扫技术应用于临床的可行性。方法:采用双源 CT 机对39例患者进行小肠造影检查,常规行 CT 平扫以及动、静脉期对比增强双能量扫描(100 kVp/230 mAs 和 l40 kVp/178 mAs)。利用 Liver VNC 软件进行后处理,获得动、静脉期的虚拟平扫 CT 图像。以常规 CT 平扫图像作为标准,对虚拟平扫图像的质量进行评估,采用4级评分法:最高为4分(图像解剖细节清晰,完全能满足诊断),最低为1分(图像模糊,不能满足诊断)。并对常规 CT 平扫、动、静脉期双能量 CT 扫描的辐射剂量进行比较。结果:39例中有腹部病变者25例,无明显异常者14例。与常规平扫图像比较,虚拟平扫图像上所有病灶均能显示,且病灶的范围、大小亦无明显差异;两位医师对虚拟平扫图像质量的评分均>2分,两者的评分差异无统计学意义(P >0.05)。所有虚拟平扫图像完全能满足诊断要求。常规平扫、双能量动脉期、双能量静脉期扫描的剂量长度乘积(DLP)分别为(283.8750±57.1195)、(289.3750±53.1543)和(301.2917±55.3346)mGy·cm,三次扫描的 DLP 的差异无统计学意义(F =0.615,P =0.544)。结论:双源 CT 小肠造影检查时可仅进行双能量增强扫描,经后处理获得的虚拟平扫图像基本可取代常规 CT 平扫,从而可减少检查的辐射剂量。%Objectire:To investigate the clinical feasibility of dual-source CT enterography using dual-energy virtual non-enhanced CT (VNCT)technique.Methods:CT enterography were performed in 39 patients with dual source CT scan-ner,including conventional non-enhanced CT scan (CNCT),arterial and venous phase contrast-enhanced CT scan (CECT) with dual energy mode (100kVp/230mAs and 140kVp/178mAs).VNCT images of arterial and venous phase were obtained after being post

  6. 双源CT双步触发技术用于心脏扫描%Application of dual-step prospective ECG-triggered dual-source CT in cardiac scan

    Institute of Scientific and Technical Information of China (English)

    李强; 钱农; 钱波; 徐烈福; 孟名柱; 潘昌杰

    2013-01-01

    Objective To introduce the application of dual-step prospective ECG-triggcrcd technical of DSCT in coronary angiog-raphy and left ventricular function analysis simultaneously. Methods Fifty-three consecutive patients suspected or diagnosed with coronary disease were examined by cardiac DSCT and MRI. Sequential acquisition and dual-step prospective ECG-triggcr were used in DSCT. Full tube current output in tube A at 70% ( HR≤70 bcats/min)or 40% ( HR>70 bcats/min) R-R interval according to heart rates and 20% tube current output in tube B at 30%-90% R-R interval in all patients. The coronary artery was divided into 16 segments according to the American Heart Association. Image quality of coronary arteries were graded with 4-point scale. LVES, LVED and LVEF were evaluated in DSCT and MR]. Paired it-test and pcarson correlation were statistically analysed. Results Fifty cases accomplished examination successfully. The average radiation docs was(3. 33±0. 65) mSv. In 669 evaluated coronary segments, 97. 76% could be diagnosed . Paired it-test indicated that the LVES, LVED and LVEF of DSCT and MR] had no significant statistically differences(P = 0. 91 ,0. 12 and 0. 16)and the correlation was good (r = 0. 96,0. 97 and 0. 89). Conclusion The second generation DSCT with dual-step prospective ECG-triggcrcd sequential acquisition can be used in coronary angiography and left ventricular function analysis simultaneously with good imaging quality of the coronary artery, reliable analysis of left ventricular function and lower radiation dose.%目的 探讨第二代双源CT(dual-source CT,DSCT)双步触发技术在冠状动脉造影兼顾左心室功能分析中的应用价值.方法 连续53例临床怀疑或确诊为冠状动脉心脏病的患者行冠状动脉DSCT造影和心脏MRI检查.DSCT采用序列扫描模式,前瞻性心电门控双步触发.扫描窗宽30%~90%R-R间期,依据不同的心率,仅在70%(心率≤70次/min)或40%(心率>70次/min)R-R间期全电

  7. Assessment of myocardial fibrosis and coronary arteries in hypertrophic cardiomyopathy using combined arterial and delayed enhanced CT: comparison with MR and coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Lei; Ma, Xiaohai; Zhang, Chen; Liu, Yi; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); DeLano, Mark C. [Michigan State University, Division of Radiology and Biomedical Imaging, College of Human Medicine, Lancing, MI (United States); Jiang, Tengyong [Capital Medical University, Department of Cardiology, Beijing Anzhen Hospital, Beijing (China)

    2013-04-15

    We sought to determine the feasibility and accuracy of dual-source computed tomography (DSCT) in assessing coronary artery disease and myocardial fibrosis of hypertrophic cardiomyopathy (HCM) compared with cardiac magnetic resonance (CMR) imaging and coronary angiography (CA). Forty-seven consecutive patients with HCM were prospectively enrolled. DSCT images were acquired in the arterial and late phases following intravenous contrast medium. The CMR and CA were performed within 7 days. Independent blinded readers read each study. Patients were classified according to myocardial delayed enhanced (MDE) CMR, coronary artery stenosis by CA, and arterial and MDE-DSCT. The diagnostic accuracy of DSCT in detecting coronary stenosis and MDE was analysed. Wall thickness determined by DSCT was strongly correlated with MR results (r = 0.91). DSCT and CMR MDE showed substantial agreement for the detection of myocardial fibrosis on per-patient and per-segment levels. The CT classification of patients by arterial stenosis and delayed enhancement had excellent agreement with MR and CA methods. The comprehensive cardiac CT examination provides reliable coronary artery and myocardial assessments. MDE-DSCT is a robust alternative method to MDE-CMR in assessing myocardial fibrosis in HCM particularly in patients with pacemakers or other contraindications to CMR. (orig.)

  8. Study on Clinical Application of of the Dual Energy Technique of Dual Source CT in Kidney Lesions%肾脏占位性病变中双源CT双能量技术的应用研究

    Institute of Scientific and Technical Information of China (English)

    马海鸿; 赵波; 周应恩

    2016-01-01

    目的:探究双源CT双能量技术在肾脏占位性病变的临床应用价值。方法选择2012年1月至2014年8月在新疆喀什地区第二人民医院接受治疗的肾脏占位性病变患者78例。分别采用常规CT扫描和双源CT双能量技术的增强扫描。将双源CT增强扫描结果记为观察组,常规CT扫描记为对照组。对比两组扫描图像及CT值,以及辐射剂量。结果观察组所收集的图像92.31%(72/78)的病患大部分能清晰显示,满足医师的诊断要求。并且观察组在各个部位扫描得到的CT值与对照组无显著差异且SNR显著高于对照组,而辐射剂量中的CTDIvoII、DLY以及ED均显著低于对照组。差异均有统计学意义(均P<0.05)。结论采用双源CT双能量技术对肾脏占位性病变进行诊断的图像质量较好,能满足检查的需要。此外,扫描结果中CT值可观、噪声比较低,而且辐射剂量非常低。在临床上具有较高的应用价值,值得推广应用。%Objective To explore the technique of dual source dual energy CT lesions clinical application value in the kidney. Methods 78 cases of renal occupying lesionsin was in the Second People's Hospital of Xinjiang Kashi Region for treatment From January 2012 to August 2014. Enhanced scan were used routine CT scan and dual energy technique of dual source CT. The dual source CT scan results recorded in the observation group, routine CT scan as control group, compared the two groups of images and the CT value, and the radiation dose. Results In the observation group, 92.31%(72/78) the patients of the collected most of the image display, to meet the requirements of medical diagnosis. And the observation group in each part of scanning CT value had no significant difference with control group and SNR was significantly higher than that of control group, and the radiation dose of CTDIvoII, DLY and ED were significantly lower than those of the control group. The differences

  9. Non-invasive prediction of hemodynamically significant coronary artery stenoses by contrast density difference in coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hell, Michaela M., E-mail: michaela.hell@uk-erlangen.de [Department of Cardiology, University of Erlangen (Germany); Dey, Damini [Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Taper Building, Room A238, 8700 Beverly Boulevard, Los Angeles, CA 90048 (United States); Marwan, Mohamed; Achenbach, Stephan; Schmid, Jasmin; Schuhbaeck, Annika [Department of Cardiology, University of Erlangen (Germany)

    2015-08-15

    Highlights: • Overestimation of coronary lesions by coronary computed tomography angiography and subsequent unnecessary invasive coronary angiography and revascularization is a concern. • Differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve, were assessed. • At a threshold of ≥24%, contrast density difference predicted hemodynamically significant lesions with a specificity of 75%, sensitivity of 33%, PPV of 35% and NPV of 73%. • The determination of contrast density difference required less time than transluminal attenuation gradient measurement. - Abstract: Objectives: Coronary computed tomography angiography (CTA) allows the detection of obstructive coronary artery disease. However, its ability to predict the hemodynamic significance of stenoses is limited. We assessed differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve (FFR). Methods: Lesion characteristics of 59 consecutive patients (72 lesions) in whom invasive FFR was performed in at least one coronary artery with moderate to high-grade stenoses in coronary CTA were evaluated by two experienced readers. Coronary CTA data sets were acquired on a second-generation dual-source CT scanner using retrospectively ECG-gated spiral acquisition or prospectively ECG-triggered axial acquisition mode. Plaque volume and composition (non-calcified, calcified), remodeling index as well as contrast density difference (defined as the percentage decline in luminal CT attenuation/cross-sectional area over the lesion) were assessed using a semi-automatic software tool (Autoplaq). Additionally, the transluminal attenuation gradient (defined as the linear regression coefficient between intraluminal CT attenuation and length from the ostium) was determined

  10. Coronary CT angiography and MR angiography of Kawasaki disease

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-15

    Although the incidence of coronary artery aneurysms has diminished in patients with Kawasaki disease, coronary artery involvement is still regarded as a major complication of the disease, significantly affecting morbidity and mortality. Recent technical advances in coronary CT angiography (CTA) and MR angiography (MRA) have led to the possibility of using these two imaging methods as minimally invasive alternatives to the more invasive diagnostic catheter angiography in evaluating coronary artery abnormalities, such as aneurysm, stenosis, and occlusion. In this article, we describe imaging techniques and findings of coronary CTA and MRA in Kawasaki disease. (orig.)

  11. Noninvasive Physiologic Assessment of Coronary Stenoses Using Cardiac CT

    Directory of Open Access Journals (Sweden)

    Lei Xu

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  13. 双源 CT 软件对肺栓塞诊断的应用%Study of the diagnosis and clinical application of pulmonary embolism with dual source CT software

    Institute of Scientific and Technical Information of China (English)

    朱建国; 郭亮

    2014-01-01

    Objective:To investigate the value of dual source CT software in the diagnosis and clinical application of pulmonary artery embolism (PE).Methods:Sixty-six consecutive patients having suspected PE underwent CT pulmonary angiography with dual-energy technique on a dual source CT scanner.All raw data were transported to the workstation,CT pulmonary angiography (CTPA)images,Lung perfusion blood volume (PBV)images,and Lung Vessels (LV)images were obtained after post-processing.The consistency of CTPA images with LV images in any parts of lung in every normal sub-jects were analyzed and examined by Kappa test.Then sensitivity and specificity of CTPA,lung PBV images,LV images, Lung PBV+LV images in the diagnosis of PE and the positive predictive value (PPV)and negative predictive value (NPV) were calculated respectively.χ2-test or exact probability test were applied to compare the accurate diagnosis rate in detecting PE in different positions of pulmonary artery.Results:CTPA images and LV images had a good consistency in showing the pulmonary arteries of 32 normal subjects in total (K=0.71,P <0.05).Of the 4 software used,the sensitivity of LV soft-ware and Lung PBV+LV was the highest (100%),yet false positive was existed,the PPV was 94.4%、97.1% respective-ly,the specificity of CTPA was the highest (100%),the specificity of Lung PBV software and LV software was 53.8%, 84.6% respectively.Software including CTPA、LV、Lung PBV+ LV in detecting embolisms in pulmonary artery trunks were completely in consistency,no statistic difference was existed in the diagnosis of PE in lobar and segmental pulmonary arteries.However,significant statistical difference was showed in sub-segment or lower pulmonary arteries (χ2 =7.58,P <0.05).As a whole,significant statistical difference was existed in the diagnosis of PE by these three software (χ2 =6.22, P <0.05).Conclusion:Dual source CT with CTPA images and LV images showed a good consistency in displaying pulmo-nary arteries

  14. Dual source spiral CT three dimensional reconstruction in the interventional treatment of liver cancer%双源螺旋CT三维重建技术在肝癌介入治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    王东林; 陈广礼

    2011-01-01

    目的 探讨双源螺旋CT三维重建技术在肝癌介入治疗中的应用价值.方法 对37例肝癌患者进行双源螺旋CT扫描诊断后,在后处理工作站进行容积再现(VR)、最大密度投影(MIP)血管重建.结果 肝动脉期VR图像和MIP多平面重建图像均能清晰显示腹腔干、脾动脉、肝总动脉左右动脉及其2~3级分支,还能清晰显示1~6级门静脉血管结构及1~3级肝静脉血管分支,具有较强的空间立体感.结论 双源螺旋CT门静脉三维重建成像是一种快捷而有效的无创性血管造影技术,有助于临床治疗方案的合理选择及疗效随访.%Objective To investigate the value of dual source spiral CT three dimensional reconstruction in the interventional treatment. Methods Totally 37 patients with liver cancer for dual source spiral CT scan diagnosis, in the post -processing workstation for volume rendering ( VR), maximum intensity projection (MIP) revascularization. Results The hepatic arterial phase MIP,VR images and multiplanar reconstruction images could clearly show the celiac trunk, splenic artery, hepatic artery about 2 ~ 3 artery and its branches, but also clearly show the 1 ~ 6 Class doors and 1 vein structure three branches of hepatic veins, with a strong spatial dimension. Conclusions The dual source spiral CT three dimensional reconstruction of portal vein imaging is a fast and effective non - invasive vascular imaging techniques, useful in clinical treatment choice and efficacy of a reasonable follow - up.

  15. 双源双能CT在尿路结石成分分析中的应用%Dual source dual energy CT in the analysis of urinary calculi composition

    Institute of Scientific and Technical Information of China (English)

    范璐; 郭君武; 张慧

    2012-01-01

    目的:探讨双源CT双能量技术应用于尿路结石成分分析中的临床价值.方法:226例尿路结石患者行双源CT双能量扫描,对其结石成分进行分析,将结果与用红外光谱法分析结石成分的结果作对比,计算双源CT在体分析草酸钙结石、磷酸盐结石、胱氨酸结石及尿酸结石的灵敏度与特异度.结果:双源CT能够准确的区分尿酸结石和非尿酸结石(灵敏度和特异度均为100%),较准确的区分草酸钙结石(灵敏度为89.03%、特异度为85.62%),磷酸盐结石(灵敏度为67.28%、特异度为90.71%)及胱氨酸结石(灵敏度为73.56%、特异度为93.43%).结论:双源CT双能量技术能在治疗前对尿路结石的成分进行初步分析,对了解结石成因,预防结石形成及指导治疗具有重要的意义.%Objective: To assess the clinical value of dual source dual energy CT in the analysis of urinary calculi composition. Methods:Dual-source CT with dual-energy scanning technique was performed in 226 patients with urinary calculi. The composition of urinary stones was compared with the results of the urinary stones composition analyzed by Fourier transform infrared spectroscopy (FTIR). The sensitivity and specificity of dual energy CT in evaluating the composition of calcium oxalate stone, phosphate stone, cystine stone and uric acid stone in vivo were calculated. Results:Dual-source CT could accurately distinguish uric acid stones and non-uric acid stones with the sensitivity and specificity as 100% respectively. The sensitivity of differentiating calcium oxalate stone, cystine stone and phosphate stone was 89. 3%, 67. 28% and 73. 56% respectively,and the specificity of the above mentioned calculi was 85. 62%,90. 71% and 93. 43% respectively. Conclusion: Analysis of urinary calculi composition before treatment could be obtained by dual-source CT with dual-energy technique, which had significant importance to understand the causes of stone,to prevent

  16. Preliminary study of application value dual-source CT combined with manometric examination on OSAHS%探讨气道双源CT和测压检查对OSAHS的联合应用价值

    Institute of Scientific and Technical Information of China (English)

    王志文; 许凌云; 张晓馨

    2013-01-01

    目的 初步探讨应用双源CT联合测压法评价OSAHS患者上气道阻塞层面的应用价值.方法 通过上气道双源CT判定结果与测压结果进行对照研究,并分析两种方法联合应用判定阻塞层面临床应用价值.结果 双源CT检查判定OSAHS患者上气道狭窄平面的阳性率为83.33%(25/30).AG200判定OSAHS患者上气道间隙阻塞的阳性率为90%(27/30).两种检查结合的阳性率可以达到96.66%(29/30).结论 双源CT检查和AG200对OSAHS患者上气道阻塞均具有诊断意义,CT检查可以反映上气道多平面联合狭窄和上气道解剖性狭窄的原因,AG200仅能单纯显示单一平面的阻塞情况.联合应用两种检查手段可以明显提高OSAHS患者诊断的阳性率,并且在形态学和功能状态表现上可以相互弥补不足,为临床提供更可靠治疗依据.%Objective To preliminarily diseuss the application value of dual-source CT combined with manometric method for evaluation of upper airway obstruction level in patients with OSAHS. Methods Through the upper airway of dual-source CT judgement result, manometric findings were compared. We combined the two methods to determine the clinical value of block level. Results Dositive rate with dual-source CT scan determining the upper airway stenosis in patients with OSAHS was 83. 33% (25/30) , AG200 determining OSAHS patients on positive airway obstruction clearance rate was 90%(27/30). Two kinds of checks can be achieved with the positive rate of 96. 66% (29/30). Conclusion Dual-source CT and AG200 of the upper airway obstruction in patients with OSAHS can make a diagnosis, CT examination can reflect on the multi-planar joint narrow airway and upper airway anatomic stenosis of the reasons, AG200 alone showed only a single plane of obstruction. Combination of two kinds of inspection methods can significantly improve the positive rate of diagnosis of OSAHS patients. And morphological and functional status in each other can

  17. Comparison of Diagnosis Value of MRI and Dual-Source CT in Knee-Joint Trauma%磁共振和双源CT在膝关节外伤中的诊断价值对比

    Institute of Scientific and Technical Information of China (English)

    杨进军; 何桂茹; 班允清

    2015-01-01

    目的 对磁共振和双源CT在膝关节外伤中的诊断价值进行对比分析. 方法 整群选取该院2011年1月—2014年5月间收治的141例膝关节外伤患者的影像资料进行回顾性分析,以手术结果作为参照,对比两种检测方法的诊断准确率.结果 双源CT与MRI对膝关节外伤的检出率分别为70.9%与94.3%,组间比较MRI的检出率显著高于CT,差异具有统计学意义(P<0.05). 以手术结果作为参照,对不同类型膝关节外伤的诊断准确率进行比较显示,MRI对于骨质损伤、韧带损伤、半月板损伤及关节囊积液的显示情况均优于双源CT,差异有统计学意义(P<0.05). 结论 MRI对于膝关节外伤的各项检出率均高于双源CT. 术前通过MRI全面检查掌握膝关节损伤情况,有助于帮忙骨科医生合理制定手术预案.%Objective To analyze and compare the diagnosis value of MRI and dual-source CT in knee-joint trauma. Methods The images about 141 patients with knee-joint trauma treated from January 2011 to May 2014 in our hospital were retrospectively analyzed. According to the operation results, the detection accuracy based on two methods was compared. Results The detection rate of knee-joint trauma based on dual-source CT and MRI was 70.9% and 94.3%. The rate of MRI was higher than that of CT (P<0.05); according to comparison results of detection accuracy for different types of knee-joint trauma, the imaging of injury of bone, ligamentous injury, meniscus injury and drainage of articular capsule based on MRI was significantly better than that of du-al-source CT (P<0.05). Conclusion The detection rate of knee-joint trauma based on MRI is higher than that of dual-source CT. Be-fore surgery, the complete inspection of knee-joint injury based on MRI is good for the orthopedists to make the reasonable opera-tion planning.

  18. 双源CT肺动脉成像在肺动脉栓塞诊断中的应用价值%Application of dual-source CT pulmonary angiography in the diagnosis of pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    张谷青; 陈月芹; 孙新海; 史志涛; 张新东; 王皆欢

    2011-01-01

    Objective : To explore the value of dual-source CT angiography of pulmonary arteries in the diagnosis of pulmonary embolism. Methods: 58 patients suspected of having pulmonary embolism were examined with dual-source CT pulmonary angiography. The effects of imaging in displaying pulmonary embolism on MPR , MIP , VR and CTVE were compared. The direct signs, the indirect signs and types were analyzed. Results : 45 cases with pulmonary embolism were diagnosed. A total of 658 emboli were found by dual-source CT , 170 of which were central type, 208 were eccentric type , 74 were mural type,and 206 were complete occlusion type. Indirect signs included mosaic sign (13 cases) , pleural effusion (27 cases) ,pulmonary artery hypertension (7 cases) , and pulmonary infarct (18 cases). 658 emboli were found on MPR,584 on MIP.the effect of VR and CTVE were not good (249 and 75 emboli were found). MIP,VR and CTVE were obviously inferior to MPR (P<0.05). Conclusion : The dual-source CT pulmonary angiography is a convenient, fast and reliable method for demonstration of pulmonary embolism. MPR, MIP,VR and CTVE play an important role in the diagnosis of pulmonary embolism.and MPR is the best among them.%目的:探讨双源CT肺动脉成像对肺动脉栓塞(PE)的诊断价值.方法:对58例临床拟诊为PE的患者行双源CT肺动脉成像,总结PE的直接、间接征象及分型,并比较MPR、MIP、VR和CTVE对肺动脉栓子的显示效果.结果:直接征象:58例中45例诊断为PE,共发现栓子 658支(中心型170支,偏心型208支,附壁型74支,完全闭塞型206支).间接征象:马赛克征13例,胸腔积液27例,肺动脉高压7例,肺梗死18例.MPR检出栓子658支,MIP检出584支,VR及CTVE对栓子的显示效果较差,分别为249支和75支.MIP、VR及CTVE对栓子的显示效果低于MPR,差异有统计学意义(P<0.05).结论:双源CT肺动脉成像能够方便、快捷、清楚地显示肺动脉栓子,对诊断PE有重要价值;MPR、MIP、VR和CTVE是

  19. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Ruzsics, Balazs; Costello, Philip [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Lee, Heon [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Seoul Medical Center, Department of Radiology, Seoul (Korea); Zwerner, Peter L.; Schoepf, U.J. [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Charleston, SC (United States); Gebregziabher, Mulugeta [Medical University of South Carolina, Department of Biostatistics, Bioinformatics, and Epidemiology, Charleston, SC (United States)

    2008-11-15

    We aimed to evaluate the feasibility of diagnosing coronary stenosis and myocardial ischemia with a single dual-energy CT (DECT) acquisition. Thirty-five patients underwent contrast-enhanced, ECG-gated DECT of the heart while independently operating the two tubes of a dual-source CT system at high- and low-energy X-ray spectra. From the same raw data, coronary CTA (cCTA) studies were reconstructed for stenosis detection, and the myocardial blood-pool was analyzed by determining the tissue iodine content. Two independent observers analyzed all studies for stenosis and myocardial blood-pool deficits. Results were correlated with SPECT, coronary catheterization and cCTA on a segmental basis. cCTA had 98% sensitivity, 88% specificity and 92% accuracy for detection of >50% stenosis. DECT detected myocardial ischemia with 84% sensitivity, 94% specificity and 92% accuracy. Our initial experience may warrant further exploration of DECT as a possibly feasible single imaging investigation for the comprehensive diagnosis of coronary stenosis and myocardial ischemia. (orig.)

  20. The value of low-dose prospective ECG-gated dual-source CT angiography in the diagnosis of coarctation of the aorta in infants and children

    Energy Technology Data Exchange (ETDEWEB)

    Nie, P. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Wang, X., E-mail: wxming369@yahoo.com.cn [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Cheng, Z.; Duan, Y.; Ji, X. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Chen, J. [CT Research Collaboration, Siemens, Beijing (China); Zhang, H. [Department of Cardiovascular Surgery, Shandong Provincial Hospital, Jinan, Shandong (China)

    2012-08-15

    Aim: To investigate the value of prospective electrocardiogram (ECG)-gated dual-source computed tomography (DSCT) in the diagnosis of coarctation of the aorta (CoA). Materials and methods: Seventeen patients clinically suspected of having CoA underwent prospective ECG-gated DSCT angiography and transthoracic echocardiography (TTE). Surgery was performed in all patients. The diagnostic accuracy of DSCT angiography and TTE was compared with the surgical findings as the reference standard. Image quality was evaluated using a five-point scale. Effective radiation dose was calculated from the dose-length product (DLP). Results: CoA was diagnosed in 17 patients by DSCT angiography and in 16 patients by TTE. A total of 46 separate cardiovascular abnormalities were confirmed by surgical findings. The diagnostic accuracy of DSCT angiography and TTE was 96.32% and 97.06%, respectively. There was no significant difference in the diagnostic accuracy between DSCT angiography and TTE ({chi}{sup 2} = 0, p > 0.05). The mean score of image quality was 4.2 {+-} 0.8. The mean effective dose was 0.69 {+-} 0.09 mSv. Conclusion: Prospective ECG-gated DSCT with a low radiation dose is a valuable technique in the diagnosis of CoA in infants and children.

  1. Comparison of dual-source CT angiography and MR angiography in preoperative evaluation of intra- and extracranial vessels: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Muehlenbruch, Georg; Das, Marco; Mahnken, Andreas Horst; Guenther, Rolf W. [RWTH Aachen University, Department of Diagnostic and Interventional Radiology, Aachen (Germany); Mommertz, Gottfried; Langer, Stefan [RWTH Aachen University, Department of Vascular Surgery, Aachen (Germany); Schaaf, Meike; Thron, A.; Krings, Timo [RWTH Aachen University, Department of Neuroradiology, Aachen (Germany); Wildberger, Joachim Ernst [University Hospital Maastricht, Department of Radiology, Maastricht (Netherlands)

    2010-02-15

    Besides the assessment of carotid artery stenosis, evaluation of the vascular anatomy and lesions within both the extra- and intracranial arteries is crucial for proper clinical evaluation, treatment choice and planning. The purpose of our study was to evaluate the potential of dual-source CTA and 3T-MRA. In 16 symptomatic CAS patients, contrast-enhanced DSCT and 3T-MRA examinations were performed. For DSCT a dual-energy protocol with a 64 x 0.6-mm collimation was applied. In 3T-MRA intracranial high-resolution unenhanced TOF and extracranial contrast-enhanced MRA were performed. All examinations were analyzed for relevant morphologic and pathologic features or anomalies, and a total of 624 vessel segments were scored. All examinations were of diagnostic image quality with good to excellent vessel visibility. Almost all intracranial arteries were significantly better visualized by MRA compared to CTA (five of six vessels, p < 0.05). DSCT however allowed for further morphological carotid stenosis description, especially with respect to calcification. Although MRA proved to be superior in visualization of smaller intracranial arteries, all pre-interventionally relevant information could be perceived from DSCT. DSCT and MRA may both be regarded as a reliable, fast, pre-interventional imaging investigation in patients with carotid artery stenosis. (orig.)

  2. A comparative study for Triple-Rule-out with different tube voltage technique of Dual-Source CT in acute chest pain%双源 CT不同管电压技术诊断急性胸痛三联症效果比较

    Institute of Scientific and Technical Information of China (English)

    王皆欢; 陈东风; 王少春; 孙占国; 王林省; 张谷青

    2014-01-01

    目的:对比双源CT胸痛三联检查在两种不同电压下显示急性胸痛患者肺动脉、主动脉及冠状动脉的图像质量以及患者所受的辐射剂量,以评估低电压扫描在急性胸痛患者推广应用的可行性。方法利用双源C T胸痛三联扫描模式,结合回顾性心电门控技术对361例胸痛三联检查患者进行统计分析,比较主动脉、肺动脉及冠状动脉的图像质量及辐射的有效剂量。结果120kV组与100kV组在图像质量的主观评分对比中差异无统计学意义(P>0.05),在患者辐射剂量的对比中,120kV组的辐射剂量大于100kV组,差异有统计学意义(P<0.05)。结论双源CT胸痛三联检查两种不同管电压扫描对急性胸痛患者的肺动脉、主动脉及冠状动脉的成像质量无影响,并且应用100kV 管电压扫描可以降低患者所受的辐射剂量,可以作为急性胸痛患者的首选。%Objective To compare the value of triple-rule-out (TRO) dual-source computed tomography angiog-raphy in acute chest pain patients with diseases of pulmonary artery ,aortic and coronary artery and radiation dose in two different voltage as well as the feasibility of generalizing and applying in patients with acute chest pain . Methods 361 patients with chest pain were analyzed statistically underwent triple-rule-out (TRO) dual-source CT combined with retrospective ECG-gated technique ,and then compare with image quality of aorta ,pulmonary artery and coronary artery and effective radiation dose .Results Subjective score of image quality of the voltage 120kV and 100kV group had no statistical significance(P>0.05) .The difference was statistically significant(P<0.05)in comparison of radiation dose .The effective radiation dose of the voltage 100kV group was lower than that of the voltage 120kV group .Conclusion The quality of pictures of pulmonary artery ,coronary artery and aorta are not affected in different tube tension

  3. Post-mortem CT-coronary angiography

    DEFF Research Database (Denmark)

    Pøhlsgaard, Camilla; Leth, Peter Mygind

    2007-01-01

      Despite the large number of people who die from complications to coronary atherosclerosis, the method of investigation of the coronary arteries has remained virtually unchanged since the time of Virchow. In this article we will present a method for investigation of the coronary arteries using p...

