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Sample records for multidetector computed tomography-guided

  1. Computed tomography - guided cutting needle biopsy of pulmonary lesions

    International Nuclear Information System (INIS)

    Liao Shin Yu; Deheinzelin, Daniel; Younes, Riad N.; Chojniak, Rubens

    2002-01-01

    The purpose of this study was to report the experience of a radiology department in the use of computed tomography-guided cutting needle biopsy of pulmonary nodules, by evaluating diagnostic yield and incidence of complications. This is a retrospective analysis of 52 consecutive patients who underwent lung lesion biopsy guided by computed tomography, performed between May 1997 and May 2000. Thirty-five patients were male and 17 were female, with ages ranging from 5 to 85 years (median, 62 years). The size of the lesions ranged from 1.8 to 15 cm (median, 5.4 cm). In a total of 52 biopsies of lung lesions, 51 biopsies (98.1%) supplied appropriate material for histopathological diagnosis, with 9 diagnosed (17.3%) as benign and 42 (80.8%) as malignant lesions. Specific diagnosis was obtained in 44 (84.6%) biopsies: 4 benign (9.1%) and 40 (90.9%) malignant lesions. The sensitivity, specificity, and accuracy of the cutting needle biopsies for determining presence of malignancy were 96.8%, 100%, and 97.2%, respectively. Complications occurred in 9 cases (17.3%), including 6 cases (11.5%) of small pneumothorax, 1 (1.9%) of hemoptysis, 1 (1.9%) of pulmonary hematoma, and 1 (1.9%) of thoracic wall hematoma. All had spontaneous resolution. There were no complications requiring subsequent intervention. The high sensitivity and specificity of the method and the low rate of complications have established cutting needle biopsy as an efficient and safe tool for the diagnosis of lung lesions. In our hospital, cutting needle biopsy is considered a reliable procedure for the evaluation of indeterminate pulmonary nodules. (author)

  2. Computed tomography-guided percutaneous gastrostomy: initial experience at a cancer center

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang Jeng; Santos, Erich Frank Vater; Guerra, Luiz Felipe Alves; Bitencourt, Almir Galvao Vieira; Barbosa, Paula Nicole Vieira Pinto; Chojniak, Rubens [A. C. Camargo Cancer Center, Sao Paulo, SP (Brazil); Universidade Federal do Espirito Santo (HUCAM/UFES), Vitoria, ES (Brazil). Hospital Universitario Cassiano Antonio de Morais. Radiologia e Diagnostico por Imagem

    2017-03-15

    Gastrostomy is indicated for patients with conditions that do not allow adequate oral nutrition. To reduce the morbidity and costs associated with the procedure, there is a trend toward the use of percutaneous gastrostomy, guided by endoscopy, fluoroscopy, or, most recently, computed tomography. The purpose of this paper was to review the computed tomography-guided gastrostomy procedure, as well as the indications for its use and the potential complications. (author)

  3. Computed tomography-guided percutaneous gastrostomy: initial experience at a cancer center

    International Nuclear Information System (INIS)

    Tyng, Chiang Jeng; Santos, Erich Frank Vater; Guerra, Luiz Felipe Alves; Bitencourt, Almir Galvao Vieira; Barbosa, Paula Nicole Vieira Pinto; Chojniak, Rubens; Universidade Federal do Espirito Santo

    2017-01-01

    Gastrostomy is indicated for patients with conditions that do not allow adequate oral nutrition. To reduce the morbidity and costs associated with the procedure, there is a trend toward the use of percutaneous gastrostomy, guided by endoscopy, fluoroscopy, or, most recently, computed tomography. The purpose of this paper was to review the computed tomography-guided gastrostomy procedure, as well as the indications for its use and the potential complications. (author)

  4. Computed tomography-guided percutaneous biopsy of pancreatic masses using pneumodissection

    Directory of Open Access Journals (Sweden)

    Chiang Jeng Tyng

    2013-06-01

    Full Text Available Objective To describe the technique of computed tomography-guided percutaneous biopsy of pancreatic tumors with pneumodissection. Materials and Methods In the period from June 2011 to May 2012, seven computed tomography-guided percutaneous biopsies of pancreatic tumors utilizing pneumodissection were performed in the authors' institution. All the procedures were performed with an automatic biopsy gun and coaxial system with Tru-core needles. The biopsy specimens were histologically assessed. Results In all the cases the pancreatic mass could not be directly approached by computed tomography without passing through major organs and structures. The injection of air allowed the displacement of adjacent structures and creation of a safe coaxial needle pathway toward the lesion. Biopsy was successfully performed in all the cases, yielding appropriate specimens for pathological analysis. Conclusion Pneumodissection is a safe, inexpensive and technically easy approach to perform percutaneous biopsy in selected cases where direct access to the pancreatic tumor is not feasible.

  5. Computed tomography-guided percutaneous biopsy of pancreatic masses using pneumodissection

    International Nuclear Information System (INIS)

    Tyng, Chiang Jeng; Bitencourt, Almir Galvao Vieira; Almeida, Maria Fernanda Arruda; Barbosa, Paula Nicole Vieira; Martins, Eduardo Bruno Lobato; Junior, Joao Paulo Kawaoka Matushita; Chojniak, Rubens; Coimbra, Felipe Jose Fernandez

    2013-01-01

    Objective: to describe the technique of computed tomography-guided percutaneous biopsy of pancreatic tumors with pneumodissection. Materials and methods: in the period from June 2011 to May 2012, seven computed tomography guided percutaneous biopsies of pancreatic tumors utilizing pneumodissection were performed in the authors' institution. All the procedures were performed with an automatic biopsy gun and coaxial system with Tru-core needles. The biopsy specimens were histologically assessed. Results: in all the cases the pancreatic mass could not be directly approached by computed tomography without passing through major organs and structures. The injection of air allowed the displacement of adjacent structures and creation of a safe coaxial needle pathway toward the lesion. Biopsy was successfully performed in all the cases, yielding appropriate specimens for pathological analysis. Conclusion: Pneumodissection is a safe, inexpensive and technically easy approach to perform percutaneous biopsy in selected cases where direct access to the pancreatic tumor is not feasible. (author)

  6. Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

    2011-03-15

    Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

  7. Uncommon primary tumors of the orbit diagnosed by computed tomography-guided core needle biopsy: report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang Jeng; Matushita Junior, Joao Paulo Kawaoka; Bitencourt, Almir Galvao Vieira; Amoedo, Mauricio Kauark; Barbosa, Paula Nicole Vieira; Chojniak, Rubens, E-mail: almirgvb@yahoo.com.br [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil). Dept. de Imagem; Neves, Flavia Branco Cerqueira Serra [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Div. de Oftalmologia

    2014-11-15

    Computed tomography-guided percutaneous biopsy is a safe and effective alternative method for evaluating selected intra-orbital lesions where the preoperative diagnosis is important for the therapeutic planning. The authors describe two cases of patients with uncommon primary orbital tumors whose diagnosis was obtained by means of computed tomography-guided core needle biopsy, with emphasis on the technical aspects of the procedure. (author)

  8. Cone-Beam Computed Tomography-Guided Percutaneous Radiologic Gastrostomy

    International Nuclear Information System (INIS)

    Moehlenbruch, Markus; Nelles, Michael; Thomas, Daniel; Willinek, Winfried; Gerstner, Andreas; Schild, Hans H.; Wilhelm, Kai

    2010-01-01

    The purpose of this study was to investigate the feasibility of a flat-detector C-arm-guided radiographic technique (cone-beam computed tomography [CBCT]) for percutaneous radiologic gastrostomy (PRG) insertion. Eighteen patients (13 men and 5 women; mean age 62 years) in whom percutaneous endoscopic gastrostomy (PEG) had failed underwent CBCT-guided PRG insertion. PEG failure or unsuitability was caused by upper gastrointestinal tract obstruction in all cases. Indications for gastrostomy were esophageal and head and neck malignancies, respectively. Before the PRG procedure, initial C-arm CBCT scans were acquired. Three- and 2-dimensional soft-tissue reconstructions of the epigastrium region were generated on a dedicated workstation. Subsequently, gastropexy was performed with T-fasteners after CBCT-guided puncture of the stomach bubble, followed by insertion of an 14F balloon-retained catheter through a peel-away introducer. Puncture of the stomach bubble and PRG insertion was technically successful in all patients without alteration of the epigastric region. There was no malpositioning of the tube or other major periprocedural complications. In 2 patients, minor complications occurred during the first 30 days of follow-up (PRG malfunction: n = 1; slight infection: n = 1). Late complications, which were mainly tube disturbances, were observed in 2 patients. The mean follow-up time was 212 days. CBCT-guided PRG is a safe, well-tolerated, and successful method of gastrostomy insertion in patients in whom endoscopic gastrostomy is not feasible. CBCT provides detailed imaging of the soft tissue and surrounding structures of the epigastric region in one diagnostic tour and thus significantly improves the planning of PRG procedures.

  9. Myocardial perfusion 320-row multidetector computed tomography-guided treatment strategy for the clinical management of patients with recent acute-onset chest pain: Design of the CArdiac cT in the treatment of acute CHest pain (CATCH)-2 randomized controlled trial.

    Science.gov (United States)

    Sørgaard, Mathias; Linde, Jesper J; Hove, Jens D; Petersen, Jan R; Jørgensen, Tem B S; Abdulla, Jawdat; Heitmann, Merete; Kragelund, Charlotte; Hansen, Thomas Fritz; Udholm, Patricia M; Pihl, Christian; Kühl, J Tobias; Engstrøm, Thomas; Jensen, Jan Skov; Høfsten, Dan E; Kelbæk, Henning; Kofoed, Klaus F

    2016-09-01

    Patients admitted with chest pain are a diagnostic challenge because the majority does not have coronary artery disease (CAD). Assessment of CAD with coronary computed tomography angiography (CCTA) is safe, cost-effective, and accurate, albeit with a modest specificity. Stress myocardial computed tomography perfusion (CTP) has been shown to increase the specificity when added to CCTA, without lowering the sensitivity. This article describes the design of a randomized controlled trial, CATCH-2, comparing a clinical diagnostic management strategy of CCTA alone against CCTA in combination with CTP. Patients with acute-onset chest pain older than 50 years and with at least one cardiovascular risk factor for CAD are being prospectively enrolled to this study from 6 different clinical sites since October 2013. A total of 600 patients will be included. Patients are randomized 1:1 to clinical management based on CCTA or on CCTA in combination with CTP, determining the need for further testing with invasive coronary angiography including measurement of the fractional flow reserve in vessels with coronary artery lesions. Patients are scanned with a 320-row multidetector computed tomography scanner. Decisions to revascularize the patients are taken by the invasive cardiologist independently of the study allocation. The primary end point is the frequency of revascularization. Secondary end points of clinical outcome are also recorded. The CATCH-2 will determine whether CCTA in combination with CTP is diagnostically superior to CCTA alone in the management of patients with acute-onset chest pain. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Cardiac Computed Tomography (Multidetector CT, or MDCT) Updated:Sep 19,2016 What is Computerized Tomography (CT)? CT is a noninvasive test that uses ...

  11. Percutaneous computed tomography-guided ethanol injection in aldosterone-producing adrenocortical adenoma

    International Nuclear Information System (INIS)

    Rossi, R.; Savastano, S.; Tommaselli, A.P.

    1995-01-01

    The feasibility, safety and effectiveness of percutaneous computed tomography-guided ethanol injection (PEI-CT) was investigated in a patient affected by aldosterone-producing adenoma (APA). A 42-year-old male patient with typical features of hyperaldosteronism presented a solitary left adrenal adenoma measuring 2 cm, with a normal contralateral gland, evidenced by both CT scan and adrenal [ 75 Se-19]-nor-cholesterol scintigraphy. After normalization of potassium plasma levels, 4 ml of sterile 95% ethanol with 0.5 ml of 80% iothalamate sodium was injected. The procedure was completed in about 30 min. No severe pain or local complication was noted. Five hour after PEI, a fourfold and a twofold increase in aldosterone and cortisol plasma levels were observed, respectively. After 11 days on a normal sodium and potassium diet, normal potassium plasma levels and reduced aldosterone plasma levels were present, with reappearance of an aldosterone postural response. Plasma renin activity and aldosterone plasma levels normalized 1 month later, with reappearance also of a plasma renin activity postural response and maintenance of normal potassium plasma levels on a high sodium and normal potassium diet. The patient has remained hypertensive, although lower antihypertensive drug dosages have been employed. After 17 months, normal biochemical, hormonal and morphological findings were present. The authors suggested PEI-CT as a further alternative approach to surgery in the management of carefully selected patients with APA. 15 refs., 2 figs., 1 tab

  12. Multidetector Computed Tomography and Neuroendocrine Pancreaticoduodenal Tumors

    International Nuclear Information System (INIS)

    Rappeport, E.D.; Palnaes Hansen, C.; Kjaer, A.; Knigge, U.

    2006-01-01

    Purpose: To investigate the accuracy of dedicated pancreatic multidetector computed tomography (MDCT) in the diagnosis of neuroendocrine pancreaticoduodenal tumors (NPTs). Material and Methods: MDCT and other imaging studies in patients with suspected NPTs were identified. Thirty dedicated MDCT studies were done in 23 patients. Fourteen patients (16 operations) subsequently had surgery. Imaging reports were reviewed and findings compared with surgical findings and findings in other imaging studies. Results: Patients with surgery : 19 NPTs (16 extrapancreatic gastrinomas and 3 pancreatic NPTs) were identified at surgery. MDCT identified 16 and somatostatin receptor scintigraphy (SRS) 11 out of 19 tumors. Endoscopic ultrasound detected 11 out of 14 NPTs. Patients without surgery : In 4 out of 9 patients, no NPTs were identified at MDCT. Conclusion: Dedicated MDCT of the pancreas can identify many NPTs, including small duodenal and periduodenal tumors, and the detection rate is better than reported in the older literature on CT

  13. Myocardial perfusion with multi-detector computed tomography: quantitative evaluation

    International Nuclear Information System (INIS)

    Carrascosa, Patricia M.; Vallejos, J.; Capunay, Carlos M.; Deviggiano, A.; Carrascosa, Jorge M.

    2007-01-01

    The objective of this work is to evaluate the skill of multidetector computer tomography, to quantify the different patterns of intensification during the evaluation of the myocardial perfusion. 45 patients were studied with suspicion of cardiovascular disease. Multi-detector computed tomography was utilized on patients at rest and in effort with pharmacological stress, after the administration of dipyridamole. Also they were evaluated using nuclear medicine [es

  14. Computed tomography-guided bupivacaine and corticosteroid injection for the treatment of symptomatic calcification in the great toe tendon

    Directory of Open Access Journals (Sweden)

    Karatoprak O

    2014-04-01

    Full Text Available Omer Karatoprak,1 Sinan Karaca,2 Mehmet Nuri Erdem,3 Ozgur Karaman,2 Azmi Hamzaoglu41Department of Orthopedic Surgery, Kadikoy Florence Nightingale Hospital, Istanbul, Turkey; 2Department of Orthopedic Surgery, Fatih Sultan Mehmet Training and Research Hospital Atasehir, Istanbul, Turkey; 3Department of Orthopedics and Traumatology, Kolan International Hospital Sisli, Istanbul, Turkey; 4Department of Orthopedic Surgery, Istanbul Florence Nightingale Hospital, Istanbul TurkeyBackground: Calcification in the great toe tendon is a rare disorder that is characterized by the deposition of calcium on degenerative collagen fibrils.Case presentations: In this report, we present two cases of calcific tendonitis: one in the adductor hallucis and the other in the flexor hallucis longus tendon. We preferred computed tomography-guided steroid injection in our cases because of pain unresponsive to conservative treatment. Patients were free of symptoms at the follow-up visit, 4 weeks after injection.Conclusion: Calcification of the hallux tendons is a rare disorder. Treatment of tendonitis consists of nonsteroidal anti-inflammatory drugs. Local anesthetic and steroid injection may be considered in cases unresponsive to conservative treatment. Because of the anatomic location of tendons, injection could be difficult. Computed tomography guidance may improve the success rate of injections.Keywords: bupivacaine, calcification, great toe tendons, corticosteroid injection

  15. Computed tomography-guided percutaneous biopsy of pancreatic masses using pneumodissection; Biopsia percutanea de massas pancreaticas guiada por tomografia computadorizada com pneumodisseccao

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang Jeng; Bitencourt, Almir Galvao Vieira; Almeida, Maria Fernanda Arruda; Barbosa, Paula Nicole Vieira; Martins, Eduardo Bruno Lobato; Junior, Joao Paulo Kawaoka Matushita; Chojniak, Rubens, E-mail: chiangjengtyng@gmail.com [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Imagem; Coimbra, Felipe Jose Fernandez [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Cirurgia Abdominal

    2013-05-15

    Objective: to describe the technique of computed tomography-guided percutaneous biopsy of pancreatic tumors with pneumodissection. Materials and methods: in the period from June 2011 to May 2012, seven computed tomography guided percutaneous biopsies of pancreatic tumors utilizing pneumodissection were performed in the authors' institution. All the procedures were performed with an automatic biopsy gun and coaxial system with Tru-core needles. The biopsy specimens were histologically assessed. Results: in all the cases the pancreatic mass could not be directly approached by computed tomography without passing through major organs and structures. The injection of air allowed the displacement of adjacent structures and creation of a safe coaxial needle pathway toward the lesion. Biopsy was successfully performed in all the cases, yielding appropriate specimens for pathological analysis. Conclusion: Pneumodissection is a safe, inexpensive and technically easy approach to perform percutaneous biopsy in selected cases where direct access to the pancreatic tumor is not feasible. (author)

  16. Three-dimensional digitizer (neuronavigator): new equipment for computed tomography-guided stereotaxic surgery.

    Science.gov (United States)

    Watanabe, E; Watanabe, T; Manaka, S; Mayanagi, Y; Takakura, K

    1987-06-01

    A new device was invented as an adjunct for computed tomography (CT)-guided stereotaxic or open neurosurgery. It is composed of a multijoint three-dimensional digitizer (sensor arm) and a microcomputer, which indicates the place of the sensor arm tip on preoperative CT images. Computed tomography scan is performed preoperatively with three markers placed on the nasion and ears. At surgery, after fixing the patient's head and the sensor arm, sampling of the standard points was done to translate the position of the tip of the sensor arm onto the CT images displayed on a computer screen. In this way positional data from conventional preoperative CT scan can be directly transferred into the surgical field. This system has the unique feature of introducing CT-guided stereotaxis into conventional open neurosurgery.

  17. Computer tomography guided lung biopsy using interactive breath-hold control

    DEFF Research Database (Denmark)

    Ashraf, Haseem; Krag-Andersen, Shella; Naqibullah, Matiullah

    2017-01-01

    Background: Interactive breath-hold control (IBC) may improve the accuracy and decrease the complication rate of computed tomography (CT)-guided lung biopsy, but this presumption has not been proven in a randomized study. Methods: Patients admitted for CT-guided lung biopsy were randomized...

  18. Percutaneous transthoracic computed tomography-guided AICD insertion in a patient with extracardiac Fontan conduit.

    LENUS (Irish Health Repository)

    Murphy, Darra T

    2011-02-01

    Percutaneous pulmonary venous atrial puncture was performed under computed tomography guidance to successfully place an automated implantable cardiac defibrillator into a 26-year-old patient with extracardiac Fontan conduit who had presented with two out-of-hospital cardiac arrests. The procedure avoided the need for lead placement at thoracotomy.

  19. First-in-Man Computed Tomography-Guided Percutaneous Revascularization of Coronary Chronic Total Occlusion Using a Wearable Computer: Proof of Concept.

    Science.gov (United States)

    Opolski, Maksymilian P; Debski, Artur; Borucki, Bartosz A; Szpak, Marcin; Staruch, Adam D; Kepka, Cezary; Witkowski, Adam

    2016-06-01

    We report a case of successful computed tomography-guided percutaneous revascularization of a chronically occluded right coronary artery using a wearable, hands-free computer with a head-mounted display worn by interventional cardiologists in the catheterization laboratory. The projection of 3-dimensional computed tomographic reconstructions onto the screen of virtual reality glass allowed the operators to clearly visualize the distal coronary vessel, and verify the direction of the guide wire advancement relative to the course of the occluded vessel segment. This case provides proof of concept that wearable computers can improve operator comfort and procedure efficiency in interventional cardiology. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  20. Computed tomography-guided percutaneous core needle biopsy of deep seated bone lesions in two dogs

    International Nuclear Information System (INIS)

    Mori, T.; Sakaida, M.; Yamada, M.; Akiyama, H.; Takai, Y.; Sakai, H.; Maruo, K.

    2006-01-01

    Computed Tomography (CT)-guided percutaneous core needle biopsies were undertaken for the diagnosis of osteosarcoma in the pelvis (case 1) and myeloma (case 2) in the seventh lumber vertebra which were difficult to targeted by palpation, ultrasound or fluoroscopy. In both cases, enough tissue for pathological diagnosis were obtained without any complication. CT-guided biopsy was thought to be a safe, easy and effective technique for the evaluation of the deep seated bone lesion

  1. The value of unenhanced multi-detector computed tomography ...

    African Journals Online (AJOL)

    Introduction: Unenhanced computed tomography (CT) is used to detect urinary tract calculi with high accuracy. The development of multi-detector CT (MDCT) allows reconstructions in coronal, sagittal and oblique directions. Objective: To compare MDCT with three-dimensional (3D) ultrasound (US) imaging in evaluating ...

  2. Usefulness of multi-detector row Computed Tomography for ...

    African Journals Online (AJOL)

    A 74-year-old female underwent surgical treatment for adenocarcinoma of the pancreatic head. Preoperative multi-detector row computed tomography (MD-CT) demonstrated tumor invasion into the accessory right colic vein and the branch of the middle colic artery (MCA), which was not detected by digital subtraction ...

  3. CASE SERIES Multi-detector computer tomography venography ...

    African Journals Online (AJOL)

    in the curved coronal plane with particular reference to the course of the common and external iliac veins through the pelvis. Axial venous. Aim. To evaluate the role of multi-detector computer tomography venography (MDCTV), compared with conventional venography, as a diagnostic tool in the management of patients with ...

  4. Multidetector computed tomography of jaw lesions in children and adolescents

    International Nuclear Information System (INIS)

    Gadodia, A.; Seith, A.; Sharma, R.; Choudhury, A.R.; Bhutia, O.; Gupta, A.

    2010-01-01

    Full text: Jaw lesions in paediatric and adolescent population are uncommon and can arise in odontogenic or non-odontogenic tissues. With the advent of multidetector computed tomography (MDCT), algorithm for imaging jaw lesions has changed dramatically. This pictorial essay describes the imaging appearance of commonly encountered jaw lesions in children and adolescents with emphasis on MDCT findings

  5. Tracheo-oesophageal fistula diagnosed with multidetector computed tomography.

    LENUS (Irish Health Repository)

    Hodnett, Pa

    2009-04-01

    This case highlights important issues in investigation of patients with suspected tracheo-oesophageal fistula including the value of multidetector computed tomography, the importance of thorough imaging evaluation when high clinical suspicion of tracheo-oesophageal fistula exists and the value of close interaction between radiologists and intensive care physicians in the investigation of these patients.

  6. Role of multidetector computed tomography (MDCT) in diagnosis of ...

    African Journals Online (AJOL)

    Aim of the work: To assess the role of multidetector computed tomographic imaging in the diagnosis of secondary intussusception with pathological leading points in children. Materials and methods: This study is a retrospective study including 12 children referred to the radiodiagnosis department at Alexandria University ...