  4. Prospective prediction of the major component of urinary stone composition with dual-source dual-energy CT in vivo.

    Science.gov (United States)

    Zhang, G-M-Y; Sun, H; Xue, H-D; Xiao, H; Zhang, X-B; Jin, Z-Y

    2016-11-01

    To prospectively evaluate the diagnostic accuracy of dual-source dual-energy computed tomography (DSDECT) for predicting the major component and determining the composition of urinary calculi in patients with urolithiasis, using postoperative in vitro Fourier transform infrared spectroscopy (FT-IR) analysis as the reference standard. Patients with known urolithiasis underwent preoperative DSDECT evaluation, and subsequently, underwent surgical removal of the stones. All patients were examined using the dual-energy renal stone protocol. Material-specific chromatic images were made using dedicated post-processing software. The final determination of stone composition was made using FT-IR postoperatively. Diagnostic parameters of DSDECT for predicting the major component and detecting the presence of four composition types were calculated. A total of 81 urinary calculi were included in this study. Forty-three were pure stones and 38 were mixed stones according to FT-IR. DSDECT correctly identified the major component of all pure stones and 36 mixed stones. The major component of two mixed stones with uric acid as the major component was falsely interpreted as calcium oxalate. The overall accuracy of DSDECT for predicting the major component of stones was 97.5% (79/81). The accuracy of DSDECT for detecting the presence of four types of composition, uric acid, cysteine, hydroxyapatite, and calcium oxalate, was 97.5% (79/81), 93.8% (76/81), 80.2% (65/81), and 93.8% (76/81), respectively. DSDECT could accurately predict the major component of urinary calculi and detect uric acid, cysteine, and calcium oxalate with a satisfactory accuracy. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  5. The Value Study In Urinary Stone Composition Analysis by Dual Source CT Dual Energy Technology%双源CT双能量技术在尿路结石成分分析中的应用价值研究

    Institute of Scientific and Technical Information of China (English)

    刘志鹏; 沈剑辉; 汤连志; 姜洪

    2016-01-01

    Objective The purpose of this paper is to explore the application value of dual energy CT technology in the determination of urinary stone composition. Methods A total of 86 patients with acute abdominal pain in our hospital from September 2014 to November 2015 were selected. For patients with implementation of dual source CT examination and by scanning results analysis of stone composition, and with the stones after operation in vitro infrared spectrum analysis results, make analysis of dual source CT diagnostic value. Results DUALSOURCE CT were found in 136 pa-tients with stones in 70 cases, 57 cases of infrared spectroscopy confirmed that 98. Among them, calcium oxalate stones 86, accounting for all 87.76%(86/98);uric acid stones in 5 cases, 7, accounting for 7.14%(7/98);other stones in 4 cas-es, 5, accounting for 5.10%(5/98). Conclusion Dual source CT in urinary system stones with good accuracy, and can effectively accurately distinguish stones of different components of the composition, make accurate judgment, provide accurate reference for clinicians to the next treatment in the analysis.%目的:该文旨在探究双源CT双能量技术在尿路结石成分分析中的应用价值。方法选取2014年9月—2015年11月间于该院检查的疑似泌尿系统结石的腹部锐痛患者共86例。对患者实施双源CT检查,由扫描结果分析结石成分,并同结石术后体外红外光谱分析结果相对照,作出双源CT诊断价值分析。结果双源CT检查后共发现70例患者的136颗结石,红外光谱证实57例,98颗。其中草酸钙结石86颗,占全部的87.76%(86/98);尿酸结石5例,7颗,占全部的7.14%(7/98);其它结石4例,5颗,占全部的5.10%(5/98)。结论双源CT在分析泌尿系统结石中的准确性较好,可有效地准确区分组成成分不同的结石,作出准确的判定,为临床医生接下来的诊疗提供准确地参考依据。

  6. Role of dual source CT perfusion imaging in the diagnosis of early radiation-induced lung injury%双源 CT灌注成像诊断早期放射性肺损伤的应用价值

    Institute of Scientific and Technical Information of China (English)

    潘利福; 邝平定

    2015-01-01

    Objective To examine the role of dual source CT perfusion imaging for early diagnosis of radiation -induced lung injury and to obtain scientific knowledge for early diagnosis of radiation induced lung injury .Method The level of dual source CT perfusion imaging perfusion values of the radiation-induced lung injury patients ( the experimental group , n=45 ) and that of the patients with no radiation-induced lung injury (the control group, n=45) was monitored.Meanwhile, the patients with radiation-induced lung injury were subjected to conventional CT examination .The sensitivity and accuracy of the two detection methods were then compared .Findings The values of lung tissue blood flow ( rrBF ) , relative blood volume ( rrBV) , relative blood capillary permeability ( chip) of the experimental group were significantly higher than those of the control group (P0.05).41 of the 45 patients of the experimental group were diagnosed as cases of radioactive lung injury.The diagnostic sensitivity and specificity were 91.1% and 97.78% respectively, which were significantly higher than those of the conventional CT technology (P<0.01).Conclusion Dual source CT perfusion imaging can display the changes after radiotherapy of lung hemodynamics and display early perfusion abnormalities in patients with radiation -induced lung injury.It can serve as an effective tool for early detection of radiation-induced lung injury .%目的:探讨双源CT灌注成像早期诊断放射性肺损伤的应用效果,为放射性肺损伤早期诊断提供依据。方法观察放射性肺损伤患者45例(观察组)和未发生放射性肺损伤患者45例(对照组)的双源CT灌注成像灌注值的水平,同时对放射性肺损伤患者采用常规的CT检查,比较两种检测方法的灵敏度和准确度。结果观察组肺组织相对血流量(rrBF)、相对血容量(rrBV)、相对毛细血管通透性(rrPS)均显著高于对照组(P<0.05);观察组45

  7. Cardiac CT: coronary arteries and beyond

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-04-15

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

  8. 泌尿系结石成分的体内双源双能量CT分析%Identification of Urinary Stone Composition with Dual-energy Acquisition of Dual-source CT in Vivo

    Institute of Scientific and Technical Information of China (English)

    凃备武; 周洁; 李惠民; 耿娟

    2013-01-01

    目的:探讨双源CT双能量技术体内分析泌尿系结石成分的可行性和准确性.方法:104例泌尿系结石患者共113结石纳入研究,全部完成双源CT双能量扫描并于工作站(syngo)上完成结石成分分析,全部结石取出后完成红外线光谱分析确定成分.结果:全部病人均顺利完成体内结石成分分析,以红外线光谱分析为参照标准,双源CT双能量分析显示尿酸、草酸钙和磷灰石成分分别得到准确性97.3%、92.9%、38.1%,灵敏度88.2%、100%、9.6%,特异度99.0%、66.7%、90.0%,阳性预测值93.8%、91.7%、63.6%,以及阴性预测值97.9%、100%、35.3%.胱氨酸盐均为假阳性.结论:双源CT双能量技术分析体内泌尿系结石成分是可行的,对尿酸和草酸钙的定性有很高的准确性,具有较高的临床实用价值.%Purpose: To investigate the clinical value of the determination of renal stone composition in vivo with dual-source dual-energy CT. Methods: One hundred and four cases with 113 renal stones were collected. All cases were scanned with dual-energy acquisition by dual-source CT. The data were sent to the workstation for the analysis of the stone composition. The urinary stones were analyzed by infrared spectroscopy after surgery. These two results were compared and the infrared spectroscopy result was taken as the reference standard. Results: The accuracy, sensitivity, specificity, positive and negative predictive value of the dual-energy CT for the diagnosis of uric acid stone were 97.3%, 88.2%, 99.0%, 93.8%, and 97.9% respectively; those of oxalate were 92.9%, 100%, 66.7%, 91.7%, 100%, and those of apatite were 38.1%, 9.6%, 90.0%, 63.6%, 35.3%. All cystine stones were with false positive results. Conclusion: Dual source dual-energy CT has high accuracy for identifying uric acid and oxalate stone in vivo and can be used clinically.

  9. 双源CT对泌尿系结石成分的定性诊断价值评价%The valuation of dual source CT for diagnosis of urinary stone composi-tion

    Institute of Scientific and Technical Information of China (English)

    马海鸿; 周应恩; 赵波

    2015-01-01

    Objective To investigate the diagnostic value of dual source CT on urinary stone constituents qualitative,aims to improve the correct diagnosis rate and the clinical curative effect. Methods Selected 53 patients with suspected urinary calculi hospitalized because of abdominal pain in our hospital from August 2014 to December 2014, 53 patients with suspected urinary calculi treated with dual source CT scan, stone composition, compared with stone infrared spectrum analysis results after the operation were analyzed. Results Dual source CT showed a total of 42 cases patients with gallstone,89 stones,postoperative infrared spectroscopy confirmed that a total of 35 cases of gallstone patients,a total of 66 star stone. There were stone of 8 components, mainly oxalic acid calculi, 30 patients, 59(89.4%) stones;followed by uric acid calculi in 3 cases,4(6.2%),2 cases of other stones 3(4.4%). Dual source CT showed containing calcium oxalate stone 76,accounting for all the stones of the 85.4%(76/89),spectrum proved that the 59(77.6%). Du-al energy that contain calcium oxalate (59/62) with accuracy of 95.2%, sensitivity 100%, specificity 61.0%(36/59),and negative predictive value of 100%. Pure calcium oxalate(20/59)with accuracy of 38.9%,sensitivity of 100%,and negative predictive value of 100%. Conclusion Using dual source CT in diagnosis of urinary calculi in the analysis of the composition of the stones in the body, good accuracy, and can better distinguish the different components of the stone,make the qualitative judgment, in order to provide evidence for clinical treatment. In the group of patients with oxalate stones up to about 90%,different from previous research,analysis may be related to regional,national,differ-ences in diet,pending further study.%目的:探讨双源CT对泌尿系结石成分定性的诊断价值,旨在提高临床诊断的正确率,改善患者的临床疗效。方法选取我院2014年8~12月间因腹痛怀疑

  10. Reconstructions with identical filling (RIF) of the heart: a physiological approach to image reconstruction in coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Reinartz, S.D.; Diefenbach, B.S.; Kuhl, C.K.; Mahnken, A.H. [University Hospital, RWTH Aachen University, Department of Diagnostic and Interventional Radiology, Aachen (Germany); Allmendinger, T. [Siemens Healthcare Sector, Department of Computed Tomography, Forchheim (Germany)

    2012-12-15

    To compare image quality in coronary artery computed tomography angiography (cCTA) using reconstructions with automated phase detection and Reconstructions computed with Identical Filling of the heart (RIF). Seventy-four patients underwent ECG-gated dual source CT (DSCT) between November 2009 and July 2010 for suspected coronary heart disease (n = 35), planning of transcatheter aortic valve replacement (n = 34) or evaluation of ventricular function (n = 5). Image data sets by the RIF formula and automated phase detection were computed and evaluated with the AHA 15-segment model and a 5-grade Likert scale (1: poor, 5: excellent quality). Subgroups regarding rhythm (sinus rhythm = SR; arrhythmia = ARR) and potential premedication were evaluated by a per-segment, per-vessel and per-patient analysis. RIF significantly improved image quality in 10 of 15 coronary segments (P < 0.05). More diagnostic segments were provided by RIF regarding the entire cohort (n = 693 vs. 590, P < 0.001) and all of the subgroups (e.g. ARR: n = 143 vs. 72, P < 0.001). In arrhythmic patients (n = 19), more diagnostic vessels (e.g. LAD: n = 10 vs. 3; P < 0.014) and complete data sets (n = 7 vs. 1; P < 0.001) were produced. RIF reconstruction is superior to automatic diastolic non-edited reconstructions, especially in arrhythmic patients. RIF theory provides a physiological approach for determining the optimal image reconstruction point in ECG-gated CT angiography. (orig.)

  11. CT of Coronary Heart Disease : Part 1, CT of Myocardial Infarction, Ischemia, and Viability

    NARCIS (Netherlands)

    Vliegenthart, Rozemarijn; Henzler, Thomas; Moscariello, Antonio; Ruzsics, Balazs; Bastarrika, Gorka; Oudkerk, Matthijs; Schoepf, U. Joseph

    OBJECTIVE. This article reviews the CT-based approaches aimed at the assessment of myocardial infarction, ischemia, and viability described in the recent literature. CONCLUSION. Rapid advances in CT technology not only have improved visualization of coronary arteries but also increasingly enable

  12. CT of Coronary Heart Disease : Part 1, CT of Myocardial Infarction, Ischemia, and Viability

    NARCIS (Netherlands)

    Vliegenthart, Rozemarijn; Henzler, Thomas; Moscariello, Antonio; Ruzsics, Balazs; Bastarrika, Gorka; Oudkerk, Matthijs; Schoepf, U. Joseph

    2012-01-01

    OBJECTIVE. This article reviews the CT-based approaches aimed at the assessment of myocardial infarction, ischemia, and viability described in the recent literature. CONCLUSION. Rapid advances in CT technology not only have improved visualization of coronary arteries but also increasingly enable non

  13. The Clinical Application Value of Dual-source CT's Dual Energy Scanning in the Diagnosis of Liver Tumor%双源CT双能量扫描诊断肝脏肿瘤临床应用价值探讨

    Institute of Scientific and Technical Information of China (English)

    余丁福

    2015-01-01

    Objective The Thesis aims to probe into the Clinical application value of dual-source CT’s dual energy scanning in the diagnosis of liver tumor.Methods We have took a comprehensive researches and analysis on the clinical image data of 50 liver tumor patients under the dual-source CT’s dual energy scan during the period of June 2013 to May 2014 in our hospital.Results With the analysis of different scan ways picked by the patients, and comparison with the value of TNE and VNC CT of the liver spleen aorta abdominalis Muscle behind muscles, it shows the difference between the two is not statistically signiifcant(P>0.05). The value of primary carcinoma of liver related with TNE and VNC CT which is relfected on the substantial iodine density image is lower than that of hepatic hemangioma and cholangiocellular carcinoma, however, the difference is statistically signiifcant.Conclusion Dual energy scanning has the potential Clinical application value in the diagnosis of liver tumor, which should get a big promotion and application.%目的:探讨双源CT双能量扫描在诊断肝脏肿瘤中的临床应用价值。方法选取2013年6月-2014年5月在该院行双源CT双能量扫描的50例肝脏肿瘤患者的临床及影像资料进行分析研究。结果针对患者选择的扫描方式不同,对比患者肝脏、脾脏、腹主动脉、肌柱后方肌肉TNE与VNC CT值,二者间的差异无统计学意义(P>0.05),原发性肝癌在实质期碘基图像上的二者数值分别低于肝血管瘤、胆管细胞癌,差异具有明显统计学意义(P<0.05)。结论双能量扫描在诊断肝脏肿瘤中具有潜在的临床应用价值,应得到推广使用。

  14. 双源CT双能量技术在痛风诊断中的初步应用%Preliminary application of dual source dual energy CT in the diagnosis of gout

    Institute of Scientific and Technical Information of China (English)

    高江晖; 李玉芳; 马洪宇; 郭文伟; 张荣恒; 李攀; 石少聪

    2016-01-01

    Objective To evaluate the effect of dual energy CT in urate crystals in extremities joints of gout. Methods Forty-two cases with gout and 12 cases as control were examinated by dual source CT. The 80 kV,140 kV and 120 kV hybrid energy were collected after one-time scaning. After scanning the image data processed within Syngo. via. Dual-Energy GOUT software,the difference between the gout group and the control group was compared. Results The 42 patients were found with hands and feet multiple urate crystals,finger( toe)between the joints and surrounding soft tissues was more seri-ous;while no gout was found in hands and feet of 12 cases of control group. Conclusions Dual source DECT technology can display the urate crystal,which can be used as routine examination for the gout screening.%目的:探讨双源CT双能量成像技术在痛风患者四肢关节尿酸盐结晶检出中的应用。方法42例痛风性关节炎患者及12例对照组患者行双源 CT双能量扫描,获得80、140 kV双能图像和120 kV混合能量图像,扫描数据在Syngo. via. Dual-Energy GOUT软件内进行图像后处理,比较痛风组与对照组痛风石的差异。结果42例患者均发现双手、双足多发尿酸盐结晶,以指(趾)间关节及周围软组织内为著,12例对照组患者双手、双足均未显示尿酸盐结晶。结论双源 CT双能量技术能明确显示尿酸盐结晶,具有较高的临床应用价值,可作为痛风筛查的常规检查项目。

  15. 双源CT脑血管成像在颅内动脉瘤早期诊断中的应用%Application of dual-source CT angiography in the early diagnosis of intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    耿云平

    2014-01-01

    目的 通过分析蛛网膜下腔出血(SAH)患者早期双源CT脑血管造影(CTA)的结果,探讨双源CT在颅内动脉瘤早期诊断中的应用.方法 对78例蛛网膜下腔出血患者行CTA检查,通过外科开颅夹闭术或DSA介入栓塞术等治疗.结果 78例CTA检查阳性70例,可疑6例,阴性2例.对可疑6例及阴性2例行DSA复查,结果确诊动脉瘤6例,阴性2例,假阳性及假阴性各2例.结论 CTA是一种快速、无创、可靠、简便的方法,能早期诊断动脉瘤,并能基本提供临床医生开颅行动脉瘤夹闭手术所需的影像学资料;对小动脉瘤的诊断尚需DSA检查进一步证实.%Objective By analyzing the early dual-source CT angiography of patients with subarachnoid hemorrhage (SAH),to study the application of dual-source CT in the early diagnosis of intracranial aneurysms.Methods Seventy-eight cases of subarachnoid hemorrhage underwent CTA,by the surgical clipping treatment or DSA intervention.Results Among the 78 cases,CTA positive in 70 cases,suspicious in 6 cases,2 cases were negative.The 6 suspicious patients and 2 negative patients underwent DSA review,6 cases were aneurysm,2 cases were negative,false positive and false negative cases were all 2 cases.Conclusions CTA is a fast,noninvasive,simple,reliable method,it can diagnose aneurysm earlier,basically it can provide the imaging datas of the surgical clipping operation required; the diagnosis of small aneurysms still need further confirmation by DSA examination.

  16. Low-dose prospectively electrocardiogram-gated axial dual-source CT angiography in patients with pulsatile bilateral bidirectional Glenn Shunt: an alternative noninvasive method for postoperative morphological estimation.

    Directory of Open Access Journals (Sweden)

    Xiaopeng Ji

    Full Text Available OBJECTIVE: To explore the clinical value of low-dose prospectively electrocardiogram-gated axial dual-source CT angiography (low-dose PGA scanning, CTA in patients with pulsatile bilateral bidirectional Glenn shunt (bBDG as an alternative noninvasive method for postoperative morphological estimation. METHODS: Twenty patients with pulsatile bBDG (mean age 4.2±1.6 years underwent both low-dose PGA scanning and conventional cardiac angiography (CCA for the morphological changes. The morphological evaluation included the anatomy of superior vena cava (SVC and pulmonary artery (PA, the anastomotic location, thrombosis, aorto-pulmonary collateral circulation, pulmonary arteriovenous malformations, etc. Objective and subjective image quality was assessed. Bland-Altman analysis and linear regression analyses were used to evaluate the correlation on measurements between CTA and CCA. Effective radiation dose of both modalities was calculated. RESULTS: The CT attenuation value of bilateral SVC and PA was higher than 300 HU. The average subjective image quality score was 4.05±0.69. The morphology of bilateral SVC and PA was displayed completely and intuitively by CTA images. There were 24 SVC above PA and 15 SVC beside PA. Thrombosis was found in 1 patient. Collateral vessels were detected in 13 patients. No pulmonary arteriovenous malformation was found in our study. A strong correlation (R2>0.8, P0.The mean effective dose of CTA and CCA was 0.50±0.17 mSv and 4.85±1.34 mSv respectively. CONCLUSION: CT angiography with a low-dose PGA scanning is an accurate and reliable noninvasive examination in the assessment of morphological changes in patients with pulsatile bBDG.

  17. Coronary CT Angiography in Coronary Artery Disease: Correlation between Virtual Intravascular Endoscopic Appearances and Left Bifurcation Angulation and Coronary Plaques

    Directory of Open Access Journals (Sweden)

    Zhonghua Sun

    2013-01-01

    Full Text Available The aim of this study is to investigate the relationship between intraluminal appearances of coronary plaques and left coronary bifurcation angle and plaque components using coronary CT virtual intravascular endoscopy (VIE. Fifty patients suspected of coronary artery disease undergoing coronary CT angiography were included in the study. The left bifurcation angle in patients with diseased left coronary artery which was measured as 94.3° ± 16.5 is significantly larger than that in patients with normal left coronary artery, which was measured as 76.5° ± 15.9 (P<0.001. Irregular VIE appearances were found in 10 out of 11 patients with mixed plaques in the left anterior descending (LAD and left circumflex (LCx, while, in 29 patients with calcified plaques in the LAD and LCx, irregular VIE appearances were only noticed in 5 patients. Using 80° as a cut-off value to determine coronary artery disease, smooth VIE appearances were found in 95% of patients (18/19 with left bifurcation angle of less than 80°, while irregular VIE appearances were observed in nearly 50% of patients (15/31 with left bifurcation angle of more than 80°. This preliminary study shows that VIE appearances of the coronary lumen are directly related to the types of plaques.

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

    Energy Technology Data Exchange (ETDEWEB)

    Marini, Davide; Agnoletti, Gabriella [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Brunelle, Francis [University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France); Sidi, Daniel; Bonnet, Damien [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Ou, Phalla [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France)], E-mail: phalla.ou@nck.aphp.fr

    2009-09-15

    Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery. Population and methods: Fifteen consecutive children (8 male and 7 female; age 9.2 {+-} 6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8 {+-} 3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard. Results: CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography. Conclusion: In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surge0008.

  19. The Application of Dual source CT and Dual Energy Imaging to the Diagnosis of Pulmonary Embolism%双源CT双能量成像在肺动脉栓塞诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    彭可雨; 阮兵; 梁汉欢; 张洪; 梁艳

    2016-01-01

    Objective To study the value of dual energy pulmonary angiography (DECTPA) with dual-source CT (DSCT) in pulmonary embolism (PE).Methods Collected the clinical data of 26 patients suspected of PE in our hospital underwent DECTPA with DSCT. Assessed the value of dual energy pulmonary angiography (DECTPA) with dual-source CT (DSCT) in pulmonary embolism (PE).Results The 96.30%, 90.57% agreement between DEPI and CTPA were showed in the levels of lung and partial lung respectively. Complete filling defects of segmental and subsegmental pulmonary arteries mostly showed correspon dence perfusion defects in the CT perfusion map. However, when there were partial filling defects, most of them were partial perfusion defects. A few of them were normal in the CT perfusion map. With CTPA as a reference standard,in the level of lung, the results show that compared with DEPI, the sensitivity was 96.30% (52/54), specificity of 100% (76/76).Conclusion There was moderate agreement between the judgement of CTPA and DEPI. The perfusion defects in the DEPI related to the degree and location of the filling defects in the CTP A. The combination of CTPA and DEPI will offer more information for diagnosis of the pulmonary embolism. It is worth promotion in the clinical.%目的:探讨双源CT双能量成像在肺动脉栓塞诊断中的应用价值。方法收集在我院使用双源CT双能量肺动脉成像检查的26例临床资料进行分析,探讨双源CT双能量肺动脉成像(DEPI)在肺动脉栓塞中的应用价值。结果在肺叶基础上,DEPI与CTPA检出血管栓塞的符合率为96.30%;在肺段的基础上,DEPI与CTPA检出血管栓塞的符合率为90.57%。当段、亚段肺动脉栓塞充盈缺损完全时,DEPI表现为肺段或亚段分布灌注缺损,当部分充盈缺损时,DEPI以灌注降低为主,少数表现为无灌注缺损;利用DEPI诊断PE的敏感性96.30%(52/54),特异性100%。结论 DEPI表现与CTPA肺动脉栓塞程度、部位有

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

    Energy Technology Data Exchange (ETDEWEB)

    Feger, S.; Rief, M.; Zimmermann, E.; Richter, F.; Roehle, R. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Dewey, M. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Institut fuer Radiologie, Berlin (Germany); Schoenenberger, E. [Medizinische Hochschule Hannover, Department of Medicine, Hannover (Germany)

    2015-07-15

    To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA). Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire. Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016). All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination. (orig.)

  1. Accuracy, image quality and radiation dose comparison of high-pitch spiral and sequential acquisition on 128-slice dual-source CT angiography in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Nie, Pei; Wang, Ximing; Cheng, Zhaoping; Ji, Xiaopeng; Duan, Yanhua [Shandong University, Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Chen, Jiuhong [CT Research Collaboration, Siemens Ltd. China, Beijing (China)

    2012-10-15

    To compare accuracy, image quality and radiation dose between high-pitch spiral and sequential modes on 128-slice dual-source computed tomographic (DSCT) angiography in children with congenital heart disease (CHD). Forty patients suspected with CHD underwent 128-slice DSCT angiography with high-pitch mode and sequential mode respectively. All the anomalies were confirmed by the surgical and/or the conventional cardiac angiography (CCA) findings. The diagnostic accuracy, the subjective and objective image quality and effective radiation doses were compared. There was no significant difference in diagnostic accuracy ({chi}{sup 2} = 0.963, P > 0.05), the objective parameters for image quality (P > 0.05) and the image quality of great vessels (u = 167.500, P > 0.05) between the two groups. The image quality of intracardiac structures and coronary arteries was significantly better in the sequential mode group than that in the high-pitch group (u = 112.500 and 100.000, P < 0.05). The mean effective dose in high-pitch group (0.17 {+-} 0.05 mSv) was significantly lower (t = 5.287, P < 0.05) than that in the sequential mode group (0.29 {+-} 0.09 mSv). Both the high-pitch and the sequential modes for 128-slice DSCT angiography provide high accuracy for the assessment of CHD in children, while the high-pitch mode, even with some image quality decrease, further significantly lowers the radiation dose. (orig.)

  2. Coronary imaging techniques with emphasis on CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lederlin, Mathieu; Latrabe, Valerie; Corneloup, Olivier; Cochet, Hubert; Montaudon, Michel; Laurent, Francois [Hopital Cardiologique, CHU Bordeaux, Thoracic and Cardiovascular Imaging Department, Pessac (France); Thambo, Jean-Benoit [Hopital Cardiologique, CHU Bordeaux, Pediatric and Adult Congenital Heart Disease Unit, Pessac (France)

    2011-12-15

    Coronary artery imaging in children is challenging, with high demands both on temporal and spatial resolution due to high heart rates and smaller anatomy. Although invasive conventional coronary angiography remains the benchmark technique, over the past 10 years, CT and MRI have emerged in the field of coronary imaging. The choice of hardware is important. For CT, the minimum requirement is a 64-channel scanner. The temporal resolution of the scanner is most important for optimising image quality and minimising radiation dose. Manufacturers have developed several modes of electrocardiographic (ECG) triggering to facilitate dose reduction. Recent technical advances have opened new possibilities in MRI coronary imaging. As a non-ionising radiation technique, MRI is of great interest in paediatric imaging. It is currently recommended in centres with appropriate expertise for the screening of patients with suspected congenital coronary anomalies. However, MRI is still not feasible in infants. This review describes and discusses the technical requirements and the pros and cons of all three techniques. (orig.)

  3. Feasibility study of dual-source CT high-pitch aorta angiography%双源CT大螺距模式主动脉成像的可行性研究

    Institute of Scientific and Technical Information of China (English)

    王利军; 孙凯; 王志琴; 董馨; 贾海亮; 杜晓辉; 张皓成

    2014-01-01

    Objective: To investigate the feasibility, image quality and radiation dose for high-pitch dual-source CT angiography (CTA) of the whole aorta. Methods: Each group of 62 and 58 patients underwent CTA either on dual-source CT device with high-pitch mode with a pitch of 3.2(group A) or conventional single-source (group B). Evaluate the image quality and radiation dose. Image quality of the aorta was independently assessed by two readers. Scanner-reported dose-length product values were used to estimate effective dose values. Results:Subjective scoring of image quality were significantly increased in the high-pitch examination protocol (2.66±0.51 vs.2.14±0.47, P<0.01) for groups A and B. Objective scoring of image quality were not significantly different. The imaging length was not significantly different, but the imaging time was significantly shorter in the high-pitch group (1.61±0.23 vs.6.52±1.41s P<0.01) for groups A and B. Radiation dose was lower. (3.97±1.07 mSv vs. 15.18±2.58 mSv, P<0.01). Conclusion:High-pitch dual-source CT angiography of the whole aorta is feasible in unselected patients. As a significant advantage over regular pitch protocols, shorter scan time, lower radiation dose and less motion artifacts is possible. this CT mode bears potential to become a standard CT protocol.%目的:利用双源CT的大螺距模式对主动脉全程扫描成像,对照评价其图像质量和有效辐射剂量,旨在研究双源CT大螺距模式行主动脉全程扫描的可行性。方法:将接受主动脉CT血管造影(CTA)的患者随机分为A、B两组,A组62例,B组58例。A组使用大螺距扫描模式,B组使用常规扫描模式;图像质量评价分客观和主观两种方法,客观评价包括图像噪声及信噪比,主观评价由2名放射科医生独立完成。辐射剂量统计使用设备自带的数据记录。结果:大螺距模式主观图像质量评分(2.66±0.51)较常规扫描组(2.14±0.47)高

  4. 双源CT前瞻性心电门控扫描在急性胸痛诊断中应用的可行性%Feasibility of Prospective EGG-Dual-Source CT in the Diagnosis of Patients with Acute Chest Pain

    Institute of Scientific and Technical Information of China (English)

    陈丹; 周嘉慧; 史雅文

    2012-01-01

    Objective To evaluate the feasibility of prospective ECG gated dual-source CT (DSCT)in patients with acute chest pain in different heart rate. Methods Forty two patients with acute chest pain underwent prospective ECG-ga ted DSCT scan. The patients were divided into two groups. In group A, the heart rate of patients was = 75 beats / min, data set was reconstructed in 70% R-R interval, ECG pulse window was set to 62% -78% . In group B, the heart rate of patients was > 75 beats / min, data set was reconstructed in 40% R-R interval, ECG pulse window was set to 32% -48%. Two experienced radiologists assessed the image quality of two groups, The images were target reconstructed on pul monary artery, aorta, coronary arteries, and the radiation dose was calculated. \\2 test was used to explore significant differ ences in assessable segments coronary artery . Two independent samples t-test was used to explore significant differences in vessel attenuation of ascending aorta and pulmonary trunk. As well as, the CT coronary angiographic images of 16 cases were compared with DSA. Results Only one case, the attenuation of ascending aorta did not meet the diagnostic criteria. The attenuation of ascending aorta and pulmonary trunk had not statistical difference between group A and B (t values were 0.254,0. 700, P values were > 0. 05). The assessable segments of coronary arteries of group A and B were 278/284 (97. 89% ) , 297/307 {96. 74% ) , and there was no statistical difference between two groups. There was good consistency between CT coronary angiographic images and DSA images. The average effective dose was (8. 67 ±2. 54)mSv. Conclu sion Prospective ECG gated DSCT angiography offers a very good image quality without heart rate control in patients with acute chest pain.%目的 探讨应用双源CT( dual-source CT,DSCT)前瞻性心电门控扫描对不同心率的急性胸痛患者诊断的可行性.方法 对42例急性胸痛患者进行DSCT前瞻性心电门控心胸联合

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

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

  6. Value of dual source CT iodine concentration in the evaluation of pathological grades of esophageal carcinoma%双源CT强化程度与食管癌病理分级的关系

    Institute of Scientific and Technical Information of China (English)

    刘小静; 周胜利; 苗重昌

    2016-01-01

    目的:探讨双源CT碘浓度评估食管癌病理分级的价值。方法回顾性分析经内镜或手术病理证实的60例食管癌患者,其中病理分级为高分化癌17例、中分化癌24例、低分化癌19例。60例均行食管双源CT双能量平扫及双期增强扫描,测量计算食管癌病灶动脉期标准化碘浓度(NIC)、静脉期NIC、动脉期病灶强化程度和静脉期强化程度。采用单因素方差分析比较不同病理分级食管癌患者间NIC及强化程度的差异,采用ROC曲线评价NIC及强化程度鉴别中、高分化食管癌与低分化食管癌的效能。结果高、中、低级别食管癌患者的动脉期NIC值分别为(1.54±0.34)、(1.72±0.50)、(2.10±0.40)mg/ml,静脉期NIC值分别为(1.55±0.52)、(1.80±0.62)、(2.18±0.35)mg/ml,静脉期强化程度分别为(25.65±4.43)、(27.55±6.82)、(30.77±6.38)HU,各组间差异均有统计学意义(P均<0.05);高、中、低级别食管癌患者的动脉期强化程度分别为(14.40±3.91)、(14.26±7.35)、(16.17±6.89) HU,差异无统计学意义(P=0.582)。动脉期NIC、静脉期NIC和静脉期强化程度鉴别中、高分化食管癌与低分化食管癌的ROC下面积分别为0.801、0.817和0.730。结论双源CT测定碘浓度评估食管癌病理分级有一定价值。%Objective To investigate the value of dual source CT iodine concentration in the assessment of pathological grade of esophageal carcinoma. Methods Retrospective review was performed on 60 cases with pathologically⁃confirmed esophageal carcinoma. Among them, 17 tumors were well differentiated, 24 were moderately differentiated and 19 were poorly differentiated. The dual⁃energy plain scan and double phase enhanced scan of dual⁃source CT were performed on all 60 cases. Normalized iodine concentration (NIC) and the enhancement degree of the esophageal carcinoma in the arterial and venous phase were

  7. Virtual non-contrast CT using dual energy spectral CT: Feasibility of coronary artery calcium scoring

    Energy Technology Data Exchange (ETDEWEB)

    Song, In Young; Yi, Jeong Geun; Park, Jeong Hee [Dept. of Radiology, Konkuk University School of Medicine, Seoul (Korea, Republic of); Lee, Sung Mok; Lee, Kyung Soo; Chung, Myung Jin [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    To evaluate the feasibility of coronary artery calcium scoring based on three virtual noncontrast-enhanced (VNC) images derived from single-source spectral dual-energy CT (DECT) as compared with true noncontrast-enhanced (TNC) images. This prospective study was conducted with the approval of our Institutional Review Board. Ninety-seven patients underwent noncontrast CT followed by contrast-enhanced chest CT using single-source spectral DECT. Iodine eliminated VNC images were reconstructed using two kinds of 2-material decomposition algorithms (material density iodine-water pair [MDW], material density iodine-calcium pair [MDC]) and a material suppressed algorithm (material suppressed iodine [MSI]). Two readers independently quantified calcium on VNC and TNC images. The Spearman correlation coefficient test and Bland-Altman method were used for statistical analyses. Coronary artery calcium scores from all three VNC images showed excellent correlation with those from the TNC images (Spearman's correlation coefficient [ρ] = 0.94, 0.88, and 0.89 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Measured coronary calcium volumes from VNC images also correlated well with those from TNC images (ρ = 0.92, 0.87, and 0.91 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Among the three VNC images, coronary calcium from MDW correlated best with that from TNC. The coronary artery calcium scores and volumes were significantly lower from the VNC images than from the TNC images (p < 0.001 for all pairs). The use of VNC images from contrast-enhanced CT using dual-energy material decomposition/suppression is feasible for coronary calcium scoring. The absolute value from VNC tends to be smaller than that from TNC.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-05-15

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

  9. 基于Random Walks算法的心脏双源CT左心房分割%Study of left atrium segmentation in dual source CT image with random walks algorithms

    Institute of Scientific and Technical Information of China (English)