  7. Frequency and Risk Factors of Various Complications After Computed Tomography-Guided Radiofrequency Ablation of Lung Tumors

    International Nuclear Information System (INIS)

    Okuma, Tomohisa; Matsuoka, Toshiyuki; Yamamoto, Akira; Oyama, Yoshimasa; Toyoshima, Masami; Nakamura, Kenji; Inoue, Yuichi

    2008-01-01

    Objective. To retrospectively determine the frequency and risk factors of various side effects and complications after percutaneous computed tomography-guided radiofrequency (RF) ablation of lung tumors. Methods. We reviewed and analyzed records of 112 treatment sessions in 57 of our patients (45 men and 12 women) with unresectable lung tumors treated by ablation. Risk factors, including sex, age, tumor diameter, tumor location, history of surgery, presence of pulmonary emphysema, electrode gauge, array diameter, patient position, maximum power output, ablation time, and minimum impedance during ablation, were analyzed using univariate and multivariate analyses. Results. Total rates of side effects and minor and major complications occurred in 17%, 50%, and 8% of treatment sessions, respectively. Side effects, including pain during ablation (46% of sessions) and pleural effusion (13% of sessions), occurred with RF ablation. Minor complications, including pneumothorax not requiring chest tube drainage (30% of sessions), subcutaneous emphysema (16% of sessions), and hemoptysis (9% of sessions) also occurred after the procedure. Regarding major complications, three patients developed fever >38.5 deg. C; three patients developed abscesses; two patients developed pneumothorax requiring chest tube insertion; and one patient had air embolism and was discharged without neurologic deficit. Univariate and multivariate analyses suggested that a lesion located ≤1 cm of the chest wall was significantly related to pain (p < 0.01, hazard index 5.76). Risk factors for pneumothorax increased significantly with previous pulmonary surgery (p < 0.05, hazard index 6.1) and presence of emphysema (p <0.01, hazard index 13.6). Conclusion. The total complication rate for all treatment sessions was 58%, and 25% of patients did not have any complications after RF ablation. Although major complications can occur, RF ablation of lung tumors can be considered a safe and minimally invasive

  8. Computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT) ablation of metastases adjacent to the liver hilum

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, Federico, E-mail: federico.collettini@charite.de [Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin (Germany); Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Singh, Anju [Department of Medical Oncology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Schnapauff, Dirk [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Powerski, Maciej Janusz [Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); and others

    2013-10-01

    Purpose: To evaluate technical feasibility and clinical outcome of computed tomography-guided high-dose-rate-brachytherapy (CT-HDRBT) ablation of metastases adjacent to the liver hilum. Materials and methods: Between November 2007 and May 2012, 32 consecutive patients with 34 metastases adjacent to the liver hilum (common bile duct or hepatic bifurcation ≤5 mm distance) were treated with CT-HDRBT. Treatment was performed by CT-guided applicator placement and high-dose-rate brachytherapy with an iridium-192 source. MRI follow-up was performed 6 weeks and every 3 months post intervention. The primary endpoint was local tumor control (LTC); secondary endpoints included time to progression (TTP) and overall survival (OS). Results: Patients were available for MRI evaluation for a mean follow-up time of 18.75 months (range: 3–56 months). Mean tumor diameter was 4.3 cm (range: 1.3–10.7 cm). One major complication was observed. Four (11.8%) local recurrences were observed after a local tumor control of 5, 8, 9 and 10 months, respectively. Twenty-two patients (68.75%) experienced a systemic tumor progression during the follow up period. Mean TTP was 12.9 months (range: 2–56 months). Nine patients died during the follow-up period. Median OS was 20.24 months. Conclusion: Minimally invasive CT-HDRBT is a safe and effective option also for unresectable liver metastases adjacent to the liver hilum that would have been untreatable by thermal ablation.

  9. Computed tomography-guided cryoablation of local recurrence after primary resection of pancreatic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Claudio Pusceddu

    2015-06-01

    Full Text Available The optimal management of local recurrences after primary resection of pancreatic cancer still remains to be clarified. A 58-yearold woman developed an isolated recurrence of pancreatic cancer six year after distal pancreatectomy. Re-resection was attempted but the lesion was deemed unresectable at surgery. Then chemotherapy was administrated without obtaining a reduction of the tumor size nor an improvement of the patient’s symptoms. Thus the patient underwent percutaneous cryoablation under computed tomography (CT-guidance obtaining tumor necrosis and a significant improvement in the quality of life. A CT scan one month later showed a stable lesion with no contrast enhancement. While the use of percutaneous cryoblation has widened its applications in patients with unresectable pancreatic cancer, it has never been described for the treatment of local pancreatic cancer recurrence after primary resection. Percutaneous cryoablation deserves further studies in the multimodality treatment of local recurrence after primary pancreatic surgery.

  10. Computed tomography-guided needle biopsy of lung lesions in fourteen cats and dogs

    International Nuclear Information System (INIS)

    Yoshida, K.; Mori, T.; Yamada, M.; Sakaida, M.; Yonemaru, K.; Murakami, M.; Sakai, H.; Maruo, K.

    2007-01-01

    Computed tomography (CT)-guided fine-needle aspirates (FNA) or core biopsies of lung lesions were performed in nine dogs and five cats. A clinical diagnosis was obtained in twelve of fourteen animals (85%), namely 80% FNA and 100% core biopsies. Eight animals had other mass (es) apart from the lung, and five were diagnosed to metastases. In only one case, the lung mass was histopathologically diagnosed as a malignant primary tumor. Iatrogenic complications through the lung biopsies were noted in four animals, and three showed mild pneumothorax on CT images and one was bleeding from the needle. However, between fifteen and thirty minutes after the biopsy, no animal indicated signs of pneumothorax or hemorrhage

  11. Computed-tomography-guided anatomic standardization for quantitative assessment of dopamine transporter SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yokoyama, Kota [National Center of Neurology and Psychiatry, Department of Radiology, Tokyo (Japan); National Center of Neurology and Psychiatry, Integrative Brain Imaging Center, Tokyo (Japan); Imabayashi, Etsuko; Matsuda, Hiroshi [National Center of Neurology and Psychiatry, Integrative Brain Imaging Center, Tokyo (Japan); Sumida, Kaoru; Sone, Daichi; Kimura, Yukio; Sato, Noriko [National Center of Neurology and Psychiatry, Department of Radiology, Tokyo (Japan); Mukai, Youhei; Murata, Miho [National Center of Neurology and Psychiatry, Department of Neurology, Tokyo (Japan)

    2017-03-15

    For the quantitative assessment of dopamine transporter (DAT) using [{sup 123}I]FP-CIT single-photon emission computed tomography (SPECT) (DaTscan), anatomic standardization is preferable for achieving objective and user-independent quantification of striatal binding using a volume-of-interest (VOI) template. However, low accumulation of DAT in Parkinson's disease (PD) would lead to a deformation error when using a DaTscan-specific template without any structural information. To avoid this deformation error, we applied computed tomography (CT) data obtained using SPECT/CT equipment to anatomic standardization. We retrospectively analyzed DaTscan images of 130 patients with parkinsonian syndromes (PS), including 80 PD and 50 non-PD patients. First we segmented gray matter from CT images using statistical parametric mapping 12 (SPM12). These gray-matter images were then anatomically standardized using the diffeomorphic anatomical registration using exponentiated Lie algebra (DARTEL) algorithm. Next, DaTscan images were warped with the same parameters used in the CT anatomic standardization. The target striatal VOIs for decreased DAT in PD were generated from the SPM12 group comparison of 20 DaTscan images from each group. We applied these VOIs to DaTscan images of the remaining patients in both groups and calculated the specific binding ratios (SBRs) using nonspecific counts in a reference area. In terms of the differential diagnosis of PD and non-PD groups using SBR, we compared the present method with two other methods, DaTQUANT and DaTView, which have already been released as software programs for the quantitative assessment of DaTscan images. The SPM12 group comparison showed a significant DAT decrease in PD patients in the bilateral whole striatum. Of the three methods assessed, the present CT-guided method showed the greatest power for discriminating PD and non-PD groups, as it completely separated the two groups. CT-guided anatomic standardization using

  12. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses

    International Nuclear Information System (INIS)

    Cantasdemir, M.; Kara, B.; Cebi, D.; Selcuk, N.D.; Numan, F.

    2003-01-01

    AIM: To report our experience with computed tomography (CT)-guided percutaneous catheter drainage (PCD) of iliopsoas abscesses. MATERIALS AND METHODS: Twenty-two iliopsoas abscesses in 21 patients (11 women, 10 men) aged between 18 and 66 years (mean 36 years) were treated with PCD. Abdominal CT demonstrated the iliopsoas abscesses, which were definitively determined by Gram staining and aspirate cultures. Twenty of the 22 iliopsoas abscesses were primary and two were secondary. All PCD procedures were performed under local anaesthesia using a single-step trocar technique (n=19) or Seldinger technique (n=3). RESULTS: PCD was an effective treatment in 21 out of the 22 iliopsoas abscesses. Recurrence was seen in three abscesses as minimal residual collections. Two of them resolved spontaneously with anti-tuberculous regimen. One required percutaneous needle aspiration. The procedure failed in a diabetic patient with a secondary abscess, who died due to sepsis. The length of time that catheters remained in place ranged from 21 to 75 days (mean 59.7 days). Complications included catheter dislocation in four abscesses, which required removal of dislocated catheters and indwelling new ones. CONCLUSION: CT-guided PCD is a safe and effective front-line treatment of iliopsoas abscesses. Surgery should be reserved for failure of PCD and presence of contraindications to PCD

  13. [Fluoroscopy dose reduction of computed tomography guided chest interventional radiology using real-time iterative reconstruction].

    Science.gov (United States)

    Hasegawa, Hiroaki; Mihara, Yoshiyuki; Ino, Kenji; Sato, Jiro

    2014-11-01

    The purpose of this study was to evaluate the radiation dose reduction to patients and radiologists in computed tomography (CT) guided examinations for the thoracic region using CT fluoroscopy. Image quality evaluation of the real-time filtered back-projection (RT-FBP) images and the real-time adaptive iterative dose reduction (RT-AIDR) images was carried out on noise and artifacts that were considered to affect the CT fluoroscopy. The image standard deviation was improved in the fluoroscopy setting with less than 30 mA on 120 kV. With regard to the evaluation of artifact visibility and the amount generated by the needle attached to the chest phantom, there was no significant difference between the RT-FBP images with 120 kV, 20 mA and the RT-AIDR images with low-dose conditions (greater than 80 kV, 30 mA and less than 120 kV, 20 mA). The results suggest that it is possible to reduce the radiation dose by approximately 34% at the maximum using RT-AIDR while maintaining image quality equivalent to the RT-FBP images with 120 V, 20 mA.

  14. Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

    International Nuclear Information System (INIS)

    Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens

    2014-01-01

    Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

  15. Efficacy of computed tomography guided radiofrequency ablation forosteoid osteomas in 31 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoon; Ahn, Joong Mo; Lee, Joon Woo; Lee, Guen Young; Lee, Eu Gene; Oh, Joo Han; Cho, Hwan Seong; Kang, Heung Sik [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-04-15

    To present the clinical outcome of computed tomography (CT) guided radiofrequency ablation (RFA) for osteoid osteoma. Thirty-one patients (M:F = 23:8, mean age: 20 years, range: 4-54 years) who underwent RFA for clinically suspected osteoid osteoma from May 2004 to December 2013 were retrospectively reviewed. RFA was done in all cases under CT guidance by one of three radiologists in our department. Electronic medical records and images were retrospectively reviewed in all patients. Lesions were located in femur (n = 20), tibia (n = 5), fibula (n = 2), humerus (n = 3), talus (n = 2), and calcaneus (n = 1). On discharge, 27 of 33 cases showed complete remission of pain (82%). One major complication (compartment syndrome) and 2 minor complications (reactive synovitis, minimal skin burn at electrode insertion site) were observed. On the last follow-up (0-78 months, mean: 12.6 months) 27 of 33 cases were successfully treated (82%) and had no more complaints. 3 cases presented remaining pain (9%). In 3 cases relapse occurred (9%) and RFA was repeated in 1 case. The repeated treatment was successful. CT-guided RFA is an effective method for the treatment of osteoid osteoma.

  16. Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

    Energy Technology Data Exchange (ETDEWEB)

    Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens, E-mail: macellomaciel@me.com [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil)

    2014-09-15

    Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

  17. Computed tomography guided needle biopsy: experience from 1,300 procedures

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Isberner, Rony Klaus; Viana, Luciana Marinho; Yu, Liao Shin; Aita, Alessandro Amorim; Soares, Fernando Augusto [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Radiologia e Patologia

    2006-01-15

    Context and objective: computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center. Design and setting: retrospective study at Hospital do Cancer A. C. Camargo, Sao Paulo.Methods: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy. Results: adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis. Conclusion: both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications. (author)

  18. Success rates for computed tomography-guided musculoskeletal biopsies performed using a low-dose technique

    International Nuclear Information System (INIS)

    Motamedi, Kambiz; Levine, Benjamin D.; Seeger, Leanne L.; McNitt-Gray, Michael F.

    2014-01-01

    To evaluate the success rate of a low-dose (50 % mAs reduction) computed tomography (CT) biopsy technique. This protocol was adopted based on other successful reduced-CT radiation dose protocols in our department, which were implemented in conjunction with quality improvement projects. The technique included a scout view and initial localizing scan with standard dose. Additional scans obtained for further guidance or needle adjustment were acquired by reducing the tube current-time product (mAs) by 50 %. The radiology billing data were searched for CT-guided musculoskeletal procedures performed over a period of 8 months following the initial implementation of the protocol. These were reviewed for the type of procedure and compliance with the implemented protocol. The compliant CT-guided biopsy cases were then retrospectively reviewed for patient demographics, tumor pathology, and lesion size. Pathology results were compared to the ultimate diagnoses and were categorized as diagnostic, accurate, or successful. Of 92 CT-guided procedures performed during this period, two were excluded as they were not biopsies (one joint injection and one drainage), 19 were excluded due to non-compliance (operators neglected to follow the protocol), and four were excluded due to lack of available follow-up in our electronic medical records. A total of 67 compliant biopsies were performed in 63 patients (two had two biopsies, and one had three biopsies). There were 32 males and 31 females with an average age of 50 (range, 15-84 years). Of the 67 biopsies, five were non-diagnostic and inaccurate and thus unsuccessful (7 %); five were diagnostic but inaccurate and thus unsuccessful (7 %); 57 were diagnostic and accurate thus successful (85 %). These results were comparable with results published in the radiology literature. The success rate of CT-guided biopsies using a low-dose protocol is comparable to published rates for conventional dose biopsies. The implemented low-dose protocol

  19. Success rates for computed tomography-guided musculoskeletal biopsies performed using a low-dose technique

    Energy Technology Data Exchange (ETDEWEB)

    Motamedi, Kambiz; Levine, Benjamin D.; Seeger, Leanne L.; McNitt-Gray, Michael F. [UCLA Health System, Radiology, Los Angeles, CA (United States)

    2014-11-15

    To evaluate the success rate of a low-dose (50 % mAs reduction) computed tomography (CT) biopsy technique. This protocol was adopted based on other successful reduced-CT radiation dose protocols in our department, which were implemented in conjunction with quality improvement projects. The technique included a scout view and initial localizing scan with standard dose. Additional scans obtained for further guidance or needle adjustment were acquired by reducing the tube current-time product (mAs) by 50 %. The radiology billing data were searched for CT-guided musculoskeletal procedures performed over a period of 8 months following the initial implementation of the protocol. These were reviewed for the type of procedure and compliance with the implemented protocol. The compliant CT-guided biopsy cases were then retrospectively reviewed for patient demographics, tumor pathology, and lesion size. Pathology results were compared to the ultimate diagnoses and were categorized as diagnostic, accurate, or successful. Of 92 CT-guided procedures performed during this period, two were excluded as they were not biopsies (one joint injection and one drainage), 19 were excluded due to non-compliance (operators neglected to follow the protocol), and four were excluded due to lack of available follow-up in our electronic medical records. A total of 67 compliant biopsies were performed in 63 patients (two had two biopsies, and one had three biopsies). There were 32 males and 31 females with an average age of 50 (range, 15-84 years). Of the 67 biopsies, five were non-diagnostic and inaccurate and thus unsuccessful (7 %); five were diagnostic but inaccurate and thus unsuccessful (7 %); 57 were diagnostic and accurate thus successful (85 %). These results were comparable with results published in the radiology literature. The success rate of CT-guided biopsies using a low-dose protocol is comparable to published rates for conventional dose biopsies. The implemented low-dose protocol

  20. Noninvasive coronary angioscopy using electron beam computed tomography and multidetector computed tomography

    NARCIS (Netherlands)

    van Ooijen, PMA; Nieman, K; de Feyter, PJ; Oudkerk, M

    2002-01-01

    With the advent of noninvasive coronary imaging techniques like multidetector computed tomography and electron beam computed tomography, new representation methods such as intracoronary visualization. have been introduced. We explore the possibilities of these novel visualization techniques and

  1. Multidetector computed tomography in the preoperative staging of gastric adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Ricardo Hoelz de Oliveira; Penachim, Thiago Jose; Martins, Daniel Lahan; Andreollo, Nelson Adami; Caserta, Nelson Marcio Gomes, E-mail: rhobarros@hotmail.com [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil)

    2015-03-15

    Objective: To evaluate the role of multidetector computed tomography in the preoperative investigation of tumor invasion depth and lymph node and metastatic involvement according to the TNM classification, in patients with gastric adenocarcinoma. Materials and Methods: Fifty-four patients with biopsy-confirmed gastric cancer underwent preoperative staging with 64-channel multidetector computed tomography. Two independent radiologists analyzed the images and classified the findings. Sensitivity, specificity, accuracy and overall accuracy were calculated for each observer. The interobserver agreement was also evaluated. Results: The accuracy in the classification of categories T ranged from 74% to 96% for observer 1 and from 80% to 92% for observer 2. The overall accuracy was 70% for both observers. The weighted kappa index was 0.75, consistent with a significant interobserver agreement. The accuracy in the classification of lymph node involvement (category N) ranged from 55% to 79% for observer 1 and from 73% to 82% for observer 2. The evaluation of metastatic involvement showed an overall accuracy of 89.6% for both observers. Conclusion: 64-channel multidetector computed tomography demonstrated clinically relevant accuracy in the preoperative staging of gastric adenocarcinoma as regards invasion depth (T category) and metastatic involvement (M category). (author)

  2. Multidetector computed tomography in the preoperative staging of gastric adenocarcinoma

    International Nuclear Information System (INIS)

    Barros, Ricardo Hoelz de Oliveira; Penachim, Thiago Jose; Martins, Daniel Lahan; Andreollo, Nelson Adami; Caserta, Nelson Marcio Gomes

    2015-01-01

    Objective: To evaluate the role of multidetector computed tomography in the preoperative investigation of tumor invasion depth and lymph node and metastatic involvement according to the TNM classification, in patients with gastric adenocarcinoma. Materials and Methods: Fifty-four patients with biopsy-confirmed gastric cancer underwent preoperative staging with 64-channel multidetector computed tomography. Two independent radiologists analyzed the images and classified the findings. Sensitivity, specificity, accuracy and overall accuracy were calculated for each observer. The interobserver agreement was also evaluated. Results: The accuracy in the classification of categories T ranged from 74% to 96% for observer 1 and from 80% to 92% for observer 2. The overall accuracy was 70% for both observers. The weighted kappa index was 0.75, consistent with a significant interobserver agreement. The accuracy in the classification of lymph node involvement (category N) ranged from 55% to 79% for observer 1 and from 73% to 82% for observer 2. The evaluation of metastatic involvement showed an overall accuracy of 89.6% for both observers. Conclusion: 64-channel multidetector computed tomography demonstrated clinically relevant accuracy in the preoperative staging of gastric adenocarcinoma as regards invasion depth (T category) and metastatic involvement (M category). (author)

  3. Integral diagnosis of coronary atherosclerosis by coronary multidetector computed tomography and by invasive coronary angiography

    International Nuclear Information System (INIS)

    Llerena Rojas, Luis Roberto; Llerena Rojas, Lorenzo D; Mendoza Rodriguez, Vladimir

    2013-01-01

    Coronary angiography by multidetector computed tomography (CMDCT) visualizes the wall and lumen of coronary arteries. Invasive coronary angiography (INVCA) only visualizes the arterial lumen but with better resolution

  4. Ultrasound and multidetector computed tomography of mandibular ...

    African Journals Online (AJOL)

    Because of local invasivity and high metastatic potential, preoperative imaging evaluation of mandibular region and tumoral staging is essential along with biopsy sampling. The present manuscript describes the ultrasound and computed tomographic imaging findings of mandibular gland adenocarcinoma in two dogs and ...

  5. Multidetector Computed Tomography in the Preoperative Workup of Hilar Cholangiocarcinoma

    International Nuclear Information System (INIS)

    Kim, Hyoung Jung; Lee, Dong Ho; Lim, Joo Won; Ko, Young Tae

    2009-01-01

    Hilar cholangiocarcinoma is associated with a dismal prognosis; however, curative resection may offer a chance of cure. Various factors should be considered in the surgical planning for curative resection. These factors include extent of bile duct involvement, relationship between portal vein and tumor involvement, diffuse hepato duodenal ligament infiltration, vascular invasion, lymph node metastasis, peritoneal seeding, and hepatic volume. Using high-quality volume data from multidetector-row computed tomography (MDCT) and adequate postprocessing images, radiologists can provide various types of information, imperative for curative resection of a hilar cholangiocarcinoma. This review illustrates the role of MDCT in the preoperative workup of hilar cholangiocarcinoma

  6. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    International Nuclear Information System (INIS)

    Palas, J.; Matos, A.P.; Ramalho, M.; Mascarenhas, V.; Heredia, V.

    2014-01-01

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  7. Multidetector computed tomography of the renal arteries in vascular emergencies

    International Nuclear Information System (INIS)

    Regine, Giovanni; Stasolla, Alessandro; Miele, Vittorio

    2007-01-01

    Multidetector computed tomography (MDCT) has drastically changed the diagnostic imaging protocol in both traumatic and non-traumatic vascular emergencies, replacing almost completely the traditional primary role of catheter angiography. MDCT is a well-established tool for the elective evaluation of stenoses, malformations, and dysplasias in the settings of renovascular hypertension, but probably less used in the settings of acute traumatic and non-traumatic clinical situations. The aim of this review is to define the role of MDCT in renal arteries emergencies

  8. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    Directory of Open Access Journals (Sweden)

    João Palas

    2014-01-01

    Full Text Available Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  9. Multi-detector computed tomography of acute abdomen

    International Nuclear Information System (INIS)

    Leschka, Sebastian; Alkadhi, Hatem; Wildermuth, Simon; Marincek, Borut; University Hospital of Zurich

    2005-01-01

    Acute abdominal pain is one of the most common causes for referrals to the emergency department. The sudden onset of severe abdominal pain characterising the ''acute abdomen'' requires rapid and accurate identification of a potentially life-threatening abdominal pathology to provide a timely referral to the appropriate physician. While the physical examination and laboratory investigations are often non-specific, computed tomography (CT) has evolved as the first-line imaging modality in patients with an acute abdomen. Because the new multi-detector CT (MDCT) scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of CT for abdominal imaging has increased rapidly. The goal of this article is to discuss the role of MDCT in the diagnostic work-up of acute abdominal pain. (orig.)