    何昌保; 马秀丽; 余长明

    2016-01-01

    For dual source CT image with contrast media,due to heart soft tissue density and contrast media uneven distribution result in the CT value of heart tissues uneven and boundary fuzzy,taking a single image segmentation algorithm is too difficult to obtain satisfactory results,so morphological reconstruction and random walks hybrid method is proposed in this paper.Firstly,we used morphological reconstruction operation on image smoothing filtering, which makes the heart cavity gray information convergence and gray level differences with the surrounding tissue and get the left atrium area with the fuzzy boundary;Then the random walks algorithm sets the seed points for each region of the image,and gives the weight of each side,and takes the weight of the edge as the transfer probability.For each unlabeled point is calculated from the point of first arrival probability of seed points.Finally,according to the first hit probability to choose the maximum that a class as belonging to the class,attribute of the unlabeled points and finally get the accurate left atrial.%针对在传统的CT介入式治疗过程中,胸腔中软组织较多软组织的厚度和注射的造影剂在心脏中呈现的不均匀分布,导致在采用CT成像的图像中胸腔内部各组织之间存在边界模糊或者确实等状况,本文提出一种采用形态重构和随机行走相结合的分割方法。首先利用形态学开闭运算对图像进行化简,并使得心脏 CT腔体边界分离,进而使得各个组织组织分离,再结合Random walks算法。从而使得不需要标记太多种子点的情况下提高了分割的速度和准确性,实验证明该方法能够达到预期的目标。

  10. Study of new dual-source dual-energy CT pulmonary angiography for pulmonary embolism diagnosis%第二代双源CT双能量成像对肺栓塞的诊断价值研究

    Institute of Scientific and Technical Information of China (English)

    吴山; 武志峰; 鄂林宁; 江小鹏

    2012-01-01

    目的:探讨西门子第二代双源CT(Somatom Definition Flash)双能量成像对肺动脉栓塞的诊断价值.方法:回顾性研究42位临床疑诊肺栓塞行双能量肺血管成像(DE-CTPA)扫描的患者的资料,利用工作站双能量软件Lung PBV(肺灌注)、Lung Vessels(肺血管)进行彩色编码成像.2名胸部影像医师结合DE-CTPA与软件提供的信息做出诊断.结果:根据临床及CT结果,其中32例(76.2%,32/42)存在肺动脉栓塞,28例在CTPA上表现为肺动脉充盈缺损,4例在CTPA上未见异常征象,而双能量成像上表现为亚段或以下水平灌注或充盈缺损.双能量Lung PBV测得32例48个栓塞肺区CT强化值(35.6±12.1)HU,低于非栓塞区域所测得的CT强化值(44.5±10.6) HU,t=-2.336,P=0.027.结论:双能量Lung PBV与Lung Vessels软件能显示肺栓塞所致的灌注及充盈缺损,结合CTPA能提高肺栓塞的检出率,特别是外周性肺动脉栓塞.%Objective: To investigate the diagnostic value of the second-generation Siemens dual-source CT(Somatom Definition Flash) dual-energy imaging of pulmonary embolism. Methods: Dual-energy pulmonary angiography (CTPA) data of 42 patients with clinically suspected pulmonary embolism were retrospectively studied by dual—energy software on the workstation. Lung PBV (lung perfusion), Lung Vessels (pulmonary vasculature) and color-coded imaging were analyzed. Two chest-imaging physicians combined information provided by both the DE-CTPA and software to make a diagnosis. Results: According to clinical and CT findings, 32 cases(76.2%, 32/42) had pulmonary embolism, with pulmonary filling defects on CTPA in 28 cases, normal CTPA but perfusion defects in sub-segments or below on DE-CTPA in four cases. Lung PBV measured 32 cases with 48 embolism pulmonary, with a CT enhancement value of (35.6+12.1) HU, lower than the non-embolism region with a CT enhancement value of (44.5±10.6) HU(t=-2.336, P=0.027). Conclusion: Dual-energy lung perfusion(Lung PBV

  11. High-pitch dual-source CT pulmonary angiography in naturally breathing patients%自然呼吸下高螺距双源CT肺动脉造影方法探讨

    Institute of Scientific and Technical Information of China (English)

    邓国辉; 胡红杰; 张文明; 陈彬; 胡吉波

    2015-01-01

    目的探讨自然呼吸状态下高螺距双源CT肺血管造影(CTPA)技术对可疑肺栓塞患者应用的可行性、影像质量。方法对54例临床疑似肺动脉栓塞的患者(高螺距组),采用第二代双源CT行CT肺血管造影(CTPA),患者在自然呼吸下行高螺距CTPA检查(螺距为3.0,120kV,100mAs,50ml对比剂);另选前期检查患者54例作为常规组行常规CTPA检查(螺距为0.8,120kV,100mAs,80ml对比剂),深吸气后屏气扫描。记录PA强化程度、图像噪声、信噪比、图像的整体质量、扫描范围内肺动脉分支是否存在对比剂充盈不均和心脏、呼吸运动伪影以及辐射剂量,结果进行统计学分析。结果高螺距组肺动脉主干(PT)及尖段(S1)肺动脉、后基底段(S10)肺动脉的平均 CT值为(404±104)、(453±119)和(453±119)HU,平均图像背景噪声(11±2)HU,平均检查时间为(0.67±0.09)s,平均辐射剂量为(142±31)mGy cm,明显优于常规组(P<0.05)。检查图像无呼吸及心脏的运动伪影。肺动脉分支未见完全或部分缺损,所有患者均达到诊断要求。结论自然呼吸下状态高螺距双源CTPA检查能得到较高质量的图像,没有产生呼吸和心脏的运动伪影,且可避免出现瓦氏(Valsalva)呼吸所致的伪影。%Objective To assess the feasibility and image quality of high- pitch dual- source CT pulmonary angiography (CTPA) in natural y breathing patients with suspected pulmonary embolism. Methods One hundred and eight patients with clin-ically suspected pulmonary embolism underwent CTPA examination with dual- source CT scanner. Patients were randomly divid-ed into 2 groups:patients in high- pitch group (n=54) received high- pitch CTPA (pitch 3.0, 120 kV, 100 mAs, 50ml contrast ma-terial) without special breathing requirement, patients in routine group (n=54) received normal mode CTPA (pitch 0.8, 120 kV, 100 m

  12. Application of dual-source 4D-CTA combined with CT perfusion imaging in diagnosis of acute cerebral ischemic diseases%双源CT 4D- CTA联合灌注成像在急性脑缺血性疾病中的应用价值

    Institute of Scientific and Technical Information of China (English)

    程有根; 杨光钊; 茅国群; 楼明芳; 魏福全

    2013-01-01

    Objective To investigate the application of dual- source four- dimensional CT angiography (4D- CTA) com-bined with CT perfusion imaging (CTPI) in diagnosis of acute cerebral ischemic diseases. Methods Thirty patients with clinical y suspected acute cerebral ischemic disease underwent head plain CT scan and whole brain CTPI examination 2~16h after onset, the images of CBF, CBV, MTT, TTP and 4D- CTA were obtained. Patients also underwent MRI examination in 1~3 d. The findings of plain CT scan, CTPI, 4D- CTA and MRI were analyzed. Results Plain CT scan found 16 ischemic lesions in 12 cases, CTPI found 32 ischemic lesions in 26 cases, MRI found 28 ischemic lesions in 25 cases, and 4D- CTA demonstrated various degree of stenosis or occlusion in supplying vessels in 20 cases. Conclusion Dual- source 4D- CTA combined with CT perfusion imaging provides comprehensive and detailed imaging information, so that has important value for early diagnosis and treatment in pa-tients with acute cerebral ischemia.%目的:探讨双源CT 4维血管造影(4D- CTA)及灌注成像(CTPI)在急性脑缺血性疾病中的应用价值。方法对30例临床拟诊为急性脑缺血性疾病的患者于发病2~24h内行头颅CT平扫和全脑CTPI检查,获得脑血流量、脑血容量、平均通过时间、达峰时间等参数图,同时获得4D- CTA图像;于发病的1~3d后行MRI检查,分析CT平扫、CTPI、4D- CTA、MRI表现。结果 CT平扫发现12例有16个缺血病灶,CTPI发现26例32个缺血病灶,MRI发现25例28个缺血病灶,4D- CTA显示有20例责任血管有不同程度的狭窄或闭塞。结论双源CT 4D- CTA联合灌注成像能为急性脑缺血患者提供全面、详细的影像学信息,对急性缺血性脑梗死的早期诊断和治疗有重要价值。

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  14. Diagnosis of coronary artery disease. Current status of CT; Diagnostik der koronaren Herzkrankheit. Aktueller Stand der CT

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Martin H.K.; Klass, O.; Brunner, H. [Klinik fuer Diagnostische und Interventionelle Radiologie, Unikliniken Ulm (Germany)

    2010-06-15

    Continuous technical innovations during the last years have established cardiac CT as a modality for noninvasive coronary angiography in clinical routine. 64 detector row generations and beyond have shown high diagnostic accuracy for obstructive stenosis detection in comparison to the standard of reference catheterization angiography. But the high radiation dose exposure associated with helical cardiac CT acquisition has sparked increasing concern in the medical community. The issue has been addressed with the newest releases of technology. Dose reduction by 80% and more is achieved with modified scan techniques rendering the method suitable for clinical routine. Symptomatic patients with an intermediate pre-test probability have been identified as the most suitable candidates for CT coronary angiography. Other appropriate indications include the rapid assessment of bypass grafts and suspected coronary anomalies. CT coronary angiography has been shown to be cost effective for the evaluation of patients with acute chest pain in the emergency department. But CT is able to provide more than coronary morphology, initial feasibility testing has shown that CT first-pass myocardial imaging can visualize perfusion defects with adenosine induced vasodilatation. Coronary morphology and functional perfusion studies have been shown to be complementary providing incremental diagnostic value over either technique alone. In the next few years a lot of comparison trials will establish the best suitable perfusion method (SPECT, MRI or CT) for hybrid imaging with CT coronary angiography. (orig.)

  15. Influence of individualized nursing intervention on success rate of holding breathing in patients undergoing dual-source CT imaging%个性化护理干预对双源CT冠状动脉成像中患者闭气成功率影响的研究

    Institute of Scientific and Technical Information of China (English)

    王颖

    2011-01-01

    in patients undergoing dual-source CT coronary angiography.

  16. Dual Source CT Angiography in Diagnosis and Treatment for Aneurvsms of Willis Circle%双源CT血管成像在Willis环区动脉瘤诊断及治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    沈国鑫; 庾君毅; 史跃; 王安明

    2011-01-01

    目的:探讨双源CT血管成像(DSCTA)在Willis环区动脉瘤的诊断、分型及介入栓塞治疗中的临床应用价值.方法:术前采用DSCTA检查筛选颅内动脉瘤患者26例(33个).采用Seldinger技术,在DSA引导下行全脑血管造影,了解动脉瘤位置、形态、大小,测量瘤颈及瘤体直径;再根据不同的解剖学形态选用不同的介入栓塞方法治疗.结果:术前DSCAT和DSA检查对颅内动脉瘤的大小、位置、形状显示一致.26例患者共33个动脉瘤均成功栓塞,完全栓塞18个,占54.54%;栓塞程度在95%以上12个,占36.36%;不完全栓塞3个,占9.09%.结论:DSCTA检查和DSA全脑血管检查可提供颅内动脉瘤的位置、形态、大小等影像解剖学资料,为动脉瘤的临床分类和治疗方法的选择提供依据.%Objective: To evaluate the clinical value of dual source CT angiography (DSCTA) in the diagnosis, classification and interventional embolisation treatment for aneurysm of Willis circle.Methods:26cases with intracranial aneurysms were screened in preoperation by DSCTA.Preoperative cerebral angiography under the guidance of the DSA was used by the Seldinger technique, the analysis and research of the information could be assisted to comprehend the location, shape, size of aneurysm, the diameter of aneurysm neck and body was measured, then appropriate interventional therapy was selected according to different anatomical patterns.Results :33 intracranial aneurysms in 26 patients were successfully embolized.Complete embolism was achieved in 18 cases (54.54%), embolismed over 95% in 12 (36.36%), partial embolism in 3 aneurysms( 9.09% ).Conclusions:Preoperative examination by DSCTA and DSA can provide the basis for aneurysm treatment, reduce blindness and shorten the treatment time.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

  18. Interscan reproducibility of quantitative coronary plaque volume and composition from CT coronary angiography using an automated method

    Energy Technology Data Exchange (ETDEWEB)

    Schuhbaeck, Annika; Achenbach, Stephan [University of Erlangen, Department of Cardiology, Erlangen (Germany); Dey, Damini [Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles (United States); Otaki, Yuka; Slomka, Piotr; Berman, Daniel S. [Cedars-Sinai Medical Center, Department of Imaging and Medicine, Los Angeles (United States); Kral, Brian G.; Lai, Shenghan [Johns Hopkins University, Department of Medicine, Devision of Cardiology, Baltimore (United States); Fishman, Elliott K.; Lai, Hong [Johns Hopkins University, Department of Medicine, Devision of Cardiology, Baltimore (United States); Johns Hopkins University, Department of Radiology, Baltimore (United States)

    2014-09-15

    Quantitative measurements of coronary plaque volume may play a role in serial studies to determine disease progression or regression. Our aim was to evaluate the interscan reproducibility of quantitative measurements of coronary plaque volumes using a standardized automated method. Coronary dual source computed tomography angiography (CTA) was performed twice in 20 consecutive patients with known coronary artery disease within a maximum time difference of 100 days. The total plaque volume (TP), the volume of non-calcified plaque (NCP) and calcified plaque (CP) as well as the maximal remodelling index (RI) were determined using automated software. Mean TP volume was 382.3 ± 236.9 mm{sup 3} for the first and 399.0 ± 247.3 mm{sup 3} for the second examination (p = 0.47). There were also no significant differences for NCP volumes, CP volumes or RI. Interscan correlation of the plaque volumes was very good (Pearson's correlation coefficients: r = 0.92, r = 0.90 and r = 0.96 for TP, NCP and CP volumes, respectively). Automated software is a time-saving method that allows accurate assessment of coronary atherosclerotic plaque volumes in coronary CTA with high reproducibility. With this approach, serial studies appear to be possible. (orig.)

  19. Pre- and postsurgical diagnostics with dual-source computed tomography in cardiac surgery; Einsatz der Dual-source-Computertomographie in der prae- und postoperativen kardiochirurgischen Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Nikolaou, K.; Saam, T.; Rist, C.; Johnson, T.; Reiser, M.F.; Becker, C.R. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Vogt, F.; Oberhoffer, M.; Reichart, B. [Ludwig-Maximilians-Universitaet Muenchen, Herzchirurgische Klinik und Poliklinik, Muenchen (Germany)

    2007-04-15

    The aim of this study was to evaluate the clinical potential of dual-source computed tomography (DSCT) in pre- and postsurgical diagnostics in the field of cardiac surgery. A total of 20 patients underwent DSCT of the heart. This CT system with two rotating X-ray tubes (Somatom Definition, Siemens Medical Solutions, Forchheim, Germany) achieves a temporal resolution of 83 ms and a spatial resolution of 0.4 x 0.4 x 0.4 mm. The patient cohort consisted of two subgroups. In a group of ten patients with known coronary artery disease (CAD), scheduled for bypass surgery (i.e., high pretest likelihood for having significant CAD), the results of DSCT coronary angiography (CTA) and invasive quantitative catheter angiography (QCA) were compared to assess the diagnostic accuracy of DSCT in the detection of significant coronary artery stenoses (>50%). In a second group of ten patients with previous aortic valve replacement (homografts), the valve opening area of the transplanted aortic valve graft was measured by DSCT and compared with echocardiography as a standard of reference to exclude postsurgical restenosis of the valve. Of 150 coronary artery segments depicted by CT, 144 (96%) were classified as ''assessable.'' A significant CAD was known in all patients, and altogether 43 significant stenoses were present according to the results of QCA. Blinded to these results, DSCTA reached a sensitivity and specificity of 95% (41/43) and 93% (103/111), yielding a positive and negative predictive value (PPV, NPV) of 79% (31/39) and 98% (103/105), respectively. In patients with aortic valve homografts, all DSCT datasets were considered as being of diagnostic image quality concerning valve depiction. The planimetric evaluation of the CT data as compared to results of echocardiography showed a significant correlation of the results (r=0.64, p=0.0467). A high-grade valve stenosis (opening area <1.0 cm{sup 2}) could be correctly excluded by DSCT in all patients. Dual-source

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

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Martin H. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Universitaetsspital Bern (Switzerland). Dept. fuer Diagnostische, Interventionelle und Paediatrische Radiologie; Zimmermann, E.; Hamm, B. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Dewey, M.

    2014-12-15

    Assessment of experience gained by local referring physicians with the procedure of coronary computed tomographic angiography (CCTA) in the everyday clinical routine. A 25-item questionnaire was sent to 179 physicians, who together had referred a total of 1986 patients for CCTA. They were asked about their experience to date with CCTA, the indications for coronary imaging, and their practice in referring patients for noninvasive CCTA or invasive catheter angiography. 53 questionnaires (30%) were assessable, corresponding to more than 72% of the patients referred. Of the referring physicians who responded, 94% saw a concrete advantage of CCTA in the treatment of patients, whereby 87% were 'satisfied' or 'very satisfied' with the reporting. For excluding coronary heart disease (CHD) where there was a low pre-test probability of disease, the physicians considered CCTA to be superior to conventional coronary diagnosis (4.2 on a scale of 1-5) and vice versa for acute coronary syndrome (1.6 of 5). The main reasons for unsuitability of CCTA for CT diagnosis were claustrophobia and the absence of a sinus rhythm. The level of exposure to radiation in CCTA was estimated correctly by only 42% of the referring physicians. 90% of the physicians reported that their patients evaluated their coronary CT overall as 'positive' or 'neutral', while 87% of the physicians whose patients had undergone both procedures reported that the patients had experienced CCTA as the less disagreeable of the two. CCTA is accepted by the referring physicians as an alternative imaging procedure for the exclusion of CHD and received a predominantly positive assessment from both the referring physicians and the patients.

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

    Institute of Scientific and Technical Information of China (English)

    Yong-Shu Gao; Xing-Can Ma

    2015-01-01

    Objective:To explore the feasibility and effectiveness of 64 slice spiral CT in evaluating the patency of coronary artery after stent implantation.Methods:The 64 slice spiral CT image data of 125 patients after coronary artery stent implantation were collected, meanwhile, the image data of 25 patients underwent coronary angiography were also collected. The feasibility and accuracy of 64 slice spiral CT coronary artery stent imaging were comparatively analyzed. Results: The 64 slice spiral CT imaging quality with a stent diameter greater than 3.00 mm was significantly superior to that with a diameter of 2.25-3.00 mm. The CT imaging quality in the left main coronary artery and anterior descending artery was significantly higher than that in the left circumflex coronary artery. The CT imaging quality in the left main coronary artery was significantly higher than that in the right coronary artery. The CT reconstruction imaging quality in the drug coating stent was significantly superior to that in the bare metal stent. The sensitivity of 64 slice spiral CT was 100.00%, and the accuracy was 100.00%. In detecting the coronary artery with occlusion and stenosis (stent stenosis greater than 50%), the sensitivity was 90.00%, the false negative rate was 10.00%, and the positive predicative value was 100.00%.Conclusions:The effect of 64 slice spiral CT coronary imaging in evaluating the patency of coronary artery after stent implantation is highly consistent with that by coronary angiography, with a simple operation, less risk, and low cost, and thus, it can be completely taken as the imaging method in evaluating the patency of coronary artery after stent implantation.

  2. Multi-detector CT coronary angiographic findings of coronary-to-pulmonary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Seok; Park, Eun Ah; Lim, Ji Yeon; Lee, Whal [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Park, Jae Hyung [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of)

    2017-01-15

    To evaluate multi-detector CT (MDCT) coronary angiographic findings of coronary-to-pulmonary artery fistula (CPAF). We retrospectively reviewed images of patients with CPAF from the coronary CT angiography (CCTA) database obtained with a 64-channel MDCT between January 2008 and March 2011. We analyzed the CCTA findings for feeding arteries, fistula, association with peripulmonary arterial aneurysms, and the presence of communication between the CPAF and bronchial arteries. Fifty-five of the 15042 (0.37%) patients were diagnosed with CPAFs. The feeding artery was single (n = 18) or multiple (n = 37). The fistula had a single drainage site (n = 54) or multiple drainage sites (n = 1). The mean diameter of the fistulous opening was 2.7 ± 1.4 mm. A peripulmonary arterial aneurysm was present in 24 (44%) patients. Communication between CPAF and bronchial arteries was present in eight (14.5%) patients. MDCT coronary angiography can provide comprehensive morphologic details on CPAF and may help in presurgical or preinterventional planning.

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

    Science.gov (United States)

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

    2016-11-01

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

  4. Application Value of Dual-source CT Low-dose Scanning in the Diagnosis of Adenoidal Hypertrophy in Children%双源CT低剂量扫描在诊断儿童腺样体肥大中的应用价值

    Institute of Scientific and Technical Information of China (English)

    王守玺

    2014-01-01

    Objective To evaluate and analyze the application value of dual-source CT low-dose scanning in the diagnosis of ade-noidal hypertrophy in children, so as to provide reliable reference for future clinical diagnostic work. Methods 76 cases of children clinically diagnosed as adenoidal hypertrophy admitted in our hospital from January, 2011 to December, 2013 were extracted. And they were divided into the control group and the observation group in accordance with the order of admission. The control group was given dual-source CT conventional-dose scanning, and the observation group was given dual-source CT low-dose scanning, the image quality, radiation dose and diagnostic results of both groups were compared and analyzed. Results There was no signifi-cant difference in the result of nasopharyngeal anatomy display between the observation group and the control group ( P>0.05), but the difference in adenoid CT value and radiation dose between the two groups was significant (P0.05),两组患儿腺样体CT值和辐射剂量比较存在差异有统计学意义(P<0.05)。结论经双源CT低剂量扫描可对儿童腺样体肥大做出准确的诊断,且其安全性较常规剂量扫描更高,临床诊断价值显著,值得关注并推广。

  5. Noninvasive Detection of Coronary Artery Stenosis Using 16-slice Spiral CT: a Comparison with Selective X-ray Coronary Angiography

    Institute of Scientific and Technical Information of China (English)

    SHI Heshui; HAN Ping; KONG Xiangquan; FENG Gansheng; Martin HK Hoffmann

    2006-01-01

    The role of 16-slice spiral CT was evaluated in the diagnosis of coronary stenosis, with selective X-ray coronary angiography (SCA) serving as the reference standard. Sixty-five patients who were suspected of having coronary heart disease, without percutaneous transluminal coronary angioplasty or coronary bypass-grafting, were investigated using 16-slice CT. Eight patients with pre-scan heart rate of more than 80 beats/min were given β-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume redering (VR), multi-planar reconstruction (MPR), curved MPR and maximum intensity projection (MIP) were used to reconstruct. Every segment of coronary artery with a diameter ≥1.5 mm was assessed, and the presence on CT with a stenosis exceeding 50% diameter reduction was compared with that on SCA. The reasons which lead to some segments unevaluable were analysed. Compared with SCA, 93% coronary segments and 94 % main branches were evaluable. Residual cardiac motion artifacts, severe calcification and poor opacification made 58%, 28% and 14% of the remaining 60 segments unevaluable respectively. Without routine administration of β-blockers, good coronary imaging quality can be acquired using 16-slice spiral CT. It is a reliable noninvasive method for detection of obstructive coronary artery disease.

  6. Feasibility of low-dose contrast medium high pitch CT angiography for the combined evaluation of coronary, head and neck arteries.

    Directory of Open Access Journals (Sweden)

    Zhiwei Wang

    Full Text Available PURPOSE: To evaluate the image quality and radiation dose of combined heart, head, and neck CT angiography (CTA using prospectively electrocardiography (ECG-triggered high-pitch spiral scan protocol, compared with single coronary CTA. MATERIALS AND METHODS: 151 consecutive patients were prospectively included and randomly divided into three groups. Group 1 (n = 47 underwent combined heart, neck, and head CTA using prospectively ECG-triggered high-pitch spiral (Flash scan protocol with a single-phase intravenous injection of iodinated contrast and saline flush; Group 2 (n = 51 underwent single coronary CTA with Flash scan protocol; and Group 3 (n = 53 underwent single coronary CTA with prospective sequence scan protocol. All patients were examined on a dual source CT (Definition FLASH. The image quality was determined for each CT study. RESULTS: Patients of scanning protocol Group 1, 2, and 3 showed no significant differences in age, sex, heart rates, and BMI. Evaluation of coronary artery image quality showed comparable results in the three scanning protocol groups on a per patient-based analysis. In group 1, image quality was found to be sufficient to be diagnostic in all arterial segments of carotid arteries. The mean dose-length product (DLP for group 1 was 256.3±24.5 mGy×cm and was significantly higher in comparison with group 2 (93.4±19.9 mGy×cm; p < 0.001. However, there was no significant difference of DLP between group 1 and group 3 (254.1±69.9 mGy×cm. CONCLUSIONS: The combined heart, neck, and head arteries scan using prospectively electrocardiography (ECG-triggered high-pitch spiral scan protocol in 1 single examination resulted in an excellent opacification of the aorta, the carotid arteries, and the coronary arteries and provided a good image quality with low radiation dose.

  7. Case Report: Coronary arterial spasm in single right coronary artery

    Institute of Scientific and Technical Information of China (English)

    En-zhi JIA; Qi-jun SHAN; Zhi-jian YANG; Tie-bing ZHU; Lian-sheng WANG; Ke-jiang CAO; Wen-zhu MA

    2009-01-01

    We presented a case of anomalous single-coronary artery detected incidentally during routine coronary angiography. A 32-year-old male Chinese patient presented with recurrent pre-syncope and six episodes of syncope. Coronary angiography and coronary-computed tomography (CT)-angiography performed by a dual-source computed tomography (DSCT) revealed that the patient had a single large right coronary artery. A moderately large branch originated from the proximal part of the single right coronary artery and extended to the left, passing the anterior to the pulmonary artery, and divided into the anterior descending artery branch and circumflex branch at the base of the left auricular appendage. The episodes of the syncope were suspected to be caused by coronary arterial spasm, so this patient was on a regimen of 30 mg of diltiazem every 6 h and had no recurrence of syncope during follow-up.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-07-01

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

  9. Application values of dual-source CT spectral imaging in the diagnosis of solitary pulmonary nodules%双源CT 能谱成像技术在肺内孤立性结节良恶性鉴别诊断的应用价值

    Institute of Scientific and Technical Information of China (English)

    曾炳亮; 李滋聪; 廖小清; 廖凤翔

    2016-01-01

    Objective To explore the diagnosis and differential diagnosis values of spectral imaging of dual-source CT in soli-tary pulmonary nodules. Methods Total of 82 patients with solitary pulmonary nodules (41 cases of benign pulmonary nodules and 41 cases of malignant pulmonary nodules),confirmed by pathology,underwent dual-source CT routine enhanced and dual energy enhancement scanning,and the corresponding CT values and iodine content were measured. The t test was performed to assess the statistical differences,which was definited with P<0.05. Results The CT value of routine enhanced was lower than that of iodine value chart both in arterial phase and venous phase,but the difference was statistically significant only in venous phase (P<0.001). The malignant group had lower normalized iodine concentration (NIC) than benign group ,the difference was statistically significant (P<0.05). Further ROC curve showed that the NIC had a high degree of sensitivity and specificity in the differential diagnosis be-tween benign and malignant pulmonary nodules. Both groups showed a continuous decline trend from 40keV to 140keV. The dif-ference in CT value was statistically significant both in arterial phase and venous phase between groups(P<0.05). Conclusion The spectral imaging of dual-source CT has great clinical value in the differential diagnosis between benign and malignant pulmonary nodules.%目的:探讨双源CT能谱成像技术对肺内良、恶性肿块鉴别诊断能力。方法回顾性分析经病理证实的82例肺内孤立性肿块(恶性肿瘤及良性肿块各41例)的常规CT增强及双源CT增强动、静脉期资料,记录各期CT值及碘含量。组间行t检验,以P<0.05为结果具有显著差异。结果无论是动脉期还是静脉期,常规增强的CT值均低于碘基图,差异仅在静脉期具有统计学意义(P<0.001)。恶性组标准化平均碘浓度含量低于良性组,组间差异有统计学意义(P<0.05),ROC曲线其

  10. Can nontriggered thoracic CT be used for coronary artery calcium scoring? A phantom study

    NARCIS (Netherlands)

    Xie, Xueqian; Greuter, Marcel J. W.; Groen, Jaap M.; de Bock, Geertruida H.; Oudkerk, Matthijs; de Jong, Pim A.; Vliegenthart, Rozemarijn

    2013-01-01

    Purpose: Coronary artery calcium score, traditionally based on electrocardiography (ECG)-triggered computed tomography (CT), predicts cardiovascular risk. However, nontriggered CT is extensively utilized. The study-purpose is to evaluate the in vitro agreement in coronary calcium score between nontr

  11. 双源 CT 双能量虚拟平扫对脂肪肝的诊断价值%The diagnostic value of dual energy virtual non-contrast images in hepatic steatosis with dual source CT scanner

    Institute of Scientific and Technical Information of China (English)

    王士阗; 王萱; 王禨; 徐凯; 薛华丹; 金征宇

    2014-01-01

    _目的:探讨双源 CT 双能量腹部虚拟平扫对脂肪肝的诊断价值。方法:回顾性分析采用双源 CT 行腹部双能量增强扫描诊断为脂肪肝的77例患者的平扫期(120 kV)及虚拟平扫(VNC)图像。虚拟平扫图像运用门脉期双能量(100及140 kV)图像重建而来。选择肝门层面测量真实平扫(TNC)与 VNC 图像上肝右叶、肝左叶、脾脏、下腔静脉的 CT 值及噪声,并在肝门层面测量上腹部前后径及左右径。记录整个扫描和平扫期对应的剂量长度乘积(DLP)。评价 TNC 与VNC 图像间各 CT 值及噪声的差异,分析两组图像上肝右叶噪声与前后径、左右径及平均径的关系。分别用肝/脾 CT 值比<0.8、肝/下腔静脉 CT 值比<1.0,做为诊断中重度脂肪肝的标准,比较 TNC 和 VNC 图像诊断中重度脂肪肝的一致性。结果:VNC 图像上肝左叶、右叶及脾脏的 CT 值均高于 TNC(P<0.01),差异小于10 HU。VNC 图像上各部位噪声均低于 TNC。TNC 图像上,肝右叶噪声与前后径、左右径、平均径均有中等相关性(r=0.562,0.608,P<0.01);在 VNC图像上,肝右叶噪声与上述径线值相关性弱。用肝/脾 CT 值比<0.8作为诊断重度脂肪肝的标准,VNC 与 TNC 图像诊断重度脂肪肝一致性的 kappa 值为0.591;用肝/静脉 CT 值比<1.0作为诊断标准,两种图像一致性的 kappa 值为0.458。用 VNC 代替 TNC 图像,可降低24.2%的总扫描剂量。结论:VNC 图像与 TNC 图像在诊断中重度脂肪肝上具有中等的一致性,推荐运用肝/脾 CT 值比<0.8这一诊断标准。%To investigate the value of dual energy (DE)virtual non-contrast (VNC)images in the diagno-sis of hepatic steatosis.Methods:This retrospective study was based on contrast enhanced abdominal DECT scan of 77 pa-tients with hepatic steatosis.The VNC images were reconstructed from two sets of

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-01

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

  13. Dual-Energy Imaging of Urate Crystals in Gout Using Dual-Source CT%双源CT双能量成像对痛风诊断价值的初步研究

    Institute of Scientific and Technical Information of China (English)

    靳国庆; 王东林; 王振杰; 李麦福

    2013-01-01

    cases. 478 sites of urate crystal deposition were displayed. The diseased sites are most in Feet and ankles were the mostly involved site. There was no urate crystal deposition found in control group. There was significant difference between two groups on displaying urate crystal(P =0.00012,P <0.001). Conclusion Dual source DECT technology can clearly display the urate crystal deposition, which can be used as routine examination for the gout diagnosis.

  14. Value of Dual-source CT Angiography in the Diagnosis of Vertebral Artery Sulcus Ring%双源 CTA 在椎动脉沟环中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    闫如意; 张朝利; 刘军华; 费军

    2014-01-01

    [Objective] To explore the value of dual-source CT angiography (DSCTA ) in the diagnosis of vertebral artery sulcus ring .[Methods]Clinical data of 62 patients with vertebral artery sulcus ring diagnosed by DSCTA were col-lected .The types of whole-ring-type vertebral artery sulcus ring were analyzed .The diameter of vertebral artery was measured .[Results] The types of 62 patients with vertebral artery included Ⅳ type in 38 patients(61 .3% ) in which 25 patients were bilateral whole-ring type and 13 patients were unilateral whole-ring type(8 patients with right side and 4 pa-tients with left side) ,Ⅲ type in 6 patients (9 .7% ) which were bone breaking in curve bone bridge arch with both beak-like sides ,typeⅠandⅡ in 18 patients(29 .0% ) in which 3 patients were type I anterior semi-ring and 15 patients were typeⅡ posterior semi-ring .The upper and lower diameters of whole-ring type vertebral artery sulcus ring were 3 .1~8 .2 (4 .8 ± 0 .3)mm and anteroposterior diameters were 4 .2~9 .1(7 .10 .3)mm .The diameter of vertebral artery in atlas ver-tebral artery sulcus ring was 1 .8~5 .9(3 .7 ± 0 .8)mm .Local stenosis of vertebral artery was found in 15 patients ,and the stenosis rate was 10% ~30% .[Conclusion]DSCTA can accurately display the shape of atlas vertebral artery sulcus ring and stenosis caused by vertebral artery entrapment .%【目的】探讨双源CT血管成像(CTA)在椎动脉沟环中的诊断价值。【方法】收集头颈部双源CTA检查中发现椎动脉沟环的患者62例的临床资料,分析椎动脉沟环分型并测量椎动脉直径。【结果】62例椎动脉沟环的分型:Ⅳ型38例,占61.3%,其中25例为双侧全环型,13例为单侧全环型(右侧8例、左侧4例);Ⅲ型6例,占9.7%,为弧形骨桥弓顶部骨质中断,两端呈鸟嘴状;Ⅰ型及Ⅱ型18例,占29.0%,其中Ⅰ型(前半环)3例、Ⅱ型(后半环)15例。测量全环型椎动脉沟环上下径3.1

  15. 胃左动脉参与肝细胞癌供血的双源CT血管成像研究%Evaluation of hepatocellular carcinoma supplied by the left gastric artery with dual-source CT angiography

    Institute of Scientific and Technical Information of China (English)

    陈光文; 涂诗琦; 陈加源; 赵黎明

    2012-01-01

    Objective:To investigate the incidence and influential factors of hepatocellular carcinoma (HCC) supplied by the left gastric artery. Methods:91 patients with HCC in left lobe were prospectively included in the study. Standardized dual source CT (DSCT) multi phases acquisition was performed for all patients. Thin slice source images were reconstruc ted using techniques ol multi planar reconstruction, curved planar reconstruction,maximum intensity projection and volume rendering to display the left gastric artery. The images were interpreted by three experienced abdominal radiologists. The in cidence of HCC fed by LGA and factors like the size, location, pseudocapsule of HCC lesions and previous history of transarterial chemoembolization (TACE) therapy were analyzed. Results:There were 23 (22. 1 %) cases supplied by LGA in 91 patients with a total of 104 HCC lesions,while 19 lesions were type macro mass compared with 4 lesions as type nodus, 22 lesions invaded Glisson capsule and 17 lesions had previous history of TACE therapy. All lesions had no unbroken pseud ocapsule. LGA participated in HCC blood supply by left lobe hepatic artery (n=3) and accessory left lobe hepatic artery (n=5) originated from LGA,as well as branch direct supplying the lesions (n=15). Conclusion:LGA is common extrahe patic collateral artery of left lobe HCC and the presence is significantly correlated with the tumor size,the location,the sta tus of pseudocapsule and history of TACE therapy of HCC lesion.%目的:探讨胃左动脉(LGA)参与肝细胞癌(HCC)供血的影响因素.方法:采用双源CT对91例左叶HCC患者进行血管成像扫描,采用MPR、CPR、MIP、VR等后处理技术重建LGA.分析LGA参与HCC供血与病灶大小、位置、假包膜的完整性及接受经导管动脉化疗栓塞(TACE)治疗的关系.结果:91例患者共计104个HCC病灶,23个病灶有LGA参与供血,发生率为22.1%.23个有LGA参与供血的HCC病灶中,19个为巨块型,4个为结节型,22

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-07-15

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

  17. Dual-Source Dual-Energy CT for the Differentiation of Urinary Stone Composition: In Vivo Study%体内泌尿系结石的双源CT双能量成像

    Institute of Scientific and Technical Information of China (English)

    张挽时; 杨琪放; 孟利民; 郭和清; 严景民; 刘红明

    2012-01-01

    件可以较好地区分体内的尿酸结石、混合尿酸结石、胱氨酸结石和含钙结石,但区分磷酸镁铵结石以及不同成分的含钙结石尚存在困难.%Objective To evaluate the ability of dual-source dual-energy CT to differentiate urinary stone of different compositions in vivo. Methods Sixty-four patients with known urinary stone disease were scanned using a DSCT scanner in the dual-energy mode. Hounsfield units (HU) of each stone were recorded for the 80 kV and the 140 kV datasets by hand-drawing method. HU difference, HU ratio and DEI were calculated. Urinary stones were classified as UA stones, mixed UA stones, cystine stones and calcium stones based on dual energy software, the results compared with the infrared spectroscopy analysis of stone samples. Use one-way ANOVA to compare HU difference, HU ratio and DEI of different stones groups according to infrared spectroscopy. Results In 55 patients, stones were sampled. Dual energy software correctly characterized 4 UA stones, 1 mixed UA stone, 2 cystine stone, and 42 calcium stones. 4 struvite stones, 1 mixed ammonium uratc and calcium stone, 1 mixed UA stone were classified as calcium stones. Statistical differences in HU difference (18±12), (214±21), (329±35), (360±49), (458±97) and (497±110) HU respectively, HU ratio (1.04±0.02, l.36±0.02, 1.49±0.04, 1.50±0.08. 1.52±0.05 and 1.53±0.04 respectively), and DEI (0.006±0.004, 0.062±0.002, 0.089±0.006, 0.095±0.0l3, 0.107±0.011 and 0.112±0.012 respectively) among UA stones, cystine stone, stravite stones, CaP stones, CaOx stones and mix calcium stones (P<0.001). There were statistical differences in HU difference, HU ratio and DEI between UA stones and ihe other groups, in HU ratio and DEI between cystine stones and the other groups, in HU difference and DEI between struvite stones and CaOx or mix calcium stones, in HU difference between cystine stones and CaOx or mix calcium stones, in DEI between CaP stones and mix

  18. Dual-source dual-energy CT for the differentiation of urinary stone composition: preliminary study%双源CT双能量成像对泌尿系统结石成分分析的初步研究

    Institute of Scientific and Technical Information of China (English)

    杨琪放; 严景民; 张挽时; 孟利民; 时惠平; 王东; 毕永民; 李相生; 方红; 郭和清

    2011-01-01

    氨酸结石、混合尿酸结石与其他类型结石.%Objective To evaluate dual-source dual-energy CT(DSCT) for the differentiation of urinary stone composition in vitro. Methods Ninety-seven urinary stones were obtained by endoscopic lithotripsy and scanned using dual-source dual-energy CT. The stones were divided into six groups according to infrared spectroscopy stone analysis: uric acid ( UA ) stones ( n = 10 ), cystine stones ( n = 5 ), struvite stones( n = 6), calcium oxalate ( CaOx ) stones ( n = 22 ), mixed UA stones ( n=7 ) and mixed calcium stones(n=47). Hounsfield units (HU) of each stone were recorded for the 80 kV and the 140 kV datasets by hand-drawing method. HU difference, HU ratio and dual energy index ( DEI ) were calculated and compared among the stone groups with one-way ANOVA. Using dual energy software to determine the composition of all stones, results were compared to infrared spectroscopy analysis. Results There were statistical differences in HU difference [(-17±13), (229±34),(309 ±45), (512 ±97), (201±64)and (530±71) HU respectively], in HU ratio (0.96±0.03, 1.34 ±0.04, 1.41 ±0.03, 1.47 ±0.03,1.30±0.07, and 1.49 ±0.03 respectively), and DEI( -0.006 ±0.004, 0.064 ±0.007, 0.080 ±0. 007, 0. 108±0.011 ,0. 055 ±0.014 and 0. 112 ±0.008 respectively ) among different stone groups(F=124. 894,407.028, 322. 864 respectively, P <0. 01 ). There were statistical differences in HU difference,HU ratio and DE1 between UA stones and the other groups( P < 0. 01 ). There were statistical differences in HU difference, HU ratio and DEI between CaOx or mixed calcium stones and the other four groups (P<0. 01 ). There was statistical difference in HU ratio between cystine and struvite stones ( P < 0. 01 ). There were statistical differences in HU difference, HU ratio and DEI between struvite and mixed UA stones (P<0. 05 ). Dual energy software correctly characterized 10 UA stones, 4 cystine stones, 22 CaOx stones and 6 mixed UA

  19. Interobserver agreement for the detection of atherosclerotic plaque in coronary CT angiography: comparison of two low-dose image acquisition protocols with standard retrospectively ECG-gated reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Schuhbaeck, Annika; Rixe, Johannes; Hamm, Christian [University of Giessen, Department of Cardiology, Giessen (Germany); Marwan, Mohamed; Gauss, Soeren; Muschiol, Gerd; Ropers, Dieter; Daniel, Werner G.; Achenbach, Stephan [University of Erlangen, Department of Cardiology, Erlangen (Germany); Schneider, Christian [University of Giessen, Department of Radiology, Giessen (Germany); Lell, Michael [University of Erlangen, Department of Radiology, Erlangen (Germany)

    2012-07-15

    We compared the interobserver variability concerning the detection of calcified and non-calcified plaque in two different low-dose and standard retrospectively gated protocols for coronary CTA. 150 patients with low heart rates and less than 100 kg body weight were randomised and examined by contrast-enhanced dual-source CT coronary angiography (100 kV, 320 mAs). 50 patients were examined with prospectively ECG-triggered axial acquisition, 50 patients with prospectively ECG-triggered high pitch spiral acquisition, and 50 patients using spiral acquisition with retrospective ECG gating. Two investigators independently analysed the datasets concerning the presence of calcified and non-calcified plaque on a per-segment level. Mean effective dose was 1.4 {+-} 0.2 mSv for axial, 0.8 {+-} 0.07 mSv for high-pitch spiral, and 5.3 {+-} 2.6 mSV for standard spiral acquisition (P < 0.0001). In axial acquisition, interobserver agreement concerning the presence of atherosclerotic plaque was achieved in 650/749 coronary segments (86.8%). In high-pitch spiral acquisition, agreement was achieved in 664/748 segments (88.8%, n.s.). In standard spiral acquisition, agreement was achieved in 672/738 segments (91.0%, P < 0.0001). Interobserver agreement was significantly higher for calcified than for non-calcified plaque in all data acquisition modes. Low-dose coronary CT angiography permits the detection of coronary atherosclerotic plaque with good interobserver agreement. (orig.)

  20. Coronary artery abnormalities in Kawasaki disease - Comparison between CT and MR coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Woo; Goo, Hyun Woo [Dept. of Radiology and Research Inst. of Radiology, Univ. of Ulsan Coll. of Medicine, Asan Medical Center, Seoul (Korea, Republic of)], e-mail: hwoogoo@amc.seoul.kr

    2013-03-15

    Background: Although CT coronary angiography (CTCA) and MR coronary angiography (MRCA) are increasingly used in patients with Kawasaki disease, comparison of coronary artery assessability and diagnostic performance between the two imaging modalities has been rarely performed. Purpose: To investigate which imaging modality, CTCA or MRCA, is better for evaluating coronary artery abnormalities in patients with Kawasaki disease. Material and Methods: Between 2003 and 2011, 56 patients (38 boys/men; age range, 1-24 years) with Kawasaki disease underwent CTCA or MRCA (group A). Of these, 17 underwent both CTCA and MRCA (group B). Visibility of 11 coronary arterial segments in each patient was graded on a four-point scale. Coronary artery aneurysm, stenosis, and occlusion were evaluated by CTCA and MRCA, based on a reference standard obtained from cardiac catheterization, echocardiography, follow-up CTCA and MRCA, and clinical history. Coronary artery assessability and diagnostic performance were compared between CTCA and MRCA. Results: In per-segment analysis, more segments were assessable on CTCA than on MRCA in both groups. In per-patient analysis of group B, no significant difference in the assessability was found between CTCA (95.0%, 128.3/135 segments) and MRCA (92.4%, 124.8/135 segments) (P > 0.05). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CTCA vs. MRCA were 93.1% vs. 77.9% (P < 0.001), 99.2% vs. 99.7% (P = 0.65), 96.8% vs. 98.7% (P = 0.65), 98.2% vs. 94.1% (P < 0.001), and 98.0% vs. 94.9% (P = 0.008), respectively, in group A, and 91.8% vs. 70.4% (P < 0.001), 99.5% vs. 99.5% (P = 1.000), 98.5% vs. 98.0% (P = 1.000), 97.2% vs. 91.1% (P = 0.006), and 97.6% vs. 92.3% (P = 0.004), respectively, in group B. Conclusion: Although CTCA and MRCA show comparable assessability in per-patient analysis, CTCA shows higher diagnostic performance than MRCA for evaluating coronary artery abnormalities in patients with Kawasaki

  1. Can nontriggered thoracic CT be used for coronary artery calcium scoring? A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Xueqian [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands and Center for Medical Imaging – North East Netherlands, Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Greuter, Marcel J. W. [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Groen, Jaap M. [Department of Radiology, Zaans Medical Center, 1500EE Zaandam (Netherlands); Bock, Geertruida H. de [Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Oudkerk, Matthijs [Center for Medical Imaging – North East Netherlands, Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands); Jong, Pim A. de [Department of Radiology, University Medical Center Utrecht, University of Utrecht, 3584CX Utrecht (Netherlands); Vliegenthart, Rozemarijn [Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands and Center for Medical Imaging – North East Netherlands, Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen (Netherlands)

    2013-08-15

    Purpose: Coronary artery calcium score, traditionally based on electrocardiography (ECG)-triggered computed tomography (CT), predicts cardiovascular risk. However, nontriggered CT is extensively utilized. The study-purpose is to evaluate the in vitro agreement in coronary calcium score between nontriggered thoracic CT and ECG-triggered cardiac CT.Methods: Three artificial coronary arteries containing calcifications of different densities (high, medium, and low), and sizes (large, medium, and small), were studied in a moving cardiac phantom. Two 64-detector CT systems were used. The phantom moved at 0–90 mm/s in nontriggered low-dose CT as index test, and at 0–30 mm/s in ECG-triggered CT as reference. Differences in calcium scores between nontriggered and ECG-triggered CT were analyzed by t-test and 95% confidence interval. The sensitivity to detect calcification was calculated as the percentage of positive calcium scores.Results: Overall, calcium scores in nontriggered CT were not significantly different to those in ECG-triggered CT (p > 0.05). Calcium scores in nontriggered CT were within the 95% confidence interval of calcium scores in ECG-triggered CT, except predominantly at higher velocities (≥50 mm/s) for the high-density and large-size calcifications. The sensitivity for a nonzero calcium score was 100% for large calcifications, but 46%± 11% for small calcifications in nontriggered CT.Conclusions: When performing multiple measurements, good agreement in positive calcium scores is found between nontriggered thoracic and ECG-triggered cardiac CT. Agreement decreases with increasing coronary velocity. From this phantom study, it can be concluded that a high calcium score can be detected by nontriggered CT, and thus, that nontriggered CT likely can identify individuals at high risk of cardiovascular disease. On the other hand, a zero calcium score in nontriggered CT does not reliably exclude coronary calcification.

  2. Fractional flow reserve derived from coronary CT angiography in stable coronary disease: a new standard in non-invasive testing?

    Energy Technology Data Exchange (ETDEWEB)

    Noergaard, B.L.; Jensen, J.M. [Aarhus University Hospital Skejby, Department of Cardiology B, Aarhus N (Denmark); Leipsic, J. [St. Paul' s Hospital, Department Radiology, Vancouver, British Columbia (Canada)

    2015-08-15

    Fractional flow reserve (FFR) measured during invasive coronary angiography is the gold standard for lesion-specific decisions on coronary revascularization in patients with stable coronary artery disease (CAD). Current guidelines recommend non-invasive functional or anatomic testing as a gatekeeper to the catheterization laboratory. However, the ''holy grail'' in non-invasive testing of CAD is to establish a single test that quantifies both coronary lesion severity and the associated ischemia. Most evidence to date of such a test is based on the addition of computational analysis of FFR to the anatomic information obtained from standard-acquired coronary CTA data sets at rest (FFR{sub CT}). This review summarizes the clinical evidence for the use of FFR{sub CT} in stable CAD in context to the diagnostic performance of other non-invasive testing modalities. (orig.)

  3. [Detection of coronary calcifications by electron beam tomography and multislice spiral CT: clinical relevance].

    Science.gov (United States)

    Achenbach, S; Schmermund, A; Erbel, R; Silber, S; Haberl, R; Moshage, W; Daniel, W G

    2003-11-01

    Coronary calcifications can be detected and quantified using electron beam tomography (EBT) or newer generation multi-slice spiral CT (MSCT) scanners. An abundance of data has been acquired by EBT. It could be shown that the amount of coronary calcium correlates to the coronary plaque burden. The detection of coronary calcium with CT imaging methods therefore provides a unique opportunity to detect and quantify coronary atherosclerosis in a subclinical stage. Consequently, the presence and amount of coronary calcium has been shown to be indicative for an increased coronary event risk in symptomatic and asymptomatic individuals. Several clinical studies found a predictive value that was superior to conventional risk factors. Clinically, the use of coronary calcification assessment may therefore be beneficial in patients who, based on traditional risk factors, seem to be at "intermediate risk" for coronary events (10-year event risk 10-20%) in order to decide on the aggressiveness of risk factor modification. The role of coronary calcium quantification to monitor the progression of disease has not been clarified yet. Large, ongoing trials will provide further data as to the relative merit of coronary calcium assessment for risk stratification and will help to more clearly define its clinical role. The relationship between coronary calcium and coronary stenoses is more complex. While the absence of coronary calcifications makes significant coronary stenoses unlikely, even large amounts of coronary calcium do not necessarily indicate the presence of coronary artery stenoses. Pronounced coronary calcifications as an isolated finding should therefore not be the motivation for invasive diagnostic procedures in the absence of other evidence of ischemic heart disease.

  4. New dual-source CT and dual-energy imaging in analysis of compositions of urinary calculi%新双源CT双能量成像对泌尿系结石成分定性诊断的价值

    Institute of Scientific and Technical Information of China (English)

    林黛英; 吴先衡; 汪丹凤; 林少帆; 黄宝泉

    2014-01-01

    目的 探讨新双源CT双能量成像分析泌尿系统结石成分的临床价值.方法 对45例尿路结石患者行双源CT双能量扫描,分析其结石成分,比较体外红外光谱法分析结石成分的结果,分析双源CT分析各种成分泌尿系结石的特异性与敏感性.结果 双源CT能准确区分尿酸结石和非尿酸结石,灵敏度和特异度均为100.00%;磷酸盐结石的诊断灵敏度为93.10%,特异度为92.00%;胱氨酸结石的诊断灵敏度为66.67%,特异度为97.90%;草酸钙结石灵敏度为85.71%,特异度为100.00%.结论 新双源CT双能量成像能在治疗前对泌尿系结石的成分进行分析,对结石的治疗及预防具有重要意义.%Objective To explore the clinical value of new dual-source CT and dual-energy imaging in the analysis of the compositions of urinary calculi.Methods The compositions of urinary calculi in 45 patients were analyzed being scanned with new dual-source CT and dual-energy imaging.The compositions of urinary calculi was compared with the results from infrared spectrometry in vitro.The sensitivity and specificity of the composition of urinary calculi were analyzed with new dual-source CT.Results Dual-source CT could accurately distinguish nonuric acid stones from uric acid calculi,and its sensitivity and specificity were both 100.00%; the diagnosis sensitivity and specificity to phosphate stones were 93.10% and 92.00%; the diagnosis sensitivity and specificity to cystine stones were 66.67% and 97.90%; and the diagnosis sensitivity and specificity to calcium oxalate stones were 85.71% and 100.00%.Conclusions Dual-source CT and dual-energy imaging can analyze the compositions of urinary calculi before treatment and has important significance in preventing and treating calculi.

  5. In vitro evaluation of 56 coronary artery stents by 256-slice multi-detector coronary CT

    Energy Technology Data Exchange (ETDEWEB)

    Steen, Henning, E-mail: henning.steen@med.uni-heidelberg.de [University of Heidelberg, Department of Cardiology, Im Neuenheimer Feld 410, Heidelberg 69120 (Germany); Andre, Florian, E-mail: Florian.Andre@med.uni-heidelberg.de [University of Heidelberg, Department of Cardiology, Im Neuenheimer Feld 410, Heidelberg 69120 (Germany); Korosoglou, Grigorios, E-mail: Grigorios.Korosoglou@med.uni-heidelberg.de [University of Heidelberg, Department of Cardiology, Im Neuenheimer Feld 410, Heidelberg 69120 (Germany); Mueller, Dirk, E-mail: Dirk.Mueller@philips.com [Philips GmbH Healthcare Division, Luebeckertordamm 5, Hamburg 20099 (Germany); Hosch, Waldemar, E-mail: Waldemar.Hosch@med.uni-heidelberg.de [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 410, Heidelberg 69120 (Germany); Kauczor, Hans-Ulrich, E-mail: Hans-Ulrich.Kauczor@med.uni-heidelberg.de [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 410, Heidelberg 69120 (Germany); Giannitsis, Evangelos, E-mail: Evangelos.Giannitsis@med.uni-heidelberg.de [University of Heidelberg, Department of Cardiology, Im Neuenheimer Feld 410, Heidelberg 69120 (Germany); Katus, Hugo A., E-mail: Hugo.Katus@med.uni-heidelberg.de [University of Heidelberg, Department of Cardiology, Im Neuenheimer Feld 410, Heidelberg 69120 (Germany)

    2011-10-15

    Objective: We sought to investigate stent lumen visibility of 56 coronary stents with the newest 256-multi-slice-CT (256-MDCT) technology for different reconstruction algorithms in an in vitro model. Background: Early identification of in-stent restenosis (ISR) is important to avoid recurrent ischemia and prevent acute myocardial infarction (AMI). Since angiography has the disadvantage of high costs and its invasiveness, MDCT could be a convenient and safe non-invasive alternative for detection of ISR. Material and methods: Percentages of in-stent lumen diameter and in-stent signal attenuation (measured as contrast-to-noise ratio (CNR)) of 56 coronary stents (group A {<=}2.5 mm; group B = 2.75-3.0 mm; group C = 3.5-4.0 mm) were evaluated in a coronary vessel in vitro phantom (iodine-filled plastic tubes) employing four different reconstruction algorithms (XCD, CC, CD, XCB) on a novel 256-MDCT (Philips-iCT, collimation = 128 mm x 0.625 mm; rotation time = 270 ms; tube current = 800 mA s with 120 kV). Analysis was conducted with the semi-automatical full-width-at-half-maximum (FWHM) method. P-values <0.05 were regarded statistically significant. Results: In-stent lumen diameter >60% for group C stents was significantly larger and CNR was significantly lower (both p < 0.05) for sharp kernels (CD; XCD) when compared to groups A/B. The FWHM-method showed significantly smaller in-stent lumen diameter (p < 0.05) when compared to the manual method. Conclusion: 256-MDCT could potentially be employed for clinical assessment of stent patency in stents >3.0 mm when analysed with cardio-dedicated sharp kernels, although clinical studies corroborating this claim should be performed. However, stents {<=}3.0 mm reconstructed by soft kernels revealed insufficient in-stent lumen visualisation and should not be used in clinical practice. Further improvements in spatial and temporal image resolution as well as reductions of radiation exposure and image noise have to be accomplished

  6. Incremental value of the CT coronary calcium score for the prediction of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Genders, Tessa S.S. [Erasmus University Medical Center, Department of Epidemiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Radiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Pugliese, Francesca; Mollet, Nico R.; Meijboom, W. Bob; Weustink, Annick C.; Mieghem, Carlos A.G. van; Feyter, Pim J. de [Erasmus University Medical Center, Department of Radiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Hunink, M.G.M. [Erasmus University Medical Center, Department of Epidemiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Radiology, P.O. Box 2040, CA, Rotterdam (Netherlands); Harvard University, Department of Health Policy and Management, Harvard School of Public Health, Boston (United States)

    2010-10-15

    To validate published prediction models for the presence of obstructive coronary artery disease (CAD) in patients with new onset stable typical or atypical angina pectoris and to assess the incremental value of the CT coronary calcium score (CTCS). We searched the literature for clinical prediction rules for the diagnosis of obstructive CAD, defined as {>=}50% stenosis in at least one vessel on conventional coronary angiography. Significant variables were re-analysed in our dataset of 254 patients with logistic regression. CTCS was subsequently included in the models. The area under the receiver operating characteristic curve (AUC) was calculated to assess diagnostic performance. Re-analysing the variables used by Diamond and Forrester yielded an AUC of 0.798, which increased to 0.890 by adding CTCS. For Pryor, Morise 1994, Morise 1997 and Shaw the AUC increased from 0.838 to 0.901, 0.831 to 0.899, 0.840 to 0.898 and 0.833 to 0.899. CTCS significantly improved model performance in each model. Validation demonstrated good diagnostic performance across all models. CTCS improves the prediction of the presence of obstructive CAD, independent of clinical predictors, and should be considered in its diagnostic work-up. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-05-15

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

  8. Dual-source CT with multiplanar reconstruction and volume rendering three-dimensional reconstruction in the evaluation of rib fractures%双源CT结合多平面重建与容积再现三维重建技术评价肋骨骨折

    Institute of Scientific and Technical Information of China (English)

    钱斌; 邹新农; 姚选军; 陶广宇; 王凯; 陈宏伟

    2011-01-01

    背景:依靠胸部摄片诊断肋骨骨折常导致误诊和漏诊.目的:分析双源CT 结合三维重建技术在肋骨骨折中的应用价值.方法:使用双源CT 对65 例肋骨骨折患者进行薄层扫描,将数据发送至工作站行多平面重建、容积再现技术,得到肋骨骨折高清晰度的三维图像后,从不同角度观察骨折线走行、骨折移位及成角情况.结果与结论:双源CT 结合三维重建图像清晰显示65 例患者286 根骨折,其中52 例保守治疗,其余13 例行切开复位、内固定治疗.制定手术方案时均参考了三维重建图像,所显示的骨折部位、移位、成角等情况与术中所见一致.提示双源CT 能明确诊断肋骨骨折,多平面重建和容积再现技术互相补充对诊断肋骨骨折及指导治疗方案有明显的优势.%BACKGROUND: Diagnosis of rib fractures relying on the chest radiograph diagnosis often leads to misdiagnos is. OBJECTIVE: To investigate the application of dual-source CT with three-dimensional reconstruction in rib fractures. METHODS: Sixty-five patients with rib fractures were scanned with dual-source CT. The data were sent to the workstation line of multi-planar reconstruction using volume rendering technique, to obtain high-resolution three-dimersion al images of rib fractures, and to observe the fracture line courses, fracture displacement and angulation of the situation from different angles. RESULTS AND CONCLUSION: The combination of dual-source CT and three-dimensional reconstruction images clearly showed 286 fractures in 65 patients, including 52 cases of consenrvative treatment, and the remaining 13 cases of surgery. The surgery programs in all patients were developed with reference to three- dimensional reoonstruction images showing the fracture position, displacement, angulation. Etc., consistent with the intraoperative findings. Dual-source CT can confirm the diagnose of rib fractures, and multi-planar reconstruction and volume

  9. 双源CT灌注成像在评估周围型肺癌血管生成中的临床价值%The Clinical Value of Dual-source CT Perfusion Imaging in the Evaluation of Generation of Peripheral Lung Cancer Angiogenesis

    Institute of Scientific and Technical Information of China (English)

    钟锦双; 陈国庆

    2016-01-01

    Objective To study the dual-source CT perfusion imaging in clinical application and value of peripheral lung cancer angiogenesis. MethodsFrom March 2014 to May 2016, the hospital make a diagnosis and give treatment line dual-source CT perfusion imaging in patients with 83 cases, of which 57 cases of lung cancer. Model adopts Siemens dual-source CT scans of patients with chest CT scan, determine the lesion, injection of contrast medium for continuous dynamic scanning, will get passed to analysis software for data processing.Results The patient with lung cancer CT perfusion parameters such as: BF, BV, TTP, signiifcantly higher than that of lung benign disease, the difference was statistically significant (P<0.05); Lung cancer patients with CT perfusion parameters values determined by MTT, signiifcantly lower than lung benign disease, the difference was statistically signiifcant (P<0.05); Organization level of EGFR and MVD in patients with lung cancer, is signiifcantly higher than tissue adjacent to carcinoma, the difference was statistically significant (P<0.05).Conclusion Dual-source CT perfusion imaging in patients with peripheral lung cancer tumor angiogenesis evaluation effect is ideal, is worthy of popularization and application.%目的:研究双源CT灌注成像在周围型肺癌血管生成中的临床应用及价值。方法选取2014年3月~2016年5月我院诊治的行双源CT灌注成像患者83例,其中肺癌57例。采用西门子双源CT扫描机型对患者行胸部CT平扫,确定病灶部位,注入对比剂进行连续动态扫描,将获得的数据传送到分析软件中进行处理。结果肺癌患者CT灌注参数值如:BF、BV、TTP,高于肺部良性疾病,差异具有统计学意义(P<0.05);肺癌患者CT灌注参数值MTT,显著低于肺部良性疾病,差异具有统计学意义(P<0.05);肺癌组织患者EGFR及MVD水平,高于癌旁组织,差异具有统计学意义(P<0.05

  10. The application value of dual-source dual-energy CT in the diagnosis and pathology grade of esophageal cancer%双源 CT 能谱曲线在食管癌诊断及其病理分级中的应用价值

    Institute of Scientific and Technical Information of China (English)

    刘小静; 苗重昌; 周胜利

    2016-01-01

    目的:探讨双源 CT 能谱曲线在食管癌诊断及其病理分级中的应用价值。方法60例经内镜或病理证实的食管癌患者行双源双能量模式扫描,两个球管管电压分别为:A 球管100 kV,B 球管140 kV,双能量扫描时两组球管同时工作。将扫描获得的两组数据上传至工作站进行相关后处理及分析:绘制食管癌病灶及正常食管管壁能谱曲线,比较食管癌病灶与正常食管壁、不同分化程度食管癌的能谱曲线特征及其斜率之间的差异与联系。食管癌病理分级依据病理结果。结果①食管癌病灶能谱曲线走行位于正常食管管壁上方,并且斜率高于正常食管壁;②不同分化程度食管癌能谱曲线走行及趋势不同,分化程度越差,曲线走行越靠上,对各组能谱曲线斜率比较可得分化程度越差,能谱曲线斜率越大。结论双源双能量 CT 能谱曲线在食管癌诊断及病理分级中有着一定的临床应用价值。%Objective To explore the application value of spectrum curve dual - energy CT in the diagnosis of esophageal cancer and it′s pathology grade. Methods 60 cases confirmed of esophageal carcinoma by endoscopic or pathology underwent dual source CT dual energy scan mode using two ball tube voltage respectively. Ball tube A was 100 kV,and ball tube B was 140 kV. The two ball tube worked at the same time when the dual energy scan was conducted. The data obtained from the dual energy scan was sent to the workstation for post - processing and analy-sis. The spectrum of esophageal carcinoma and normal esophageal wall was drawn,then the differences and relationship of the spectral curve and the slope between esophageal carcinoma and normal esophageal wall,different grades of esophageal cancer were analyzed and compared. The grade of the esophageal cancer was based on the pathology. Results ①The spectral curve of esophageal cancer was located above the normal esophageal

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-12-15

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

  12. CT virtual endoscopy and 3D stereoscopic visualisation in the evaluation of coronary stenting.

    Science.gov (United States)

    Sun, Z; Lawrence-Brown

    2009-10-01

    The aim of this case report is to present the additional value provided by CT virtual endoscopy and 3D stereoscopic visualisation when compared with 2D visualisations in the assessment of coronary stenting. A 64-year old patient was treated with left coronary stenting 8 years ago and recently followed up with multidetector row CT angiography. An in-stent restenosis of the left coronary artery was suspected based on 2D axial and multiplanar reformatted images. 3D virtual endoscopy was generated to demonstrate the smooth intraluminal surface of coronary artery wall, and there was no evidence of restenosis or intraluminal irregularity. Virtual fly-through of the coronary artery was produced to examine the entire length of the coronary artery with the aim of demonstrating the intraluminal changes following placement of the coronary stent. In addition, stereoscopic views were generated to show the relationship between coronary artery branches and the coronary stent. In comparison with traditional 2D visualisations, virtual endoscopy was useful for assessment of the intraluminal appearance of the coronary artery wall following coronary stent implantation, while stereoscopic visualisation improved observers' understanding of the complex cardiac structures. Thus, both methods could be used as a complementary tool in cardiac imaging.