  10. Multidetector computer tomography in the pancreatic adenocarcinoma assessment: an update

    Directory of Open Access Journals (Sweden)

    Vincenza Granata

    2016-11-01

    Full Text Available Abstract Ductal adenocarcinoma of the pancreas is one of the most aggressive forms of cancer, with only a minority of cases being resectable at the moment of their diagnosis. The accurate detection and characterization of pancreatic carcinoma is very important for patient management. Multidetector-row computed tomography (MDCT has become the cross-sectional modality of choice in the diagnosis, staging, treatment planning, and follow-up of patients with pancreatic tumors. However, approximately 11% of ductal adenocarcinomas still remain undetected at MDCT because of the lack of attenuation gradient between the lesion and the adjacent pancreatic parenchyma. In this systematic literature review we investigate the current evolution of the CT technique, limitations, and perspectives in the evaluation of pancreatic carcinoma.

  11. Multi-detector row computed tomography and blunt chest trauma

    International Nuclear Information System (INIS)

    Scaglione, Mariano; Pinto, Antonio; Pedrosa, Ivan; Sparano, Amelia; Romano, Luigia

    2008-01-01

    Blunt chest trauma is a significant source of morbidity and mortality in industrialized countries. The clinical presentation of trauma patients varies widely from one individual to another and ranges from minor reports of pain to shock. Knowledge of the mechanism of injury, the time of injury, estimates of motor vehicle accident velocity and deceleration, and evidence of associated injury to other systems are all salient features to provide for an adequate assessment of chest trauma. Multi-detector row computed tomography (MDCT) scanning and MDCT-angiography are being used more frequently in the diagnosis of patients with chest trauma. The high sensitivity of MDCT has increased the recognized spectrum of injuries. This new technology can be regarded as an extremely valuable adjunct to physical examination to recognize suspected and unsuspected blunt chest trauma

  12. [The different manifestations of pulmonary aspergillosis: multidetector computed tomography findings].

    Science.gov (United States)

    Koren Fernández, L; Alonso Charterina, S; Alcalá-Galiano Rubio, A; Sánchez Nistal, M A

    2014-01-01

    Pulmonary aspergillosis is a fungal infection usually caused by inhaling Aspergillus fumigatus spores. However, when we talk about aspergillosis, we normally refer to the spectrum of clinical and radiological findings that depend directly on the patient's immune status, on the prior existence of lung disease, and on the virulence of the infective organism. There are four types of pulmonary aspergillosis (aspergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing pulmonary aspergillosis, and invasive aspergillosis), and each type has its own distinct radiologic findings. We review the signs of pulmonary aspergillosis on multidetector computed tomography and we correlate them with patients' symptoms and immune responses. Likewise, we discuss the differential diagnoses. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

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

    International Nuclear Information System (INIS)

    Macedo, Clarissa Aguiar de; Baena, Marcos Eduardo da Silva; Uezumi, Kiyomi Kato; Castro, Claudio Campi de; Lucarelli, Claudio Luiz; Cerri, Giovanni Guido

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-15

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

  15. Computed-Tomography-Guided Percutaneous Core Needle Biopsies of Suspected Malignant Lymphomas: Impact of Biopsy, Lesion, and Patient Parameters on Diagnostic Yield

    International Nuclear Information System (INIS)

    Hesselmann, V.; Zaehringer, M.; Krug, B.; Wesselmann, C.; Haferkamp, K.; Wickenhauser, C.; Lackner, K.

    2004-01-01

    Purpose: To investigate the diagnostic yield of core needle biopsy in patients with malignant lymphoma. Material and Methods: Computed-tomography-guided core needle biopsies in patients with malignant lymphoma performed in the period 1996 to 2001 were evaluated retrospectively. A biopsy was considered as 'fully diagnostic' if a histological diagnosis, including the histologic subtype in the event of malignant lymphoma, was achieved and the clinical course and CT follow-up of at least 6 months confirmed the biopsy results. A biopsy was regarded as 'partly diagnostic' if histological work-up defined malignant lymphoma but not the histological subtype, and if histological diagnosis bore therapeutic relevance. Diagnostic yield was correlated with features such as size of specimen, location and depth of the target lesion, and experience of the investigator. Results: 45 biopsies were performed in 40 patients. With respect to definite histopathological diagnosis, 31 biopsies (68.9%) were diagnostic and 14 (31.1%) non-diagnostic. In 4 cases (8.8%), biopsies yielded partly diagnostic results, since therapy could be scheduled after biopsy without final sub-classification. Statistical analysis of biopsy parameters revealed that sample sizes were significantly larger in the diagnostic group. Conclusion: CT-guided biopsy can be considered as an alternative for lymphoma diagnosis and should be the first interventional procedure. The most important parameter for diagnostic success is the size of the specimen

  16. Multidetector-row computed tomography management of acute pulmonary embolism

    International Nuclear Information System (INIS)

    Yasui, Takahiro; Tanabe, Nobuhiro; Terada, Jiro

    2007-01-01

    The purpose of this study was to evaluate the usefulness and safety of multidetector-row computed tomography (MDCT) pulmonary angiography and indirect venography management of acute pulmonary embolism (PE), including indication for inferior vena cava (IVC) filter. Seventy-one consecutive patients who were clinically suspected of PE and underwent 16-slice MDCT pulmonary angiography and indirect venography were enrolled. Management included indication of IVC filter for patients with extensive deep venous thrombosis (DVT) in submassive or massive PE. A right ventricular to left ventricular short-axis diameter by MDCT >1.0 was judged as submassive PE. All patients were followed for 1 year. MDCT identified 50 patients with venous thromboembolism and 47 patients had acute PE: 4 were judged as massive, 14 as submassive, and 29 as non-massive by MDCT; 3 patients had DVT alone and 7 patients had caval or iliac DVT. Only 1 patient with massive PE and DVT near the right atrium died of recurrence. No other patients died of PE. Management based on MDCT pulmonary angiography combined with indirect venography is considered to be safe and reliable in patients with suspected acute PE. (author)

  17. Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, M.P.; Kiuru, M.J.; Koskinen, S.K. [Helsinki Univ. Central Hospital, Toeoeloe Trauma Center (Finland). Dept. of Radiology

    2004-11-01

    Purpose: To analyze multidetector computed tomography (MDCT) cervical spine findings in trauma patients with advanced ankylosing spondylitis (AS). Material and Methods: Using PACS, 2282 cervical spine MDCT examinations requested by emergency room physicians were found during a period of 3 years. Of these patients, 18 (16 M, aged 41-87, mean 57 years) had advanced AS. Primary imaging included radiography in 12 and MRI in 11 patients. Results: MDCT detected one facet joint subluxation and 31 fractures in 17 patients: 14 transverse fractures, 8 spinous process fractures, 2 Jefferson's fractures, 1 type I and 2 type II odontoid process fractures, and 1 each: atlanto-occipital joint fracture and C2 laminar fracture plus isolated transverse process and facet joint fractures. Radiographs detected 48% and MRI 60% of the fractures. MRI detected all transverse and odontoid fractures, demonstrating spinal cord abnormalities in 72%. Conclusion: MDCT is superior to plain radiographs or MRI, showing significantly more injuries and yielding more information on fracture morphology. MRI is valuable, however, in evaluating the spinal cord and soft-tissue injuries. Fractures in advanced AS often show an abnormal orientation and are frequently associated with spinal cord injuries. In these patients, for any suspected cervical spine injuries, MDCT is therefore the imaging modality of choice.

  18. Value of Multidetector Computed Tomography in Assessing Blunt Multitrauma Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ahvenjaervi, L.; Mattila, L.; Ojala, R.; Tervonen, O. [Oulu Univ. Hospital (Finland). Dept. of Diagnostic Radiology

    2005-04-01

    Purpose: To find out if multidetector computed tomography (MDCT), using a dedicated trauma protocol, provides sufficient diagnostic information of the injuries of blunt multitrauma patients to enable the planning of treatment for all body compartments. Material and Methods: One-hundred-and-thirty-three patients exposed to high-energy trauma were referred and scanned with the standardized MDCT multitrauma protocol. The imaging protocol consisted of axial scanning of the head and helical scanning of the facial bones, cervical spine, thorax, abdomen, and pelvis. The scanning times were 12 s for the head, 19-21 s for the facial bones and cervical spine (1 mm collimation), and 32-50 s for the thorax, abdomen, and pelvis (2 mm collimation). One-hundred-and-forty milliliters of non-iodinated contrast material (300 mg I/ml) was administered intravenously at 3 ml/s. Results: Ninety-nine of the patients (74%) had at least one finding consistent with trauma. The most frequent findings were in the thorax in 58 patients (44%). Nineteen false-negative findings and two false-positive findings were made. The overall sensitivity of MDCT was 94%, specificity 100%, and accuracy 97%. Conclusion: MDCT is accurate in the assessment of blunt multitrauma patients. The decision to treat the patient can be made on the basis of MDCT with a reasonable level of certainty.

  19. Impact of multi-detector row computed tomography on the tactics of cardiovascular surgery. From qualitative evaluation to quantitative assessment

    International Nuclear Information System (INIS)

    Imagawa, Hiroshi; Kawachi, Kanji; Takano, Shinji

    2005-01-01

    We assessed the role of multi-detector row computed tomography in cardiovascular surgery. The efficacy of multi-detector row computed tomography was assessed concerning the graft patency of coronary artery bypass, arterial atheromatous degeneration, small vessel imaging, and left ventricular volume measurement. Images were reconstructed using both the volume-rendering and the maximum-intensity-profile methods. Arterial atherosclerotic degeneration was assessed by aortic wall volume and aortic calcification volume. In the assessment of bypass graft patency, multidetector row computed tomography showed a 98% correct positive ratio with sensitivity and specificity of 98% and 100%, respectively. Atheromatous degeneration showed matching results in more than 70% of cases compared with intraoperative findings. More than 92% of arterial branches with diameters of 3 mm or greater were detected by preoperative multi-detector row computed tomography images, though only 6% of branches with diameters of 2 mm or less could be visualized. There was a positive linear correlation between left ventricular volumes determined by multi-detector row computed tomography and those calculated from cine angiography. Multi-detector row computed tomography clearly visualized coronary bypass grafts and aortic arterial branches, providing detailed vascular images. Atheromatous degeneration assessed by multi-detector row computed tomography was equivalent with intraoperative findings in more than 70% of cases. Left ventricular volumes measured by multi-detector row computed tomography correlated closely with those determined by cine-angiography. Multidetector row computed tomography is an efficient and promising modality in cardiovascular surgery. (author)

  20. Four-dimensional volume-of-interest reconstruction for cone-beam computed tomography-guided radiation therapy.

    Science.gov (United States)

    Ahmad, Moiz; Balter, Peter; Pan, Tinsu

    2011-10-01

    Data sufficiency are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) on linear accelerator-integrated scanners for image-guided radiotherapy. Scan times must be in the range of 4-6 min to avoid undersampling artifacts. Various image reconstruction algorithms have been proposed to accommodate undersampled data acquisitions, but these algorithms are computationally expensive, may require long reconstruction times, and may require algorithm parameters to be optimized. The authors present a novel reconstruction method, 4D volume-of-interest (4D-VOI) reconstruction which suppresses undersampling artifacts and resolves lung tumor motion for undersampled 1-min scans. The 4D-VOI reconstruction is much less computationally expensive than other 4D-CBCT algorithms. The 4D-VOI method uses respiration-correlated projection data to reconstruct a four-dimensional (4D) image inside a VOI containing the moving tumor, and uncorrelated projection data to reconstruct a three-dimensional (3D) image outside the VOI. Anatomical motion is resolved inside the VOI and blurred outside the VOI. The authors acquired a 1-min. scan of an anthropomorphic chest phantom containing a moving water-filled sphere. The authors also used previously acquired 1-min scans for two lung cancer patients who had received CBCT-guided radiation therapy. The same raw data were used to test and compare the 4D-VOI reconstruction with the standard 4D reconstruction and the McKinnon-Bates (MB) reconstruction algorithms. Both the 4D-VOI and the MB reconstructions suppress nearly all the streak artifacts compared with the standard 4D reconstruction, but the 4D-VOI has 3-8 times greater contrast-to-noise ratio than the MB reconstruction. In the dynamic chest phantom study, the 4D-VOI and the standard 4D reconstructions both resolved a moving sphere with an 18 mm displacement. The 4D-VOI reconstruction shows a motion blur of only 3 mm, whereas the MB reconstruction shows a motion blur of 13 mm

  1. High and intermediate risk prostate cancer treated with three-dimensional computed tomography-guided brachytherapy: 2-8-year follow-up

    International Nuclear Information System (INIS)

    Koutrouvelis, Panos G.; Gillenwater, Jay; Lailas, Niko; Hendricks, Fred; Katz, Stuart; Sehn, James; Gil-Montero, Guillermo; Khawand, Nabil

    2003-01-01

    Purpose: To report post-brachytherapy results in high and intermediate risk patients of prostatic adenocarcinoma. Methods and materials: From June 1994 to June 2000, 356 consecutive high and intermediate risk patients were treated with three-dimensional computed tomography-guided stereotactic pararectal brachytherapy. The age was 42-90 years (median, 68 years), the initial prostate volume was 14-180 cm 3 (median, 59 cm 3 ), and initial PSA was 1.7-143 ng/ml (median, 10.5 ng/ml). Three hundred forty-eight patients were available for follow-up for 2 - 8 years (median, 4.5 years). Two hundred eighty patients had one or more high risk factors (PSA >20 ng/ml, Gleason>7, Stage T2b, T3a, or T3b). Sixty-eight patients had only one intermediate risk factor (PSA 10-20 ng/ml or Gleason=7). Patients with both intermediate risks were considered high risk. The high-risk group was further stratified into subgroups with similar risk profile. A dose of 144 Gy with 125 I or 120 Gy with 103 Pd was achieved in 90-100% of the target. Thirty (30) patients (9%) had prior transurethral resection and 229 (64%) were treated with 3 months neoadjuvant androgen ablation. Results: Biochemical disease-free survival was 92% of 280 high risk patients and 96% of 68 intermediate risk patients. Seven patients (2%) required catheterization during the first year for urinary retention, nine patients (3%) required TUR 1-3 years post-implant, three patients (1%) developed grade 1 or 2 incontinence after a second TUR, and four patients (1%) developed grade 3 rectal complications. Conclusion: This method produces a high level of biochemical control 2-8 years (median 4.5 years). Morbidity is acceptable regardless of risk profile or initial prostate volume

  2. Evaluation of a novel Seldinger-needle for computed tomography guided interventions: initial experiences; Evaluierung einer neuen Seldinger-Nadel fuer computertomografisch gesteuerte Interventionen: Erste Erfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Plumhans, C.; Mahnken, A.; Iwa, R.; Behrendt, F.F.; Sebastian, K.; Guenther, R.W.; Honnef, D. [Universitaetsklinikum RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik

    2009-02-15

    To evaluate a new Seldinger puncture device for computed tomography-guided interventions under difficult conditions, to analyze applicability, and to investigate assets and drawbacks. From November 2007 to March 2008, we performed CT-guided interventions in 16 patients (7 women, 9 men; mean age 62 years old) using a new 20G-Seldinger needle (Sika-Med, Wiehl, Germany). This novel needle serves as a guide for many different interventional devices due to a guide wire welded on the proximal needle end. It allows continuous application of anesthesia via four tiny holes at the distal needle end until the region of interest is reached. Each intervention was subject to difficult interventional conditions. The indications for intervention were drainage (n = 7), Trucut biopsy of tumor (n = 8) and radiofrequency ablation (n = 1). Handling, success, advantages, drawbacks, complications and patient tolerance were noted after each procedure. A pain scale from 1 - 10 was used to grade the pain level during the intervention. All interventions were performed successfully and no severe complications were observed. Patient tolerance was very good resulting in a mean pain score of 2 {+-} 1. Regions with dangerous and difficult access were successfully reached with the new Seldinger needle in 15 of 16 cases by dilatation of the puncture tract and continuous administration of local anesthesia via the system. Furthermore, different devices such as Trucut systems and a drainage catheter were able to be inserted without complication via the needle. With a proximal removable luer-lock connection, liquid material was able to be aspirated in six cases. Under difficult interventional conditions, the use of a Seldinger needle as a reliable technique for CT-guided interventions can provide a safe and successful procedure. (orig.)

  3. Osteoid osteomas in common and in technically challenging locations treated with computed tomography-guided percutaneous radiofrequency ablation

    International Nuclear Information System (INIS)

    Mylona, Sophia; Patsoura, Sofia; Karapostolakis, Georgios; Galani, Panagiota; Pomoni, Anastasia; Thanos, Loukas

    2010-01-01

    To evaluate the efficacy of computed tomography (CT)-guided radiofrequency (RF) ablation for the treatment of osteoid osteomas in common and in technically challenging locations. Twenty-three patients with osteoid osteomas in common (nine cases) and technically challenging [14 cases: intra-articular (n = 7), spinal (n = 5), metaphyseal (n = 2)] positions were treated with CT-guided RF ablation. Therapy was performed under conscious sedation with a seven-array expandable RF electrode for 8-10 min at 80-110 C and power of 90-110 W. The patients went home under instruction. A brief pain inventory (BPI) score was calculated before and after (1 day, 4 weeks, 6 months and 1 year) treatment. All procedures were technically successful. Primary clinical success was 91.3% (21 of total 23 patients), despite the lesions' locations. BPI score was dramatically reduced after the procedure, and the decrease in BPI score was significant (P < 0.001, paired t-test; n - 1 = 22) for all periods during follow up. Two patients had persistent pain after 1 month and were treated successfully with a second procedure (secondary success rate 100%). No immediate or delayed complications were observed. CT-guided RF ablation is safe and highly effective for treatment of osteoid osteomas, even in technically difficult positions. (orig.)

  4. Computed tomography-guided interstitial high dose rate brachytherapy for centrally located liver tumours: a single institution study

    Energy Technology Data Exchange (ETDEWEB)

    Tselis, Nikolaos; Chatzikonstantinou, Georgios; Zamboglou, Nikolaos [Klinikum Offenbach, Department of Radiation Oncology, Offenbach am Main (Germany); Kolotas, Christos [Hirslanden Medical Center, Institute for Radiotherapy, Aarau (Switzerland); Milickovic, Natasa; Baltas, Dimos [Klinikum Offenbach, Department of Medical Physics and Engineering, Offenbach am Main (Germany)

    2013-08-15

    To evaluate the clinical outcome of computed tomography (CT)-guided interstitial (IRT) high-dose-rate (HDR) brachytherapy (BRT) in the treatment of unresectable primary and secondary liver malignancies. This report updates and expands our previously described experience with this treatment technique. Forty-one patients with 50 tumours adjacent to the liver hilum and bile duct bifurcation were treated in 59 interventions of CT-guided IRT HDR BRT. The tumours were larger than 4 cm with a median volume of 84 cm{sup 3} (38-1,348 cm{sup 3}). The IRT HDR BRT delivered a median total physical dose of 20.0 Gy (7.0-32.0 Gy) in twice daily fractions of median 7.0 Gy (4.0-10.0 Gy) in 19 patients and in once daily fractions of median 8.0 Gy (7.0-14.0 Gy) in 22 patients. With a median follow-up of 12.4 months, the local control for metastatic hepatic tumours was 89 %, 73 % and 63 % at 6, 12 and 18 months respectively. The local control for primary hepatic tumours was 90 %, 81 % and 50 % at 6, 12 and 18 months respectively. Severe side effects occurred in 5.0 % of interventions with no treatment-related deaths. CT-guided IRT HDR BRT is a promising procedure for the radiation treatment of centrally located liver malignancies. (orig.)

  5. 3D artificial bones for bone repair prepared by computed tomography-guided fused deposition modeling for bone repair.

    Science.gov (United States)

    Xu, Ning; Ye, Xiaojian; Wei, Daixu; Zhong, Jian; Chen, Yuyun; Xu, Guohua; He, Dannong

    2014-09-10

    The medical community has expressed significant interest in the development of new types of artificial bones that mimic natural bones. In this study, computed tomography (CT)-guided fused deposition modeling (FDM) was employed to fabricate polycaprolactone (PCL)/hydroxyapatite (HA) and PCL 3D artificial bones to mimic natural goat femurs. The in vitro mechanical properties, in vitro cell biocompatibility, and in vivo performance of the artificial bones in a long load-bearing goat femur bone segmental defect model were studied. All of the results indicate that CT-guided FDM is a simple, convenient, relatively low-cost method that is suitable for fabricating natural bonelike artificial bones. Moreover, PCL/HA 3D artificial bones prepared by CT-guided FDM have more close mechanics to natural bone, good in vitro cell biocompatibility, biodegradation ability, and appropriate in vivo new bone formation ability. Therefore, PCL/HA 3D artificial bones could be potentially be of use in the treatment of patients with clinical bone defects.

  6. Percutaneous computed tomography-guided core needle biopsy of soft tissue tumors: results and correlation with surgical specimen analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Grigio, Henrique Ramos; Bitencourt, Almir Galvao Vieira; Pinto, Paula Nicole Vieira; Tyng, Chiang J.; Cunha, Isabela Werneck da; Aguiar Junior, Samuel; Lopes, Ademar, E-mail: chojniak@uol.com.br [Hospital A.C. Camargo, Sao Paulo, SP (Brazil)

    2012-09-15

    Objective: To evaluate the efficacy of percutaneous computed tomography (CT)-guided core needle biopsy of soft tissue tumors in obtaining appropriate samples for histological analysis, and compare its diagnosis with the results of the surgical pathology as available. Materials and Methods: The authors reviewed medical records, imaging and histological reports of 262 patients with soft-tissue tumors submitted to CT-guided core needle biopsy in an oncologic reference center between 2003 and 2009. Results: Appropriate samples were obtained in 215 (82.1%) out of the 262 patients. The most prevalent tumors were sarcomas (38.6%), metastatic carcinomas (28.8%), benign mesenchymal tumors (20.5%) and lymphomas (9.3%). Histological grading was feasible in 92.8% of sarcoma patients, with the majority of them (77.9%) being classified as high grade tumors. Out of the total sample, 116 patients (44.3%) underwent surgical excision and diagnosis confirmation. Core biopsy demonstrated 94.6% accuracy in the identification of sarcomas, with 96.4% sensitivity and 89.5% specificity. A significant intermethod agreement about histological grading was observed between core biopsy and surgical resection (p < 0.001; kappa = 0.75). Conclusion: CT-guided core needle biopsy demonstrated a high diagnostic accuracy in the evaluation of soft tissue tumors as well as in the histological grading of sarcomas, allowing an appropriate therapeutic planning (author)

  7. Preliminary Results of Emergency Computed Tomography-Guided Ventricular Drain Placement-Precision for the Most Difficult Cases.