  13. Development of coronary vasospasm during adenosine-stress myocardial perfusion CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Jeong Gu; Choi, Seong Hoon; Kang, Byeong Seong; Bang, Min Aeo; Kwon, Woon Jeong [Dept. of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

    2015-06-15

    Adenosine is a short-acting coronary vasodilator, and it is widely used during pharmacological stress myocardial perfusion imaging. It has a well-established safety profile, and most of its side effects are known to be mild and transient. Until now, coronary vasospasm has been rarely reported as a side effect of adenosine during or after adenosine stress test. This study reports a case of coronary vasospasm which was documented on stress myocardial perfusion CT imaging during adenosine stress test.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  19. The Relationship of Epicardial Fat Volume to Coronary Plaque, Severe Coronary Stenosis, and High-Risk Coronary Plaque Features Assessed by Coronary CT Angiography

    Science.gov (United States)

    Rajani, Ronak; Shmilovich, Haim; Nakazato, Ryo; Nakanishi, Rine; Otaki, Yuka; Cheng, Victor Y.; Hayes, Sean W.; Thomson, Louise E.J.; Friedman, John D.; Slomka, Piotr J.; Min, James K.; Berman, Daniel S.; Dey, Damini

    2013-01-01

    Background Associations of epicardial fat volume (EFV) measured on non-contrast cardiac computed tomography (NCT) include coronary plaque, myocardial ischemia and adverse cardiac events. Objectives This study aimed to define the relationship of EFV to coronary plaque type, severe coronary stenosis, and to the presence of high-risk plaque features (HRPFs). Methods We retrospectively evaluated 402 consecutive patients, with no prior history of coronary artery disease, who underwent same day non-contrast cardiac computed tomography (NCT) and coronary CT angiography (CTA). EFV was measured on NCT using validated, semi-automated, software. The coronary arteries were evaluated for coronary plaque type [calcified (CP), non-calcified (NCP) or partially-calcified (MP)] and coronary stenosis severity ≥70% using coronary CTA. For patients with NCP and PCP, 2 high risk plaque features were evaluated: Low-attenuation plaque and positive remodeling. Results There were 402 patients with a median age of 66 years (range 23–92) of whom 226 (56%) were male. The EFV was larger in patients with CP (112 ± 55 cm3 vs. 89 ± 39 cm3), PCP (110 ± 57 cm3 vs. 98 ± 45 cm3) and NCP (115 ± 44 cm3 vs. EFV 100 ± 52 cm3. In the 192 patients with PCP or NCP, on multivariable analysis, after adjusting for conventional cardiovascular risk factors, EFV was an independent predictor of ≥70% coronary artery stenosis (OR 3.0, 95% CI 1.3–6.6, p=0.008), any high risk plaque features (OR 1.7, 95% CI 0.9–3.4, p=0.04) and low attention plaque (OR 2.4, 95% CI 1.1–5.1, p=0.02), but not of positive remodeling. Conclusions Epicardial fat volume is larger in patients with CP, PCP and NCP. In patients with NCP and PCP, EFV is significantly associated with severe coronary stenosis, high risk plaque features and low attenuation plaque. PMID:23622507

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  4. Dual-source CT Low-dose Technology Used in Suspected Lesions in Patients with Chest CT Examination%双源CT低剂量技术在疑是胸部病变患者CT检查中的应用

    Institute of Scientific and Technical Information of China (English)

    刘素芝; 郭占林; 张颖

    2016-01-01

    目的:研究双源CT低剂量技术在疑是胸部病变患者CT检查中的应用价值。方法选取2013年11月至2014年11月来我院接受检查的161例疑是胸部病变患者,按照患者前来就诊的先后顺序将患者分为7组,每组23例,对7组患者分别采用常规管电流量110mAs和低管电流量105,100,95,90,85,80 mAs进行测量,比较各组患者肺动脉分叉平面肺动脉信噪比、肺动脉-竖脊肌对比噪声比、降主动脉信噪比、降主动脉-竖脊肌对比噪声比、图像主观质量评分及病变检出情况。结果随着放射剂量的降低,肺动脉和降主动脉的信噪比逐渐降低(P<0.05);各组图像质量评分随着球管电流量的减小而降低(P<0.05);80mAs低管电流量组病变检出率为81.25%较其余各组显著较低(P<0.05)。结论双源CT低剂量技术能在疑是胸部病变患者CT检查中给予准确判断,能有效降低放射对人体造成的伤害,建议行双源CT检查时采用85mAs的参考管电流量,既能获得准确清晰的诊断图像又能明显降低患者所受辐射剂量。%Objective to study the dual-source CT low-dose technology in the application of CT examination in patients with suspected chest lesions. Methods Selection in November 2013 to November 2014 in our hospital for inspection of 161 patients with suspected chest lesions, according to the order of patients in the hospital can be divided into 7 groups, each group of 23 cases, the 7 groups patients respectively using conventional pipe electricity flow 110 mAs and low electrical flow 105, 100, 95, 90, 85, 80 mAs measurement, comparison between groups in patients with pulmonary artery bifurcation plane the signal-to-noise ratio of pulmonary artery, pulmonary artery - sma vertical contrast to noise ratio, the descending aorta signal-to-noise ratio, the descending aorta-sma vertical contrast to noise ratio, the subjective image quality score and lesion detection

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  6. CT measurement of coronary calcium mass: impact on global cardiac risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Christoph R.; Majeed, Amal; Reiser, Maximilian F. [Ludwig-Maximilians-University Hospital Munich, Department of Clinical Radiology, Munich (Germany); Crispin, Alexander [University Hospital Munich, Department of Medical Data Processing, Biometry, and Epidemiology, Munich (Germany); Knez, Andreas; Boekstegers, Peter; Steinbeck, Gerhard [University Hospital Munich, Department of Cardiology, Munich (Germany); Schoepf, U. Joseph [Harvard Medical School, Department of Radiology, Brigham and Women' s Hospital, Boston, MA (United States)

    2005-01-01

    Coronary calcium mass percentiles can be derived from electron beam CT as well as from multidetector-row CT of all manufacturers. Coronary calcium mass may serve as a more individualized substitute for age for cardiac risk stratification. The aim was to investigate the potential impact of CT coronary calcium mass quantification on cardiac risk stratification using an adjusted Framingham score. Standardized coronary calcium mass was determined by multidetector-row CT in a total of 1,473 patients (1,038 male, 435 female). The impact on risk stratification of replacing the traditional Framingham age point score by a point score based on calcium mass relative to age was tested. Any coronary calcium found in males in the age group of 20-34 years and females in the age group of 20-59 years results in an increase of the Framingham score by 9 and 4-7 points, respectively. Only in males 65 years of age and older, none or minimal amounts of coronary calcium decrease the Framingham score by three points. The coronary calcium mass and age-related scoring system may have impact on the reassignment of patients with an intermediate Framingham risk to a lower or higher risk group. (orig.)

  7. Quantitative relationship between coronary calcium content and coronary flow reserve as assessed by integrated PET/CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Curillova, Zelmira [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); VA Boston Healthcare System, Division of Cardiology, Department of Medicine, West Roxbury, MA (United States); Yaman, Bettina F.; Sitek, Arkadius; El Fakhri, Georges [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Dorbala, Sharmila [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Kwong, Raymond Y. [Harvard Medical School, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women' s Hospital, Boston, MA (United States); Brigham and Women' s Hospital, Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Anagnostopoulos, Constantinos [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Royal Brompton Hospital, Department of Nuclear Medicine, London (United Kingdom); Di Carli, Marcelo F. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Harvard Medical School, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women' s Hospital, Boston, MA (United States); Brigham and Women' s Hospital, Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Boston, MA (United States)

    2009-10-15

    To evaluate the relationship between coronary artery calcium (CAC) and coronary vasodilator function. We evaluated 136 patients without known coronary artery disease (CAD) undergoing vasodilator stress {sup 82}Rb PET/CT and CAC scoring who showed normal myocardial perfusion. The CAC score, resting and hyperemic myocardial blood flow (MBF), coronary flow reserve (CFR) and coronary vascular resistance were analyzed. Global and regional CAC scores showed significant but weak inverse correlations with hyperemic MBF (r=-0.31 and r=-0.26, p{<=}0.0002 respectively) and CFR (r=-0.28 and r=-0.2, p{<=}0.001 respectively). With increasing CAC score, there was a modest stepwise decline in CFR on a per-patient basis (1.8{+-}0.5 vs 1.7{+-}0.5 vs 1.5{+-}0.4, p=0.048, with total CAC=0, 1-400 and >400, respectively) and on a per-vessel basis. In multivariable modeling only body mass index and CAC score were predictive of CFR. In patients with an intermediate likelihood of, but without overt, CAD, there is a statistically significant but weak inverse correlation between CAC content and coronary vasodilator function. The strength of this association weakens after adjusting CAC scores for age, gender and coronary risk factors. This suggests that CAC and coronary vasodilator function provide biologically different information regarding atherosclerosis. (orig.)

  8. 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...

  9. Improved non-calcified plaque delineation on coronary CT angiography by sonogram-affirmed iterative reconstruction with different filter strength and relationship with BMI.

    Science.gov (United States)

    Zhao, Lei; Plank, Fabian; Kummann, Moritz; Burghard, Philipp; Klauser, Andrea; Dichtl, Wolfgang; Feuchtner, Gudrun

    2015-04-01

    To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP). A total of 57 patients [28.1% females; body mass index (BMI) 29.2±6.5 kg/m(2)] were investigated. CCTA was performed using 128-slice dual-source CT. Images were reconstructed with standard FBP and sinogram-affirmed IR using different filter strength (IR-2, IR-3, IR-4) (SAFIRE, Siemens, Germany). Image quality of CCTA and a non-calcified plaque outer border delineation score were evaluated by using a 5-scale score: from 1= poor to 5= excellent. Image noise, contrast-to-noise ratio (CNR) of aortic root, left main (LM) and right coronary artery, and the non-calcified plaque delineation were quantified and compared among the 4 image reconstructions, and were compared between different BMI groups (BMI BMI groups within same reconstruction (all P>0.05). Significant differences in image quality and plaque delineation scores among different image reconstructions both in low and high BMI groups (all PBMI is increasing. Importantly, 18% of non-calcified plaques were missed with FBP. IR-4 shows the best image quality score and plaque delineation score among the different IR-filter strength.

  10. 单次对比增强双源双能量CT血管成像评估颅内出血及其原因%Evaluation of intracranial hemorrhage and its causes by single-contrast-enhanced dual-source dual-energy CT angiography

    Institute of Scientific and Technical Information of China (English)

    柴学; 张龙江; 盛会雪; 金征宇; 张兆琪; 卢光明

    2012-01-01

    目的 随着双源CT在临床的推广应用,双源CT双能量成像已成为研究热点.文中探讨单次对比增强的双源双能量CT血管血管成像 (CT angiography,CTA)对评估颅内出血及其原因的应用价值.方法对43例蛛网膜下腔出血患者进行双源CT头颅常规平扫(conventional nonenhanced CT,CNCT)及对比增强双能量CT扫描(80kV/400mA和140kV/95mA).利用Liver VNC软件进行对比增强双能量CT数据处理得到虚拟平扫(virtual nonenhanced CT,VNCT)数据,与CNCT检出的蛛网膜下腔出血比较,分析CNCT和VNCT的图像质量、辐射剂量、平均CT值、信噪比、对比噪声比及病灶检出率的差异.利用双能量CTA判断颅内血管异常,并与数字减影血管造影(digital subtraction angiography,DSA)所检出的病变比较诊断符合率.结果 双能量VNCT的图像质量低于常规平扫(Z值=-6.576,P<0.01),但可满足临床诊断要求.VNCT的正常脑组织及出血区CT值、信号噪声比(signal-to-noise ratio,SNR)及对比噪声比(contrast-to-noise ratio,CNR)低于CNCT(P<0.01).VNCT和CNCT对病灶的检出结果 相似.在43例临床疑有脑血管病变的患者中,双能量CTA检出25例患者为动脉瘤,4例为动静脉畸形,3例为烟雾病,11例为阴性,与DSA或手术证实结果 完全一致.双能量CTA患者接受的辐射剂量明显低于常规DSA(P<0.01).结论 从双源双能量CT中获得VNCT平扫图像可用于诊断颅内出血,图像质量可满足临床诊断需要.双能量CTA与DSA的诊断符合率很高.应用该技术可减少每次平扫所接受的辐射剂量,具有潜在的临床应用价值.%Objective Dual-source dual-energy CT imaging is becoming a focus of research with its wide clinical application . This study aimed to investigate intracranial hemorrhage and its causes by single contrast-enhanced dual-source dual-energy CT angiography (CTA). Methods Forty-three patients suspected of subarachnoid hemorrhage underwent head conventional

  11. Coronary artery calcification detected by a mobile helical CT unit in a mass screening. The frequency and relationship to coronary risk factors and coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Itani, Yasutaka; Watanabe, Shigeru; Masuda, Yoshiaki [Chiba Univ. (Japan). School of Medicine; Hanamura, Kazuhisa; Asakura, Kazuhiro; Sone, Shusuke; Sunami, Yuko; Shimura, Akimitsu; Miyamoto, Tadaaki

    2001-06-01

    A strong relationship is known to exist between coronary artery disease (CAD) and coronary artery calcification (CAC) detected by CT. In this study, we investigated the frequency of CAC and the relationship between coronary risk factors, CAD and CAC in a mass screening using a mobile helical CT unit. The total number of participants was 10008 people undergoing a medical examination for lung cancer and tuberculosis using a mobile helical CT unit. We measured the CT density of the coronary artery to detect CAC. The CT density threshold for determining CAC was above +110HU. The frequency of CAC was 16.0% in the overall patient population and significantly higher in males than in females (20.6% vs 10.7%). Frequency increased with age in both genders. Hypertension and diabetes mellitus were significantly related to CAC. Smoking showed a correlation with CAC only in males. A significant relationship was observed between CAD and CAC in males. In particular, the relationship between them was strongest in males under 60 years of age. Furthermore, the odds ratio of CAC in predicting CAD increased with increasing risk factors in both genders. (author)

  12. Coronary CT Angiography in Heavily Calcified Coronary Arteries: Improvement of Coronary Lumen Visualization and Coronary Stenosis Assessment With Image Postprocessing Methods

    Science.gov (United States)

    Sun, Zhonghua; Ng, Curtise K.C.; Xu, Lei; Fan, Zhanming; Lei, Jing

    2015-01-01

    Abstract To compare the diagnostic value of coronary CT angiography (CCTA) with use of 2 image postprocessing methods (CCTA_S) and (CCTA_OS) and original data (CCTA_O) for the assessment of heavily calcified plaques. Fifty patients (41 men, 9 women; mean age 61.9 years ± 9.1) with suspected coronary artery disease who underwent CCTA and invasive coronary angiography (ICA) examinations were included in the study. Image data were postprocessed with “sharpen” and smooth reconstruction algorithms in comparison with the original data without undergoing any image postprocessing to determine the effects on suppressing blooming artifacts due to heavy calcification in the coronary arteries. Minimal lumen diameter and degree of stenosis were measured and compared between CCTA_S, CCTA_OS, and CCTA_O with ICA as the reference method. The area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC) was also compared among these 3 CCTA techniques. On a per-vessel assessment, the sensitivity, specificity, positive predictive value and negative predictive value, and 95% confidence interval (CI) were 100% (95% CI: 89%, 100%), 33% (95% CI: 22%, 45%), 41% (95% CI: 30%, 53%), 100% (95% CI: 85%, 100%) for CCTA_O, 94% (95% CI: 79%, 99%), 66% (95% CI: 54%, 77%), 57% (95% CI: 43%, 70%), and 95% (95% CI: 85%, 99%) for CCTA_S, 94% (95% CI: 79%, 99%), 44% (95% CI: 32%, 57%), 44% (95% CI: 32%, 57%), and 97% (95% CI: 79%, 99%) for CCTA_OS, respectively. The AUC by ROC curve analysis for CCTA_S showed significant improvement for detection of >50% coronary stenosis in left anterior descending coronary artery compared to that of CCTA_OS and CCTA_O methods (P coronary stenosis in the left circumflex and right coronary arteries (P > 0.05). CCTA with “sharpen” reconstruction reduces blooming artifacts from heavy calcification, thus, leading to significant improvement of specificity and positive predictive value of CCTA in patients with heavily calcified

  13. Feasibility and accuracy of tissue characterization with dual source computed tomography

    NARCIS (Netherlands)

    Van Abbema, Joanne K.; Van der Schaaf, Arjen; Kristanto, Wisnu; Groen, Jaap M.; Greuter, Marcel J. W.

    2012-01-01

    PURPOSE: To evaluate the feasibility and accuracy of a model for tissue characterization with dual source computed tomography (DSCT). METHODS AND MATERIALS: A model for tissue characterization in CT was used with a parameterization of linear attenuation coefficients. Sixteen chemical substances with

  14. 双源CT全脑灌注对短暂性脑缺血发作脑血流动力学变化的评价%The evaluation of cerebral hemodynamic changes of transient ischemic attack in dual source CT perfusion

    Institute of Scientific and Technical Information of China (English)

    卞力勇

    2015-01-01

    Objective To explore cerebral hemodynamic changes of transient ischemic attack(TIA)in dual source CT perfusion(CTP). Method Twenty patients with suspected TIA underwent plain CT and CTP within 24h of the onset of symptoms. The results of the abnormal regions of the cerebral blood flow and the contralatcral normal region were comparatively analyzed. Result Lacunar infarction were found in 15 out of 20 patients who were all with abnormal perfusion area. The imaging results demonstrated that significantly larger time to peak(TTP) delay in 20 patients with abnormal perfusion area was found compared with that in contralateral normal region(P 0.05),and no significant change of cerebral blood flow(CBF) was found.Conclusion CTP with dual source CT can accurately display cerebral hemodynamic changes of transient ischemic attack(TIA) and provides objective evidence for early diagnosis and treatment.%目的:探讨双源CT全脑灌注对短暂性脑缺血发作(transient ischemic attack, TIA)血流动力学改变的临床价值。方法临床拟诊TIA患者20例,均在症状出现24小时内行头颅CT平扫及CT Perfusion检查,将脑血流异常区与健侧对应区的情况做对比分析。结果20例患者中,15例患者出现腔梗改变。20例患者均出现灌注异常区,患侧达峰时间(time to peak,TTP)时间较健侧明显延长(P0.05),所有患者脑血流量(cerebral blood flow,CBF)无明显改变。结论双源CT全脑灌注能较好地反映TIA脑血流动力学变化,为早期诊断、治疗提供客观依据。

  15. Dual energy perfusion imaging using dual source CT in the diagnosis and clinical application of pulmonary embolism%双源CT双能量肺灌注成像对肺栓塞的诊断和临床应用价值

    Institute of Scientific and Technical Information of China (English)

    周运锋; 史河水; 崔立明; 蒋日峰; 李欣; 刘永华; 韩萍

    2012-01-01

    Objective:To investigate the value of dual energy pulmonary perfusion imaging using dual source CT in the diagnosis and clinical application of pulmonary artery embolism (PE). Methods: Seventy-eight consecutive patients suspected of having PE underwent CT pulmonary arteriography with dual-energy technique on a dual source CT scanner. CT pulmonary arteriography (CTPA) and perfusion blood volume (PBV) images after post-processing of the raw data were obtained. Evaluation of the PBV image quality and typing of PE were performed by two radiologists as well as to observe the presence,location,extent of PE. The PBV appearances and its relationship with CTA images as well as pulmonary parenchyma abnormities were analyzed. The consistency of the 2 observers in evaluating the PBV image quality and typing were examined by Kappa value. The sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of PBV images for the diagnosis of PE were calculated. Results:The ranking of PBV image quality and typing showed very good agreement between two observers,the K value was 0. 87 and 0. 80, respectively (Pdual source CT.%目的:探讨双源CT双能量肺灌注成像对肺动脉栓塞的诊断和临床应用价值.方法:对疑诊肺动脉栓塞的78名患者行双源CT肺动脉成像双能量扫描,数据经后处理得到肺动脉血管图像(CTA)和肺灌注图像(PBV).两位医师对PBV图像进行质量评价和分型,同时观察CTA图像有无栓塞以及栓塞的部位、程度.分析PBV图像的表现与CTA图像、肺部异常改变的关系.用Kappa系数检验两

  16. 双源CT Flash扫描模式对复杂性先天性心脏病临床诊断价值研究%Study on Clinical Diagnostic Value for Diagnosing Complex Congenital Heart Disease with Flash Spiral Mode of Dual-source CT

    Institute of Scientific and Technical Information of China (English)

    肖红; 杨立; 刘艳

    2015-01-01

    目的 探讨双源CT Flash扫描模式应用于复杂性先天性心脏病的诊断价值.方法 对20例经手术证实的复杂先心病患者的心脏双源CT和超声心动图检查资料进行回顾性分析.结果 心脏内部畸形共41处,双源CT检出30处,超声心动图检出40处,两者诊断正确率分别为73.17%(30/41)和97.56%(40/41),差异具有统计学意义(x2=7.91,P=0.0049);心脏血管连接处畸形共有14处,双源CT检出13处,超声心动图检出12处,两者诊断正确率分别为92.86%(13/14)和85.71%(12/14),差异无统计学意义(x2=0.74,P=0.3875);心脏周围血管畸形41处,双源CT检出39处,超声心动图检出28处,两者诊断正确率分别为95.12%(39/41)和68.29%(28/41),差异具有统计学意义(x2=8.15,P=0.0042).全部畸形共96处,双源CT检出82处,正确率为85.42%,超声心动图检出80处,正确率为83.33%,两者比较差异无统计学意义(x2=0.15, P=0.6985).结论 双源CT对于先天性心脏病心脏周围血管部分畸形的诊断具有明显优势;对于整体诊断,双源CT和超声心动图的诊断能力没有明显差异.%Objective To evaluate the diagnostic value and surgery significance of dual-source CT Flash spiral model for diagnosing complex congenital heart disease. Methods Retrospectively analysis the 20 children with complex congenital heart disease, all of them were examined by the Flash CT and echocardiograph,and received surgical operation treatment. Results There were 41intracardiac deformities.30(73.17%) were detected by Flash CT and 40(97.56%) were detected by echocardiograph,a statistically significant difference between the diagnosis accuracy of Flash CT and echocardiograph (x2=7.91 ,P=0.0049). There were 14 heart-vessel conjunction deformities.13 (92.86%) were detected by Flash CT and 12 (85.71%) were detected by echocardiograph,their diagnosis accuracy had no difference (x2=0.74,P=0.3875).There were 41 great vessel deformities. 39 (95.12%) were detected by Flash CT and 28

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore investig......BACKGROUND: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore...... investigated the relationship between gender, CAC and use of subsequent invasive coronary angiography and coronary revascularisation in a cohort of patients with chest discomfort and low to intermediate pretest probability of coronary artery disease who underwent a CCTA at our diagnostic centre. METHODS......-up was 28.5% in men versus 18.3% in women (pCAC-adjusted HR in women versus men was 0.98 (95% CI 0.85 to 1.13) for invasive coronary angiography and 0.73 (95% CI 0.57 to 0.93) for coronary...

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

    LENUS (Irish Health Repository)

    Ryan, E Ronan

    2012-02-01

    A 41-year-old man collapsed after lifting weights at a gym. Following admission to the emergency department, a 64-slice cardiac computed tomography (CT) revealed a Stanford Type A aortic dissection arising from a previous coarctation repair. Multiphasic reconstructions demonstrated an unstable, highly mobile aortic dissection flap that extended proximally to involve the right coronary artery ostium. Our case is an example of the application of electrocardiogram-gated cardiac CT in directly visualizing involvement of the coronary ostia in acute aortic dissection, which may influence surgical management.

  19. Coronary CT angiography: IVUS image fusion for quantitative plaque and stenosis analyses

    Science.gov (United States)

    Marquering, Henk A.; Dijkstra, Jouke; Besnehard, Quentin J. A.; Duthé, Julien P. M.; Schuijf, Joanne D.; Bax, Jeroen J.; Reiber, Johan H. C.

    2008-03-01

    Rationale and Objective: Due to the limited temporal and spatial resolution, coronary CT angiographic image quality is not optimal for robust and accurate stenosis quantification, and plaque differentiation and quantification. By combining the high-resolution IVUS images with CT images, a detailed representation of the coronary arteries can be provided in the CT images. Methods: The two vessel data sets are matched using three steps. First, vessel segments are matched using anatomical landmarks. Second, the landmarks are aligned in cross-sectional vessel images. Third, the semi-automatically detected IVUS lumen contours are matched to the CTA data, using manual interaction and automatic registration methods. Results: The IVUS-CTA fusion tool facilitates the unique combined view of the high-resolution IVUS segmentation of the outer vessel wall and lumen-intima transitions on the CT images. The cylindrical projection of the CMPR image decreases the analysis time with 50 percent. The automatic registration of the cross-vessel views decreases the analyses time with 85 percent. Conclusions: The fusion of IVUS images and their segmentation results with coronary CT angiographic images provide a detailed view of the lumen and vessel wall of coronary arteries. The automatic fusion tool makes such a registration feasible for the development and validation of analysis tools.

  20. Feasibility of prospectively ECG-triggered high-pitch coronary CT angiography with 30 mL iodinated contrast agent at 70 kVp: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Long Jiang; Qi, Li; Tang, Chun Xiang; Zhou, Chang Sheng; Ji, Xue Man; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Wang, Jing [Medical School of Nanjing University, Department of Cardiology, Jinling Hospital, Nanjing, Jiangsu (China); Spearman, James V.; De Cecco, Carlo Nicola; Meinel, Felix G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2014-07-15

    To evaluate the feasibility, image quality and radiation dose of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) with 30 mL contrast agent at 70 kVp. Fifty-eight patients with suspected coronary artery disease, a body mass index (BMI) of less than 25 kg/m{sup 2}, sinus rhythm and a heart rate (HR) of less than 70 beats per minute (bpm) were prospectively enrolled in this study. Thirty mL of 370 mg I/mL iodinated contrast agent was administrated at a flow rate of 5 mL/s. All patients underwent prospectively ECG-triggered high-pitch CCTA on a second-generation dual-source CT system at 70 kVp using automated tube current modulation. Fifty-six patients (96.6 %) had diagnostic CCTA images and two patients (3.4 %) had one vessel with poor image quality each rated as non-diagnostic. No significant effects of HR, HR variability and BMI on CCTA image quality were observed (all P > 0.05). Effective dose was 0.17 ± 0.02 mSv and the size-specific dose estimate was 1.03 ± 0.13 mGy. Prospectively ECG-triggered high-pitch CCTA at 70 kVp with 30 mL of contrast agent can provide diagnostic image quality at a radiation dose of less than 0.2 mSv in patients with a BMI of less than 25 kg/m{sup 2} and an HR of less than 70 bpm. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

  2. Coronary heart disease risk assessment and characterization of coronary artery disease using coronary CT angiography: comparison of asymptomatic and symptomatic groups

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Y. [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Kim, Y., E-mail: yookkim@ewha.ac.k [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Chung, I.-M. [Division of Cardiology in Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Ryu, J.; Park, H. [Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2010-08-15

    Aim: To evaluate the prevalence of coronary artery disease (CAD) in relation to risk of coronary heart disease (CHD) and assess plaque characteristics from coronary computed tomography (CT) angiography in asymptomatic and symptomatic patients. Materials and methods: Three hundred and ninety consecutive patients [asymptomatic group, n = 138; symptomatic group (atypical or non-anginal chest pain), n = 252] were retrospectively enrolled. They were subsequently classified into three CHD risk categories, based on the National Cholesterol Education Program guidelines, and 10 year risks of coronary events were calculated using Framingham risk score. CT was evaluated for stenosis, plaque composition, and coronary calcium scores. Results: CAD was observed in 42% of the asymptomatic group and 62% of the symptomatic group. In the former, the prevalence of CAD in low-, moderate- and high-risk subgroups was 21.4, 47.4 and 65%, respectively, and was 33.3, 74.4, and 72.4% in the symptomatic group. Framingham 10-year risks of coronary events were significantly higher in patients with CAD than in normal participants, and receiver operating characteristics curves showed that discriminatory power was poor in the asymptomatic group and symptomatic men, and good in symptomatic women. Of the participants in the asymptomatic group, 12% exhibited only non-calcified plaques and of the symptomatic group, 7% exhibited only non-calcified plaques. The coronary calcium score was significantly higher for significant stenosis than for non-significant stenosis in both groups. Conclusions: The prevalence of CAD was not negligible even in subgroups with low-to-moderate CHD risk. Additionally, the Framingham risk score was effective for predicting CAD only in symptomatic women. Coronary calcium scores correlated with significant stenosis; however, a sizeable percentage of both groups had only non-calcified plaques.

  3. Clinical evaluation of new automatic coronary-specific best cardiac phase selection algorithm for single-beat coronary CT angiography.

    Science.gov (United States)

    Wang, Hui; Xu, Lei; Fan, Zhanming; Liang, Junfu; Yan, Zixu; Sun, Zhonghua

    2017-01-01

    The aim of this study was to evaluate the workflow efficiency of a new automatic coronary-specific reconstruction technique (Smart Phase, GE Healthcare-SP) for selection of the best cardiac phase with least coronary motion when compared with expert manual selection (MS) of best phase in patients with high heart rate. A total of 46 patients with heart rates above 75 bpm who underwent single beat coronary computed tomography angiography (CCTA) were enrolled in this study. CCTA of all subjects were performed on a 256-detector row CT scanner (Revolution CT, GE Healthcare, Waukesha, Wisconsin, US). With the SP technique, the acquired phase range was automatically searched in 2% phase intervals during the reconstruction process to determine the optimal phase for coronary assessment, while for routine expert MS, reconstructions were performed at 5% intervals and a best phase was manually determined. The reconstruction and review times were recorded to measure the workflow efficiency for each method. Two reviewers subjectively assessed image quality for each coronary artery in the MS and SP reconstruction volumes using a 4-point grading scale. The average HR of the enrolled patients was 91.1±19.0bpm. A total of 204 vessels were assessed. The subjective image quality using SP was comparable to that of the MS, 1.45±0.85 vs 1.43±0.81 respectively (p = 0.88). The average time was 246 seconds for the manual best phase selection, and 98 seconds for the SP selection, resulting in average time saving of 148 seconds (60%) with use of the SP algorithm. The coronary specific automatic cardiac best phase selection technique (Smart Phase) improves clinical workflow in high heart rate patients and provides image quality comparable with manual cardiac best phase selection. Reconstruction of single-beat CCTA exams with SP can benefit the users with less experienced in CCTA image interpretation.

  4. Compare and Research the Radiation dose and Image Quality on Dual Energy Dual Source Spiral CT Pulmonary Artery Imaging%双源双能量螺旋CT肺动脉成像辐射剂量与图像质量的对比研究

    Institute of Scientific and Technical Information of China (English)

    张筱双

    2015-01-01

    Objective To compare the difference of the radiation dose and image quality on dual energy dual source spiral CT pulmonary artery imaging.Methods 80 cases of pulmonary embolism patients in our hospital were selected as the research object. All patients were willing to accept CTPA examination, 40 cases in each group. A group used tube voltage 80/Sn140KV check, B group used tube voltage 100/Sn140KV examination, compared two groups’ pulmonary artery, pulmonary artery, the dorsal fat CT value, other indicators and CT image treatment subjective evaluation, calculation of signal to noise ratio (SNR), contrast to noise ratio (CNR) and effective dose (ED).Results The average CT value of A group’s pulmonary artery, mean CNR index were signiifcantly higher than those of group B(P<0.05), subjective CT image quality evaluation results show score were not signiifcantly different between A group and B group, but ed level of group A was signiifcantly lower than that of group B(P<0.05).Conclusion Dual source dual energy CT pulmonary artery imaging using scanning 80/Sn140 kV has high value in the diagnosis of CT images at the same time, and can greatly reduce the radiation dose during examination, which has clinical application and popularization value.%目的:对比第二代双源双能量螺旋CT肺动脉成像(CTPA)不同辐射剂量下CT图像质量的差异性。方法筛选我院收治的肺栓塞患者80例,作为研究对象。所有患者均自愿接受CTPA检查,每组40例,其中A组管电压80/Sn140KV检查,B组管电压100/Sn140KV检查,比较两组患者肺动脉主干、肺动脉段、背部脂肪CT值等指标,并对CT影像治疗进行主观评分,计算信噪比(SNR)、对比噪声比(CNR)、有效剂量(ED)等。结果 A组患者肺动脉平均CT值、平均CNR指标明显高于B组(P<0.05),主观CT影像质量评价结果显示A组与B组评分无显著差异,但A组ED水平明显低于B组(P<0.05)。结论

  5. 双源CT双能量肺动脉血管成像技术早期诊断肺动脉栓塞患者的实效性评价%The Effectiveness of Dual-source Dual-energy CT Pulmonary Angiography of the Early Diagnosis of Patients with Pulmonary Embolism

    Institute of Scientific and Technical Information of China (English)

    李卫星; 姚菁菁

    2015-01-01

    Objective To investigate the effectiveness of dual-source dual-energy CT pulmonary angiography of the early diagnosis of patients with pulmonary embolism. Methods 40 patients with suspicious pulmonary disease were chosen in our hospital to receive treatment. All patients are dual-source dual-energy CT scan lung machine, with dual-energy scan data evaluation software were analyzed and the lungs into upper, middle and lower, the energy imaging were analyzed. MPR, MIP, VR, CTVE technology to reconstruct the original data were used. Results In 40 patients, 18 patients were diagnosed with pulmonary embolism, pneumonia in 4 patients, 3 patients with lung cancer, 15 patients with normal. 18 cases of patients with pulmonary embolism, a total of 218 emboli, which of central emboli 90, eccentric 46, mural-type 42, type 40 totally were occluded. 15 normal patients, their lung tissue perfusion were analyzed, the upper lungs and lungs, middle and lower comparative analysis, the difference was not statistically significant (t= 1.149,1.021,1.027,1.135, P> 0.05). The normal lung tissue perfusion and pulmonary embolism were analyzed, the upper lungs and lungs, middle and lower comparative analysis, the difference was not statistically significant (t = 6.394,6.092,6.607,6.862, P <0.05). Conclusion Dual-source dual-energy CT pulmonary angiography for the diagnosis of pulmonary embolism in patients has a very important sense and the ability to detect the disease at an early stage of pulmonary embolism, so it is worthy of promotion.%目的:探讨双源CT双能量肺动脉血管成像技术早期诊断肺动脉栓塞患者的实效性评价,为临床提供参考。方法选择我院2013年1月至2014年3月收治的40例可疑肺栓塞疾病患者,所有患者均以双源CT机进行肺部双能量扫描,扫描数据以双能量的评估软件分析,肺部分成上、中、下,进行能量成像分析。采用MPR、MIP、VR、CTVE技术对原始数据进行重建。结果40

  6. Computerized analysis of coronary artery disease: Performance evaluation of segmentation and tracking of coronary arteries in CT angiograms

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Chuan, E-mail: chuan@umich.edu; Chan, Heang-Ping; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella A.; Hadjiiski, Lubomir M.; Patel, Smita; Wei, Jun [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109 (United States)

    2014-08-15

    Purpose: The authors are developing a computer-aided detection system to assist radiologists in analysis of coronary artery disease in coronary CT angiograms (cCTA). This study evaluated the accuracy of the authors’ coronary artery segmentation and tracking method which are the essential steps to define the search space for the detection of atherosclerotic plaques. Methods: The heart region in cCTA is segmented and the vascular structures are enhanced using the authors’ multiscale coronary artery response (MSCAR) method that performed 3D multiscale filtering and analysis of the eigenvalues of Hessian matrices. Starting from seed points at the origins of the left and right coronary arteries, a 3D rolling balloon region growing (RBG) method that adapts to the local vessel size segmented and tracked each of the coronary arteries and identifies the branches along the tracked vessels. The branches are queued and subsequently tracked until the queue is exhausted. With Institutional Review Board approval, 62 cCTA were collected retrospectively from the authors’ patient files. Three experienced cardiothoracic radiologists manually tracked and marked center points of the coronary arteries as reference standard following the 17-segment model that includes clinically significant coronary arteries. Two radiologists visually examined the computer-segmented vessels and marked the mistakenly tracked veins and noisy structures as false positives (FPs). For the 62 cases, the radiologists marked a total of 10191 center points on 865 visible coronary artery segments. Results: The computer-segmented vessels overlapped with 83.6% (8520/10191) of the center points. Relative to the 865 radiologist-marked segments, the sensitivity reached 91.9% (795/865) if a true positive is defined as a computer-segmented vessel that overlapped with at least 10% of the reference center points marked on the segment. When the overlap threshold is increased to 50% and 100%, the sensitivities were 86

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-09-15

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

  8. Quantitative micro-CT based coronary artery profiling using interactive local thresholding and cylindrical coordinates.

    Science.gov (United States)

    Panetta, Daniele; Pelosi, Gualtiero; Viglione, Federica; Kusmic, Claudia; Terreni, Marianna; Belcari, Nicola; Guerra, Alberto Del; Athanasiou, Lambros; Exarchos, Themistoklis; Fotiadis, Dimitrios I; Filipovic, Nenad; Trivella, Maria Giovanna; Salvadori, Piero A; Parodi, Oberdan

    2015-01-01

    Micro-CT is an established imaging technique for high-resolution non-destructive assessment of vascular samples, which is gaining growing interest for investigations of atherosclerotic arteries both in humans and in animal models. However, there is still a lack in the definition of micro-CT image metrics suitable for comprehensive evaluation and quantification of features of interest in the field of experimental atherosclerosis (ATS). A novel approach to micro-CT image processing for profiling of coronary ATS is described, providing comprehensive visualization and quantification of contrast agent-free 3D high-resolution reconstruction of full-length artery walls. Accelerated coronary ATS has been induced by high fat cholesterol-enriched diet in swine and left coronary artery (LCA) harvested en bloc for micro-CT scanning and histologic processing. A cylindrical coordinate system has been defined on the image space after curved multiplanar reformation of the coronary vessel for the comprehensive visualization of the main vessel features such as wall thickening and calcium content. A novel semi-automatic segmentation procedure based on 2D histograms has been implemented and the quantitative results validated by histology. The potentiality of attenuation-based micro-CT at low kV to reliably separate arterial wall layers from adjacent tissue as well as identify wall and plaque contours and major tissue components has been validated by histology. Morphometric indexes from histological data corresponding to several micro-CT slices have been derived (double observer evaluation at different coronary ATS stages) and highly significant correlations (R2 > 0.90) evidenced. Semi-automatic morphometry has been validated by double observer manual morphometry of micro-CT slices and highly significant correlations were found (R2 > 0.92). The micro-CT methodology described represents a handy and reliable tool for quantitative high resolution and contrast agent free full length

  9. Correlations Between the Gradient of Contrast Density, Evaluated by Cardio CT, and Functional Significance of Coronary Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Orzan Marius

    2016-06-01

    Full Text Available Background: Assessment of the hemodynamic significance of a coronary artery stenosis is a challenging task, being extremely important for the establishment of indication for revascularization in atherosclerotic coronary artery stenosis. The aim of this study was to evaluate the role of a new marker reflecting the functional significance of a coronary artery stenosis, represented by the attenuation degree of contrast density along the stenosis by Coronary CT.

  10. Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Schuhbaeck, Annika; Achenbach, Stephan; Hecker, Franziska; Rixe, Johannes [University of Giessen, Department of Cardiology, Giessen (Germany); Layritz, Christian; Eisentopf, Jasmin; Pflederer, Tobias; Gauss, Soeren; Kalender, Willi; Daniel, Werner G.; Lell, Michael; Ropers, Dieter [University of Erlangen, Departments of Cardiology and Radiology, Erlangen (Germany)

    2013-03-15

    We evaluated the potential of prospectively ECG-triggered high-pitch spiral acquisition with low tube voltage and current in combination with iterative reconstruction to achieve coronary CT angiography with sufficient image quality at an effective dose below 0.1 mSv. Contrast-enhanced coronary dual source CT angiography (2 x 128 x 0.6 mm, 80 kV, 50 mAs) in prospectively ECG-triggered high-pitch spiral acquisition mode was performed in 21 consecutive individuals (body weight <100 kg, heart rate {<=}60/min). Images were reconstructed with raw data-based filtered back projection (FBP) and iterative reconstruction (IR). Image quality was assessed on a 4-point scale (1 = no artefacts, 4 = unevaluable). Mean effective dose was 0.06 {+-} 0.01 mSv. Image noise was significantly reduced in IR (128.9 {+-} 46.6 vs. 158.2 {+-} 44.7 HU). The mean image quality score was lower for IR (1.9 {+-} 1.1 vs. 2.2 {+-} 1.0, P < 0.0001). Of 292 coronary segments, 55 in FBP and 40 in IR (P = 0.12) were graded ''unevaluable''. In patients with a body weight {<=}75 kg, both in FBP and in IR, the rates of fully evaluable segments were significantly higher in comparison to patients >75 kg. Coronary CT angiography with an estimated effective dose <0.1 mSv may provide sufficient image quality in selected patients through the combination of high-pitch spiral acquisition and raw data-based iterative reconstruction. (orig.)

  11. 双源双能量CT对新疆南疆地区儿童输尿管结石的诊断价值%The Value of Dual-source Dual-energy CT in the Diagnosis of Ureteral Cal-culi in Children in Southern Xinjiang

    Institute of Scientific and Technical Information of China (English)

    马依迪丽·尼加提; 田序伟

    2015-01-01

    Objective To explore the application value of low-dose dual-source dual-energy CT in the diagnosis of urinary tract stones in children. Methods This study will explore the dual energy CT technology in southern xinjiang xinjiang regional chil-dren's disease diagnosis and differential diagnosis of ureteral calculi application value, and the image quality, the signal-to-noise ratio, lesion detection rate and identify differences, evaluate the feasibility of its application in clinical, 56 children cases CT in-spection and ultrasonic inspection group, analysis between the two groups statistically for difficult diagnosis of ureteral calculi. Results The dual source CT dual energy diagnosis of 56 cases of ureteral calculi children, all cases by ultrasound, including 1 case of abdominal segment, 3 cases of basin section, 2 cases of multiple ultrasound was not diagnosed or missed diagnosis of ureteral calculi. CT in the diagnosis of 47 cases with kidney seeper, 14 patients with moderately severe water, 9 cases with merger of urinary tract infection, 2 cases of diagnosis of urinary tuberculosis, 1 case of neurogenic bladder. Conclusion Low-dose CT in the diagnosis of dual energy not diagnosed with routine inspection method and its complications, complications were found very good diagnostic value.%目的:双源双能量低剂量CT在诊断儿童泌尿系结石中的应用价值。方法该研究将探究采用双能量CT技术在新疆南疆地区儿童输尿管结石疾病诊断和鉴别诊断的意义,然后比较其图像质量、信噪比、病变检出率这几方面,分析其在临床诊断中的可行性,将56例儿童病例分CT检查组及超声检查组,分析两组间对于难诊断型输尿管结石的统计学差异。结果双源双能量CT诊断输尿管结石儿童56例,所有病例均经过B超检查,其中1例腹段、3例盆段、2例多发输尿管结石B超未诊出或漏诊;CT诊断47例有肾积水、其中14例伴有中重度积水,9

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-05-15

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

  13. Coronary imaging quality in routine ECG-gated multidetector CT examinations of the entire thorax: preliminary experience with a 64-slice CT system in 133 patients

    Energy Technology Data Exchange (ETDEWEB)

    Delhaye, Damien; Remy-Jardin, Martine; Salem, Randa; Teisseire, Antoine; Khalil, Chadi; Remy, Jacques [Hospital Calmette, University Center of Lille, Department of Thoracic Imaging, Lille Cedex (France); Delannoy-Deken, Valerie; Duhamel, Alain [University of Lille, Department of Medical Statistics, Lille Cedex (France)

    2007-04-15

    To evaluate image quality in the assessment of the coronary arteries during routine ECG-gated multidetector CT (MDCT) of the chest. One hundred and thirty three patients in sinus rhythm underwent an ECG-gated CT angiographic examination of the entire chest without {beta}-blockers with a 64-slice CT system. In 127 patients (95%), it was possible to assess the coronary arteries partially or totally; coronary artery imaging failed in six patients (5%), leading to a detailed description of the coronary arteries in 127 patients. Considering ten coronary artery segments per patient, 75% of coronary segments were assessable (948/1270 segments). When the distal segments were excluded from the analysis (i.e., seven coronary segments evaluated per patient), the percentage of assessable segments was 86% (768/889 proximal and mid coronary segments) and reached 93% (474/508) when assessing proximal segments exclusively. The mean number of assessable segments was significantly higher in patients with a heart rate {<=}80 bpm (n=95) than in patients with a heart rate >80 bpm (n=38) (p<0.002). Proximal and mid-coronary segments can be adequately assessed during a whole-chest ECG-gated CT angiographic examination without administration of {beta}-blockers in patients with a heart rate below 80 bpm. (orig.)

  14. Coronary artery calcification scoring in low-dose ungated CT screening for lung cancer: interscan agreement.

    NARCIS (Netherlands)

    Jacobs, P.C.; Isgum, I.; Gondrie, M.J.; Mali, W.P.Th.; Ginneken, B. van; Prokop, M.; Graaf, Y. van der

    2010-01-01

    OBJECTIVE: In previous studies detection of coronary artery calcification (CAC) with low-dose ungated MDCT performed for lung cancer screening has been compared with detection with cardiac CT. We evaluated the interscan agreement of CAC scores from two consecutive low-dose ungated MDCT examinations.

  15. Coronary Artery Calcification Scoring in Low-Dose Ungated CT Screening for Lung Cancer : Interscan Agreement

    NARCIS (Netherlands)

    Jacobs, Peter C. A.; Isgum, Ivana; Gondrie, Martijn J. A.; Mali, Willem P. Th. M.; van Ginneken, Bram; Prokop, Mathias; van der Graaf, Yolanda

    2010-01-01

    OBJECTIVE. In previous studies detection of coronary artery calcification (CAC) with low-dose ungated MDCT performed for lung cancer screening has been compared with detection with cardiac CT. We evaluated the interscan agreement of CAC scores from two consecutive low-dose ungated MDCT examinations.

  16. Characteristics of coronary artery disease in symptomatic type 2 diabetic patients: evaluation with CT angiography

    Directory of Open Access Journals (Sweden)

    Zhu Zhi-yu

    2010-11-01

    Full Text Available Abstract Background Coronary artery disease (CAD is a common and severe complication of type 2 diabetes mellitus (DM. The aim of this study is to identify the features of CAD in diabetic patients using coronary CT angiography (CTA. Methods From 1 July 2009 to 20 March 2010, 113 consecutive patients (70 men, 43 women; mean age, 68 ± 10 years with type 2 DM were found to have coronary plaques on coronary CTA. Their CTA data were reviewed, and extent, distribution and types of plaques and luminal narrowing were evaluated and compared between different sexes. Results In total, 287 coronary vessels (2.5 ± 1.1 per patient and 470 segments (4.2 ± 2.8 per patient were found to have plaques, respectively. Multi-vessel disease was more common than single vessel disease (p p p p p = 0.855. Extent of CAD, types of plaques and luminal narrowing were not significantly different between male and female diabetic patients. Conclusions Coronary CTA depicted a high plaque burden in patients with type 2 DM. Plaques, which were mainly calcified, were more frequently detected in the proximal segment of the LAD artery, and increased attention should be paid to the significant prevalence of obstructive stenosis. In addition, DM reduced the sex differential in CT findings of CAD.

  17. Coronary CT angiography: Comparison of a novel iterative reconstruction with filtered back projection for reconstruction of low-dose CT—Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Takx, Richard A.P. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, Maastricht University Medical Centre, Maastricht (Netherlands); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Moscariello, Antonio [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, Policlinico Universitario Campus Bio-Medico, Rome (Italy); Das, Marco [Department of Radiology, Maastricht University Medical Centre, Maastricht (Netherlands); Rowe, Garrett [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoenberg, Stefan O.; Fink, Christian [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany); Henzler, Thomas [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University (Germany)

    2013-02-15

    Objective: To prospectively compare subjective and objective image quality in 20% tube current coronary CT angiography (cCTA) datasets between an iterative reconstruction algorithm (SAFIRE) and traditional filtered back projection (FBP). Materials and methods: Twenty patients underwent a prospectively ECG-triggered dual-step cCTA protocol using 2nd generation dual-source CT (DSCT). CT raw data was reconstructed using standard FBP at full-dose (Group{sub 1}a) and 80% tube current reduced low-dose (Group{sub 1}b). The low-dose raw data was additionally reconstructed using iterative raw data reconstruction (Group{sub 2}). Attenuation and image noise were measured in three regions of interest and signal-to-noise-ratio (SNR) as well as contrast-to-noise-ratio (CNR) was calculated. Subjective diagnostic image quality was evaluated using a 4-point Likert scale. Results: Mean image noise of group{sub 2} was lowered by 22% on average when compared to group{sub 1}b (p < 0.0001–0.0033), while there were no significant differences in mean attenuation within the same anatomical regions. The lower image noise resulted in significantly higher SNR and CNR ratios in group{sub 2} compared to group{sub 1}b (p < 0.0001–0.0232). Subjective image quality of group{sub 2} (1.88 ± 0.63) was also rated significantly higher when compared to group{sub 1}b (1.58 ± 0.63, p = 0.004). Conclusions: Image quality of 80% tube current reduced iteratively reconstructed cCTA raw data is significantly improved when compared to standard FBP and consequently may improve the diagnostic accuracy of cCTA.

  18. Coronary Artery Calcification Is Often Unreported in CT Pulmonary Angiograms in Patients With Suspected Pulmonary Embolism: An Opportunity to Improve Diagnosis of Acute Coronary Syndrome

    OpenAIRE

    Johnson, Patrick Connor

    2015-01-01

    Objective: In patients with suspected pulmonary thromboembolism (PTE), coronary artery calcification (CAC) can be an incidental finding in CT pulmonary angiograms. We evaluated the frequency of unreported CAC and its association with diagnosis of acute coronary syndrome (ACS). Methods: The data of 469 consecutive patients who were referred to the emergency radiology department for CT pulmonary angiography because of suspicion for PTE were reviewed. Radiology reports were rechecked, and pos...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-02-15

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

  20. Image Quality in Reduced-Dose Coronary CT Angiography

    NARCIS (Netherlands)

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

    2011-01-01

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

  1. Role of multi-slice CT coronary angiography in evaluating the different patterns of coronary artery disease in patients with unstable angina

    Directory of Open Access Journals (Sweden)

    Gamal Eldine M. Niazi

    2015-09-01

    Conclusion: Non-invasive multi-slice CT coronary angiography is a reliable technique of high ability to detect coronary artery disease and estimate the degree of obstruction, number of affected arteries and the pattern of their affection and can be used in workup in patients with unstable angina.

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

    Directory of Open Access Journals (Sweden)

    Guray Oncel

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-03-15

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

  4. The performance of abdominal visceral artery aneurysm angiography with dual-source CT%腹部内脏动脉瘤双源CT血管造影表现

    Institute of Scientific and Technical Information of China (English)

    岳学旺; 孔生; 孔淑红

    2015-01-01

    Objective To investigate the performance of abdominal visceral artery aneurysm in dual‐source CT angiogra‐phy (CTA) and to evaluate the clinical value of CTA in the diagnosis of abdominal visceral artery aneurysm .Methods Thirty patients of spontaneous abdominal visceral artery aneurysm were analyzed retrospectively and combined the original and post‐processing images (VR ,CPR ,MIP ,MPR) for diagnosis .Results 30 cases of patients with abdominal visceral artery aneurysm were successfully completed the CT angiography ,and the images were clear .CTA can clearly display the aneurysm ,including 3 polyarteritis nodosa patients who had multiple viscera aneurysm .Besides ,28 patients of solitary an‐eurysm included 12 cases of dplenic aneurysm ,3 cases of hepatic artery aneurysm ,8 cases of renal artery aneurysm (one of patients had aneurysm in bilateral respectively) ,1 case of celiac trunkaneurysm ,1 case of pseudoaneurysm of celiac trunk and 3 cases of superior mesenteric aneurysm .Conclusion Dual‐soure CT angiography and post‐processing technology have a good diagnostic valve for abdominal visceral artery aneurysm and relative disease and it provides the basis for clinical di‐agnosis and treatment .%目的:探讨腹部内脏动脉瘤双源CT血管造影(CTA)的表现。方法回顾性分析30例腹部内脏动脉瘤患者CT原始及后处理图像,主要应用容积显示(VR)、最大密度投影(MIP)、曲面重组(CPR)、多平面重组(MPR)等后处理技术,进行图像重建观察动脉瘤情况,并结合横断面图像对疾病进行诊断。结果30例腹部内脏动脉血管造影成功,图像清晰。CTA能清晰显示腹部内脏动脉瘤,包括3例结节性多动脉炎患者,均可见多发内脏动脉瘤,此外单发动脉瘤中包括:脾动脉瘤12例、肝动脉瘤3例、肾动脉瘤8例(1例患者双肾均可见一单发动脉瘤)、腹腔干动脉瘤1例、腹腔干假性动脉瘤1例、肠系

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  6. Preliminary study of dual energy scanning of dual source CT for diagnosing hepatic tumors%双源CT双能量扫描在肝脏肿瘤应用价值的初步探讨

    Institute of Scientific and Technical Information of China (English)

    王翔; 王涛; 王小琴

    2013-01-01

    目的 探讨双源CT(DSCT)双能量扫描在肝脏肿瘤诊断中的应用价值.方法 回顾性分析2011年4~12月该院行DSCT扫描肝脏肿瘤患者20例的临床资料.结果 患者肝脏、脾脏、腹主动脉、脊柱后缘肌肉普通平扫与虚拟平扫(P>0.05),原发性肝癌与胆管细胞癌和肝海绵状血管瘤在碘图中差异有统计学意义(P0. 05). The iodine imaging showed statistical difference between primary liver cancer with bile duct cell carcinoma and hepatic cavernous hemangioma(P<0. 05). Conclusion Dual energy scanning of DSCT has the latent clinical application value in the diagnosis of hepatic tumors.

  7. Coronary CT angiography in clinical triage of patients at high risk of coronary artery disease

    DEFF Research Database (Denmark)

    Kühl, J Tobias; Hove, Jens D; Kristensen, Thomas S

    2017-01-01

    in patients with high likelihood of coronary artery disease and could, in theory, be used to triage high risk patients. As many obstacles remain, including logistical and safety issues, our study does not support the use of CCTA as an additional diagnostic test before ICA in an all-comer NSTEMI population.......%) coronary artery diameter stenosis with a sensitivity, specificity, and positive and negative predictive value of 99%, 81%, 96% and 95%, respectively. CCTA was used to triage patients into guideline defined treatment groups of "no or medical treatment", "referral to percutaneous coronary intervention...

  8. 双源CT双能量碘图对急性坏死性胰腺炎影像的诊断价值%The Value of Dual-source Dual-energy CT with Iodine Overlay in the Diagnosis of Acute Necrotizing Pancreatitis

    Institute of Scientific and Technical Information of China (English)

    袁元; 黄子星; 李真林; 宋彬; 邓莉萍

    2012-01-01

    Objective To investigate the clinical value of dual-source computed tomography dual-energy Iodine overlay technique in the imaging diagnosis of acute necrotizing pancreatitis. Methods The imaging data were retrospectively analyzed in 67 cases of acute necrotizing pancreatitis underwent contrast-enhanced dual-source dual-energy CT in portal venous phase. The CT imaging parameters, including the difference of CT value between pancreatic parenchyma and necrotic lesion, contrast-to-noise ratio of pancreatic parenchyma-to-necrosis, area of pancreatic necrosis and score of subjective diagnosis, were measured and assessed on CT images of 80 kV, 140 kV, weighted-average 120 kV as well as Iodine overlay. Results The differences of CT value between pancreatic parenchyma and necrosis in the images of 80 kV, 140 kV, weighted-average 120 kV and Iodine overlay were (67. 40 ±20.82) HU,(42. 87±14. 99) HU, (48. 69±15. 82) HU, (33. 01 ± 10. 26) HU, respectively;contrast-to-noise ratios of pancreatic parenchyma-to-necrosis of each group were 8. 36 ± 3. 58, 5. 85±2. 65, 7. 68±3. 51, 10. 60± 4. 34;area of pancreatic necrosis of each group was (3. 78 ±2. 68) cm2, (3.28 ± 2.59) cm2, (3. 37±2. 46) cm2, (2. 42 ± 1. 98) cm2 ;the score of subjective diagnosis of each group was 3. 88 ±0. 33, 3. 31 ± 0. 80, 3. 58 ±0. 66, 2. 81 ± 0. 76, respectively. The four indexes in the images of Iodine overlay were significantly different from those of another three groups (P<0. 05). Contrast-to-noise ratio of pancreatic parenchyma-to-necrosis in the images of Iodine overlay was significantly higher than that of another three groups, while the difference of CT value, area of pancreatic necrosis and score of subjective diagnosis were lower. Conclusion Dual-source CT dual-energy Iodine overlay is not helpful to improve subjective judgment in the diagnosis of pancreatic necrosis, but contributes to the display of hypoperfusion area around the necrosis.%目的 初步探讨双源CT双能量碘

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-04-15

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

  10. 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...

  11. 双能量CT在肾癌诊断及分型中的应用%Application of dual-source dual-energy CT scanning in diagnosis and typing of renal cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    金原; 武志峰; 吴山; 刘世杰; 王沙沙

    2014-01-01

    Objective To investigate the value of dual-energy virtual unenhanced and dual-energy iodine value distribution diagram type of kidney cancer.Methods A retrospective analysis of 35 cases of renal cell carcinoma dual-energy CT scan data,compared to kidney pathology data,analyze the image quality and radiation dose dual-energy virtual unenhanced and dual energy distribution of iodine in clear cell carcinoma and non-clear cell carcinoma the differences that exist.Results Unenhanced and virtual unenhanced image quality was quite,CT value (routine unenhanced renal parenchyma 31.90±4.10 HU,abdominal aortic 45.60±6.30 HU,psoas 50.00±6.6 HU3,kidney 1.410±17.06 HU; virtual unenhanced renal parenchyma abdominal aortic 33.20±5.50 HU,48.30±8.00 HU,52.40±10.63 HU psoas kidney 0.87±17.48 HU),signal to noise ratio (routine unenhanced renal abdominal aorta 3.22±1.49,5.13±2.57,4.56±2.12 psoas kidney 3.24±2.27 virtual unenhanced renal abdominal aorta 2.73±1.08,3.79±1.64,3.23±1.35 psoas kidney 2.18± 1.57) had not significantly different (P > 0.05).Clear cell carcinoma of the skin medullart junction of iodinedistribution of images Iodine (2.75±1.05) mg/ml was higher than non-clear cell carcinoma (1.25±0.72) mg/ml,the difference was statistically significant (t =7.048,P < 0.05).Conclusions CT examination in patients with renal cell carcinoma virtual unenhanced image quality is similar with routine unenhanced image quality,it reduces radiation dose.The distribution of iodine can provide more diagnostic information that can help us be more intuitive and accurate judgments of the blood supply and kidney cancer subtypes.%目的 探讨双能量CT虚拟平扫及双能量碘分布图在肾癌诊断及分型中的应用价值.方法 收集35例肾癌患者双能量增强CT扫描数据及病理结果,分析双能量CT虚拟平扫的图像质量及辐射剂量、双能量碘分布图在透明细胞癌及非透明细胞癌中存在的差异.结果 虚拟平扫与常规平扫

  12. Non-invasive assessment of coronary artery bypass grafts - an update; Koronare Bypassdiagnostik mit CT und MRT - eine Bestandsaufnahme

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Ehrhard, K.; Kunz, R.P.; Oberholzer, K.; Mildenberger, P.; Thelen, M. [Klinik und Poliklinik fuer Radiologie der Johannes Gutenberg-Univ. Mainz (Germany); Abegunewardene, N.; Horstick, G. [2. Medizinische Klinik und Poliklinik der Johannes Gutenberg-Univ. Mainz (Germany); Hake, U. [Klinik und Poliklinik fuer Herz-Thorax- und Gefaesschirurgie der Johannes Gutenberg-Univ. Mainz (Germany)

    2004-08-01

    The limited lifetime and the correlation between graft occlusion and recurring symptoms underline the need for repeated imaging of coronary artery bypass grafts. CT and MRI allow for noninvasive imaging of coronary bypasses with high accuracies concerning the patency of these vessels. Multidetector CT seem to be the CT technique of choice, especially after the introduction of 16 slice CT scanners for morphologic assessment of coronary artery bypass grafts. Compared with MRI, CT is a robust technique for assessment of cardiac anastomoses, native coronary arteries, anf for the detection of graft stenoses. MRI, however, is able to deliver functional information about the grafts and the recipient coronary arteries by determining the coronary flow reserve. Furthermore, it can be integrated in a multiparametric MR examination protocol. The follow-up of asymptomatic patients can primarily be done by these non-invasive techniques as nearly every third patient reveals an asymptomatic bypass occlusion 5 years after operation. Furthermore, patients with atypical complaints after the operation may undergo non-invasive imaging as long as documented patency of the bypass averts coronary angiography. Patients with recurrent angina pectoris and/or myocardial ischemia discovered by other cardiologic tests have to undergo coronary angiography. (orig.)