    Science.gov (United States)

    Nowacki, Andreas; Wagner, Franca; Söll, Nicole; Hakim, Arsany; Beck, Jürgen; Raabe, Andreas; Z'Graggen, Werner J

    2018-04-05

    External ventricular drainage (EVD) catheter placement is one of the most commonly performed neurosurgical procedures. The study's objective was to compare a computed tomography (CT) bolt scan-guided approach for the placement of EVDs with conventional landmark-based insertion. In this retrospective case-control study, we analyzed patients undergoing bolt-kit EVD catheter placement, either CT-guided or landmark-based, between 2013 and 2016. The CT bolt scan-guided approach was based on a dose-reduced CT scan after bolt fixation with immediate image reconstruction along the axis of the bolt to evaluate the putative insertion axis. If needed, angulation of the bolt was corrected and the procedure repeated before the catheter was inserted. Primary endpoint was the accuracy of insertion. Secondary endpoints were the overall number of attempts, duration of intervention, complication rates, and cumulative radiation dose. In total, 34 patients were included in the final analysis. In the group undergoing CT-guided placement, the average ventricle width was significantly smaller (P = 0.04) and average midline shift significantly more pronounced (P = 0.01). CT-guided placement resulted in correct positioning of the catheter in the ipsilateral frontal horn in all 100% of the cases compared with landmark-guided insertion (63%; P = 0.01). Application of the CT-guided approach increased the number of total CT scans (3.6 ± 1.9) and the overall radiation dose (3.34 ± 1.61 mSv) compared with the freehand insertion group (1.84 ± 2.0 mSv and 1.55 ± 1.66 mSv). No differences were found for the other secondary outcome parameters. CT-guided bolt-kit EVD catheter placement is feasible and accurate in the most difficult cases. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Prognostic Factors Influencing the Development of an Iatrogenic Pneumothorax for Computed Tomography-Guided Radiofrequency Ablation of Upper Renal Tumor

    International Nuclear Information System (INIS)

    Park, B.K.; Kim, C.K.

    2008-01-01

    Background: Percutaneous radiofrequency (RF) ablation of upper renal tumors is considered a minimally invasive treatment, but this technique may cause pneumothorax. Purpose: To assess retrospectively the prognostic factors influencing the development of iatrogenic pneumothorax for RF ablation of upper renal tumors. Material and Methods: Computed tomography (CT)-guided RF ablation was performed in 24 patients (21 men, three women; age range 31-77 years, mean age 53.3 years) with 28 upper renal tumors. Various factors for pneumothorax-complicated (PC) upper renal tumors and non-pneumothoracic (NP) upper renal tumors were compared during RF ablation to determine which of the factors were involved in the development of pneumothorax. Results: Among 28 upper renal tumors in 24 patients, a pneumothorax occurred accidentally in six patients with eight tumors and intentionally in two patients with two tumors. This complication was treated with conservative management, instead of tube drainage. PC upper renal tumors had shorter distance from the lung or from the costophrenic line to the tumor, a larger angle between the costophrenic line and the tumor, and a higher incidence of intervening lung tissue than NP upper renal tumors (P<0.01). Intervening lung tissue was more frequently detected on CT images obtained with the patient in the prone position than on CT images obtained with the patient in the supine position. Conclusion: The presence of intervening lung tissue and the close proximity between an upper renal tumor and the lung are high risk factors for developing an iatrogenic pneumothorax. Pre-ablation CT scan should be performed in the prone position to exactly evaluate intervening lung tissue

  9. Feasibility of Computed Tomography-Guided Methods for Spatial Normalization of Dopamine Transporter Positron Emission Tomography Image.

    Science.gov (United States)

    Kim, Jin Su; Cho, Hanna; Choi, Jae Yong; Lee, Seung Ha; Ryu, Young Hoon; Lyoo, Chul Hyoung; Lee, Myung Sik

    2015-01-01

    Spatial normalization is a prerequisite step for analyzing positron emission tomography (PET) images both by using volume-of-interest (VOI) template and voxel-based analysis. Magnetic resonance (MR) or ligand-specific PET templates are currently used for spatial normalization of PET images. We used computed tomography (CT) images acquired with PET/CT scanner for the spatial normalization for [18F]-N-3-fluoropropyl-2-betacarboxymethoxy-3-beta-(4-iodophenyl) nortropane (FP-CIT) PET images and compared target-to-cerebellar standardized uptake value ratio (SUVR) values with those obtained from MR- or PET-guided spatial normalization method in healthy controls and patients with Parkinson's disease (PD). We included 71 healthy controls and 56 patients with PD who underwent [18F]-FP-CIT PET scans with a PET/CT scanner and T1-weighted MR scans. Spatial normalization of MR images was done with a conventional spatial normalization tool (cvMR) and with DARTEL toolbox (dtMR) in statistical parametric mapping software. The CT images were modified in two ways, skull-stripping (ssCT) and intensity transformation (itCT). We normalized PET images with cvMR-, dtMR-, ssCT-, itCT-, and PET-guided methods by using specific templates for each modality and measured striatal SUVR with a VOI template. The SUVR values measured with FreeSurfer-generated VOIs (FSVOI) overlaid on original PET images were also used as a gold standard for comparison. The SUVR values derived from all four structure-guided spatial normalization methods were highly correlated with those measured with FSVOI (P normalization methods provided reliable striatal SUVR values comparable to those obtained with MR-guided methods. CT-guided methods can be useful for analyzing dopamine transporter PET images when MR images are unavailable.

  10. The story of 12 Chachapoyan mummies through multidetector computed tomography

    International Nuclear Information System (INIS)

    Friedrich, Klaus M.; Nemec, Stefan; Czerny, Christian; Fischer, Helga; Plischke, Sonja; Gahleitner, Andre; Viola, Thomas Bence; Imhof, Herwig; Seidler, Horst; Guillen, Sonja

    2010-01-01

    Objective: To assess the imaging findings in Chachapoyan mummies of Peru through multidetector computed tomography (MDCT). Materials and methods: Twelve human mummies and three burial objects from Laguna de los Condores, Peru, about 500-1000 years old, were studied, using a MDCT unit. In addition to the standard whole-body acquisitions, high-resolution scans from areas of particular interest were acquired individually (e.g., temporal bone, teeth). Results: Eight mummies were female, three male, and sex was indeterminable in one mummy; the age of the mummies included newborn, 0.7 years, 2.5 years, 13 years, 13 years, 16 years, and six between 20 and 40 years old. The stature of the mummies was reconstructed (mean ± standard deviation; adults: 145 ± 14 cm, adolescents: 116 ± 17 cm, 2.5 years old child: 72 cm, newborns: 41 ± 3 cm). Dental conditions were compromised in seven and excellent in five mummies. Besides a dislocation of the ossicles, temporal bones and ears were normal in all mummies. An occipital osteoma, a tuberculous spondylodiscitis, and also probable tuberculous erosions at one tarsal joint and one sacral bone, osteoarthritis or tuberculous affection of a sacroiliac joint, as well as five cases of pulmonary tuberculosis were observed. Ten mummies were buried in the fetal position, two were found packaged in bundles; the burial technique was studied in detail. A necklace was found with one mummy. The added burial objects were identified as skeletal parts of two leopardis pardalis and one lagothrix flavicauda. Conclusions: MDCT non-invasively revealed information about age, sex, stature, diseases, burial practices and other cultural aspects of the Chachapoyas.

  11. Lung surgery assisted by multidetector-row computed tomographic simulation

    International Nuclear Information System (INIS)

    Oizumi, Hiroyuki; Endoh, Makoto; Ota, Hiroshi; Takeda, Shinichi; Suzuki, Jun; Fukaya, Ken; Chiba, Masato; Sadahiro, Mitsuaki

    2009-01-01

    We describe the benefits of lung resection simulation using multidetector computed tomography (MDCT). Since 2004, the 1.0-mm slice digital imaging and communications in medicine (DICOM) server has been used for storing data obtained using 64-row MDCT. We observed that an abnormality could not be visualized from the pleural surface in 10 nodules of 18 lesions undergoing wedge lung resection. These 10 nodules were resected through simulation using a three-dimensional (3D) volume-rendering method by considering parameters such as the position, depth, or distance from the interlobar abnormalities, etc., without the need for any marking methods. For lung lobectomy, identification of the branching structures, diameter, and length of the arteries is useful in selecting the procedure for blood vessel treatment. However, in the initial 10 patients of this series, the preoperative identification of 2 small arterial branches was unsuccessful when this method was used. Therefore, it is important to carefully examine the original data in all 3 views, id est (i.e.), axial, sagittal, and coronal views. The visualization of venous branches in affected segments and intersegmental veins has facilitated the preoperative determination of the anatomical intersegmental plane. We divided the cases of thoracoscopic lung segmentectomy into 3 groups (level 1: simple, level 2: intermediate, and level 3: complex) on the basis of the technical complexity. Only level 1 segmentectomies were performed without MDCT simulation. Further, level 2 and 3 segmentectomies could be successfully performed because of the introduction of MDCT simulation in 25 of 35 patients. Thus, this simulation technique may be useful during a thoracoscopic procedure for lung surgery. (author)

  12. The story of 12 Chachapoyan mummies through multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, Klaus M., E-mail: klaus.friedrich@meduniwien.ac.at [Medical University Vienna, Department of Radiology, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Nemec, Stefan, E-mail: stefan.nemec@meduniwien.ac.at [Medical University Vienna, Department of Radiology, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Czerny, Christian, E-mail: christian.czerny@meduniwien.ac.at [Medical University Vienna, Department of Radiology, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Fischer, Helga, E-mail: helga.fischer@akhwien.at [Medical University Vienna, Department of Radiology, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Plischke, Sonja, E-mail: sonja.plischke@akhwien.at [Medical University Vienna, Department of Radiology, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Gahleitner, Andre, E-mail: andre.gahleitner@meduniwien.ac.at [Medical University Vienna, Department of Radiology, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Viola, Thomas Bence, E-mail: bence.viola@univie.ac.at [University of Vienna, Department of Anthropology, Althanstrasse 14, A-1091 Vienna (Austria); Imhof, Herwig, E-mail: herwig.imhof@meduniwien.ac.at [Medical University Vienna, Department of Radiology, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Seidler, Horst, E-mail: horst.seidler@univie.ac.at [University of Vienna, Department of Anthropology, Althanstrasse 14, A-1091 Vienna (Austria); Guillen, Sonja [University of Vienna, Department of Anthropology, Althanstrasse 14, A-1091 Vienna (Austria)

    2010-11-15

    Objective: To assess the imaging findings in Chachapoyan mummies of Peru through multidetector computed tomography (MDCT). Materials and methods: Twelve human mummies and three burial objects from Laguna de los Condores, Peru, about 500-1000 years old, were studied, using a MDCT unit. In addition to the standard whole-body acquisitions, high-resolution scans from areas of particular interest were acquired individually (e.g., temporal bone, teeth). Results: Eight mummies were female, three male, and sex was indeterminable in one mummy; the age of the mummies included newborn, 0.7 years, 2.5 years, 13 years, 13 years, 16 years, and six between 20 and 40 years old. The stature of the mummies was reconstructed (mean {+-} standard deviation; adults: 145 {+-} 14 cm, adolescents: 116 {+-} 17 cm, 2.5 years old child: 72 cm, newborns: 41 {+-} 3 cm). Dental conditions were compromised in seven and excellent in five mummies. Besides a dislocation of the ossicles, temporal bones and ears were normal in all mummies. An occipital osteoma, a tuberculous spondylodiscitis, and also probable tuberculous erosions at one tarsal joint and one sacral bone, osteoarthritis or tuberculous affection of a sacroiliac joint, as well as five cases of pulmonary tuberculosis were observed. Ten mummies were buried in the fetal position, two were found packaged in bundles; the burial technique was studied in detail. A necklace was found with one mummy. The added burial objects were identified as skeletal parts of two leopardis pardalis and one lagothrix flavicauda. Conclusions: MDCT non-invasively revealed information about age, sex, stature, diseases, burial practices and other cultural aspects of the Chachapoyas.

  13. Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

    Directory of Open Access Journals (Sweden)

    Korevaar Erik W

    2008-01-01

    Full Text Available Abstract Background The shift from conventional two-dimensional (2D to three-dimensional (3D-conformal target definition and dose-planning seems to have introduced volumetric as well as geometric changes. The purpose of this study was to compare coverage of computed tomography (CT-based breast and boost planning target volumes (PTV, absolute volumes irradiated, and dose delivered to the organs at risk with conventional 2D and 3D-conformal breast conserving radiotherapy. Methods Twenty-five patients with left-sided breast cancer were subject of CT-guided target definition and 3D-conformal dose-planning, and conventionally defined target volumes and treatment plans were reconstructed on the planning CT. Accumulated dose-distributions were calculated for the conventional and 3D-conformal dose-plans, taking into account a prescribed dose of 50 Gy for the breast plans and 16 Gy for the boost plans. Results With conventional treatment plans, CT-based breast and boost PTVs received the intended dose in 78% and 32% of the patients, respectively, and smaller volumes received the prescribed breast and boost doses compared with 3D-conformal dose-planning. The mean lung dose, the volume of the lungs receiving > 20 Gy, the mean heart dose, and volume of the heart receiving > 30 Gy were significantly less with conventional treatment plans. Specific areas within the breast and boost PTVs systematically received a lower than intended dose with conventional treatment plans. Conclusion The shift towards CT-guided target definition and planning as the golden standard for breast conserving radiotherapy has resulted in improved target coverage at the cost of larger irradiated volumes and an increased dose delivered to organs at risk. Tissue is now included into the breast and boost target volumes that was never explicitly defined or included with conventional treatment. Therefore, a coherent definition of the breast and boost target volumes is needed, based on

  14. Computed tomography-guided needle aspiration and biopsy of pulmonary lesions - A single-center experience in 1000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Poulou, Loukia S.; Tsagouli, Paraskevi; Thanos, Loukas [Dept. of Medical Imaging and Interventional Radiology, General Hospital of Chest Diseases ' Sotiria' , Athens (Greece)], e-mail: ploukia@hotmail.com; Ziakas, Panayiotis D. [Program of Outcomes Research, Div. of Infectious Diseases, Warren Alpert Medical School, Brown Univ., RI, and Div. of Infectious Diseases, Rhode Island Hospital, Rhode Island (United States); Politi, Dimitra [Dept. of Cythopathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece); Trigidou, Rodoula [Dept. of Pathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece)

    2013-07-15

    Background: Computed tomography (CT)-guided fine needle aspiration (FNA) and biopsies are well-established, minimally invasive diagnostic tools for pulmonary lesions. Purpose: To analyze retrospectively the results of 1000 consecutive lung CT-guided FNA and/or core needle biopsies (CNB), the main outcome measures being diagnostic yield, and complication rates. Material and Methods: Patients considered eligible were those referred to our department for lung lesions. The choice of FNA, CNB, or both was based upon the radiologist's judgment. Diagnostic yield was defined as the probability of having a definite result by cytology/histology. Results: The study included 733 male patients and 267 female patients, with a mean (SD) age of 66.4 (11.4) years. The mean (SD) lesion size was 3.7 (2.4) cm in maximal diameter. Six hundred and forty-one (64%) patients underwent an FNA procedure, 245 (25%) a CNB, and 114 (11%) had been subjected to both. The diagnostic yield was 960/994 (96.6%); this decreased significantly with the use of CNB only (odds ratio [OR] 0.32; 95% CI 0.12 - 0.88; P = 0.03), while it increased with lesion size (OR 1.35; 95% CI 1.03 - 1.79; P = 0.03 per cm increase). In 506 patients (52.7%), a malignant process was diagnosed by cytopathology/histology. The complication rate reached 97/1000 (9.7%); complications included: hemorrhage, 62 (6.2%); pneumothorax, 28 (2.8%); hemorrhage and pneumothorax, 5 (0.5%); and hemoptysis, 2 (0.2%). It was not significantly affected by the type of procedure or localization of the lesion. The overall risk for complications was three times higher for lesions <4 cm (OR 3.26; 95% CI 1.96 - 5.42; P < 0.001). Conclusion: CT-guided lung biopsy has a high diagnostic yield using FNA, CNB, or both. The CNB procedure alone will not suffice. Complication rates were acceptable and correlated inversely with lesion size, not localization or type of procedure.

  15. The clinical feasibility and effect of online cone beam computer tomography-guided intensity-modulated radiotherapy for nasopharyngeal cancer

    International Nuclear Information System (INIS)

    Wang Jin; Bai Sen; Chen Nianyong; Xu Feng; Jiang Xiaoqin; Li Yan; Xu Qingfeng; Shen Yali; Zhang Hong; Gong Youling; Zhong Renming; Jiang Qingfeng

    2009-01-01

    Background and purpose: Online adaptive correction in image-guided intensity-modulated radiotherapy appeared to be a promising approach for precision radiation treatment in head and neck tumors. This protocol was designed to evaluate the clinical feasibility and effect of online cone beam computed tomography (CBCT) guidance in IMRT of nasopharyngeal cancer (NPC). Methods and materials: The Elekta Synergy system, which integrates an X-ray volumetric imager (XVI), was used to deliver radiation treatment for 22 cases of NPC. The acquired CBCT was registered to the planning CT for online and offline analysis. The systematic and random setup errors, as well as planning target volume (PTV) margin, were calculated at different correction threshold levels. The impact of online setup correction on dosimetry was evaluated by simulation of pre-correction errors. Results: The correction-of-setup-errors frequencies for 1, 2 and 3 mm thresholds were 41.3-53.9%, 12.7-21.2% and 6.3-10.3%, respectively. Online correction was effective at the 2 mm threshold level for all three axes. The pre-correction systematic errors for the whole group ranged 1.1-1.3 mm, and the random errors were also 1.1-1.3 mm. After online correction, the systematic and random errors ranged 0.4-0.5 mm and 0.7-0.8 mm, respectively, in the three directions. The PTV margins for the pre-correction, pretreatment and post-treatment positions were 3.5-4.2 mm, 1.6-1.8 mm and 2.5-3.2 mm, respectively, in three directions. Analysis of hypothetical dosimetric change due to a translational isocenter shift of 3 mm showed that if no correction was applied, the mean maximum dose to both the brain stem and spinal cord would be increased by 10 Gy, the mean dose to the left and right parotids would be increased by 7.8 and 8.5 Gy, respectively, and the dose to target volumes would be decreased: 4 Gy for 95% GTV and 5.6 Gy for 95% CTV 60. Conclusions: CBCT-based online correction increased the accuracy of IMRT for NPC and

  16. Three-dimensional computed tomography-guided monotherapeutic pararectal brachytherapy of prostate cancer with seminal vesicle invasion

    International Nuclear Information System (INIS)

    Koutrouvelis, Panos; Lailas, Niko; Hendricks, Fred; Gil-Montero, Guillermo; Sehn, James; Katz, Stuart

    2001-01-01

    Purpose: To treat patients with prostate cancer and seminal vesicle invasion with monotherapeutic three dimensional computed tomography (3-DCT)-guided posterior pararectal brachytherapy. Methods and materials: Three hundred and sixty two patients with clinical stage T1 a,b or T2 a,b of prostate cancer were referred for 3-DCT-guided brachytherapy. Each underwent further staging with 3-D CT-guided pararectal biopsy of the seminal vesicles under local anesthesia during the pre-treatment CT-planning. Forty-three patients (12%) were upstaged to T3 cNoMo disease. In the set of 43 patients, Eight had Gleason's score≤6, 24 Gleason's score=7, and 11 patients ≥8. Initial PSA was 20 in 18 patients. Of the 43 patients, 37 patients were treated monotherapeutically with 3-D CT-guided brachytherapy. No patients received hormone therapy after the implant. The prescribed dosage to the seminal vesicles and prostate is 120 Gy with Pd-103 seeds and 144 Gy with 1-125 seeds. Results: The prescribed dosage was achieved in all 37 patient's throughout the seminal vesicles whose range of target radiation extended 5-10 mm outside the target in the adjacent fat as calculated with post-implant CT-dosimetry with Varian Brachy Vision or MMS software. Prostate Specific Antigen (PSA) outcome data were available in 34 patients treated with monotherapy and follow up ranged from 12-56 months (median, 24 months). Decreased PSA levels were stratified into six groups based on the presenting Gleason's score and initial PSA. In the first group (with Gleason's score≤6 and initial PSA 20 ng/ml), PSA decreased to less than 0.5 ng/ml in four out of eight patients (50%). All of the patients in the fourth group (with Gleason's score≥8 and initial PSA 20 ng/ml). There were no patients with Gleason's score of 1-6 and greater than 20 ng/ml initial PSA. Patients, irrespective of the Gleason's score and PSA, had an overall response of decreased PSA (less than 1 ng/ml) of 79%. Conclusion: 3-D CT

  17. Computed tomography-guided percutaneous ozone injection of the Gasserian ganglion for the treatment of trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    An JX

    2018-01-01

    Full Text Available Jian-Xiong An,1,2 Hui Liu,1 Ruo-Wen Chen,1,2 Yong Wang,1 Wen-Xing Zhao,1 Derek Eastwood,3 John P Williams4 1Department of Anesthesiology, Pain Medicine & Critical Care Medicine, Aviation General Hospital of China Medical University & Beijing Institute of Translational Medicine, Chinese Academy of Sciences, 2Department of Anesthesiology, Weifang Medical University, Beijing, People’s Republic of China; 3Department of Pain Services, Wirral University Teaching Hospital, Wirral, Merseyside, UK; 4Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Objective: The aim of this study was to evaluate the therapeutic effect of computed tomography (CT-guided percutaneous ozone injection for refractory trigeminal neuralgia. Design: A retrospective evaluation was performed in the study. Setting: The study was conducted at a university hospital pain center. Patients and methods: A total of 29 patients with a clinical diagnosis of refractory trigeminal neuralgia were enrolled. All patients were treated with a percutaneous ozone injection and one patient was excluded. There were 21 patients with classical trigeminal neuralgia (group A and seven patients with painful trigeminal neuropathy caused by post-herpetic neuralgia (group B. The percutaneous injection was an oxygen–ozone mixture at an ozone concentration of 30 mg/­mL into the Gasserian ganglion performed under CT guidance. The number of ­procedures performed varied from one to as many as 16. Outcomes were evaluated using visual analog scale (VAS pain scores. Results: The combined VAS scores were 7.11 ± 1.23 pretreatment, 2.86 ± 1.69 posttreatment (P < 0.05 and 3.25 ± 2.01 after 6-month follow-up (P < 0.05. In group A, the VAS scores were 7.10 ± 1.04 pretreatment and 2.90 ± 1.84 posttreatment (P < 0.05. In group B, the VAS scores were 7.14 ± 1.77 pretreatment and 2.71 ± 1.25 posttreatment (P < 0.05. After 6-months follow-up, the VAS score was 3.38

  18. Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

    International Nuclear Information System (INIS)

    Laan, Hans Paul van der; Dolsma, Wil V; Maduro, John H; Korevaar, Erik W; Langendijk, Johannes A

    2008-01-01

    The shift from conventional two-dimensional (2D) to three-dimensional (3D)-conformal target definition and dose-planning seems to have introduced volumetric as well as geometric changes. The purpose of this study was to compare coverage of computed tomography (CT)-based breast and boost planning target volumes (PTV), absolute volumes irradiated, and dose delivered to the organs at risk with conventional 2D and 3D-conformal breast conserving radiotherapy. Twenty-five patients with left-sided breast cancer were subject of CT-guided target definition and 3D-conformal dose-planning, and conventionally defined target volumes and treatment plans were reconstructed on the planning CT. Accumulated dose-distributions were calculated for the conventional and 3D-conformal dose-plans, taking into account a prescribed dose of 50 Gy for the breast plans and 16 Gy for the boost plans. With conventional treatment plans, CT-based breast and boost PTVs received the intended dose in 78% and 32% of the patients, respectively, and smaller volumes received the prescribed breast and boost doses compared with 3D-conformal dose-planning. The mean lung dose, the volume of the lungs receiving > 20 Gy, the mean heart dose, and volume of the heart receiving > 30 Gy were significantly less with conventional treatment plans. Specific areas within the breast and boost PTVs systematically received a lower than intended dose with conventional treatment plans. The shift towards CT-guided target definition and planning as the golden standard for breast conserving radiotherapy has resulted in improved target coverage at the cost of larger irradiated volumes and an increased dose delivered to organs at risk. Tissue is now included into the breast and boost target volumes that was never explicitly defined or included with conventional treatment. Therefore, a coherent definition of the breast and boost target volumes is needed, based on clinical data confirming tumour control probability and normal