  13. The value of dual-source dual-energy CT angiography in the diagnosis of carotid artery stenosis%双能量颈部CT血管成像诊断颈动脉狭窄性病变的价值

    Institute of Scientific and Technical Information of China (English)

    郑玲; 周长圣; 赵艳娥; 张龙江; 李敏; 刘德志; 卢光明

    2011-01-01

    Objective Carotid artery stenosis is one of the important causes of ischemic cerebrovascular diseases, for which angiography remains a chief diagnostic option. Dual-source dual-energy CT, as a newly developed technique, has its unique superiority in angiography, but reports have not seen on its application to the diagnosis of carotid artery stenosis. The authors evaluated dual-source dual-energy CT angiography ( CTA) in the diagnosis of carotid artery stenosis by comparing it with digital subtraction angiography ( DSA). Methods Forty patients first underwent dual-source dual-energy CTA and then DSA of the carotid artery within two weeks. The carotid artery was classified into common carotid artery, extracranial internal carotid artery and intracranial internal carotid artery. Carotid stenosis was rated as mild ( ≤29% ) , moderate (30% -69% ) , severe (70% - 99% ) and occlusion ( 100% ) in the analyses of CTA and DSA images. The sensitivity, specificity, accuracy, PPV and NPV of CTA in the diagnosis of carotid artery stenosis were calculated with DSA as the reference standard. Results Of 240 vessel segments in 40 patients, CTA displayed 70 with various de- grees of stenosis (mild; n = 35, moderate; n = 25, and severe; n = 10) and 170 normal segments, while DSA exhibited 75 with various degrees of stenosis (mild; n = 38, moderate; n = 24, and severe; n = 13) and 165 normal segments. With DSA as the reference standard, the sensitivity, specificity, accuracy, PPV and NPV of CTA in the detection of carotid artery stenosis were 92.0% (69/75) , 99. 4% (164/165), 97.1% (233/240), 98.6% (69/70), and 96. 5% (164/170), respectively. Conclusion Dual-source dual-energy CTA has a high sensitivity in the detection of carotid artery stenosis, which can be used in the screening and diagnosis of carotid artery stenosis as a routine modality.%目的 颈动脉狭窄是缺血性脑血管疾病发病的重要原因之一,目前,临床仍采用常规血管造影的方法对该病进

  14. Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dekker, Martijn A.M. den; Pelgrim, Gert Jan; Pundziute, Gabija; Heuvel, Edwin R. van den; Oudkerk, Matthijs; Vliegenthart, Rozemarijn, E-mail: r.vliegenthart@umcg.nl

    2015-01-15

    Highlights: • The majority of anatomical coronary stenoses do not cause myocardial ischemia. • cCTA-derived CCO decrease expresses luminal density gradient across stenosis. • CCO decrease differentiates between anatomical stenoses with and without associated myocardial ischemia. • CCO decrease assessment can exclude the majority of stenoses without hemodynamic significance. - Abstract: Purpose: We assessed the association between corrected contrast opacification (CCO) based on coronary computed tomography angiography (cCTA) and inducible ischemia by adenosine perfusion magnetic resonance imaging (APMR). Methods: Sixty cardiac asymptomatic patients with extra-cardiac arterial disease (mean age 64.4 ± 7.7 years; 78% male) underwent cCTA and APMR. Luminal CT attenuation values (Hounsfield Units) were measured in coronary arteries from proximal to distal, with additional measurements across sites with >50% lumen stenosis. CCO was calculated by dividing coronary CT attenuation by descending aorta CT attenuation. A reversible perfusion defect on APMR was considered as myocardial ischemia. Results: In total, 169 coronary stenoses were found. Seven patients had 8 perfusion defects on APMR, with 11 stenoses in corresponding vessels. CCO decrease across stenoses with hemodynamic significance was 0.144 ± 0.112 compared to 0.047 ± 0.104 across stenoses without hemodynamic significance (P = 0.003). CCO decrease in lesions with and without anatomical stenosis was similar (0.054 ± 0.116 versus 0.052 ± 0.101; P = 0.89). Using 0.20 as preliminary CCO decrease cut-off, hemodynamic significance would be excluded in 82.9% of anatomical stenoses. Conclusions: CCO decrease across coronary stenosis is associated with myocardial ischemia on APMR. CCO based on common cCTA data is a novel method to assess hemodynamic significance of anatomical stenosis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-03-15

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

  16. Diagnostic accuracy and utility of coronary CT angiography with consideration of unevaluable results: A systematic review and multivariate Bayesian random-effects meta-analysis with intention to diagnose

    Energy Technology Data Exchange (ETDEWEB)

    Menke, Jan [University Medical Center Goettingen, Institute for Diagnostic and Interventional Radiology, Goettingen (Germany); Kowalski, Joerg [Dr. Lauterbach-Klinik, Department of Cardiology, Bad Liebenstein (Germany)

    2016-02-15

    To meta-analyze diagnostic accuracy, test yield and utility of coronary computed tomography angiography (CCTA) in coronary artery disease (CAD) by an intention-to-diagnose approach with inclusion of unevaluable results. Four databases were searched from 1/2005 to 3/2013 for prospective studies that used 16-320-row or dual-source CTs and provided 3 x 2 patient-level data of CCTA (positive, negative, or unevaluable) versus catheter angiography (positive or negative) for diagnosing ≥50 % coronary stenoses. A Bayesian multivariate 3 x 2 random-effects meta-analysis considered unevaluable CCTAs. Thirty studies (3422 patients) were included. Compared to 16-40 row CT, test yield and accuracy of CCTA has significantly increased with ≥64-row CT (P < 0.05). In ≥64-row CT, about 2.5 % (95 %-CI, 0.9-4.8 %) of diseased patients and 7.5 % (4.5-11.2 %) of non-diseased patients had unevaluable CCTAs. A positive likelihood ratio of 8.9 (6.1-13.5) indicated moderate suitability for identifying CAD. A negative likelihood ratio of 0.022 (0.01-0.04) indicated excellent suitability for excluding CAD. Unevaluable CCTAs had an equivocal likelihood ratio of 0.42 (0.22-0.71). In the utility analysis, CCTA was useful at intermediate pre-test probabilities (16-70 %). CCTA is useful at intermediate CAD pre-test probabilities. Positive CCTAs require verification to confirm CAD, unevaluable CCTAs require alternative diagnostics, and negative CCTAs exclude obstructive CAD with high certainty. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Carbone, Iacopo; Cannata, David; Algeri, Emanuela; Galea, Nicola; Napoli, Alessandro; Catalano, Carlo; Passariello, Roberto; Francone, Marco [Sapienza University of Rome, Department of Radiological, Onchological and Anatomopathological Sciences, Policlinico Umberto I, Rome (Italy); De Zorzi, Andrea [Bambino Gesu Hospital, Cardiology Division, Rome (Italy); Bosco, Giovanna; D' Agostino, Rita [Sapienza University of Rome, Unit of Paediatric Cardiology, Policlinico Umberto I, Rome (Italy); Menezes, Leon [University College of London, Institute of Nuclear Medicine, London (United Kingdom)

    2011-09-15

    Kawasaki disease (KD) is a systemic vasculitis that mainly affects coronary arteries in children, and requires regular follow-up from the time of diagnosis. To evaluate the feasibility of 64-slice CT angiography (CTA) for follow-up of patients with KD using previously performed invasive catheter coronary angiography (CCA) as reference standard. The study group comprised 12 patients (age 17.6 {+-} 2.9 years, mean{+-}SD) with a diagnosis of KD and a previously performed CCA (interval, 32.6 {+-} 13.5 months) who underwent 64-slice cardiac CTA. The quality of the images for establishing the presence of coronary abnormalities was determined by two observers. The CTA findings were compared with those from the prior CCA. Adequate image quality was obtained in all patients. Mean effective dose for CTA was 6.56 {+-} 0.95 mSv. CTA allowed accurate identification, characterization and measurement of all coronary aneurysms (n = 32), stenoses (n = 3) and occlusions (n = 9) previously demonstrated by CCA. One patient with disease progression went on to have percutaneous coronary intervention. Coronary lesions were reliably evaluated by 64-slice CTA in the follow-up of compliant patients with KD, reducing the need for repeated diagnostic invasive CCA. Hence, in an adequately selected patient population, the role of CCA could be limited almost only to therapeutic procedures. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-15

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

  20. Changes in Medical Management after Coronary CT Angiography

    Directory of Open Access Journals (Sweden)

    Vânia Mairi Naue

    2015-01-01

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

  1. Changes in Medical Management after Coronary CT Angiography

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

  2. Comparison of iodinated contrast media for the assessment of atherosclerotic plaque attenuation values by CT coronary angiography: Observations in an ex vivo model

    NARCIS (Netherlands)

    L. la Grutta (Ludovico); M. Galia (Massimo); G. Gentile; G. Lo Re (G.); E. Grassedonio (Emanuele); F. Coppolino; E. Maffei (Erica); E. Maresi (E.); A. Lo Casto (A.); F. Cademartiri (Filippo); M. Midiri (Massimo)

    2013-01-01

    textabstractObjective: To compare the influence of different iodinated contrast media with several dilutions on plaque attenuation in an ex vivo coronary model studied by multislice CT coronary angiography. Methods: In six ex vivo left anterior descending coronary arteries immersed in oil, CT (slice

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  5. Relation between intravascular clots of pulmonary artery and lung perfusion defects: assessment with dual source CT low-dose contrast perfusion imaging%低剂量对比剂双能量肺灌注成像评估肺动脉内血栓与灌注缺损间的关系

    Institute of Scientific and Technical Information of China (English)

    沈比先; 谭四平; 彭冬红; 汪春荣; 贾飞鸽; 李元歌; 罗玉娟; 楚二伟

    2012-01-01

    目的:应用双源CT低剂量对比剂双能量肺灌注成像评估急性肺动脉栓塞患者血管内血栓与肺灌注缺损间的关系,以提高对肺动脉栓塞诊断的准确性.方法:随机选择无肺动脉栓塞患者的低剂量与常规剂量双能量肺灌注成像各15例,对比分析其图像质量;收集20例疑肺动脉栓塞患者行低剂量双能量肺灌注成像;同时获得肺动脉CTA及肺灌注图像.分析肺动脉内有无血栓.以及血栓的部位、数量及形态特征.用双能量肺灌注分析软件判断有无灌注缺损及缺损的部位、形态及范围.对比分析并统计肺动脉内血栓与肺灌注缺损间的关系.结果:肺动脉栓塞患者的低剂量与常规剂量双能量肺灌注成像质量无明显差异(P>0.05).20例疑似病例中,15例诊断为肺动脉栓塞,其中13例患者肺灌注图像中出现102个肺叶、肺段、或亚段灌注缺损,4例共6个灌注缺损CTA无明确血栓;11例肺动脉CTA显示43个血栓,其中9例血栓与灌注缺损同时存在,2例CTA共5个血栓肺内无灌注缺损.75个灌注缺损与栓塞肺动脉供血范围一致,21个灌注缺损(8段、13亚段)与肺动脉供血范围无关.结论:综合分析双源CT低剂量双能量肺灌注图与CTPA,可以提高肺动脉栓塞诊断的准确性.%Objective: To assess the relation between intravascular clots of pulmonary artery and lung perfusion defects with dual source CT low-dose contrast perfusion imaging so as to elevate the accuracy of diagnosis of PE. Methods: The image quality of low-dose and conventional dose dual energy lung perfusion imaging (DEPI) of patients without pulmonary embolism (PE). With 15 cases in each sose, were analyzed. Twenty consecutive patients with suspected PE underwent dual source CT low-dose contrast perfusion imaging and CT pulmonary angiography (CTPA) and lung perfusion images were aquired at the same time. The intravascular clots of pulmonary artery if or not, including the

  6. Relation between intravascular clots of pulmonary artery and lung perfusion defects: assessment with dual source CT low-dose contrast perfusion imaging%双源CT低剂量对比剂肺灌注成像评估肺动脉内血栓与灌注缺损间的关系

    Institute of Scientific and Technical Information of China (English)

    谭四平; 沈比先; 陈丽兴; 薛水培; 楚二伟; 刘康; 汪春荣; 贾飞鸽

    2012-01-01

    Objective: To assess the relation between intravascular clots of pulmonaiy artery and lung perfusion defects with dual source CT low-dose contrast perfusion imaging. Materials and Methods: Image quality of low-dose and conventional dose dual energy lung perfusion imaging (DEP1) in 15 patients without pulmonary embolism (PE) was analyzed. Twenty consecutive patients with suspected PE underwent dual source CT low-dose contrast perfusion imaging. CT pulmonary angiogra-phy (CTPA) and lung perfusion images were analyzed at the same time. Intravascular clots of pulmonary artery were analyzed,including the location,number and morphology by the axial image and three-dimensional reconstruction of CTPA. Lung perfusion defects and its location,extent were evaluated with lung PBV software on the workstation. The relationship between in-trava8Cular clots of pulmonary artery and lung perfusion defects were analyzed statistically. Results: No significant difference was found in the image quality of low-dose and conventional dose DEPI of patients without PE(P>0.05). One hundred and two perfusion defects were found in 13 patients by pulmonary perfusion imaging,including lobular,segmental and BubsegmentaJ perfusion defects. Six perfusion defects in 4 cases had no clear intravascular clots. Images of axial CTPA and three-dimensional reconstruction showed 43 intravascular clots in 11 patients. Two cases with 5 intravascular clots depicted by CTPA showed no perfusion defects. Nine cases showed both intravascular clots and perfusion defects,with 21 perfusion defects unrelated to the blood supply areas of pulmonary artery(8 segmental and 13 subsegmental),and the remaining 75 perfusion defects consistent with the blood supply areas of pulmonary artery. Conclusion: There is unexpected dissociation between the intravascular clots of pulmonary artery and lung perfusion defects. Analysing the perfusion maps and CTPA of dual source CT low-dose contrast perfusion image will improve the accuracy

  7. 双源双能量CT评价兔VX2移植瘤介入术疗效的实验研究%The laboratory research of dual-source and dual-energy CT in evaluating the effect of rabbit VX2 tumor interventional therapy

    Institute of Scientific and Technical Information of China (English)

    祁克信; 劳群; 贾玉柱

    2013-01-01

    Objective To explore the diagnostic value of the dual-energy technique with dual-source in the evaluation of therapeutic effect of interventional therapy for hepatocarcinoma.Methods 8 rabbits with tumor growing well were treated with intervention operation,paralleled with double energy CT scan and focal area image,CT and color order change were measured by dual energy liver OVERLAY workstation.Meanwhile,The necrosis and survival of tumor were evaluated by dual energy CT after hepatocarcinoma intervention therapy.Results Taking pathologic diagnosis as gold standard,compared with imaging and pathological results in the order of black,red,orange and red,accuracies were 87.2%,72.3%,71.5% and 83.6% respectively.Sensitivities were 95.1%,37.4%,54.7% and 63.8% respectively.Specificities were 85.4%,86.3%,81.5% and 85.8% respectively.Positive predictives value were 61.4%,54.2%,62.4% and 55.6% respectively.Negative predictive values were 96.3%,76.2%,79.7% and 91.3 % respectively.According to the Spearman relevance analysis,there was strong positive correlation between survival of tumor cells and image color scale (r =12.35,P < 0.05).Conclusion The necrosis and survival of tumor cells in rabbit VX2 liver tumor model can be preliminarily reflected by dual source CT dual energy enhancement scanning.The results provide good reference to the application of dual-source and dual-energy in clinical diagnosis and treatment.%目的 探讨双源双能量CT评价肝癌介入治疗疗效的价值.方法 8只生长良好的荷瘤兔,行介入手术,并进行双源双能量CT扫描,利用双源工作站OVERLAY信息图像,测量病灶区CT值,并记录其色阶变化,探讨双能量CT在肝癌介入治疗后肿瘤存活与坏死情况.结果 以全部的病理诊断为金标准,经过病理和影像对照分析,按黑色、暗红色、红色、橘红色顺序,色阶准确度分别为87.2%、72.3%、71.5%、83.6%,敏感度分别为95.1

  8. 双源螺旋CT灌注孤立性肺结节的诊断技术及临床价值分析%The Analysis on Diagnosis Technology and Clinical Value of Perfusion Solitary Pulmonary Nodules of Dual Source Spiral CT

    Institute of Scientific and Technical Information of China (English)

    李雪萍; 刘彪; 黄波; 毛健强; 莫家强; 黄伟兰; 梁岳杰

    2014-01-01

    目的:研究比较双源螺旋CT灌注成像对于孤立性肺结节(SPN)良恶性的诊断价值及临床应用。方法对于我院2011年11月至2013年12月50例未经治疗的直径≤3.0cm的肺孤立结节根据病理结果分为恶性结节组和良性结节组,分别进行双源螺旋CT灌注成像,计算结节的血流量(BF)、血容量(BV)、平均通过时间(MTT)和通透性值(Permeability,PMB)。同时绘制同层面结节的时间-密度曲线(TAC),判断结节良恶性,和手术病理结果进行对比分析,计算各灌注参数对于孤立性肺结节良恶性诊断的准确率、敏感性和特异性。结果经CT引导下肺穿刺活检或手术病理证实,发现恶性结节34例,良性结节16例。两组结节的各灌注参数差异显著, P<0.01;同层面结节的TAC曲线良恶性差异显著,有助于提示结节性质,血容量(BV)、平均通过时间(MTT)、血流量(BF)和通透性值(PMB)对于孤立性肺结节良恶性诊断的准确率、敏感性和特异性分别为88%,88.24%,87.50%;90%,94.12%,%Objective research and compare the diagnosis value and clinical application of optimum and malignant influence of dual source spiral CT perfusion imaging on solitary pulmonary nodules (SPN). Methods According to the pathological results, the 50 cases of untreated solitary pulmonary nodules with Diameter of≤3.0cm from November 2011 to December 2013 can be divided into malignant nodules group and benign nodules group, and conduct dual source spiral CT perfusion imaging on each group, calculate the blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability (PMB) of nodules. At the same time, draw the time-density curve in the same level node (TAC) to judge the optimum and malignant influence of nodules and the operation pathology results to conduct compare and analysis, calculate the accuracy, sensitivity and specificity of each perfusion parameters on the malignant and benign

  9. Non-invasive assessment of functionally relevant coronary artery stenoses with quantitative CT perfusion: preliminary clinical experiences

    Energy Technology Data Exchange (ETDEWEB)

    So, Aaron [Lawson Health Research Institute, Imaging Program, London, Ontario (Canada); Robarts Research Institute, Imaging Research Laboratories, London, Ontario (Canada); University of Western Ontario, Medical Biophysics, London, Ontario (Canada); Wisenberg, Gerald [Lawson Health Research Institute, Imaging Program, London, Ontario (Canada); University of Western Ontario, Medical Biophysics, London, Ontario (Canada); University of Western Ontario, Medical Imaging, London, Ontario (Canada); London Health Sciences Centre, Cardiology, London, Ontario (Canada); Islam, Ali; Amann, Justin; Romano, Walter [University of Western Ontario, Medical Imaging, London, Ontario (Canada); St. Joseph' s Health Care, Radiology, London, Ontario (Canada); Brown, James; Humen, Dennis; Jablonsky, George [London Health Sciences Centre, Cardiology, London, Ontario (Canada); Li, Jian-Ying; Hsieh, Jiang [GE Healthcare, CT Engineering, Waukesha, Wisconsin (United States); Lee, Ting-Yim [Lawson Health Research Institute, Imaging Program, London, Ontario (Canada); Robarts Research Institute, Imaging Research Laboratories, London, Ontario (Canada); University of Western Ontario, Medical Biophysics, London, Ontario (Canada); University of Western Ontario, Medical Imaging, London, Ontario (Canada)

    2012-01-15

    We developed a quantitative Dynamic Contrast-Enhanced CT (DCE-CT) technique for measuring Myocardial Perfusion Reserve (MPR) and Volume Reserve (MVR) and studied their relationship with coronary stenosis. Twenty-six patients with Coronary Artery Disease (CAD) were recruited. Degree of stenosis in each coronary artery was classified from catheter-based angiograms as Non-Stenosed (NS, angiographically normal or mildly irregular), Moderately Stenosed (MS, 50-80% reduction in luminal diameter), Severely Stenosed (SS, >80%) and SS with Collaterals (SSC). DCE-CT at rest and after dipyridamole infusion was performed using 64-slice CT. Mid-diastolic heart images were corrected for beam hardening and analyzed using proprietary software to calculate Myocardial Blood Flow (MBF, in mLmin{sup -1}100 g{sup -1}) and Blood Volume (MBV, in mL100 g{sup -1}) parametric maps. MPR and MVR in each coronary territory were calculated by dividing MBF and MBV after pharmacological stress by their respective baseline values. MPR and MVR in MS and SS territories were significantly lower than those of NS territories (p < 0.05 for all). Logistic regression analysis identified MPR MVR as the best predictor of {>=}50% coronary lesion than MPR or MVR alone. DCE-CT imaging with quantitative CT perfusion analysis could be useful for detecting coronary stenoses that are functionally significant. (orig.)

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    CT angiography (CTA) can rule out significant stenoses with a very high reliability, whereas its ability to confirm significant stenoses is suboptimal. In contrast, measurements of myocardial blood flow (MBF) provide information on the haemodynamic consequences of stenoses. Therefore, a combinati...... of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by (15)O-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses....

  11. Quantification of coronary flow using dynamic angiography with 320-detector row CT and motion coherence image processing: Detection of ischemia for intermediate coronary stenosis.

    Science.gov (United States)

    Nagao, Michinobu; Yamasaki, Yuzo; Kamitani, Takeshi; Kawanami, Satoshi; Sagiyama, Koji; Yamanouchi, Torahiko; Shimomiya, Yamato; Matoba, Tetsuya; Mukai, Yasushi; Odashiro, Keita; Baba, Shingo; Maruoka, Yasuhiro; Kitamura, Yoshiyuki; Nishie, Akihiro; Honda, Hiroshi

    2016-05-01

    Anatomical coronary stenosis is not always indicative of functional stenosis, particularly for intermediate coronary lesions. The purpose of this study is to propose a new method for quantifying coronary flow using dynamic CT angiography for the whole heart (heart-DCT) and investigate its ability for detecting ischemia from intermediate coronary stenosis. Participants comprised 36 patients with coronary artery disease who underwent heart-DCT using 320-detector CT with tube voltage of 80kV and myocardial perfusion scintigraphy (MPS). Heart-DCT was continuously performed at mid-diastole throughout 15-25 cardiac cycles with prospective ECG-gating after bolus injection of contrast media (12-24ml). Dynamic datasets were computed into 90-100 data sets by motion coherence image processing (MCIP). Next, time-density curves (TDCs) for coronary arteries with a diameter >3mm were automatically calculated for all phases using MCIP. On the basis of the maximum slope method, coronary flow index (CFI) was defined as the ratio of the maximum upslope of coronary artery attenuation to the upslope of ascending aorta attenuation on the TDC, and was used to quantify coronary flow. CFIs for the proximal and distal sites of coronary arteries with mild-to-moderate stenosis were calculated. Coronary territories were categorized as non-ischemic or ischemic by MPS. Receiver-operating-characteristic (ROC) analysis was performed to determine the optimal cutoff for CFI to detect ischemia. Distal CFI was significantly lower for ischemia (0.26±0.08) than for non-ischemia (0.50±0.17, pcoronary flow quantification using heart-DCT. Distal CFI can detect myocardial ischemia derived from intermediate coronary stenosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-15

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

  13. Cancerogenesis Risks between 64 and 320 Row Detector CT for Coronary CTA Screening

    Directory of Open Access Journals (Sweden)

    Atif N Khan

    2014-01-01

    Full Text Available Objectives: This study compares cancerogenesis risks posed by the 64 row detector and the 320 row detector computed tomography scanners used during coronary computed tomography angiography (CCTA following decennial screening guidelines. Material and Methods: Data of the radiation absorbed after CCTA by lung, thyroid, and female breast in patients between 50 and 70 years of age obtained from prior published literature for the 64 row CT scanner were compared with data from our study using 320 row detector CT scanner. Data from the 64 row and the 320 row detector CT scanners was used to determine lifetime attributable risks (LAR of cancer based on the biological effects of ionizing radiation (BEIR VII report. Results: The relative reduction of LAR (% for 50-, 60-, and 70-year-old patients undergoing scanning with the 320 row detector CT scanner was 30% lower for lung, and more than 50% lower for female breast when compared with results from 64 row detector CT scanner. The use of 320 row detector CT would result in a combined cumulative cancer incidence of less than 1/500 for breast in women and less than 1/1000 for lung in men; By comparison, this is much lower than other more common risk factors: 16-fold for lung cancer in persistent smokers, 2-fold for breast cancer with a first degree family member history of breast cancer, and 10-fold for thyroid cancer with a family member with thyroid cancer. Decennial screening would benefit at least 355,000 patients from sudden cardiac death each year, 94% of whom have significant coronary artery disease, with at least one stenosis >75%. LAR for thyroid cancer was negligible for both scanners. Conclusion: Lung and female breast LAR reductions with 320 row detector compared with 64 row detector CT are substantial, and the benefits would outweigh increased cancer risks with decennial screening in the age group of 50-70 years.

  14. 双源光子CT大螺距、低辐射剂量、低对比剂用量扫描方案在主动脉夹层病变中的应用%The Application of Dual-source Single Photons CT with Big Pitch, Low Radiation Dose and Low Contrast Agent in Lesions Such as the Aortic Dissection

    Institute of Scientific and Technical Information of China (English)

    邹新华; 李文武

    2016-01-01

    目的 总结双源光子CT单能大螺距、低辐射剂量、低对比剂用量扫描方案在主动脉夹层病变中的应用价值.方法 对临床怀疑主动脉夹层病变的患者行双源光子CT血管造影,随机使用大螺距扫描方案及回顾性门控标准技术扫描方案进行扫描.观察及分析胸腹主动脉病变,有无夹层、夹层破口的位置及数目等,对比这两种扫描方案的图像质量、辐射剂量、对比剂用量差异.结果 两种扫描方案得到的图像均可清晰显示主动脉夹层的破口、内膜片、撕裂范围、各主要功能血管的累及情况.A组与B组扫描范围差异无显著性意义.两组的重建及重组图像质量均达优化标准.A组扫描时间约(1.37±0.19)s,B组扫描时间约(14.23±2.01)s,A组辐射剂量为(4.59±0.88)mSv,B组辐射剂量为(15.95±0.99)mSv,A组造影剂用量为(55±5)ml,B组造影剂用量为(85±5)ml,两组差异有显著性意义.结论 双源光子CT大螺距、低辐射剂量、低对比剂用量扫描方案对主动脉夹层病变的检查及诊断更具优势.%Objective To conclude the application value of dual-source single photons CT with low dose and low -dose contrast agent in chest aortic lesions.Methods Patients suspected aortic dissection in clinical are designed to do dual-source CT angiography, using big pitch scanning solutions or retrospective gating standard scanning technology to scan randomly. Then to observe and analyze the aortic disease in chest and abdomen,with or without dissection, the location and number of interlayer crevasse, the scope of tear, diaphragm, whether the main functional vascular are involved, with or without intramural hematoma, penetrating ulcer and aneurysm. At last, contrast the differences among the image quality, radiation dose and dosage of contrast agent of the two scanning modes.Results Both ways can show the location and number of interlayer crevasse, diaphragm,the scope of tear, whether the main

  15. CT Coronary angiography in clinical practice : Klinische toepassing van CT coronair angiografie

    NARCIS (Netherlands)

    A.C. Weustink (Annick)

    2010-01-01

    markdownabstract__Abstract__ Stable angina is a common and disabling disease with coronary artery disease (CAD) accounting for 68% of heart related deaths (I). Common risk factors for CAD 1nclude hypertension, h1gh cholesterol levels, cigarette smoking, obesity, and a family history of heart diseas

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

    Science.gov (United States)

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

    2010-03-01

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

  17. Quantification of coronary artery stenosis with high-resolution CT in comparison with histopathology in an ex vivo study

    Energy Technology Data Exchange (ETDEWEB)

    Dettmer, Matthias, E-mail: dettmerms@upmc.edu [Department of Pathology and Laboratory Medicine, University of Pittsburgh, S-417 BST 200 Lothrop Street, Pittsburgh, PA 15261 (United States); Glaser-Gallion, Nicola, E-mail: nicola.glaser-gallion@kssg.ch [Institute of Radiology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen (Switzerland); Stolzmann, Paul, E-mail: paul.stolzmann@usz.ch [Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich (Switzerland); Glaser-Gallion, Florian, E-mail: florian.glaser-gallion@kssg.ch [Institute of Radiology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen (Switzerland); Fornaro, Juergen, E-mail: juergen.fornaro@kssg.ch [Institute of Radiology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen (Switzerland); Feuchtner, Gudrun, E-mail: Gudrun.Feuchtner@i-med.ac.at [Department of Radiology II, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck (Austria); Jochum, Wolfram, E-mail: wolfram.jochum@kssg.ch [Institute of Pathology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen (Switzerland); Alkadhi, Hatem, E-mail: hatem.alkadhi@usz.ch [Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich (Switzerland); Wildermuth, Simon, E-mail: simon.wildermuth@kssg.ch [Institute of Radiology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen (Switzerland); Leschka, Sebastian, E-mail: sebastian.leschka@kssg.ch [Institute of Radiology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen (Switzerland)

    2013-02-15

    Purpose: To investigate the ex vivo performance of high-resolution computed tomography (CT) for quantitative assessment of percentage diameter stenosis in coronary arteries compared to histopathology. Materials and methods: High-resolution CT was performed in 26 human heart specimens after the injection of iodinated contrast media into the coronary arteries. Coronary artery plaques were visually identified on CT images and the grade of stenosis for each plaque was measured with electronic calipers. All coronary plaques were characterized by histopathology according to the Stary classification, and the percentage of stenosis was measured. Results: CT depicted 84% (274/326) of all coronary plaques identified by histology. Missed plaques by CT were of Stary type I (n = 31), type II (n = 16), and type III (n = 5). The stenosis degree significantly correlated between CT and histology (r = 0.81, p < 0.001). CT systematically overestimated the stenosis of calcified plaques (mean difference - 11.0 ± 9.5%, p < 0.01) and systematically underestimated the stenosis of non-calcified plaques (mean difference −6.8 ± 10.4%, p < 0.05), while there was no significant difference for mixed-type plaques (mean difference −0.4 ± 11.7%, p = 0.85). There was a significant underestimation of stenosis degree as measured by CT for Stary II plaques (mean difference −14 ± 9%, p < 0.01) and a significant overestimation for Stary VII plaques (mean difference 9 ± 10%, p < 0.05), but there was no significant difference in stenosis degree between both modalities for other plaque types. Conclusions: High-resolution CT reliably depicts advanced stage coronary plaques with an overall good correlation of stenosis degree compared to histology, however, the degree of stenosis is systematically overestimated in calcified and underestimated in non-calcified plaques.

  18. Relation of aortic calcification, wall thickness, and distensibility with severity of coronary artery disease: evaluation with coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Seonah; Yong, Hwan Seok; Doo, Kyung Won; Kang, Eun-Young; Woo, Ok Hee; Choi, Eun Jung [Dept. of Radiology, Korea Univ. Guro Hospital, Korea Univ. College of Medicine, Seoul (Korea, Republic of)], e-mail: yhwanseok@naver.com

    2012-10-15

    Background Three known risk factors for aortic atherosclerosis predict the severity of coronary artery disease (CAD): aortic calcification (AC), aortic wall thickness (AWT), and aortic distensibility (AD). Purpose To determine the relationship of AC, AWT, and AD with the severity of CAD. Material and Methods A total of 104 patients who underwent both coronary CT angiography (CCTA) and invasive coronary angiography were enrolled. The severity of CAD was assessed by three methods: the segment involvement score (SIS), the segment stenosis score (SSS), and the modified Gensini score (mG). We quantified AC using the Agatston method on low-dose ungated chest CT (LDCT). We measured AWT at the thickest portion of the descending thoracic aorta on CCTA. AD was calculated as the difference between the maximum and minimum areas of the ascending aorta and the pulse pressure. The relationships between the severity of CAD and the three aortic factors were assessed. Results The AC and AWT of the thoracic aorta were significantly higher in the occlusive CAD (OCAD) group (1984.21 {+-} 2986.10 vs. 733.00 {+-} 1648.71, P = 0.01; 4.13 {+-} 1.48 vs. 3.40 {+-} 1.01, P = 0.22). Patients with OCAD had more than one epicardial coronary artery with >50% luminal stenosis. The AC (r = 0.453 with SIS; r = 0.454 with SSS; r = 0.427 with mG) and the AWT (r = 0.279 with SIS; r = 0.324 with SSS; r = 0.304 with mG) were significantly correlated with all three methods, and the AD was negatively correlated with the SIS (r = - 0.221, P < 0.05, respectively) in the unadjusted model. After adjustment for cardiovascular risk factors, only the correlations between AC and all three methods assessing CAD remained significant. Conclusion There are significant relationships between AC, AWT and AD and severity of CAD. In particular, AC measured on LDCT is the most consistent predictor of severity of CAD.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-15

    Congenital coronary fistulae are a diagnostic challenge. A prerequisite for best management is accurate anatomical evaluation, traditionally provided by invasive catheter angiography. Multislice CT (MSCT) is an emerging noninvasive technique for coronary artery evaluation. We present a 3-year-old boy and highlight the clinical usefulness of new-generation MSCT to study coronary artery fistulae in children. Multiplanar and 3-D reconstruction offer invaluable information to plan the best therapeutic strategy in this setting. We provide evidence for the expanding clinical role of MSCT for coronary artery imaging in children. (orig.)

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

    Science.gov (United States)

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

    2013-10-01

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

  1. Automated coronary artery calcification detection on low-dose chest CT images

    Science.gov (United States)

    Xie, Yiting; Cham, Matthew D.; Henschke, Claudia; Yankelevitz, David; Reeves, Anthony P.

    2014-03-01

    Coronary artery calcification (CAC) measurement from low-dose CT images can be used to assess the risk of coronary artery disease. A fully automatic algorithm to detect and measure CAC from low-dose non-contrast, non-ECG-gated chest CT scans is presented. Based on the automatically detected CAC, the Agatston score (AS), mass score and volume score were computed. These were compared with scores obtained manually from standard-dose ECG-gated scans and low-dose un-gated scans of the same patient. The automatic algorithm segments the heart region based on other pre-segmented organs to provide a coronary region mask. The mitral valve and aortic valve calcification is identified and excluded. All remaining voxels greater than 180HU within the mask region are considered as CAC candidates. The heart segmentation algorithm was evaluated on 400 non-contrast cases with both low-dose and regular dose CT scans. By visual inspection, 371 (92.8%) of the segmentations were acceptable. The automated CAC detection algorithm was evaluated on 41 low-dose non-contrast CT scans. Manual markings were performed on both low-dose and standard-dose scans for these cases. Using linear regression, the correlation of the automatic AS with the standard-dose manual scores was 0.86; with the low-dose manual scores the correlation was 0.91. Standard risk categories were also computed. The automated method risk category agreed with manual markings of gated scans for 24 cases while 15 cases were 1 category off. For low-dose scans, the automatic method agreed with 33 cases while 7 cases were 1 category off.

  2. Sudden death as a late sequel of Kawasaki disease: postmortem CT demonstration of coronary artery aneurysm.

    Science.gov (United States)

    Okura, Naoki; Okuda, Takahisa; Shiotani, Seiji; Kohno, Mototsugu; Hayakawa, Hideyuki; Suzuki, Atsuko; Kawasaki, Tomisaku

    2013-02-10

    Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that primarily affects the coronary artery (CA) and presents during childhood. The characteristic coronary arterial lesion of KD is an aneurysm. Ischemic heart disease derived from a CA aneurysm is experienced approximately two decades after the onset of acute KD. In recent years, the primary issue of concern has been asymptomatic adults with a CA aneurysm caused by undiagnosed KD. We present a case of sudden death as a late KD sequel in a young adult. A postmortem CT scan revealed a coarse calcification of a left anterior descending CA aneurysm, which was confirmed at the time of autopsy. A postmortem CT scan is useful in cases of sudden death where the detection of a calcified CA aneurysm would suggest to the forensic pathologist that the deceased suffered from a late sequel of KD. The use of screening postmortem CT scans for young people may detect cases of unsuspected CA aneurysms, raising the possibility of untreated KD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Triple-rule-out CT angiography for evaluation of acute chest pain and possible acute coronary syndrome.

    Science.gov (United States)

    Halpern, Ethan J

    2009-08-01

    Triple-rule-out (TRO) computed tomographic (CT) angiography can provide a cost-effective evaluation of the coronary arteries, aorta, pulmonary arteries, and adjacent intrathoracic structures for the patient with acute chest pain. TRO CT is most appropriate for the patient who is judged to be at low to intermediate risk for acute coronary syndrome (ACS) and whose symptoms may also be attributed to acute pathologic conditions of the aorta or pulmonary arteries. Although a regular cardiac rhythm remains an important factor in coronary CT image quality, newer CT scanners with 64 or more detector rows afford rapid electrocardiographically (ECG) gated imaging to provide high-quality TRO CT studies in patients with a heart rate of up to 80 beats per minute. Injection of iodinated contrast material ( 300 HU) and in the pulmonary arteries (> 200 HU). To limit radiation exposure, the TRO CT examination does not include the entire chest but is constrained to incorporate the aortic arch down through the heart. Scanning parameters, including prospective ECG tube current modulation and prospective ECG gating with the "step-and-shoot" technique, are tailored to reduce radiation exposure (optimally, 5-9 mSv). When performed with appropriate attention to timing and technique, TRO CT provides coronary image quality equal to that of dedicated coronary CT angiography and pulmonary arterial images that are free of motion artifact related to cardiac pulsation. In an appropriately selected emergency department patient population, TRO CT can safely eliminate the need for further diagnostic testing in over 75% of patients.

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

    Science.gov (United States)

    Ku, Bon S.; Halpern, Ethan J.

    2010-01-01

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

  5. Application of flash dual-source computed tomography angiography in free heart rate triple-rule-out chest pain examination%炫速双源CT在自由心率胸痛三联成像中的应用价值

    Institute of Scientific and Technical Information of China (English)

    陈洪亮; 邱丽华; 刁显明; 张君海; 袁梦华; 敖永胜; 陈丽

    2016-01-01

    目的 探讨炫速双源CT在自由心率胸痛三联成像中的图像质量和临床价值.方法 2014年5月至2015年4月胸痛患者行炫速双源CT扫描整个胸部,同时行冠状动脉数字减影血管造影(DSA)检查,共104例.采用多种重组方式显示冠状动脉、肺动脉、主动脉,评价成像质量和能否满足临床诊断需要,并对冠状动脉狭窄情况与DSA进行对比.结果 扫描时间为(7.3±1.9)s.升主动脉CT值为(440.5±84.3)Hu;肺动脉平均CT值为(344.5±88.8)Hu,主动脉和肺动脉图像质量全部为优.全组1352段冠状动脉质量基本能满足诊断,其中优89.5%,良10.3%,差0.2%.共15段管腔重度狭窄(其中3段闭塞),27段管腔中度狭窄,43段管腔轻度狭窄,与DSA比较差异无统计学意义(P>0.05).结论 炫速双源CT扫描速度快,时间分辨率高,自由心率胸主动脉、肺动脉和冠状动脉成像图像质量好,对胸痛三联症的及时准确诊断具有较大的临床意义.%Objective To evaluate the imaging quality and clinical value of the flash dual-source CT in the free heart rate triple-rule-out chest pain examination. Methods From May 2015 to April 2015, a total of 104 patients with chest pain underwent both flash dual-source CT to scan the entire chest and digital subtraction angiography (DSA) to ex-amine coronary artery. Various combination methods were utilized to image aorta, pulmonary artery and coronary ar-tery for evaluating whether the flash dual-source CT imaging quality to meet the needs of clinical diagnosis. The flash dual-source CT image of coronary stenosis also was compared with DSA. Results With scanning time of (7.3 ± 1.9) s, the ascending aorta CT value of (440.5±84.3) Hu, pulmonary average CT value of (344.5±88.8) Hu, the aorta and pul-monary artery image quality is both excellent. Full set of 1352 segments of coronary artery qualities can meet the needs of clinical diagnosis with excellent 89.5%, good 10.3%and only 0.2%poor. Compared with DSA

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

  7. Multiple giant coronary aneurysms arising from coronary istula to the pulmonary artery revealed in aorta CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju; Lee, Ki Nam [Dept. of Radiology, Dong A University Hospital, Dong-A University College of Medicine, Busan (Korea, Republic of); Lee, Jong Min [Dept. of Radiology, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    2015-12-15

    Coronary fistula is a rare coronary abnormality through which blood drains into the cardiac chamber, great vessel or other vessels. In addition, giant aneurysm arising from coronary fistula is rare pathologic manifestation. Herein, we presented a rare case of multiple giant coronary artery aneurysms arising from coronary to pulmonary artery fistula in a 79-year-old woman presenting with sudden loss of consciousness. The aneurysms were detected using thoracic computed tomography angiography and consequently confirmed by invasive coronary angiography.

  8. Genome-wide association study of coronary and aortic calcification in lung cancer screening CT

    Science.gov (United States)

    de Vos, Bob D.; van Setten, Jessica; de Jong, Pim A.; Mali, Willem P.; Oudkerk, Matthijs; Viergever, Max A.; Išgum, Ivana

    2016-03-01

    Arterial calcification has been related to cardiovascular disease (CVD) and osteoporosis. However, little is known about the role of genetics and exact pathways leading to arterial calcification and its relation to bone density changes indicating osteoporosis. In this study, we conducted a genome-wide association study of arterial calcification burden, followed by a look-up of known single nucleotide polymorphisms (SNPs) for coronary artery disease (CAD) and myocardial infarction (MI), and bone mineral density (BMD) to test for a shared genetic basis between the traits. The study included a subcohort of the Dutch-Belgian lung cancer screening trial comprised of 2,561 participants. Participants underwent baseline CT screening in one of two hospitals participating in the trial. Low-dose chest CT images were acquired without contrast enhancement and without ECG-synchronization. In these images coronary and aortic calcifications were identified automatically. Subsequently, the detected calcifications were quantified using coronary artery calcium Agatston and volume scores. Genotype data was available for these participants. A genome-wide association study was conducted on 10,220,814 SNPs using a linear regression model. To reduce multiple testing burden, known CAD/MI and BMD SNPs were specifically tested (45 SNPs from the CARDIoGRAMplusC4D consortium and 60 SNPS from the GEFOS consortium). No novel significant SNPs were found. Significant enrichment for CAD/MI SNPs was observed in testing Agatston and coronary artery calcium volume scores. Moreover, a significant enrichment of BMD SNPs was shown in aortic calcium volume scores. This may indicate genetic relation of BMD SNPs and arterial calcification burden.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-11-15

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

  10. 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.

  11. Feasibility analysis of diagnosis of ligament injury in the craniocervical junction with dual source CT%CT双能量技术在颅颈交界区韧带损伤诊断中的应用可行性分析

    Institute of Scientific and Technical Information of China (English)

    张武; 陈晶; 陈建强; 战跃福; 王雄; 杨光; 梁其洲

    2016-01-01

    Craniocervical junction is the key transitional part from head to neck, which has complex structure and special functions. Craniocervical ligament plays an important role in maintaining the stability, normal activities, and flexion and extension of the head and neck. The ligaments injuries have great harm to the health of the body, including at-lantoaxial dislocation, injury of medulla oblongata resulting paralysis and even death. Craniocervical junction has lots of ligaments, which were distributed deeply and were overlapped with each other. The diagnosis of ligament injury in cra-niocervical junction is difficult, which attract great attention from clinical and imaging researchers. This review aims at providing a reference for clinical diagnosis, treatment and prognosis of ligament injury in craniocervical junction by ana-lyzing the feasibility of diagnosis of ligament injury with dual source CT.%颅颈交界区是头颅向颈椎过渡的关键部位,该区域结构复杂,功能特殊。颅颈交界区韧带在维持颅颈部的稳定和正常旋转、屈伸运动中扮演着重要角色。颅颈交界区韧带损伤,轻则引起寰枕枢关节脱位,重则损伤延髓、颈髓引起瘫痪甚至危及生命。颅颈交界区韧带众多,位置深,相互重叠,其损伤诊断困难,成为临床和影像研究的热点和难点。本文通过对CT双能量技术在韧带损伤诊断中的应用可行性进行分析、综述,为颅颈交界区韧带损伤的临床诊断、治疗及预后评估提供技术支持和参考依据。

  12. Estimation of organ-absorbed radiation doses during 64-detector CT coronary angiography using different acquisition techniques and heart rates: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, Kosuke; Koshida, Kichiro; Kawashima, Hiroko (Dept. of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa Univ., Kanazawa (Japan)), email: matsuk@mhs.mp.kanazawa-u.ac.jp; Noto, Kimiya; Takata, Tadanori; Yamamoto, Tomoyuki (Dept. of Radiological Technology, Kanazawa Univ. Hospital, Kanazawa (Japan)); Shimono, Tetsunori (Dept. of Radiology, Hoshigaoka Koseinenkin Hospital, Hirakata (Japan)); Matsui, Osamu (Dept. of Radiology, Faculty of Medicine, Kanazawa Univ., Kanazawa (Japan))

    2011-07-15

    Background: Though appropriate image acquisition parameters allow an effective dose below 1 mSv for CT coronary angiography (CTCA) performed with the latest dual-source CT scanners, a single-source 64-detector CT procedure results in a significant radiation dose due to its technical limitations. Therefore, estimating the radiation doses absorbed by an organ during 64-detector CTCA is important. Purpose: To estimate the radiation doses absorbed by organs located in the chest region during 64-detector CTCA using different acquisition techniques and heart rates. Material and Methods: Absorbed doses for breast, heart, lung, red bone marrow, thymus, and skin were evaluated using an anthropomorphic phantom and radiophotoluminescence glass dosimeters (RPLDs). Electrocardiogram (ECG)-gated helical and ECG-triggered non-helical acquisitions were performed by applying a simulated heart rate of 60 beats per minute (bpm) and ECG-gated helical acquisitions using ECG modulation (ECGM) of the tube current were performed by applying simulated heart rates of 40, 60, and 90 bpm after placing RPLDs on the anatomic location of each organ. The absorbed dose for each organ was calculated by multiplying the calibrated mean dose values of RPLDs with the mass energy coefficient ratio. Results: For all acquisitions, the highest absorbed dose was observed for the heart. When the helical and non-helical acquisitions were performed by applying a simulated heart rate of 60 bpm, the absorbed doses for heart were 215.5, 202.2, and 66.8 mGy for helical, helical with ECGM, and non-helical acquisitions, respectively. When the helical acquisitions using ECGM were performed by applying simulated heart rates of 40, 60, and 90 bpm, the absorbed doses for heart were 178.6, 139.1, and 159.3 mGy, respectively. Conclusion: ECG-triggered non-helical acquisition is recommended to reduce the radiation dose. Also, controlling the patients' heart rate appropriately during ECG-gated helical acquisition with

  13. 双源CT单能谱成像技术在腰椎峡部裂术后去除金属内固定伪影的应用%The application of monoenergetic technology of dual-source CT in removing the artifact of metal fixation after the operation of lumbar spondylolysis

    Institute of Scientific and Technical Information of China (English)

    毛锡金; 夏吉凯; 曹新山

    2014-01-01

    Objective To explore the clinical value of monoenergetic technology of dual-source CT in removing the artifact of me-tallic fixation after the operation of lumbar spondylolysis.Methods 24 cases of patients with metallic fixation after operation of lum-bar spondylolysis were scanned by dual-energy CT.To reconstruct the imaging using monoenergetic and 3D Inspace software,obtain 50,80,110,140,170 keV five groups of images and the multi-planar reconstruction*(MPR),volume vendering(VR),maximum intensity projection(MIP)imaging in different conditions.The five groups image and average weighted 120kev image are evaluate by two senior radiologist.The quality score of five groups of images and the average weighted images are analyzed statistically using Kruskal-Wallis test.The clinical value of images in the optimal condition are evaluated by two senior department of orthopedics phy-sicians.The results of two radiologists and department of orthopedics physician are examined by kappa test to evaluate consistency. Results In all patients after operation,the case of 110keV images above 3 points is 24,the case of 80keV images above 3 points is 14,the case of of 140keV images above 3 points is 13,the case of weighted average 120kev images above 3 points is 8.Images in 110keV have the best quality (F=98.523,P<0.01).MPR,VR,MIP images are reconstructed in 110keV.The ratio of image which are excellent and have high clinical value is 86.1%,especially the ratio of MPR image is 100%.Conclusion Monoenergetic technology of dual-source CT has a higher clinical value in removing the artifact of metallic fixation after the operation of lumbar spondylolysis.Under the condition of 110keV the quality of images are best,the reconstructed images using MPR Technology have the best clinical value.%目的:探索双源CT单能谱成像技术在腰椎峡部裂术后去除金属内固定伪影的临床应用价值。方法24例腰椎峡部裂内固定术后患者,采用双源CT双能量模式扫

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-11-15

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

  15. [Impact of both cardiac-CT and cardiac-MR on the assessment of coronary risk].

    Science.gov (United States)

    Silber, S; Richartz, B M

    2005-01-01

    invasive strategy should be performed. Since non-invasive coronary angiography (CTA) with cardiac-CT has been shown to provide a high negative predictive value, CTA (with good imaging quality) is suitable for ruling out a significant obstructive CAD in the group at intermediate risk for an obstructive CAD. Another approach could be a functional test to initially prove a relevant, inducible myocardial ischemia: In a large cohort it was shown that patients will only prognostically benefit from revascularization procedures if the ischemic myocardial area is greater than 10%. Therefore, the assessment of the extent of myocardial ischemia is the domain of modern stress imaging tests. Stress-echocardiography and myocardial scintigraphy have almost the same sensitivity (74-80%, 84-90%, respectively) and specificity (84-89%, 77-86%, respectively), which are considerably higher than for stress-ECG. Cardiac MR is most suitable for the assessment of myocardial perfusion, because it traces the first pass dynamics of gadolinium at rest and during stress in reproducible slices at an acceptable spatial and a high temporal resolution without ionizing radiation. Whether the non-invasive coronary angiography with cardiac-CT and the Adenosin-perfusion imaging with cardiac-MR will completely replace diagnostic cardiac catheterization and stress-echocardiography as well as myocardial scintigraphy remains to be evaluated in further studies.

  16. Prospective and retrospective ECG-gating for CT coronary angiography perform similarly accurate at low heart rates

    Energy Technology Data Exchange (ETDEWEB)

    Stolzmann, Paul, E-mail: paul.stolzmann@usz.ch [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Goetti, Robert; Baumueller, Stephan [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Plass, Andre; Falk, Volkmar [Clinic for Cardiovascular Surgery, University Hospital Zurich (Switzerland); Scheffel, Hans; Feuchtner, Gudrun; Marincek, Borut [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Alkadhi, Hatem [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Leschka, Sebastian [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2011-07-15

    Objective: To compare, in patients with suspicion of coronary artery disease (CAD) and low heart rates, image quality, diagnostic performance, and radiation dose values of prospectively and retrospectively electrocardiography (ECG)-gated dual-source computed tomography coronary angiography (CTCA) for the diagnosis of significant coronary stenoses. Materials and methods: Two-hundred consecutive patients with heart rates {<=}70 bpm were retrospectively enrolled; 100 patients undergoing prospectively ECG-gated CTCA (group 1) and 100 patients undergoing retrospectively-gated CTCA (group 2). Coronary artery segments were assessed for image quality and significant luminal diameter narrowing. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and accuracy of both CTCA groups were determined using conventional catheter angiography (CCA) as reference standard. Radiation dose values were calculated. Results: Both groups were comparable regarding gender, body weight, cardiovascular risk profile, severity of CAD, mean heart rate, heart rate variability, and Agatston score (all p > 0.05). There was no significant difference in the rate of non-assessable coronary segments between group 1 (1.6%, 24/1404) and group 2 (1.4%, 19/1385; p = 0.77); non-diagnostic image quality was significantly (p < 0.001) more often attributed to stair step artifacts in group 1. Segment-based sensitivity, specificity, PPV, NPV, and accuracy were 98%, 98%, 88%, 100%, and 100% among group 1; 96%, 99%, 90%, 100%, and 98% among group 2, respectively. Parameters of diagnostic performance were similar (all p > 0.05). Mean effective radiation dose of prospectively ECG-gated CTCA (2.2 {+-} 0.4 mSv) was significantly (p < 0.0001) smaller than that of retrospectively ECG-gated CTCA (8.1 {+-} 0.6 mSv). Conclusion: Prospectively ECG-gated CTCA yields similar image quality, performs as accurately as retrospectively ECG-gated CTCA in patients having heart rates {<=}70 bpm

  17. Coronary artery wall imaging in mice using osmium tetroxide and micro-computed tomography (micro-CT)

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Vinay M.; Kozlowski, Megan; Donahue, Danielle; Miller, Elishiah; Xiao, Xianghui; Chen, Marcus Y.; Yu, Zu-Xi; Connelly, Patricia; Jeffries, Kenneth; Wen, Han (NIH)

    2012-05-10

    The high spatial resolution of micro-computed tomography (micro-CT) is ideal for 3D imaging of coronary arteries in intact mouse heart specimens. Previously, micro-CT of mouse heart specimens utilized intravascular contrast agents that hardened within the vessel lumen and allowed a vascular cast to be made. However, for mouse coronary artery disease models, it is highly desirable to image coronary artery walls and highlight plaques. For this purpose, we describe an ex vivo contrast-enhanced micro-CT imaging technique based on tissue staining with osmium tetroxide (OsO{sub 4}) solution. As a tissue-staining contrast agent, OsO{sub 4} is retained in the vessel wall and surrounding tissue during the fixation process and cleared from the vessel lumens. Its high X-ray attenuation makes the artery wall visible in CT. Additionally, since OsO{sub 4} preferentially binds to lipids, it highlights lipid deposition in the artery wall. We performed micro-CT of heart specimens of 5- to 25-week-old C57BL/6 wild-type mice and 5- to 13-week-old apolipoprotein E knockout (apoE{sup -/-}) mice at 10 {mu}m resolution. The results show that walls of coronary arteries as small as 45 {mu}m in diameter are visible using a table-top micro-CT scanner. Similar image clarity was achieved with 1/2000th the scan time using a synchrotron CT scanner. In 13-week-old apoE mice, lipid-rich plaques are visible in the aorta. Our study shows that the combination of OsO{sub 4} and micro-CT permits the visualization of the coronary artery wall in intact mouse hearts.

  18. 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.

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

    Science.gov (United States)

    Radecki, Ryan Patrick

    2013-10-01

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

  20. Feasibility of contrast material volume reduction in coronary artery imaging using 320-slice volume CT

    Energy Technology Data Exchange (ETDEWEB)

    Hein, Patrick A.; May, Juliane; Rogalla, Patrik; Hamm, Bernd; Lembcke, Alexander [Charite-University Hospital, Department of Radiology, Berlin (Germany); Butler, Craig [Charite-University Hospital, Department of Radiology, Berlin (Germany); University of Alberta, Department of Cardiology, Edmonton, Alberta (Canada)

    2010-06-15

    To assess reduced volumes of contrast agent on image quality for coronary computed tomography angiography (CCTA) by using single-beat cardiac imaging with 320-slice CT. Forty consecutive male patients (mean age: 55.8 years) undergoing CCTA with body weight {<=}85 kg, heart rate {<=}65 bpm, and ejection fraction {>=}55% were included. Image acquisition protocol was standardized (120 kV, 400 mA, and prospective ECG-triggered single-beat nonspiral CCTA). Patients were randomly assigned to one of four groups (G1: received 40 ml, G2: 50 ml, G3: 60 ml, G4: 70 ml). Groups were compared with respect to aortic attenuation, image noise, and image quality. CT values (mean {+-} standard deviation) in the aortic root were measured as 423 {+-} 38 HU in G1, and 471 {+-} 68, 463 {+-} 60, and 476 {+-} 78 HU in G2-4, respectively. There were no statistically significant differences in attenuation among the groups (P > 0.068). All 40 CT datasets were rated diagnostic, and image noise and image quality were not statistically different among groups. Using 320-slice volume CT, diagnostic image quality can be achieved with 40 ml of contrast material in CCTA in patients with normal body weight, cardiac function, and low heart rate. (orig.)

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

    Science.gov (United States)

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

    2015-01-01

    Aim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified by CACS severity, remains unknown. Methods and results From a 12-centre, 6-country observational registry, 3217 asymptomatic individuals without known coronary artery disease (CAD) underwent CACS and CCTA. Individuals were categorized by CACS as: 0–10, 11–100, 101–400, 401–1000, >1000. For CCTA analysis, the number of obstructive vessels—as defined by the per-patient presence of a ≥50% luminal stenosis—was used to grade the extent and severity of CAD. The incremental prognostic value of CCTA over and above FRS was measured by the likelihood ratio (LR) χ2, C-statistic, and continuous net reclassification improvement (NRI) for prediction, discrimination, and reclassification of all-cause mortality and non-fatal myocardial infarction. During a median follow-up of 24 months (25th–75th percentile, 17–30 months), there were 58 composite end-points. The incremental value of CCTA over FRS was demonstrated in individuals with CACS >100 (LRχ2, 25.34; increment in C-statistic, 0.24; NRI, 0.62, all P 0.05). For subgroups with CACS >100, the utility of CCTA for predicting the study end-point was evident among individuals whose CACS ranged from 101 to 400; the observed predictive benefit attenuated with increasing CACS. Conclusion Coronary CT angiography provides incremental prognostic utility for prediction of mortality and non-fatal myocardial infarction for asymptomatic individuals with moderately high CACS, but not for lower or higher CACS. PMID:25205531

  2. Assessments of Coronary Artery Visibility and Radiation Dose in Infants with Congenital Heart Disease on Cardiac 128-slice CT and on Cardiac 64-slice CT.

    Science.gov (United States)

    Cui, Y; Huang, M; Zheng, J; Li, J; Liu, H; Liang, C

    2016-01-01

    The aim of this study was to compare the coronary artery visibility and radiation dose in infants with CHD on cardiac 128-slice CT and on cardiac 64-slice CT. The images of 200 patients were analyzed in this study, 100 patients were selected randomly from a group of 789 infants (coronary artery segments was graded on a four-point scale. The coronary arteries were considered to be detected or visible when grade was 2 or higher. The visibility of the coronary artery segments and the radiation dose was compared between the two groups. Except for the rate of LM (96 vs. 99%), the detection rates of the total, LAD, LCX, RCA, and the proximal segment of the RCA in the 256-slice CT group were significantly higher than those in the 64-slice CT group (51.7, 53.33, 33.67, 53.33, and 99 vs. 34.8, 34.33, 18, 30.67, and 75%, respectively). The counts of visibility score (4/3/2/1) for the LM and the proximal segment of the RCA were 62/22/12/4 and 56/20/17/7, respectively, in the 128-slice CT group and 17/42/30/1 and 9/30/38/25, respectively, in the 64-slice CT group. There were significant differences, especially for score 4 and 3, between the two groups. The radiation dose in the 128-slice CT group was significantly decreased than those in the 64-slice CT group (CTDIvol 1.88 ± 0.51 vs. 5.61 ± 0.63 mGy; SSDE 4.48 ± 1.15 vs. 13.97 ± 1.52 mGy; effective radiation dose 1.36 ± 0.44 vs. 4.06 ± 0.7 mSv). With reduced radiation dose, the visibility of the coronary artery in infants with CHD via prospective ECG-triggered mode on a 128-slice CT is superior to that of the 64-slice CT using retrospective ECG-gated spiral mode.

  3. Left Circumflex Coronary Artery Fistula Connected to the Right Bronchial Artery Associated with Bronchiectasis: Multidetector CT and Coronary Angiography Findings

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Jin; Choo, Ki Seok [Dept. of Radiology, Medical Research Institute, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2013-04-15

    Coronary to bronchial artery fistula is a rare vascular anomaly secondary to enlargement of pre-existing vascular anastomosis between the coronary and bronchial arteries. This occurs when there is a constant disturbance of the pressure equilibrium involving either coronary or broncho-pulmonary disorder. Localized bronchiectasis is the most common related condition in patients with a coronary to bronchial artery fistula. Herein, we report on a case of a large left circumflex coronary artery to right bronchial artery fistula associated with bronchiectasis.

  4. Prospective ECG-gated 320-row CT angiography of the whole aorta and coronary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yu.; Fan, Zhanming; Xu, Lei; Yang, Lin; Xin, Haiyan; Zhang, Nan [Capital Medical University, Department of Radiology, Beijing An Zhen Hospital, Beijing (China); Capital Medical University, Ministry of Education, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Beijing (China); Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing An Zhen Hospital, Beijing (China)

    2012-11-15

    To investigate the feasibility of using a prospective ECG-gated wide-volume protocol in CT angiography (CTA) of the whole aorta and coronary arteries (CA). A total of 61 consecutive patients with suspected acute aortic diseases underwent CTA of the whole aorta using a prospective ECG-gated wide-volume CT protocol without heart rate (HR) control. The exposure window was set at 40-50 % of R-R interval (HR {>=}70 bpm) or 70-80 % of R-R interval (HR <70 bpm) in a single heartbeat. The image quality of the ascending aorta, aortic valve and CA was evaluated for motion artefacts. The mean attenuation was measured at different levels of the aorta. The radiation dose and contrast medium volume were recorded. All of the examinations were performed successfully. The image quality was acceptable in the ascending aorta, aortic valve (100 %) and CA (94.4 %). The mean radiation dose was 18.42 {+-} 5.02 mSv. Of 61 patients, 14 were diagnosed with aortic aneurysm and 35 were diagnosed with aortic dissection or intramural haematoma. Coronary artery stenosis was detected in 12 patients. For patients with aortic diseases, CTA of the whole aorta using a prospective ECG-gated wide-volume protocol has the potential to provide additional information about the CA and aortic valve with lower radiation exposure. (orig.)

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

    Science.gov (United States)

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

    2014-03-01

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

  6. Risk stratification of non-contrast CT beyond the coronary calcium scan.

    Science.gov (United States)

    Madaj, Paul; Budoff, Matthew J

    2012-01-01

    Coronary artery calcification (CAC) is a well-known marker for coronary artery disease and has important prognostic implications. CAC is able to provide clinicians with a reliable source of information related to cardiovascular atherosclerosis, which carries incremental information beyond Framingham risk. However, non-contrast scans of the heart provide additional information beyond the Agatston score. These studies are also able to measure various sources of fat, including intrathoracic (eg, pericardial or epicardial) and hepatic, both of which are thought to be metabolically active and linked to increased incidence of subclinical atherosclerosis as well as increased prevalence of type 2  diabetes. Testing for CAC is also useful in identifying extracoronary sources of calcification. Specifically, aortic valve calcification, mitral annular calcification, and thoracic aortic calcium (TAC) provide additional risk stratification information for cardiovascular events. Finally, scanning for CAC is able to evaluate myocardial scaring due to myocardial infarcts, which may also add incremental prognostic information. To ensure the benefits outweigh the risks of a scanning for CAC for an appropriately selected asymptomatic patient, the full utility of the scan should be realized. This review describes the current state of the art interpretation of non-contrast cardiac CT, which clinically should go well beyond coronary artery Agatston scoring alone.

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Accuracy of coronary plaque detection and assessment of interobserver agreement for plaque quantification using automatic coronary plaque analysis software on coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Laqmani, A.; Quitzke, M.; Creder, D.D.; Adam, G.; Lund, G. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology and Nuclearmedicine; Klink, T. [Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology

    2016-10-15

    To evaluate the accuracy of automatic plaque detection and the interobserver agreement of automatic versus manually adjusted quantification of coronary plaques on coronary CT angiography (cCTA) using commercially available software. 10 cCTA datasets were evaluated using plaque software. First, the automatically detected plaques were verified. Second, two observers independently performed plaque quantification without revising the automatically constructed plaque contours (automatic approach). Then, each observer adjusted the plaque contours according to plaque delineation (adjusted approach). The interobserver agreement of both approaches was analyzed. 32 of 114 automatically identified findings were true-positive plaques, while 82 (72 %) were false-positive. 20 of 52 plaques (38 %) were missed by the software (false-negative). The automatic approach provided good interobserver agreement with relative differences of 0.9 ± 16.0 % for plaque area and -3.3 ± 33.8 % for plaque volume. Both observers independently adjusted all contours because they did not represent the plaque delineation. Interobserver agreement decreased for the adjusted approach with relative differences of 25.0 ± 24.8 % for plaque area and 20.0 ± 40.4 % for plaque volume. The automatic plaque analysis software is of limited value due to high numbers of false-positive and false-negative plaque findings. The automatic approach was reproducible but it necessitated adjustment of all constructed plaque contours resulting in deterioration of the interobserver agreement.

  9. Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Schertler, Thomas; Scheffel, Hans; Frauenfelder, Thomas; Desbiolles, Lotus; Leschka, Sebastian; Stolzmann, Paul; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Department of Medical Radiology, Institute of Diagnostic Radiology, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland); Flohr, Thomas G. [Computed Tomography CTE PA, Siemens Medical Solutions, Forchheim (Germany)

    2007-12-15

    The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1{+-}16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1{+-}6 HU comparing right and left coronary artery and 56{+-}9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291{+-}65 HU in the ascending aorta, 334{+-}93 HU in the pulmonary trunk, and 285{+-}66 HU and 268{+-}67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-15

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

  11. Real-time fusion of coronary CT angiography with X-ray fluoroscopy during chronic total occlusion PCI

    Energy Technology Data Exchange (ETDEWEB)

    Ghoshhajra, Brian B.; Takx, Richard A.P. [Harvard Medical School, Cardiac MR PET CT Program, Massachusetts General Hospital, Department of Radiology and Division of Cardiology, Boston, MA (United States); Stone, Luke L.; Yeh, Robert W.; Jaffer, Farouc A. [Harvard Medical School, Cardiac Cathetrization Laboratory, Cardiology Division, Massachusetts General Hospital, Boston, MA (United States); Girard, Erin E. [Siemens Healthcare, Princeton, NJ (United States); Brilakis, Emmanouil S. [Cardiology Division, Dallas VA Medical Center and UT Southwestern Medical Center, Dallas, TX (United States); Lombardi, William L. [University of Washington, Cardiology Division, Seattle, WA (United States)

    2017-06-15

    The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with X-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. (orig.)

  12. Diagnostic Performance of First-Pass Myocardial Perfusion Imaging without Stress with Computed Tomography (CT) Compared with Coronary CT Angiography Alone, with Fractional Flow Reserve as the Reference Standard.

    Science.gov (United States)

    Osawa, Kazuhiro; Miyoshi, Toru; Miki, Takashi; Koyama, Yasushi; Sato, Shuhei; Kanazawa, Susumu; Ito, Hiroshi

    2016-01-01

    Coronary computed tomography angiography (CCTA) in combination with first-pass CT myocardial perfusion imaging (MPI) has a better diagnostic performance than CCTA alone, compared with invasive coronary angiography as the reference standard. The aim of this study was to investigate the additional diagnostic value of first-pass CT-MPI without stress for detecting hemodynamic significance of coronary stenosis, compared with invasive fractional flow reserve (FFR). We recruited 53 patients with suspected coronary artery disease undergoing both CCTA and first-pass CT-MPI without stress and invasive FFR, and 75 vessels were analyzed. We used the same raw data for CCTA and CT-MPI. First-pass CT-MPI was reconstructed by examining the diastolic signal densities as a bull's eye map. Invasive FFR CT-MPI and CCTA alone was 0.81 (0.73-0.90) and 0.70 (0.61-0.81), respectively (P = 0.036). CCTA plus first-pass CT-MPI without stress showed 0.73 sensitivity, 0.74 specificity, 0.53 positive predictive value, and 0.87 negative predictive value for detecting hemodynamically significant coronary stenosis. First-pass CT-MPI without stress correctly reclassified 38% of CCTA false-positive vessels as true negative. First-pass CT-MPI without stress combined with CCTA demonstrated excellent diagnostic accuracy, compared with invasive FFR as the reference standard. This technique could complement CCTA for diagnosis of coronary artery disease.

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

    Energy Technology Data Exchange (ETDEWEB)

    Dekker, Martijn A.M. den; Oudkerk, Matthijs; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Department of Radiology, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Smet, Kristof de [University of Brussels, Department of Radiology, Brussels (Belgium); Bock, Geertruida H. de [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Department of Epidemiology, Groningen (Netherlands); Tio, Rene A. [University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen (Netherlands)

    2012-12-15

    A systematic review and meta-analysis to assess sensitivity and specificity of coronary CT angiography (CCTA) for significant stenosis at different degrees of coronary calcification. A literature search was performed including studies describing test characteristics of CCTA for significant stenosis, performed with at least 16-MDCT and according to calcium score (CS). Invasive coronary angiography was the reference standard. Pooled sensitivity and specificity of CCTA by CS categories and CT equipment were calculated. Of 14,121 articles, 51 studies reported on the impact of calcium scoring on diagnostic performance of CCTA and could be included in the systematic review. Twenty-seven of these studies (5,203 participants) were suitable for meta-analysis. On a patient-basis, sensitivity of CCTA for significant stenosis was 95.8, 95.6, 97.6 and 99.0% for CS 0-100, 101-400, 401-1,000 and >1,000 respectively. Specificity was 91.2, 88.2, 50.6 and 84.0% respectively. Specificity of CCTA was significantly lower for CS 401-1,000 due to lack of patients without significant stenosis. Sensitivity and specificity of 16-MDCT were significantly lower compared to more modern CT systems. Even in cases of severe