  19. An analysis of brachytherapy with computed tomography-guided permanent implantation of Iodine-125 seeds for recurrent nonkeratin nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Shen X

    2015-05-01

    Full Text Available Xinying Shen,1,2 Yong Li,2 Yanfang Zhang,2 Jian Kong,2 Yanhao Li1 1Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 2Department of Interventional Radiology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, People’s Republic of China Background: 125I seed implantation is a new method in treatment of nasopharyngeal carcinoma (NPC, and it is worthwhile to evaluate its feasibility. In this study, we performed brachytherapy with computed tomography (CT-guided permanent implantation of 125I seeds in the treatment of patients with the recurrence of NPC.Methods: A total 30 patients (20 male and ten female at the median age of 55 (range 25–80 years were diagnosed with recurrent nonkeratin NPC, with a total 38 lesions and a short disease-free interval (median ~11 months after primary radiotherapy alone or combined with chemotherapy. Patients received CT scan, starting from 2 months after the treatment. Follow-up was conducted for ~2–38 months to observe the local control rate and overall survival rate. We also analyzed the possible correlation between survival periods and the status of recurrent tumors.Results: The local control rates at 6, 12, 24, 30, and 36 months after the procedure of 125I seed implantation were 86.8%, 73.7%, 26.3%, 15.8%, and 5.3%, respectively. The overall 1-, 2-, and 3-year survival rates were 80.0% (24/30, 30.0% (9/30, and 6.7% (2/30, respectively, with a median survival period of 18 months (17.6±8.6 months. Interestingly, the survival periods of the patients who had primary radiotherapy with or without chemotherapy were 15.8±7.9 and 24.3±7.9 months, respectively. Kaplan–Meier survival analysis demonstrated that χ2 (log rank was 7.555, with very significant difference (P<0.01. The survival periods of patients in tumor stages I, II, III, and IV were 25.4±8.7, 19.8±9.4, 16.1±4.5, and 12.8±7.8 months, respectively, with

  20. ULTRASONOGRAPHY AND COMPUTED TOMOGRAPHY GUIDED FINE NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSING INTRA-ABDOMINAL LESIONS- A 6-YEAR RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL IN MANIPUR

    Directory of Open Access Journals (Sweden)

    Ratan Konjengbam

    2017-07-01

    Full Text Available BACKGROUND Fine-Needle Aspiration Cytology (FNAC is a widely used method, which is accurate and safe in a readily palpable masses. But, in those inaccessible lesions and deeper organs are safely aspirated using fine needle radiological procedure like ultrasound or computed tomography guided. The aim of the study is to assess the utility of FNAC in the diagnosis of intra-abdominal lesions and different pattern of lesions in particular to the sites. MATERIALS AND METHODS This retrospective study was done in the Department of Pathology, Regional Institute of Medical Sciences (RIMS, Imphal, between June 2010 and June 2016. The study included 128 intra-abdominal masses. Giemsa and Papanicolaou’s stains were used. The cytological diagnosis was correlated with clinical and radiological data to arrive at a final diagnosis. RESULTS Reports on FNAC smears were retrospectively analysed, which had been done in various anatomic sites- liver (70 cases, colon (19 cases, gallbladder (17 cases, mesenteric lymph nodes (12 cases, ovary (3 cases, adrenals (2 cases and 1 case each of pancreas, peritoneal wall, pelvic, suprapubic and flank masses. The mean age was 42.16 years with M:F of 1.3:1. The diagnostic yield was 85.2% in combination for Ultrasound Guided (USG and Computed Tomography (CT guided aspiration. The smears were classified as benign neoplastic, malignant neoplastic, non-neoplastic, inconclusive and unsatisfactory for interpretation. There were 79 (61.7% malignant neoplastic lesion, 5 (3.9% benign neoplastic lesion, 25 (19.5% non-neoplastic lesion, one (0.7% inconclusive lesions and 18 (14.1% unsatisfactory smears. The liver and the colon were the most common sites. Adenocarcinomas and Hepatocellular Carcinoma (HCC were the most common malignant lesions comprising of 35 (44.3% and 25 (31.6% of the total malignant lesions diagnosed. CONCLUSION Intra-abdominal FNA is a simple, economical and a safe procedure with high sensitivity, specificity and

  1. Long-term internal thoracic artery bypass graft patency and geometry assessed by multidetector computed tomography

    DEFF Research Database (Denmark)

    Zacho, Mette; Damgaard, Sune; Lilleoer, Nikolaj Thomas

    2012-01-01

    The left internal thoracic artery (LITA) undergoes vascular remodelling when used for coronary artery bypass grafting. In this study we tested the hypothesis that the extent of the LITA remodelling late after coronary artery bypass grafting assessed by multidetector computed tomography is related...

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

    NARCIS (Netherlands)

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

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-09-15

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

  4. Transmural myocardial perfusion gradients in relation to coronary artery stenoses severity assessed by cardiac multidetector computed tomography

    DEFF Research Database (Denmark)

    Linde, Jesper James; Kühl, Jørgen Tobias; Hove, Jens Dahlgaard

    2015-01-01

    To assess the relationship between epicardial coronary artery stenosis severity and the corresponding regional transmural perfusion at rest and during adenosine stress, using multidetector computed tomography (MDCT). We evaluated the relationship between the severity of coronary artery diameter...

  5. Diagnostic ability of Barrett's index to detect dysthyroid optic neuropathy using multidetector computed tomography

    International Nuclear Information System (INIS)

    Monteiro, Mario L.R.; Goncalves, Allan C.P.; Silva, Carla T.M.; Moura, Janete P.; Ribeiro, Carolina S.; Gebrim, Eloisa M.M.S.; Universidade de Sao Paulo; Universidade de Sao Paulo

    2008-01-01

    Objectives: The objective of this study was to evaluate the ability of a muscular index (Barrett's Index), calculated with multidetector computed tomography, to detect dysthyroid optic neuropathy in patients with Graves' orbitopathy. Methods: Thirty-six patients with Graves' orbitopathy were prospectively studied and submitted to neuro-ophthalmic evaluation and multidetector computed tomography scans of the orbits. Orbits were divided into two groups: those with and without dysthyroid optic neuropathy. Barrett's index was calculated as the percentage of the orbit occupied by muscles. Sensitivity and specificity were determined for several index values. Results: Sixty-four orbits (19 with and 45 without dysthyroid optic neuropathy) met the inclusion criteria for the study. The mean Barrett's index values (±SD) were 64.47% ± 6.06% and 49.44% ± 10.94% in the groups with and without dysthyroid optic neuropathy, respectively (p 60% should be carefully examined and followed for the development of dysthyroid optic neuropathy. (author)

  6. Quantitative assessment of left ventricular systolic wall thickening using multidetector computed tomography

    DEFF Research Database (Denmark)

    Kristensen, Thomas S; Kofoed, Klaus F; Møller, Daniel V

    2009-01-01

    BACKGROUND: Multidetector computed tomography (MDCT) of the heart provides both anatomical and functional information. The objective of this study was to evaluate the accuracy of quantitative assessment of left ventricular contractile function in relation to two-dimensional transthoracic echocard......BACKGROUND: Multidetector computed tomography (MDCT) of the heart provides both anatomical and functional information. The objective of this study was to evaluate the accuracy of quantitative assessment of left ventricular contractile function in relation to two-dimensional transthoracic...... echocardiography (TTE). MATERIALS AND METHODS: Sixty-four patients with known or suspected coronary artery disease underwent ECG-gated 64-slice MDCT and TTE. Regional left ventricular contractile function was measured by percent systolic wall thickening (SWT) in 16 myocardial segments using MDCT, and compared...

  7. Multi-detector row computed tomography angiography of peripheral arterial disease

    International Nuclear Information System (INIS)

    Kock, Marc C.J.M.; Dijkshoorn, Marcel L.; Pattynama, Peter M.T.; Myriam Hunink, M.G.

    2007-01-01

    With the introduction of multi-detector row computed tomography (MDCT), scan speed and image quality has improved considerably. Since the longitudinal coverage is no longer a limitation, multi-detector row computed tomography angiography (MDCTA) is increasingly used to depict the peripheral arterial runoff. Hence, it is important to know the advantages and limitations of this new non-invasive alternative for the reference test, digital subtraction angiography. Optimization of the acquisition parameters and the contrast delivery is important to achieve a reliable enhancement of the entire arterial runoff in patients with peripheral arterial disease (PAD) using fast CT scanners. The purpose of this review is to discuss the different scanning and injection protocols using 4-, 16-, and 64-detector row CT scanners, to propose effective methods to evaluate and to present large data sets, to discuss its clinical value and major limitations, and to review the literature on the validity, reliability, and cost-effectiveness of multi-detector row CT in the evaluation of PAD. (orig.)

  8. Multidetector computed tomography arteriography in the preoperative assessment of patients with ureteropelvic junction obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Braun, Petra [Department of Radiology, Hospital de la Plana, Ctra. de Vila-real a Borriana KM. 0.5, 12540 Vila-real (Spain)]. E-mail: PetraBraun@gmx.de; Guilabert, Jose Pamies [Department of Radiology, Hospital de la Plana, Ctra. de Vila-real a Borriana KM. 0.5, 12540 Vila-real (Spain); Kazmi, Faaiza [Department of Radiology, Penn State Milton S. Hershey Medical Center (United States)

    2007-01-15

    Background: Nowadays, endoscopic management of ureteropelvic junction (UPJ) obstruction is the treatment of choice. However, in the presence of crossing vessels, the success rate of endoscopic management decreases and the risk of hemorrhagic and vascular complications rises. The purpose of this study is to evaluate patients with UPJ obstruction using contrast enhanced multidetector computed tomography (CT) angiography to aid in surgical planning and management. Patients and methods: Between 2001 and 2005, 27 patients (mean age: 43 years; age range: 17-75 years) with UPJ obstruction were studied with multidetector CT angiography. Identification and characterization of crossing vessels was performed with multidirectional images and three-directional reconstructions. Results: 12 patients (44%) were found to have 16 crossing vessels (vessels in contact with the UPJ or within a vicinity of less than 2 mm). Nine of these vessels were arteries and seven were veins. Nine vessels crossed anteriorly, two posteriorly, and one anteromedially. Endopyelotomy was contraindicated in these 12 patients due to the presence of crossing vessels. Eleven out of the 12 patients underwent a pyeloplasty by open surgery or laparoscopy, where the presence of crossing vessels was confirmed. One of the 12 patients did not undergo surgery. Conclusion: Multidetector CT angiography permits an adequate preoperative assessment of patients with UPJ obstruction as it is able to identify the presence and location of crossing vessels. Furthermore, it allows to study in detail the anatomy of the renal area and its vascular variants.

  9. Bosniak classification of renal cystic lesions according to multidetector computed tomography findings

    International Nuclear Information System (INIS)

    Miranda, Christiana Maia Nobre Rocha de; Padilha, Igor Gomes; Farias, Lucas de Padua Gomes de; Rocha, Milzi Sarmento da; Maranhao, Carol Pontes de Miranda; Santos, Carla Jotta Justo dos

    2014-01-01

    Renal cystic lesions are usually diagnosed in the radiologists' practice and therefore their characterization is crucial to determine the clinical approach to be adopted and prognosis. The Bosniak classification based on computed tomography findings has allowed for standardization and categorization of lesions in increasing order of malignancy (I, II, IIF, III and IV) in a simple and accurate way. The present iconographic essay developed with multidetector computed tomography images of selected cases from the archives of the authors' institution, is aimed at describing imaging findings that can help in the diagnosis of renal cysts. (author)

  10. Multidetector computed tomographic pulmonary angiography in patients with a high clinical probability of pulmonary embolism.

    Science.gov (United States)

    Moores, L; Kline, J; Portillo, A K; Resano, S; Vicente, A; Arrieta, P; Corres, J; Tapson, V; Yusen, R D; Jiménez, D

    2016-01-01

    ESSENTIALS: When high probability of pulmonary embolism (PE), sensitivity of computed tomography (CT) is unclear. We investigated the sensitivity of multidetector CT among 134 patients with a high probability of PE. A normal CT alone may not safely exclude PE in patients with a high clinical pretest probability. In patients with no clear alternative diagnosis after CTPA, further testing should be strongly considered. Whether patients with a negative multidetector computed tomographic pulmonary angiography (CTPA) result and a high clinical pretest probability of pulmonary embolism (PE) should be further investigated is controversial. This was a prospective investigation of the sensitivity of multidetector CTPA among patients with a priori clinical assessment of a high probability of PE according to the Wells criteria. Among patients with a negative CTPA result, the diagnosis of PE required at least one of the following conditions: ventilation/perfusion lung scan showing a high probability of PE in a patient with no history of PE, abnormal findings on venous ultrasonography in a patient without previous deep vein thrombosis at that site, or the occurrence of venous thromboembolism (VTE) in a 3-month follow-up period after anticoagulation was withheld because of a negative multidetector CTPA result. We identified 498 patients with a priori clinical assessment of a high probability of PE and a completed CTPA study. CTPA excluded PE in 134 patients; in these patients, the pooled incidence of VTE was 5.2% (seven of 134 patients; 95% confidence interval [CI] 1.5-9.0). Five patients had VTEs that were confirmed by an additional imaging test despite a negative CTPA result (five of 48 patients; 10.4%; 95% CI 1.8-19.1), and two patients had objectively confirmed VTEs that occurred during clinical follow-up of at least 3 months (two of 86 patients; 2.3%; 95% CI 0-5.5). None of the patients had a fatal PE during follow-up. A normal multidetector CTPA result alone may not safely

  11. Multidetector computed tomography has replaced conventional intravenous excretory urography in imaging of the kidneys: A scoping review of multidetector computed tomography findings in renal tuberculosis

    Directory of Open Access Journals (Sweden)

    Ntombizakhona B.A. Mthalane

    2018-02-01

    Full Text Available Background: Tuberculosis (TB is a worldwide infectious disease burden, especially in non-developed countries, with increased morbidity and mortality among human immunodeficiency virus (HIV-infected patients. Extrapulmonary TB is rare and renal TB is one of the commonest manifestations. The end result of renal TB is end-stage renal disease; however, this can be avoided if the diagnosis is made early. The diagnosis of renal TB is challenging because of the non-specific presentation and low sensitivity of clinical tests. Although the sequel of TB infection in the kidney causes varying manifestations depending on the stage of the disease, multidetector computed tomography (MDCT is capable of demonstrating early findings. We performed a 20-year scoping review of MDCT findings in renal TB to promote awareness. Aim: To identify specific MDCT imaging characteristics of renal TB, promote early diagnosis and increase awareness of the typical imaging features. Methods and material: We searched published and unpublished literature from 1997 to 2017 using a combination of search terms on electronic databases. We followed the Joanna Briggs Institute guidelines. Results: A total of 150 articles were identified, of which 145 were found through electronic search engines and 5 were obtained from grey literature. Seventy-nine articles that fulfilled our inclusion criteria were reviewed. These included original research, case reports, literature review, organisational reports and grey literature. Conclusion: Multidetector computed tomography can reproduce images comparable with intravenous excretory urography; together with advantages of being able to better assess the renal parenchyma and surrounding spaces, it is important in suggesting the diagnosis of renal TB and clinicians should consider including MDCT when investigating patients with recurrent urinary tract infection not responding to usual antimicrobial therapy.

  12. Multiplanar and two-dimensional imaging of central airway stenting with multidetector computed tomography

    Directory of Open Access Journals (Sweden)

    Ozgul Mehmet

    2012-08-01

    Full Text Available Abstract Background Multidetector computed tomography (MDCT provides guidance for primary screening of the central airways. The aim of our study was assessing the contribution of multidetector computed tomography- two dimensional reconstruction in the management of patients with tracheobronchial stenosis prior to the procedure and during a short follow up period of 3 months after the endobronchial treatment. Methods This is a retrospective study with data collected from an electronic database and from the medical records. Patients evaluated with MDCT and who had undergone a stenting procedure were included. A Philips RSGDT 07605 model MDCT was used, and slice thickness, 3 mm; overlap, 1.5 mm; matrix, 512x512; mass, 90 and kV, 120 were evaluated. The diameters of the airways 10 mm proximal and 10 mm distal to the obstruction were measured and the stent diameter (D was determined from the average between D upper and D lower. Results Fifty-six patients, 14 (25% women and 42 (75% men, mean age 55.3 ± 13.2 years (range: 16-79 years, were assessed by MDCT and then treated with placement of an endobronchial stent. A computed tomography review was made with 6 detector Philips RSGDT 07605 multidetector computed tomography device. Endobronchial therapy was provided for the patients with endoluminal lesions. Stents were placed into the area of stenosis in patients with external compression after dilatation and debulking procedures had been carried out. In one patient the migration of a stent was detected during the follow up period by using MDCT. Conclusions MDCT helps to define stent size, length and type in patients who are suitable for endobronchial stinting. This is a non-invasive, reliable method that helps decisions about optimal stent size and position, thus reducing complications.

  13. Multi-Detector Computed Tomography Imaging Techniques in Arterial Injuries

    Directory of Open Access Journals (Sweden)

    Cameron Adler

    2018-04-01

    Full Text Available Cross-sectional imaging has become a critical aspect in the evaluation of arterial injuries. In particular, angiography using computed tomography (CT is the imaging of choice. A variety of techniques and options are available when evaluating for arterial injuries. Techniques involve contrast bolus, various phases of contrast enhancement, multiplanar reconstruction, volume rendering, and maximum intensity projection. After the images are rendered, a variety of features may be seen that diagnose the injury. This article provides a general overview of the techniques, important findings, and pitfalls in cross sectional imaging of arterial imaging, particularly in relation to computed tomography. In addition, the future directions of computed tomography, including a few techniques in the process of development, is also discussed.

  14. Bosniak classification of renal cystic lesions according to multidetector computed tomography findings; Classificacao de Bosniak das lesoes cisticas renais segundo achados na tomografia computadorizada multidetectores

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Christiana Maia Nobre Rocha de; Padilha, Igor Gomes; Farias, Lucas de Padua Gomes de; Rocha, Milzi Sarmento da, E-mail: maiachristiana@globo.com [Universidade Federal de Alagoas (UFAL), Maceio, AL (Brazil); Maranhao, Carol Pontes de Miranda; Santos, Carla Jotta Justo dos [Clinica de Medicina Nuclear e Radiologia de Maceio (MedRadiUS), Maceio, AL (Brazil)

    2014-03-15

    Renal cystic lesions are usually diagnosed in the radiologists' practice and therefore their characterization is crucial to determine the clinical approach to be adopted and prognosis. The Bosniak classification based on computed tomography findings has allowed for standardization and categorization of lesions in increasing order of malignancy (I, II, IIF, III and IV) in a simple and accurate way. The present iconographic essay developed with multidetector computed tomography images of selected cases from the archives of the authors' institution, is aimed at describing imaging findings that can help in the diagnosis of renal cysts. (author)

  15. Prevalence and Characteristics of Myocardial Bridging in Multidetector-Row Computed Tomography Coronary Angiography

    International Nuclear Information System (INIS)

    Carrascosa, Patricia; Martin Lopez, Elba; Capunay, Carlos; Deviggiano, Alejandro; Vallejos, Javier; Carrascosa, Jorge

    2009-01-01

    Background: Myocardial bridging (MB) are congenital defects of the coronary arteries in which a segment of an epicardial artery lies in the myocardium for part of its course. The current gold standard for diagnosing MB is coronary angiography; however other invasive techniques are also useful. Myocardial bridging can also be visualized with the use of novel non-invasive imaging techniques such as multidetector-row computed tomography coronary angiography (MDCT-CA). Objectives: To assess the prevalence and characteristics of myocardial bridging in patients undergoing multidetector-row computed tomography coronary angiography (MDCT-CA). Material and Methods: A total of 452 consecutive patients were evaluated with 16-row and 64-row MDCT-CA due to the presence of abnormal findings in myocardial perfusion image tests, symptoms suggestive of coronary artery disease, and in asymptomatic patients with a family history of coronary artery disease. The presence of MB, their location and characteristics were analyzed. Myocardial bridging were classified as complete and incomplete bridges with respect to continuity of the myocardium over the tunneled segment of the artery involved. Quantitative measurements of vessel diameter during systole and diastole were evaluated. Results: The prevalence of MB was 35.18%; 88 were complete and 71 incomplete. Among complete MB, 6 affected both systole and diastole, 27 presented only systolic compression and 55 showed no compression. Incomplete MB showed absence of arterial compression. Conclusions: Multidetector-row computed tomography coronary angiography detected a higher prevalence of MB in the study population and allowed to classify them and to assess their functional aspects throughout the cardiac cycle. (authors) [es

  16. The normal anatomy and variations of the bronchial arteries: evaluation with multidetector computed tomography.

    Science.gov (United States)

    Yener, Özlem; Türkvatan, Aysel; Yüce, Gökhan; Yener, Ali Ümit

    2015-02-01

    In this study, we aimed to reveal the normal anatomy and variations of the bronchial arterial system and to determine the sex distribution of these variations by retrospectively reviewing the images of patients who underwent thoracal multidetector computed tomographic angiography for various reasons. Multidetector computed tomographic images of a total of 208 patients (151 men; mean age, 59 years) were retrospectively reviewed to assess the normal anatomy and variations of the bronchial arterial system. A total of 531 bronchial arteries (median, 3; minimum, 1; maximum, 5; mean, 2.5) were detected. The number (mean diameter) of the right bronchial arteries were higher than the left bronchial arteries (290 [1.43 mm] and 241 [1.26 mm], respectively; P arteries were higher with men than with women (2.58 [1.45 mm] and 2.47 [1.32 mm], respectively; P artery, and, secondarily (13.46%), the combination of 2 right (1 intercostal-bronchial trunk and 1 bronchial artery) and 1 left bronchial arteries. Seventy-eight ectopic bronchial arteries were detected in 59 cases (28.3%). They most commonly originated from the aortic arch (37.2%), the descending aorta below the level of T6 (35.9%), or the aortic branches (16.7%). The number of right ectopic bronchial arteries was significantly higher than the left ectopic bronchial arteries (50 [64%] vs 28 [36%]; P arteries was statistically higher with men versus women (45 [29.8%] vs 14 [24.6%]; P arteries can vary substantially among individuals. Multidetector computed tomographic angiography enables a detailed road map of the bronchial arterial system to interventional radiologists and thoracic surgeons. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  18. Assessment of adult congenital heart disease with multi-detector computed tomography - beyond coronary lumenography

    International Nuclear Information System (INIS)

    Nicol, E.D.; Gatzoulis, M.; Padley, S.P.G.; Rubens, M.

    2007-01-01

    Adult congenital heart disease is an increasingly prevalent condition with more than 135,000 patients affected in England alone. With this increased patient population and an increase in interventional procedures being performed on them, traditional imaging techniques such as cardiac magnetic resonance (CMR) may be unavailable locally or contra-indicated. Cardiac multidetector computed tomography (MDCT) is rapidly emerging as an alternative imaging method for the investigation of these patients and this review highlights the broad application of cardiac MDCT to this population and makes recommendations on the stardardized reporting of complex congenital heart disease

  19. Multidetector computed tomography-spectrum of blunt chest wall and lung injuries in polytraumatized patients

    Energy Technology Data Exchange (ETDEWEB)

    Peters, S., E-mail: soeren.peters@rub.d [Department of Radiology and Nuclear Medicine, BG Universitaetsklinikum Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789 Bochum (Germany); Nicolas, V.; Heyer, C.M. [Department of Radiology and Nuclear Medicine, BG Universitaetsklinikum Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789 Bochum (Germany)

    2010-04-15

    Accidental injuries are the leading cause of death in the 15 to 44-year-old age group. Blunt chest trauma is often encountered in these patients and is associated with a mortality of up to 25%. Although conventional radiography still plays an important role in the initial emergency room setting, for follow-up in the intensive care unit, multidetector computed tomography has established itself as the standard imaging method for the evaluation of chest trauma patients. The following review presents salient radiological findings of the chest wall and shoulder girdle, thoracic spine, pleural space, and lung in polytraumatized patients.

  20. Multidetector computed tomography of urolithiasis. Technique and results; Multidetektor-Computertomografie der Urolithiasis. Technik und Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Karul, M.; Regier, M. [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Zentrum fuer Radiologie und Endoskopie; Heuer, R. [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Zentrum fuer Operative Medizin

    2013-02-15

    The diagnosis of acute urolithiasis results from unenhanced multidetector computed tomography (MDCT). This test analyses the functional and anatomical possibility for passing an ureteral calculi, the localization and dimension of which are important parameters for further therapy. Alternatively chronic urolithiasis could be ruled out by magnetic resonance urography (MRU). MRU is the first choice especially in pregnant women and children because of radiation hygiene. Enhanced MDCT must be emphasized as an alternative to intravenous urography (IVU) for diagnosis of complex drainage of urine and suspected disorder of the involved kidney. This review illustrates the principles of different tests and the clinical relevance thereof. (orig.)

  1. Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)]. E-mail: rakesh.sinha@uhl-tr.nhs.uk; Verma, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)

    2005-10-01

    Large bowel obstruction may present as an emergency as high-grade colonic obstruction and can result in perforation. Perforated large bowel obstruction causes faecal peritonitis, which can result in high morbidity and mortality. Multidetector row computed tomography (MDCT) has the potential of providing an accurate diagnosis of large bowel obstruction. The rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of the various causes of large bowel obstruction with emphasis on important pathogenic factors, CT appearances and the use of multiplanar reformatted images in the diagnostic workup.

  2. Multidetector computed tomography diagnosis of gastric volvulus through the foramen of Morgagni.

    Science.gov (United States)

    Lecouvet, S; Coulier, B; Pierard, F; Gogoase, M; Coppens, J P; Van Hoof, M

    2014-01-01

    Morgagni hernia is considered to be the rarest form of all diaphragmatic hernias. It develops through a congenital defect in the retrosternal area. Usually asymptomatic, this entity can lead to life-threatening complications such as incarceration, strangulation or volvulus of the herniated viscus. We hereby report a rare case of organoaxial gastric volvulus producing through the foramen of Morgagni in a 78-year-old woman. The full diagnosis was made by upper gastro-intestinal series and multidetector computed tomography (MDCT). The basic anatomy, physiopathology, diagnostic methods, complications and surgical treatment of Morgagni hernia are briefly reviewed.

  3. Assessment of adult congenital heart disease with multi-detector computed tomography - beyond coronary lumenography

    Energy Technology Data Exchange (ETDEWEB)

    Nicol, E.D. [Department of Radiology, Royal Brompton Hospital, London (United Kingdom) and Department of Cardiology, Royal Brompton Hospital, London (United Kingdom)]. E-mail: e.nicol@rbht.nhs.uk; Gatzoulis, M. [Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital and National Heart and Lung Institute, London (United Kingdom); Padley, S.P.G. [Department of Radiology, Royal Brompton Hospital, London (United Kingdom); Rubens, M. [Department of Radiology, Royal Brompton Hospital, London (United Kingdom)

    2007-06-15

    Adult congenital heart disease is an increasingly prevalent condition with more than 135,000 patients affected in England alone. With this increased patient population and an increase in interventional procedures being performed on them, traditional imaging techniques such as cardiac magnetic resonance (CMR) may be unavailable locally or contra-indicated. Cardiac multidetector computed tomography (MDCT) is rapidly emerging as an alternative imaging method for the investigation of these patients and this review highlights the broad application of cardiac MDCT to this population and makes recommendations on the stardardized reporting of complex congenital heart disease.

  4. Computed tomography with multidetectors in the diagnosis of coronary stenosis

    International Nuclear Information System (INIS)

    Lombo, Bernardo; Carvajal, Codos A; Tafur, Monica; Gomez, Rafael

    2007-01-01

    Coronary angiography that uses multislice spiral computed tomography is a noninvasive technique for the detection of coronary stenosis that has had significant improvements in recent years. The introduction of 16 and 64 row scanners, the development of synchronized scanning electrocardiogram and better reconstruction techniques permit higher spatial and temporal resolution that allows better identification of coronary plaques and significant obstructive coronary lesions. In the next years Multislice spiral computed tomography will continue maturing and it will become a useful non invasive diagnostic imaging tool for the diagnosis of coronary disease and will be integrated to the cardiologic management protocols. Our next review will be focused on the basic and technical aspects of the scanner, diagnostic performance and clinical applications of this new technology

  5. Prognostic implications of nonobstructive coronary plaques in patients with non-ST-segment elevation myocardial infarction: a multidetector computed tomography study

    DEFF Research Database (Denmark)

    Kristensen, Thomas S; Kofoed, Klaus F; Kühl, Jørgen T

    2011-01-01

    We sought to determine whether the amount of noncalcified plaque (NCP) in nonobstructive coronary lesions as detected by multidetector computed tomography (MDCT) was a predictor of future coronary events.......We sought to determine whether the amount of noncalcified plaque (NCP) in nonobstructive coronary lesions as detected by multidetector computed tomography (MDCT) was a predictor of future coronary events....

  6. Contrast-enhanced ultrasound vs multidetector-computed tomography for detecting liver metastases in colorectal cancer: a prospective, blinded, patient-by-patient analysis

    DEFF Research Database (Denmark)

    Rafaelsen, S R; Jakobsen, A

    2011-01-01

    This study compared the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and multidetector-computed tomography (MDCT) in the detection of liver metastases in patients with colorectal cancer.......This study compared the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and multidetector-computed tomography (MDCT) in the detection of liver metastases in patients with colorectal cancer....

  7. Sex estimation from sternal measurements using multidetector computed tomography.

    Science.gov (United States)

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Inci, Ercan; Bilgili, Mustafa Gokhan; Solmaz, Dilek; Erdil, Irem; Can, Ismail Ozgur

    2014-12-01

    We aimed to show the utility and reliability of sternal morphometric analysis for sex estimation.Sex estimation is a very important step in forensic identification. Skeletal surveys are main methods for sex estimation studies. Morphometric analysis of sternum may provide high accuracy rated data in sex discrimination. In this study, morphometric analysis of sternum was evaluated in 1 mm chest computed tomography scans for sex estimation. Four hundred forty 3 subjects (202 female, 241 male, mean age: 44 ± 8.1 [distribution: 30-60 year old]) were included the study. Manubrium length (ML), mesosternum length (2L), Sternebra 1 (S1W), and Sternebra 3 (S3W) width were measured and also sternal index (SI) was calculated. Differences between genders were evaluated by student t-test. Predictive factors of sex were determined by discrimination analysis and receiver operating characteristic (ROC) analysis. Male sternal measurement values are significantly higher than females (P discrimination analysis, MSL has high accuracy rate with 80.2% in females and 80.9% in males. MSL also has the best sensitivity (75.9%) and specificity (87.6%) values. Accuracy rates were above 80% in 3 stepwise discrimination analysis for both sexes. Stepwise 1 (ML, MSL, S1W, S3W) has the highest accuracy rate in stepwise discrimination analysis with 86.1% in females and 83.8% in males. Our study showed that morphometric computed tomography analysis of sternum might provide important information for sex estimation.

  8. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations

    Directory of Open Access Journals (Sweden)

    Carlos Fernando de Mello Júnior

    2016-06-01

    Full Text Available Abstract Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations.

  9. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations

    Energy Technology Data Exchange (ETDEWEB)

    Mello Junior, Carlos Fernando de; Araujo Neto, Severino Aires; Carvalho Junior, Arlindo Monteiro de; Negromonte, Gustavo Ramalho Pessoa; Oliveira, Carollyne Dantas de [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil); Reboucas, Rafael Batista, E-mail: severinoaires@hotmail.com [Faculdade de Ciencias Medicas da Paraiba, Joao Pessoa, PB (Brazil)

    2016-05-15

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations. (author)

  10. Diagnostic ability of barrett's index to detect dysthyroid optic neuropathy using multidetector computed tomography

    Directory of Open Access Journals (Sweden)

    Mário L. R. Monteiro

    2008-01-01

    Full Text Available OBJECTIVES: The objective of this study was to evaluate the ability of a muscular index (Barrett's Index, calculated with multidetector computed tomography, to detect dysthyroid optic neuropathy in patients with Graves' orbitopathy. METHODS: Thirty-six patients with Graves' orbitopathy were prospectively studied and submitted to neuro-ophthalmic evaluation and multidetector computed tomography scans of the orbits. Orbits were divided into two groups: those with and without dysthyroid optic neuropathy. Barrett's index was calculated as the percentage of the orbit occupied by muscles. Sensitivity and specificity were determined for several index values. RESULTS: Sixty-four orbits (19 with and 45 without dysthyroid optic neuropathy met the inclusion criteria for the study. The mean Barrett's index values (± SD were 64.47% ± 6.06% and 49.44% ± 10.94%in the groups with and without dysthyroid optic neuropathy, respectively (p60% should be carefully examined and followed for the development of dysthyroid optic neuropathy.

  11. Visibility of sutures of the orbit and periorbital region using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, Hubert; Preis, Markus; Koesling, Sabrina [Dept. of Diagnostic Radiology, Martin-Luther-University Halle-Wittenberg, Halle (Germany)

    2014-12-15

    Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube current from 25 to 370 mAs, depending on the CT indication. The visibility of sutures was estimated according to a 4-point scale from 'not visible to well visible' The chi-squared test was used to test the association of the visibility of sutures with the slice thickness, tube current, and age of patients. Statistical significance was assumed at p < 0.05. Overall, best visibility was found for the sutura frontozygomatica (98%), sutura frontonasalis (88.5%), and sutura sphenozygomatica (71.5%), followed by the sutura zygomaticomaxillaris (65.8%), sutura temporozygomatica (41.8%), sutura frontomaxillaris (44.5%), and sutura sphenofrontalis (31%). Poor visibility was found for the sutura frontolacrimalis (16.8%) and sutura frontoethmoidalis (1.3%). The sutura ethmoidomaxillaris, sutura lacrimomaxillaris, and sutura ethmoidolacrimalis were not visible. Although the sutures of the superior, lateral, and inferior orbit are well visible, those of the medial orbit are poorly visible on CT scans.

  12. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations

    International Nuclear Information System (INIS)

    Mello Junior, Carlos Fernando de; Araujo Neto, Severino Aires; Carvalho Junior, Arlindo Monteiro de; Negromonte, Gustavo Ramalho Pessoa; Oliveira, Carollyne Dantas de; Reboucas, Rafael Batista

    2016-01-01

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations. (author)

  13. Normal mediastinal and hilar lymph nodes in children on multi-detector row chest computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Jong, Pim A. de; Nievelstein, Rutger-Jan A. [University Medical Center Utrecht and Wilhelmina Children' s Hospital, Department of Radiology, Utrecht (Netherlands)

    2012-02-15

    To study normal mediastinal and hilar lymph nodes on multi-detector chest computed tomography (CT). A cohort of 120 children aged 1-17 years underwent emergency CT, including the chest, after high-energy trauma. Axial 5-mm reconstructions were evaluated for lymph nodes at hilar and various mediastinal levels and the short-axis diameters were measured. At least one lymph node was found in 115 (96%) children, with subcarinal (69%), lower paratracheal (64%) and hilar (60%) nodes being most common. Up to 10 years of age most lymph nodes were smaller than or equal to 7 mm. In older children lymph nodes measuring up to 10-mm-short-axis diameter were found. Lymph nodes were rare along the mammary vessels, at lower oesophageal and at prevascular and posterior mediastinal levels in children. Mediastinal and hilar lymph nodes are more common than previously thought, probably because of increased detection by modern multi-detector CT. Lymph node location and age have to be taken into account when evaluating lymph nodes in the paediatric chest. (orig.)

  14. Normal mediastinal and hilar lymph nodes in children on multi-detector row chest computed tomography

    International Nuclear Information System (INIS)

    Jong, Pim A. de; Nievelstein, Rutger-Jan A.

    2012-01-01

    To study normal mediastinal and hilar lymph nodes on multi-detector chest computed tomography (CT). A cohort of 120 children aged 1-17 years underwent emergency CT, including the chest, after high-energy trauma. Axial 5-mm reconstructions were evaluated for lymph nodes at hilar and various mediastinal levels and the short-axis diameters were measured. At least one lymph node was found in 115 (96%) children, with subcarinal (69%), lower paratracheal (64%) and hilar (60%) nodes being most common. Up to 10 years of age most lymph nodes were smaller than or equal to 7 mm. In older children lymph nodes measuring up to 10-mm-short-axis diameter were found. Lymph nodes were rare along the mammary vessels, at lower oesophageal and at prevascular and posterior mediastinal levels in children. Mediastinal and hilar lymph nodes are more common than previously thought, probably because of increased detection by modern multi-detector CT. Lymph node location and age have to be taken into account when evaluating lymph nodes in the paediatric chest. (orig.)

  15. Diagnostic performance of 64-slice multidetector coronary computed tomographic angiography in women.

    Science.gov (United States)

    Jug, Borut; Gupta, Mohit; Papazian, Jenny; Li, Dong; Tsang, Janet; Bhatia, Harpreet; Karlsberg, Ronald; Budoff, Matthew

    2012-12-01

    Diagnostic approach to chest pain in women is challenging, but still under-investigated. The purpose of this study was to assess the diagnostic performance of 64-slice multidetector coronary computed tomographic angiography (CCTA) in women with chest pain. We included 606 patients--255 women and 351 men (mean age 61 ± 12 years for both)--who had been referred for a CCTA and an invasive coronary angiography (diagnostic standard) because of chest pain, either as part of clinical work-up in two urban medical centers or as part of the multicenter ACCURACY trial. On a patient-based model, the sensitivity, specificity, and positive predictive value (PPV) and negative predictive value to detect ≥50% and ≥70% stenosis were 98%, 84%, 87%, and 97% and 96%, 83%, 77%, and 97%, respectively, for women and 97%, 83%, 89%, and 95% and 94%, 91%, 90%, and 94%, respectively, for men. There were no statistically significant differences between men and women in diagnostic performance measures except for the PPV of detecting a ≥70% stenosis (P = .007). In women with chest pain, 64-slice multidetector CCTA is at least as sensitive and specific as in men. Our findings suggest that CCTA is a promising diagnostic tool for timely detection and/or exclusion of CAD in symptomatic intermediate-risk female populations.

  16. Noninvasive imaging of coronary arteries: current and future role of multidetector row computer tomography

    International Nuclear Information System (INIS)

    Nedevska, M.; Stoinova, V.

    2006-01-01

    Full text: This review will present the current and future role of cardiac computer tomography (CCT), and particular multidetector CCT, for imaging of atherosclerotic pathologic changes of the coronary arteries. Atherosclerosis and its cardio-vascular complications represent one of the major issues of public health in industrial countries. Different imaging modalities, including invasive coronarography, have been aimed to the diagnosis of the disease, when it provokes symptomatic decrease of the blood flow. In spite of development of surgical and percutaneous methods for coronary revascularization, coronary artery disease remains the major cause of death in North America and Europe. This demonstrates the need of novel, complementary diagnostic strategies, aimed to identify asymptomatic stages as the basis of pharmacological interventions. Noninvasive coronary angiography with multidetector CT allows both assessment of luminal stenosis and subclinical disease of arterial wall. Large trails are missing now to understand and present what will be the role of this technology in the comprehensive assessment of patients, suspected of having CAD. Based on experience and current potentials we will describe how tomographic coronary imaging may eventually supplement traditional angiographic techniques in understanding the patterns of atherosclerotic CAD development

  17. An Unusual Left Ventricular Outflow Pseudoaneurysm: Usefulness of Echocardiography and Multidetector Computed Tomography for Surgical Repair

    International Nuclear Information System (INIS)

    Da Col, Uberto; Ramoni, Enrico; Di Bella, Isidoro; Ragni, Temistocle

    2009-01-01

    Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and it arises posteriorly to the aortic root. Due to these anatomical features, its imaging assessment is challenging and surgical repair requires complex procedures. An unusual case of LVOT pseudoaneurysm is described. It was detected by transthoracic ecocardiography 7 months after aortic root replacement for acute endocarditis. Multidetector computed tomography (MDCT) confirmed the presence of a pouch located between the aortic root and the right atrium. Computed tomography also detected the origin of the pseudoaneurysm from the muscular interventricular septum of the LVOT, rather below the aortic valve plane. It was repaired with an extracardiac surgical approach, sparing the aortic root bioprosthesis previously implanted. The high-resolution three-dimensional details provided by the preoperative MDCT allowed us to plan a simple and effective surgical strategy.

  18. Association between diabetes and different components of coronary atherosclerotic plaque burden as measured by coronary multidetector computed tomography.

    Science.gov (United States)

    Yun, Chun-Ho; Schlett, Christopher L; Rogers, Ian S; Truong, Quynh A; Toepker, Michael; Donnelly, Patrick; Brady, Thomas J; Hoffmann, Udo; Bamberg, Fabian

    2009-08-01

    The aim of the study was to assess differences in the presence, extent, and composition of coronary atherosclerotic plaque burden as detected by coronary multidetector computed tomography (MDCT) between patients with and without diabetes mellitus. We compared coronary atherosclerotic plaques (any plaque, calcified [CAP], non-calcified [NCAP, and mixed plaque [MCAP

  19. Nutcracker or left renal vein compression phenomenon: multidetector computed tomography findings and clinical significance

    International Nuclear Information System (INIS)

    Cuellar i Calabria, Hug; Quiroga Gomez, Sergi; Sebastia Cerqueda, Carmen; Boye de la Presa, Rosa; Miranda, Americo; Alvarez-Castells, Agusti

    2005-01-01

    The use of multidetector computed tomography (MDCT) in routine abdominal explorations has increased the detection of the nutcracker phenomenon, defined as left renal vein (LRV) compression by adjacent anatomic structures. The embryology and anatomy of the nutcracker phenomenon are relevant as a background for the nutcracker syndrome, a rare cause of hematuria as well as other symptoms. MDCT examples of collateral renal vein circulation (gonadal, ureteric, azygous, lumbar, capsular) and aortomesenteric (anterior) and retroaortic (posterior) nutcracker phenomena in patients with no urologic complaint are shown as well as studies performed on patients with gross hematuria of uncertain origin. Incidental observation of collateral veins draining the LRV in abdominal MDCT explorations of asymptomatic patients may be a sign of a compensating nutcracker phenomenon. Imbalance between LRV compression and development of collateral circulation may lead to symptomatic nutcracker syndrome. (orig.)

  20. Current role of multidetector computed tomography in imaging of wrist injuries.

    Science.gov (United States)

    Syed, Mohd Arif; Raj, Vimal; Jeyapalan, Kanagaratnam

    2013-01-01

    Imaging of the wrist is challenging to both radiologists and orthopedic surgeons. This is primarily because of the complex anatomy/functionality of the wrist and also the fact that many frequent injuries are sustained to the hands. On going developments in multidetector computed tomography (MDCT) technology with its "state of the art" postprocessing capabilities have revolutionized this field. Apart from routine imaging of wrist trauma, it is now possible to assess intrinsic ligaments with MDCT arthrography, thereby avoiding invasive diagnostic arthroscopies. Postoperative wrist imaging can be a diagnostic challenge, and MDCT can be helpful in assessment of these cases because volume acquisition and excellent postprocessing abilities help to evaluate these wrists in any desired plane and thinner slices. This article pictorially reviews the current clinical role of MDCT imaging of wrist in our practice. It also describes arthrography technique and scanning parameters used at our center. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Nutcracker or left renal vein compression phenomenon: multidetector computed tomography findings and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Cuellar i Calabria, Hug; Quiroga Gomez, Sergi; Sebastia Cerqueda, Carmen; Boye de la Presa, Rosa; Miranda, Americo; Alvarez-Castells, Agusti [Hospitals Universitaris Vall D' Hebron, Institut de Diagnostic Per La Imatge, Servei De Radiodiagnostic, Barcelona (Spain)

    2005-08-01

    The use of multidetector computed tomography (MDCT) in routine abdominal explorations has increased the detection of the nutcracker phenomenon, defined as left renal vein (LRV) compression by adjacent anatomic structures. The embryology and anatomy of the nutcracker phenomenon are relevant as a background for the nutcracker syndrome, a rare cause of hematuria as well as other symptoms. MDCT examples of collateral renal vein circulation (gonadal, ureteric, azygous, lumbar, capsular) and aortomesenteric (anterior) and retroaortic (posterior) nutcracker phenomena in patients with no urologic complaint are shown as well as studies performed on patients with gross hematuria of uncertain origin. Incidental observation of collateral veins draining the LRV in abdominal MDCT explorations of asymptomatic patients may be a sign of a compensating nutcracker phenomenon. Imbalance between LRV compression and development of collateral circulation may lead to symptomatic nutcracker syndrome. (orig.)

  2. Multiparametric multidetector computed tomography scanning on suspicion of hyperacute ischemic stroke: validating a standardized protocol

    Directory of Open Access Journals (Sweden)

    Felipe Torres Pacheco

    2013-06-01

    Full Text Available Multidetector computed tomography (MDCT scanning has enabled the early diagnosis of hyperacute brain ischemia. We aimed at validating a standardized protocol to read and report MDCT techniques in a series of adult patients. The inter-observer agreement among the trained examiners was tested, and their results were compared with a standard reading. No false positives were observed, and an almost perfect agreement (Kappa>0.81 was documented when the CT angiography (CTA and cerebral perfusion CT (CPCT map data were added to the noncontrast CT (NCCT analysis. The inter-observer agreement was higher for highly trained readers, corroborating the need for specific training to interpret these modern techniques. The authors recommend adding CTA and CPCT to the NCCT analysis in order to clarify the global analysis of structural and hemodynamic brain abnormalities. Our structured report is suitable as a script for the reproducible analysis of the MDCT of patients on suspicion of ischemic stroke.

  3. Interventional management of intractable sympathetically mediated pain by computed tomography-guided catheter implantation for block and neuroablation of the thoracic sympathetic chain: technical approach and review of 322 procedures.

    Science.gov (United States)

    Agarwal-Kozlowski, K; Lorke, D E; Habermann, C R; Schulte am Esch, J; Beck, H

    2011-08-01

    We retrospectively evaluated the safety and efficacy of computed tomography-guided placement of percutaneous catheters in close proximity to the thoracic sympathetic chain by rating pain intensity and systematically reviewing charts and computed tomography scans. Interventions were performed 322 times in 293 patients of mean (SD) age 59.4 (17.0) years, and male to female ratio 105:188, with postherpetic neuralgia (n = 103, 35.1%), various neuralgias (n = 88, 30.0%), complex regional pain syndrome (n = 69, 23.6%), facial pain (n = 17, 5.8%), ischaemic limb pain (n = 7, 2.4%), phantom limb pain (n = 4, 1.4%), pain following cerebrovascular accident (n = 2, 0.7%), syringomyelia (n = 2, 0.7%) and palmar hyperhidrosis (n = 1, 0.3%). The interventions were associated with a total of 23 adverse events (7.1% of all procedures): catheter dislocation (n = 9, 2.8%); increase in pain intensity (n = 8, 2.5%); pneumothorax (n = 3, 0.9%); local infection (n = 2, 0.6%); and puncture of the spinal cord (n = 1, 0.3%). Continuous infusion of 10 ml.h(-1) ropivacaine 0.2% through the catheters decreased median (IQR [range]) pain scores from 8 (6-9 [2-10]) to 2 (1-3 [0-10]) (p < 0.0001). Chemical neuroablation was necessary in 137 patients (46.8%). We conclude that this procedure leads to a significant reduction of pain intensity in otherwise obstinate burning or stabbing pain and is associated with few hazards. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  4. Sex differences in aortic valve calcification measured by multidetector computed tomography in aortic stenosis.

    Science.gov (United States)

    Aggarwal, Shivani R; Clavel, Marie-Annick; Messika-Zeitoun, David; Cueff, Caroline; Malouf, Joseph; Araoz, Philip A; Mankad, Rekha; Michelena, Hector; Vahanian, Alec; Enriquez-Sarano, Maurice

    2013-01-01

    Aortic valve calcification (AVC) is the intrinsic mechanism of valvular obstruction leading to aortic stenosis (AS) and is measurable by multidetector computed tomography. The link between sex and AS is controversial and that with AVC is unknown. We prospectively performed multidetector computed tomography in 665 patients with AS (aortic valve area, 1.05±0.35 cm(2); mean gradient, 39±19 mm Hg) to measure AVC and to assess the impact of sex on the AVC-AS severity link in men and women. AS severity was comparable between women and men (peak aortic jet velocity: 4.05±0.99 versus 3.93±0.91 m/s, P=0.11; aortic valve area index: 0.55±0.20 versus 0.56±0.18 cm(2)/m(2); P=0.46). Conversely, AVC load was lower in women versus men (1703±1321 versus 2694±1628 arbitrary units; PAVC load were much greater in men than in women (odds ratio, 5.07; PAVC showed good associations with hemodynamic AS severity in men and women (all r>0.67; PAVC load, absolute or indexed, was higher in men versus women (all P≤0.01). In this large AS population, women incurred similar AS severity than men for lower AVC loads, even after indexing for their smaller body size. Hence, the relationship between valvular calcification process and AS severity differs in women and men, warranting further pathophysiological inquiry. For AS severity diagnostic purposes, interpretation of AVC load should be different in men and in women.

  5. Positron Emission Tomography/Computed Tomography-Guided Intensity-Modulated Radiotherapy for Limited-Stage Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shirvani, Shervin M.; Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Heymach, John V.; Fossella, Frank V. [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Chang, Joe Y., E-mail: jychang@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    2012-01-01

    Purpose: Omitting elective nodal irradiation from planning target volumes does not compromise outcomes in patients with non-small-cell lung cancer, but whether the same is true for those with limited-stage small-cell lung cancer (LS-SCLC) is unknown. Therefore, in the present study, we sought to determine the clinical outcomes and the frequency of elective nodal failure in patients with LS-SCLC staged using positron emission tomography/computed tomography and treated with involved-field intensity-modulated radiotherapy. Methods and Materials: Between 2005 and 2008, 60 patients with LS-SCLC at our institution underwent disease staging using positron emission tomography/computed tomography before treatment using an intensity-modulated radiotherapy plan in which elective nodal irradiation was intentionally omitted from the planning target volume (mode and median dose, 45 Gy in 30 fractions; range, 40.5 Gy in 27 fractions to 63.8 Gy in 35 fractions). In most cases, concurrent platinum-based chemotherapy was administered. We retrospectively reviewed the clinical outcomes to determine the overall survival, relapse-free survival, and failure patterns. Elective nodal failure was defined as recurrence in initially uninvolved hilar, mediastinal, or supraclavicular nodes. Survival was assessed using the Kaplan-Meier method. Results: The median age of the study patients at diagnosis was 63 years (range, 39-86). The median follow-up duration was 21 months (range, 4-58) in all patients and 26 months (range, 4-58) in the survivors. The 2-year actuarial overall survival and relapse-free survival rate were 58% and 43%, respectively. Of the 30 patients with recurrence, 23 had metastatic disease and 7 had locoregional failure. We observed only one isolated elective nodal failure. Conclusions: To our knowledge, this is the first study to examine the outcomes in patients with LS-SCLC staged with positron emission tomography/computed tomography and treated with definitive intensity

  6. Positron Emission Tomography/Computed Tomography-Guided Intensity-Modulated Radiotherapy for Limited-Stage Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Shirvani, Shervin M.; Komaki, Ritsuko; Heymach, John V.; Fossella, Frank V.; Chang, Joe Y.

    2012-01-01

    Purpose: Omitting elective nodal irradiation from planning target volumes does not compromise outcomes in patients with non–small-cell lung cancer, but whether the same is true for those with limited-stage small-cell lung cancer (LS-SCLC) is unknown. Therefore, in the present study, we sought to determine the clinical outcomes and the frequency of elective nodal failure in patients with LS-SCLC staged using positron emission tomography/computed tomography and treated with involved-field intensity-modulated radiotherapy. Methods and Materials: Between 2005 and 2008, 60 patients with LS-SCLC at our institution underwent disease staging using positron emission tomography/computed tomography before treatment using an intensity-modulated radiotherapy plan in which elective nodal irradiation was intentionally omitted from the planning target volume (mode and median dose, 45 Gy in 30 fractions; range, 40.5 Gy in 27 fractions to 63.8 Gy in 35 fractions). In most cases, concurrent platinum-based chemotherapy was administered. We retrospectively reviewed the clinical outcomes to determine the overall survival, relapse-free survival, and failure patterns. Elective nodal failure was defined as recurrence in initially uninvolved hilar, mediastinal, or supraclavicular nodes. Survival was assessed using the Kaplan-Meier method. Results: The median age of the study patients at diagnosis was 63 years (range, 39–86). The median follow-up duration was 21 months (range, 4–58) in all patients and 26 months (range, 4–58) in the survivors. The 2-year actuarial overall survival and relapse-free survival rate were 58% and 43%, respectively. Of the 30 patients with recurrence, 23 had metastatic disease and 7 had locoregional failure. We observed only one isolated elective nodal failure. Conclusions: To our knowledge, this is the first study to examine the outcomes in patients with LS-SCLC staged with positron emission tomography/computed tomography and treated with definitive

  7. Computed tomography guided navigation assisted percutaneous ablation of osteoid osteoma in a 7-year-old patient: the low dose approach

    Energy Technology Data Exchange (ETDEWEB)

    Krokidis, Miltiadis; Tappero, Carlo; Bogdanovic, Daniel; Stamm, Anna-Christina [Inselspital, Bern University Hospital, Department of Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland); Ziebarth, Kai [Inselspital, Bern University Hospital, Department of Pediatric Surgery, Bern (Switzerland)

    2017-07-15

    Osteoid osteoma (OO) is a benign tumour that can cause severe pain and functional limitation to children and young adults; the treatment of choice is image-guided ablation. Due to the very small size of the lesion, detection and accurate needle placement may be challenging. Computed tomography (CT) offers very detailed imaging of the skeleton and is the modality of choice for the detection of small OO and for ablation guidance. Nevertheless, CT-guided positioning of the ablation applicator is linked to significant radiation exposure, particularly for the paediatric population. This case describes the successful use of a novel CT-based navigation system that offers the possibility of accurate ablation with only minimal radiation exposure in a paediatric patient. (orig.)

  8. Computed tomography-guided percutaneous trephine removal of the nidus in osteoid osteoma patients: experience of a single center in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Petrilli, Marcelo; Senerchia, Andreza Almeida; Petrilli, Antonio Sergio; Lederman, Henrique Manoel; Garcia Filho, Reynaldo Jesus, E-mail: andrezasenerchia@hotmail.com [Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil). Instituto de Oncologia Pediatrica

    2015-07-15

    Objective: to report the results of computed tomography (CT)-guided percutaneous resection of the nidus in 18 cases of osteoid osteoma. Materials and methods: the medical records of 18 cases of osteoid osteoma in children, adolescents and young adults, who underwent CT-guided removal of the nidus between November, 2004 and March, 2009 were reviewed retrospectively for demographic data, lesion site, clinical outcome and complications after procedure. Results: clinical follow-up was available for all cases at a median of 29 months (range 6-60 months). No persistence of pre-procedural pain was noted on 17 patients. Only one patient experienced recurrence of symptoms 12 months after percutaneous resection, and was successfully retreated by the same technique, resulting in a secondary success rate of 18/18 (100%). Conclusion: CT-guided removal or destruction of the nidus is a safe and effective alternative to surgical resection of the osteoid osteoma nidus. (author)

  9. Multi-detector computed tomography (MDCT imaging of cardiovascular effects of pulmonary embolism: What the radiologists need to know

    Directory of Open Access Journals (Sweden)

    Mohamed Aboul-fotouh E. Mourad

    2017-09-01

    Full Text Available Background: Patients with pulmonary embolism have high mortality and morbidity rate due to right heart failure and circulatory collapse leading to sudden death. Multi-detector computed tomography MDCT can efficiently evaluate the cardiovascular factors related to pulmonary embolism. Objectives: To evaluate the diagnostic accuracy of multi-detector computed tomography (MDCT in differentiation of between sever and non-severe pulmonary embolism groups depending on the associated cardiovascular parameters and create a simple reporting system. Patients & methods: Prospective study contained 145 patients diagnosed clinically pulmonary embolism. All patients were examined by combined electrocardiographically gated computed tomography pulmonary angiography-computed tomography venography (ECG-CTPA-CTV using certain imaging criteria in a systematic manner. Results: Our study revealed 95 and 55 non-severe and severe pulmonary embolism groups respectively. Many cardiovascular parameters related to pulmonary embolism shows significant p value and can differentiate between sever and non-severe pulmonary embolism patients include pulmonary artery diameter, intraventricular septum flattening, bowing, superior vena cava and Azygos vein diameters, right and left ventricular diameters. Conclusion: Multi-detector computed tomography (MDCT can be valuable to assess the severity of pulmonary embolism using the related cardiovascular parameters and leading the management strategy aim for best outcome. Keywords: Pulmonary embolism, MDCT, Cardiovascular, Computed tomography venography

  10. Computed Tomography-Guided Core-Needle Biopsy Specimens Demonstrate Epidermal Growth Factor Receptor Mutations in Patients with Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Chen, C.M.; Chang, J.W.C.; Cheung, Y.C.; Lin, G.; Hsieh, J.J.; Hsu, T.; Huang, S.F.

    2008-01-01

    Background: Target therapy with a new class of epidermal growth factor receptor (EGFR) inhibitors shows improved clinical response in EGFR gene-mutated lung cancers. Purpose: To evaluate the use of computed tomography (CT)-guided core-needle biopsy specimens for the assessment of EGFR gene mutation in non-small-cell lung cancer (NSCLC). Material and Methods: Seventeen (nine males, eight females) patients with advanced NSCLC were enrolled in this study. All patients underwent CT-guided core-needle biopsy of the lung tumor prior to treatment with the EGFR inhibitor gefitinib. There were no life-threatening complications of biopsy. The specimens were sent fresh-frozen for EGFR mutation analysis and histopathological study. Results: There were 12 (70.6%) EGFR gene mutants and five (29.4%) nonmutants. The objective response rate to gefitinib therapy was 73.3% (11 of 15 patients), with 91.7% (11 of 12 mutants) for the mutant group and 0% for the nonmutant group. Conclusion: CT-guided core-needle biopsy of advanced NSCLC enables the acquisition of sufficient tissue for EGFR gene mutation analysis

  11. Preoperative Computed Tomography-Guided Percutaneous Hookwire Localization of Metallic Marker Clips in the Breast with a Radial Approach: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Uematsu, T.; Kasami, M.; Uchida, Y.; Sanuki, J.; Kimura, K.; Tanaka, K.; Takahashi, K. [Dept. of Diagnostic Radiology, Dept. of Pathology, and Dept. of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka (Japan)

    2007-07-15

    Background: Hookwire localization is the current standard technique for radiological marking of nonpalpable breast lesions. Stereotactic directional vacuum-assisted breast biopsy (SVAB) is of sufficient sensitivity and specificity to replace surgical biopsy. Wire localization for metallic marker clips placed after SVAB is needed. Purpose: To describe a method for performing computed tomography (CT)-guided hookwire localization using a radial approach for metallic marker clips placed percutaneously after SVAB. Material and Methods: Nineteen women scheduled for SVAB with marker-clip placement, CT-guided wire localization of marker clips, and, eventually, surgical excision were prospectively entered into the study. CT-guided wire localization was performed with a radial approach, followed by placement of a localizing marker-clip surgical excision. Feasibility and reliability of the procedure and the incidence of complications were examined. Results: CT-guided wire localization surgical excision was successfully performed in all 19 women without any complications. The mean total procedure time was 15 min. The median distance on CT image from marker clip to hookwire was 2 mm (range 0-3 mm). Conclusion: CT-guided preoperative hookwire localization with a radial approach for marker clips after SVAB is technically feasible.

  12. Preoperative computed tomography-guided percutaneous hookwire localization of metallic marker clips in the breast with a radial approach: initial experience.

    Science.gov (United States)

    Uematsu, T; Kasami, M; Uchida, Y; Sanuki, J; Kimura, K; Tanaka, K; Takahashi, K

    2007-06-01

    Hookwire localization is the current standard technique for radiological marking of nonpalpable breast lesions. Stereotactic directional vacuum-assisted breast biopsy (SVAB) is of sufficient sensitivity and specificity to replace surgical biopsy. Wire localization for metallic marker clips placed after SVAB is needed. To describe a method for performing computed tomography (CT)-guided hookwire localization using a radial approach for metallic marker clips placed percutaneously after SVAB. Nineteen women scheduled for SVAB with marker-clip placement, CT-guided wire localization of marker clips, and, eventually, surgical excision were prospectively entered into the study. CT-guided wire localization was performed with a radial approach, followed by placement of a localizing marker-clip surgical excision. Feasibility and reliability of the procedure and the incidence of complications were examined. CT-guided wire localization surgical excision was successfully performed in all 19 women without any complications. The mean total procedure time was 15 min. The median distance on CT image from marker clip to hookwire was 2 mm (range 0-3 mm). CT-guided preoperative hookwire localization with a radial approach for marker clips after SVAB is technically feasible.

  13. Short-term outcomes and safety of computed tomography-guided percutaneous microwave ablation of solitary adrenal metastasis from lung cancer: A multi-center retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Men, Min; Ye, Xin; Yang, Xia; Zheng, Aimin; Huang, Guang Hui; Wei, Zhigang [Dept. of Oncology, Shandong Provincial Hospital Affiliated with Shandong University, Jinan (China); Fan, Wei Jun [Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou (China); Zhang, Kaixian [Dept. of Oncology, Teng Zhou Central People' s Hospital Affiliated with Jining Medical College, Tengzhou (China); Bi, Jing Wang [Dept. of Oncology, Jinan Military General Hospital of Chinese People' s Liberation Army, Jinan (China)

    2016-11-15

    To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed. Their tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis). CT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer.

  14. Reproducibility of coronary atherosclerotic plaque characteristics in populations with low, intermediate, and high prevalence of coronary artery disease by multidetector computer tomography

    DEFF Research Database (Denmark)

    de Knegt, Martina C; Linde, Jesper J; Fuchs, Andreas

    2016-01-01

    To evaluate the interobserver agreement of visual coronary plaque characteristics by 320-slice multidetector computed tomography (MDCT) in three populations with low, intermediate and high CAD prevalence and to identify determinants for the reproducible assessment of these plaque characteristics...

  15. In vivo assessment of the gastric mucosal tolerance dose after single fraction, small volume irradiation of liver malignancies by computed tomography-guided, high-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Streitparth, Florian; Pech, Maciej; Boehmig, Michael; Ruehl, Ricarda; Peters, Nils; Wieners, Gero; Steinberg, Johannes; Lopez-Haenninen, Enrique; Felix, Roland; Wust, Peter; Ricke, Jens

    2006-01-01

    Purpose: The aim of this study was to assess the tolerance dose of gastric mucosa for single-fraction computed tomography (CT)-guided, high-dose-rate (HDR) brachytherapy of liver malignancies. Methods and Materials: A total of 33 patients treated by CT-guided HDR brachytherapy of liver malignancies in segments II and/or III were included. Dose planning was performed upon a three-dimensional CT data set acquired after percutaneous applicator positioning. All patients received gastric protection post-treatment. For further analysis, the contours of the gastric wall were defined in every CT slice using Brachyvision Software. Dose-volume histograms were calculated for each treatment and correlated with clinical data derived from questionnaires assessing Common Toxicity Criteria (CTC). All patients presenting symptoms of upper GI toxicity were examined endoscopically. Results: Summarizing all patients the minimum dose applied to 1 ml of the gastric wall (D 1ml ) ranged from 6.3 to 34.2 Gy; median, 14.3 Gy. Toxicity was present in 18 patients (55%). We found nausea in 16 (69%), emesis in 9 (27%), cramping in 13 (39%), weight loss in 12 (36%), gastritis in 4 (12%), and ulceration in 5 patients (15%). We found a threshold dose D 1ml of 11 Gy for general gastric toxicity and 15.5 Gy for gastric ulceration verified by an univariate analysis (p = 0.01). Conclusions: For a single fraction, small volume irradiation we found in the upper abdomen a threshold dose D 1ml of 15.5 Gy for the clinical endpoint ulceration of the gastric mucosa. This in vivo assessment is in accordance with previously published tolerance data

  16. Micro-Computed-Tomography-Guided Analysis of In Vitro Structural Modifications in Two Types of 45S5 Bioactive Glass Based Scaffolds.

    Science.gov (United States)

    Westhauser, Fabian; Ciraldo, Francesca; Balasubramanian, Preethi; Senger, Anne-Sophie; Schmidmaier, Gerhard; Moghaddam, Arash; Boccaccini, Aldo R

    2017-11-23

    Three-dimensional 45S5 bioactive glass (BG)-based scaffolds are being investigated for bone regeneration. Besides structural properties, controlled time-dependent alteration of scaffold morphology is crucial to achieve optimal scaffold characteristics for successful bone repair. There is no in vitro evidence concerning the dependence between structural characteristics and dissolution behavior of 45S5 BG-based scaffolds of different morphology. In this study, the dissolution behavior of scaffolds fabricated by the foam replica method using polyurethane foam (Group A) and maritime sponge Spongia Agaricina (Group B) as sacrificial templates was analyzed by micro-computed-tomography (µCT). The scaffolds were immersed in Dulbecco's Modified Eagle Medium for 56 days under static cell culture conditions and underwent µCT-analysis initially, and after 7, 14, and 56 days. Group A showed high porosity (91%) and trabecular structure formed by macro-pores (average diameter 692 µm ± 72 µm). Group-B-scaffolds were less porous (51%), revealing an optimal pore size distribution within the window of 110-500 µm pore size diameter, combined with superior mechanical stability. Both groups showed similar structural alteration upon immersion. Surface area and scaffold volume increased whilst density decreased, reflecting initial dissolution followed by hydroxycarbonate-apatite-layer-formation on the scaffold surfaces. In vitro- and/or in vivo-testing of cell-seeded BG-scaffolds used in this study should be performed to evaluate the BG-scaffolds' time-dependent osteogenic properties in relation to the measured in vitro structural changes.

  17. Determinants of Local Progression After Computed Tomography-Guided Percutaneous Radiofrequency Ablation for Unresectable Lung Tumors: 9-Year Experience in a Single Institution

    International Nuclear Information System (INIS)

    Okuma, Tomohisa; Matsuoka, Toshiyuki; Yamamoto, Akira; Oyama, Yoshimasa; Hamamoto, Shinichi; Toyoshima, Masami; Nakamura, Kenji; Miki, Yukio

    2010-01-01

    The purpose of this study was to retrospectively determine the local control rate and contributing factors to local progression after computed tomography (CT)-guided radiofrequency ablation (RFA) for unresectable lung tumor. This study included 138 lung tumors in 72 patients (56 men and 16 women; age 70.0 ± 11.6 years (range 31-94); mean tumor size 2.1 ± 1.2 cm [range 0.2-9]) who underwent lung RFA between June 2000 and May 2009. Mean follow-up periods for patients and tumors were 14 and 12 months, respectively. The local progression-free rate and survival rate were calculated to determine the contributing factors to local progression. During follow-up, 44 of 138 (32%) lung tumors showed local progression. The 1-, 2-, 3-, and 5-year overall local control rates were 61, 57, 57, and 38%, respectively. The risk factors for local progression were age (≥70 years), tumor size (≥2 cm), sex (male), and no achievement of roll-off during RFA (P < 0.05). Multivariate analysis identified tumor size ≥2 cm as the only independent factor for local progression (P = 0.003). For tumors <2 cm, 17 of 68 (25%) showed local progression, and the 1-, 2-, and 3-year overall local control rates were 77, 73, and 73%, respectively. Multivariate analysis identified that age ≥70 years was an independent determinant of local progression for tumors <2 cm in diameter (P = 0.011). The present study showed that 32% of lung tumors developed local progression after CT-guided RFA. The significant risk factor for local progression after RFA for lung tumors was tumor size ≥2 cm.

  18. Feasibility of computed tomography-guided core needle biopsy in producing state-of-the-art clinical management in Chinese lung cancer.

    Science.gov (United States)

    Chen, Hua-Jun; Yang, Jin-Ji; Fang, Liang-Yi; Huang, Min-Min; Yan, Hong-Hong; Zhang, Xu-Chao; Xu, Chong-Rui; Wu, Yi-Long

    2014-03-01

    A satisfactory biopsy determines the state-of-the-art management of lung cancer in this era of personalized medicine. This study aimed to investigate the suitability and efficacy of computed tomography (CT)-guided core needle biopsy in clinical management. A cohort of 353 patients with clinically suspected lung cancer was enrolled in the study. Patient factors and biopsy variables were recorded. Epidermal growth factor receptor (EGFR) gene mutations and echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) rearrangement were detected in tumor specimens. Adequacy of biopsic obtainment for clinical trial screening and tissue bank establishment were reviewed. Overall diagnostic accuracy of malignancy achieved 98.5%. The median biopsy time of the cohort was 20 minutes. In patients with non-small cell lung cancer (NSCLC), 99.3% (287/289) were diagnosed as specific histologic subtypes, and two patients (0.7%) were determined as NSCLC not otherwise specified (NOS). EGFR mutations were analyzed in 81.7% (236/289) of patients with NSCLC, and 98.7% (233/236) showed conclusive results. EML4-ALK gene fusion was tested in 43.9% (127/289) of NSCLC patients, and 98.4% (125/127) showed conclusive results: 6.4% (8/125) of those had gene fusion. Ninety-six NSCLC patients participated in clinical trial screening and provided mandatory tumor slides for molecular profiling. Pathological evaluation was fulfilled in 90 patients (93.8%); 99.4% (320/322) of patients with malignancy provided extra tissue for the establishment of a tumor bank. CT-guided core needle biopsy provided optimal clinical management in this era of translational medicine. The biopsic modality should be prioritized in selected lung cancer patients.

  19. Cone-beam computed tomography fusion and navigation for real-time positron emission tomography-guided biopsies and ablations: a feasibility study.

    Science.gov (United States)

    Abi-Jaoudeh, Nadine; Mielekamp, Peter; Noordhoek, Niels; Venkatesan, Aradhana M; Millo, Corina; Radaelli, Alessandro; Carelsen, Bart; Wood, Bradford J

    2012-06-01

    To describe a novel technique for multimodality positron emission tomography (PET) fusion-guided interventions that combines cone-beam computed tomography (CT) with PET/CT before the procedure. Subjects were selected among patients scheduled for a biopsy or ablation procedure. The lesions were not visible with conventional imaging methods or did not have uniform uptake on PET. Clinical success was defined by adequate histopathologic specimens for molecular profiling or diagnosis and by lack of enhancement on follow-up imaging for ablation procedures. Time to target (time elapsed between the completion of the initial cone-beam CT scan and first tissue sample or treatment), total procedure time (time from the moment the patient was on the table until the patient was off the table), and number of times the needle was repositioned were recorded. Seven patients underwent eight procedures (two ablations and six biopsies). Registration and procedures were completed successfully in all cases. Clinical success was achieved in all biopsy procedures and in one of the two ablation procedures. The needle was repositioned once in one biopsy procedure only. On average, the time to target was 38 minutes (range 13-54 min). Total procedure time was 95 minutes (range 51-240 min, which includes composite ablation). On average, fluoroscopy time was 2.5 minutes (range 1.3-6.2 min). An integrated cone-beam CT software platform can enable PET-guided biopsies and ablation procedures without the need for additional specialized hardware. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

  20. Implications for high-precision dose radiation therapy planning or limited surgical resection after percutaneous computed tomography-guided lung nodule biopsy using a tract sealant

    Directory of Open Access Journals (Sweden)

    Patricia M. de Groot, MD

    2018-04-01

    Full Text Available Purpose: Precision radiation therapy such as stereotactic body radiation therapy and limited resection are being used more frequently to treat intrathoracic malignancies. Effective local control requires precise radiation target delineation or complete resection. Lung biopsy tracts (LBT on computed tomography (CT scans after the use of tract sealants can mimic malignant tract seeding (MTS and it is unclear whether these LBTs should be included in the calculated tumor volume or resected. This study evaluates the incidence, appearance, evolution, and malignant seeding of LBTs. Methods and materials: A total of 406 lung biopsies were performed in oncology patients using a tract sealant over 19 months. Of these patients, 326 had follow-up CT scans and were included in the study group. Four thoracic radiologists retrospectively analyzed the imaging, and a pathologist examined 10 resected LBTs. Results: A total of 234 of 326 biopsies (72%, including primary lung cancer [n = 98]; metastases [n = 81]; benign [n = 50]; and nondiagnostic [n = 5] showed an LBT on CT. LBTs were identified on imaging 0 to 3 months after biopsy. LBTs were typically straight or serpiginous with a thickness of 2 to 5 mm. Most LBTs were unchanged (92% or decreased (6.3% over time. An increase in LBT thickness/nodularity that was suspicious for MTS occurred in 4 of 234 biopsies (1.7%. MTS only occurred after biopsy of metastases from extrathoracic malignancies, and none occurred in patients with lung cancer. Conclusions: LBTs are common on CT after lung biopsy using a tract sealant. MTS is uncommon and only occurred in patients with extrathoracic malignancies. No MTS was found in patients with primary lung cancer. Accordingly, potential alteration in planned therapy should be considered only in patients with LBTs and extrathoracic malignancies being considered for stereotactic body radiation therapy or wedge resection.

  1. Micro-Computed-Tomography-Guided Analysis of In Vitro Structural Modifications in Two Types of 45S5 Bioactive Glass Based Scaffolds

    Directory of Open Access Journals (Sweden)

    Fabian Westhauser

    2017-11-01

    Full Text Available Three-dimensional 45S5 bioactive glass (BG-based scaffolds are being investigated for bone regeneration. Besides structural properties, controlled time-dependent alteration of scaffold morphology is crucial to achieve optimal scaffold characteristics for successful bone repair. There is no in vitro evidence concerning the dependence between structural characteristics and dissolution behavior of 45S5 BG-based scaffolds of different morphology. In this study, the dissolution behavior of scaffolds fabricated by the foam replica method using polyurethane foam (Group A and maritime sponge Spongia Agaricina (Group B as sacrificial templates was analyzed by micro-computed-tomography (µCT. The scaffolds were immersed in Dulbecco’s Modified Eagle Medium for 56 days under static cell culture conditions and underwent µCT-analysis initially, and after 7, 14, and 56 days. Group A showed high porosity (91% and trabecular structure formed by macro-pores (average diameter 692 µm ± 72 µm. Group-B-scaffolds were less porous (51%, revealing an optimal pore size distribution within the window of 110–500 µm pore size diameter, combined with superior mechanical stability. Both groups showed similar structural alteration upon immersion. Surface area and scaffold volume increased whilst density decreased, reflecting initial dissolution followed by hydroxycarbonate-apatite-layer-formation on the scaffold surfaces. In vitro- and/or in vivo-testing of cell-seeded BG-scaffolds used in this study should be performed to evaluate the BG-scaffolds’ time-dependent osteogenic properties in relation to the measured in vitro structural changes.

  2. Feasibility of optimizing the dose distribution in lung tumors using fluorine-18-fluorodeoxyglucose positron emission tomography and single photon emission computed tomography guided dose prescriptions

    International Nuclear Information System (INIS)

    Das, S.K.; Miften, M.M.; Zhou, S.; Bell, M.; Munley, M.T.; Whiddon, C.S.; Craciunescu, O.; Baydush, A.H.; Wong, T.; Rosenman, J.G.; Dewhirst, M.W.; Marks, L.B.

    2004-01-01

    The information provided by functional images may be used to guide radiotherapy planning by identifying regions that require higher radiation dose. In this work we investigate the dosimetric feasibility of delivering dose to lung tumors in proportion to the fluorine-18-fluorodeoxyglucose activity distribution from positron emission tomography (FDG-PET). The rationale for delivering dose in proportion to the tumor FDG-PET activity distribution is based on studies showing that FDG uptake is correlated to tumor cell proliferation rate, which is shown to imply that this dose delivery strategy is theoretically capable of providing the same duration of local control at all voxels in tumor. Target dose delivery was constrained by single photon emission computed tomography (SPECT) maps of normal lung perfusion, which restricted irradiation of highly perfused lung and imposed dose-function constraints. Dose-volume constraints were imposed on all other critical structures. All dose-volume/function constraints were considered to be soft, i.e., critical structure doses corresponding to volume/function constraint levels were minimized while satisfying the target prescription, thus permitting critical structure doses to minimally exceed dose constraint levels. An intensity modulation optimization methodology was developed to deliver this radiation, and applied to two lung cancer patients. Dosimetric feasibility was assessed by comparing spatially normalized dose-volume histograms from the nonuniform dose prescription (FDG-PET proportional) to those from a uniform dose prescription with equivalent tumor integral dose. In both patients, the optimization was capable of delivering the nonuniform target prescription with the same ease as the uniform target prescription, despite SPECT restrictions that effectively diverted dose from high to low perfused normal lung. In one patient, both prescriptions incurred similar critical structure dosages, below dose-volume/function limits

  3. Perfusion computed tomography-guided intravenous thrombolysis for acute ischemic stroke beyond 4.5 hours: a case-control study.

    Science.gov (United States)

    García-Bermejo, Pablo; Calleja, Ana I; Pérez-Fernández, Santiago; Cortijo, Elisa; del Monte, José M; García-Porrero, Miguel; Fe Muñoz, M; Fernández-Herranz, Rosario; Arenillas, Juan F

    2012-01-01

    Extending the therapeutic window of intravenous thrombolysis for acute ischemic stroke beyond the established 4.5-hour limit is of critical importance in order to increase the proportion of thrombolysed stroke patients. In this setting, the capacity of MRI to select acute stroke patients for reperfusion therapies in delayed time windows has been and is being tested in clinical trials. However, whether the more available and cost-effective perfusion computed tomography (PCT) may be useful to select candidates for delayed intravenous thrombolysis remains largely unexplored. We aimed to evaluate the safety and efficacy of PCT-guided intravenous thrombolysis beyond 4.5 h after stroke onset. We prospectively studied all consecutive acute ischemic stroke patients treated with intravenous tissue plasminogen activator (tPA) in our stroke unit between January 2008 and December 2010. Patients treated within 0- 4.5 h were treated according to non-contrast CT (NCCT) criteria. Beyond 4.5 h, patients received intravenous tPA according to PCT criteria, i.e. an infarct core on cerebral blood volume (CBV) maps not exceeding one third of the middle cerebral artery (MCA) territory and tissue at risk as defined by mean transit time-CBV mismatch greater than 20%. Predetermined primary endpoints were symptomatic hemorrhagic transformation and favorable long-term outcome, while early neurological improvement and MCA recanalization were considered secondary endpoints. Statistical analysis included bivariate comparisons between the two groups for each endpoint and logistic regression models when significance was found in bivariate analyses. This study was approved by our local ethics committee. A total of 245 patients received intravenous thrombolysis. After the groups were matched by baseline National Institutes of Health Stroke Scale score, 172 patients treated at 4.5 h were finally included. Early and late groups were comparable regarding baseline variables; only cardioembolic etiology

  4. Pulmonary Emphysema in Cystic Fibrosis Detected by Densitometry on Chest Multidetector Computed Tomography

    Science.gov (United States)

    Wielpütz, Mark O.; Weinheimer, Oliver; Eichinger, Monika; Wiebel, Matthias; Biederer, Jürgen; Kauczor, Hans-Ulrich; Heußel, Claus P.

    2013-01-01

    Background Histopathological studies on lung specimens from patients with cystic fibrosis (CF) and recent results from a mouse model indicate that emphysema may contribute to CF lung disease. However, little is known about the relevance of emphysema in patients with CF. In the present study, we used computationally generated density masks based on multidetector computed tomography (MDCT) of the chest for non-invasive characterization and quantification of emphysema in CF. Methods Volumetric MDCT scans were acquired in parallel to pulmonary function testing in 41 patients with CF (median age 20.1 years; range 7-66 years) and 21 non-CF controls (median age 30.4 years; range 4-68 years), and subjected to dedicated software. The lung was segmented, low attenuation volumes below a threshold of -950 Hounsfield units were assigned to emphysema volume (EV), and the emphysema index was computed (EI). Results were correlated with forced expiratory volume in 1 s percent predicted (FEV1%), residual volume (RV), and RV/total lung capacity (RV/TLC). Results We show that EV was increased in CF (457±530 ml) compared to non-CF controls (78±90 ml) (PEmphysema in CF was detected from early adolescence (~13 years) and increased with age (rs=0.67, Pemphysema detected by densitometry on chest MDCT is a characteristic pathology that contributes to airflow limitation and may serve as a novel endpoint for monitoring lung disease in CF. PMID:23991177

  5. Noninvasive Coronary Angiography with 64-Channel Multidetector Computed Tomography in Patients with Acute Coronary Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ulimoen, G. R.; Gjoennaess, E.; Atar, D.; Dahl, T.; Stranden, E.; Sandbaek, G. (Dept. of Radiology, Dept. of Vascular Diagnosis and Research, and Division of Cardiology, Aker Univ. Hospital, Oslo (Norway))

    2008-12-15

    Background: Advances in computer tomography (CT) imaging technology in recent years have facilitated the possibility of noninvasive coronary angiography. Purpose: To compare the diagnostic accuracy of 64-channel multidetector computed tomography (MDCT) with conventional invasive coronary angiography (ICA) for the detection of significant coronary stenosis in patients with acute coronary syndrome (ACS). Material and Methods: MDCT was performed in 60 patients classified with non-ST-elevation infarction (NSTEMI) or unstable angina and scheduled for ICA within 3 days. The diagnostic accuracy of MDCT was evaluated using quantitative coronary angiography (QCA) as the gold standard. Results: 48 out of 60 patients had interpretable scans by both MDCT and ICA. On a segment-based analysis, 488 out of 665 segments with a diameter of =1.5 mm, as defined by QCA, were interpretable by MDCT. Sensitivity was 78%, specificity 87%, positive predictive value 47%, and negative predictive value 97% in detecting and excluding significant coronary stenosis, as defined with MDCT. On a per patient-based analysis, sensitivity was 89%, specificity 50%, positive predictive value 84%, and negative predictive value 60%. Conclusion: Limited diagnostic accuracy restricts the usefulness of coronary MDCT in patient groups with a high pretest probability of disease, such as in acute coronary syndrome.

  6. Noninvasive Coronary Angiography with 64-Channel Multidetector Computed Tomography in Patients with Acute Coronary Syndrome

    International Nuclear Information System (INIS)

    Ulimoen, G. R.; Gjoennaess, E.; Atar, D.; Dahl, T.; Stranden, E.; Sandbaek, G.

    2008-01-01

    Background: Advances in computer tomography (CT) imaging technology in recent years have facilitated the possibility of noninvasive coronary angiography. Purpose: To compare the diagnostic accuracy of 64-channel multidetector computed tomography (MDCT) with conventional invasive coronary angiography (ICA) for the detection of significant coronary stenosis in patients with acute coronary syndrome (ACS). Material and Methods: MDCT was performed in 60 patients classified with non-ST-elevation infarction (NSTEMI) or unstable angina and scheduled for ICA within 3 days. The diagnostic accuracy of MDCT was evaluated using quantitative coronary angiography (QCA) as the gold standard. Results: 48 out of 60 patients had interpretable scans by both MDCT and ICA. On a segment-based analysis, 488 out of 665 segments with a diameter of =1.5 mm, as defined by QCA, were interpretable by MDCT. Sensitivity was 78%, specificity 87%, positive predictive value 47%, and negative predictive value 97% in detecting and excluding significant coronary stenosis, as defined with MDCT. On a per patient-based analysis, sensitivity was 89%, specificity 50%, positive predictive value 84%, and negative predictive value 60%. Conclusion: Limited diagnostic accuracy restricts the usefulness of coronary MDCT in patient groups with a high pretest probability of disease, such as in acute coronary syndrome

  7. Multidetector row computed tomography may accurately estimate plaque vulnerability. Does MDCT accurately estimate plaque vulnerability? (Pro)

    International Nuclear Information System (INIS)

    Komatsu, Sei; Imai, Atsuko; Kodama, Kazuhisa

    2011-01-01

    Over the past decade, multidetector row computed tomography (MDCT) has become the most reliable and established of the noninvasive examination techniques for detecting coronary heart disease. Now MDCT is chasing intravascular ultrasound (IVUS) in terms of spatial resolution. Among the components of vulnerable plaque, MDCT may detect lipid-rich plaque, the lipid pool, and calcified spots using computed tomography number. Plaque components are detected by MDCT with high accuracy compared with IVUS and angioscopy when assessing vulnerable plaque. The TWINS study and TOGETHAR trial demonstrated that angioscopic loss of yellow color occurred independently of volumetric plaque change by statin therapy. These 2 studies showed that plaque stabilization and regression reflect independent processes mediated by different mechanisms and time course. Noncalcified plaque and/or low-density plaque was found to be the strongest predictor of cardiac events, regardless of lesion severity, and act as a potential marker of plaque vulnerability. MDCT may be an effective tool for early triage of patients with chest pain who have a normal electrocardiogram (ECG) and cardiac enzymes in the emergency department. MDCT has the potential ability to analyze coronary plaque quantitatively and qualitatively if some problems are resolved. MDCT may become an essential tool for detecting and preventing coronary artery disease in the future. (author)

  8. Prevalence of extra-cardiac findings on studies of noninvasive coronary angiography multidetector computed tomography 64 rows

    International Nuclear Information System (INIS)

    Carrascosa, Patricia M.; Capunay, Carlos M.; Deviggiano, A.; Melendez, F.; Carrascosa, Jorge M.; Garcia, M.

    2007-01-01

    The aim of this paper is to show the importance of evaluating in a full form images obtained from a studio of noninvasive coronary angiography by multidetector computed tomography (AC-TCMD). 90 users of AC-TCMD were evaluated retrospectively conducted between October 2006 and April 2007 with a multidetector tomography of 64-rows(Phillips Medical Systems) . The images were reprocessed with a maximum field of vision and determined the presence of extra-cardiac findings, which were classified according to their impact on the management and treatment of patient at 3 degrees: low, medium and high grade. The studies were assessed jointly by a cardiologist and a radiologist qualified for cardiac and corporal evaluation. Extra-cardiac findings were identified in 58 patients. There were 38 patients with findings of low grade, 31 medium grade and 1 high grade. It was recommended to 16 patients its monitoring by images on reasonable period of time [es

  9. Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it.

    Science.gov (United States)

    Paulus, Elena M; Fabian, Timothy C; Savage, Stephanie A; Zarzaur, Ben L; Botta, Vandana; Dutton, Wesley; Croce, Martin A

    2014-02-01

    Aggressive screening to diagnose blunt cerebrovascular injury (BCVI) results in early treatment, leading to improved outcomes and reduced stroke rates. While computed tomographic angiography (CTA) has been widely adopted for BCVI screening, evidence of its diagnostic sensitivity is marginal. Previous work from our institution using 32-channel multidetector CTA in 684 patients demonstrated an inadequate sensitivity of 51% (Ann Surg. 2011,253: 444-450). Digital subtraction angiography (DSA) continues to be the reference standard of diagnosis but has significant drawbacks of invasiveness and resource demands. There have been continued advances in CT technology, and this is the first report of an extensive experience with 64-channel multidetector CTA. Patients screened for BCVI using CTA and DSA (reference) at a Level 1 trauma center during the 12-month period ending in May 2012 were identified. Results of CTA and DSA, complications, and strokes were retrospectively reviewed and compared. A total of 594 patients met criteria for BCVI screening and underwent both CTA and DSA. One hundred twenty-eight patients (22% of those screened) had 163 injured vessels: 99 (61%) carotid artery injuries and 64 (39%) vertebral artery injuries. Sixty-four-channel CTA demonstrated an overall sensitivity per vessel of 68% and specificity of 92%. The 52 false-negative findings on CTA were composed of 34 carotid artery injuries and 18 vertebral artery injuries; 32 (62%) were Grade I injuries. Overall, positive predictive value was 36.2%, and negative predictive value was 97.5%. Six procedure-related complications (1%) occurred with DSA, including two iatrogenic dissections and one stroke. Sixty-four-channel CTA demonstrated a significantly improved sensitivity of 68% versus the 51% previously reported for the 32-channel CTA (p = 0.0075). Sixty-two percent of the false-negative findings occurred with low-grade injuries. Considering complications, cost, and resource demand associated with

  10. Complications of myocardial infarction on multidetector-row computed tomography of chest

    International Nuclear Information System (INIS)

    Raj, V.; Karunasaagarar, K.; Rudd, J.H.F.; Screaton, N.; Gopalan, D.

    2010-01-01

    Myocardial infarction (MI) secondary to coronary artery disease remains the leading cause of death in the western world. The advent of early reperfusion therapy has substantially decreased in-hospital mortality and has improved the outcome in survivors of the acute phase of MI. Complications of MI include ischaemic, mechanical, arrhythmic, embolic and inflammatory disturbances. Although some of these complications may be infrequent, their importance is underscored because of the potential ability to correct them with early diagnosis and appropriate treatment. The majority of these complications will be detected on clinical examination and confirmed by echocardiography. Some patients may undergo non-electrocardiogram (ECG)-gated thoracic multidetector-row computed tomography (MDCT) due to non-specific presentation. In this group, it is imperative for the radiologist to be aware of and be confident in diagnosing the complications secondary to MI. This review illustrates the spectrum and imaging features of acute and chronic complications of MI that can be visualized on both ECG-gated cardiac and non-ECG-gated thoracic MDCT.

  11. MULTIDETECTOR COMPUTED TOMOGRAPHY FOR IDENTIFICATION OF INSTABILITY OF AORTIC ANEURYSM WALL

    Directory of Open Access Journals (Sweden)

    M. V. Vishnyakova Jr.

    2015-01-01

    Full Text Available Background: Aortic aneurysm is characterized by high incidence, polymorphic clinical features and sudden onset of severe complications.Aim: To develop a standard multidetector computed tomography (MDCT protocol for aortic aneurysm examination and image analysis for detection the signs of aortic wall instability.Materials and methods: The data of 279 patients with aortic aneurysm who underwent MDCT examination during 2009–2014 was analyzed to identify aortic wall instability signs.Results: Complicated course of aortic aneurysm was observed in 100 cases (36%. The most common sign of aortic wall instability was aortic dissection. According to our results, a new definition of aortic aneurysm complications was elaborated. It included signs of aortic wall instability with incomplete and/or complete disruption of aortic wall layers. A scheme of the most common patterns of aortic wall abnormalities was proposed, allowing a radiologist to reach high accuracy in characterizing this pathology.Conclusion: A dedicated MDCT protocol for aortic aneurysm detection and image analysis can increase quality of radiologic assessment of aneurysm wall allowing to approach to the level of histological accuracy.

  12. Nasal and skull base anatomy of endoscopic endonasal transsphenoidal surgery with multi-detector computed tomography

    International Nuclear Information System (INIS)

    Hasegawa, Yuzo; Saeki, Naokatsu; Murai, Hisayuki; Horiguchi, Kentaro; Hanazawa, Toyoyuki; Okamoto, Miyoshi; Yanagawa, Noriyuki

    2008-01-01

    The endoscope is a new and highly useful instrument for transphenoidal surgery (TSS), and is generally used because of its minimally invasiveness. In addition, endoscopic transsphenoidal surgey (eTSS) has a potential for more radical tumor removal at the pituitary and the parasellar regions by wider visualization and more powerful illumination. To operate these regions safely, we need to know nasal and skull base anatomy under the endoscope which looks different from images under a microscope. In this paper, we demonstrated nasal and skull base anatomy with multi-detector computed tomography, which was performed in 23 recent patients with pituitary and parasellar legions. In the nasal legion, deviation of nasal septum and deviation of sphenoid ostium are important for endonasal approach of eTSS, and often determine the difficulty of surgery in the nasal cavity. Our study showed that deviation of nasal septum was seen in 26% of patients. Deviation of sphenoid ostium was 5.5±1.5 mm from the midline. The anatomy of sphenoid sinus plays a key role in our determination of the safety of a bony opening of the sella. In addition to sellar, presellar, and concha types, carotid prominence and optic prominence are important to determine the midline orientation. Development of carotid prominence was significantly related to the extent of lateral pneumatization of sphenoid sinus (P=0.0016). Reconstructed 3D-image of sphenoid sinus was very useful in visual understanding skull base anatomy. (author)

  13. Imaging of peripheral arteries by 16-row multidetector computed tomography angiography: A feasible tool?

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, Anuj [Department of Radiology, National Organ Transplant Program, Tripoli (Libyan Arab Jamahiriya)]. E-mail: dranujmish@yahoo.com; Bhaktarahalli, Jahnavi Narayanaswamy [Department of Clinical Pathology, Tripoli Medical Centre, Tripoli (Libyan Arab Jamahiriya); Ehtuish, Ehtuish F. [Department of Surgery, National Organ Transplant Program, Tripoli (Libyan Arab Jamahiriya)

    2007-03-15

    Objective: To evaluate the efficacy of multidetector (16-row) computed tomography (MDCT) in imaging the upper and lower limb arterial tree in trauma and peripheral arterial occlusive disease (PAOD). Methods: Thirty-three patients underwent MDCT angiography (MDCTA) of the upper or the lower limb on 16-row MDCT scanner between November, 2004 and July, 2005. The findings were compared with the surgical outcome in cases with trauma and suspected arterial injuries or color Doppler correlation was obtained for patients of PAOD. Results: MDCTA allowed a comprehensive diagnostic work-up in all trauma cases with suspected arterial injuries. In the 23 cases of PAOD, MDCT adequately demonstrated the presence of stenosis or occlusion, its degree and extent, the presence of collaterals and plaques. Conclusion: Our experience of CT angiography (CTA) with 16-row MDCT scanner has clearly demonstrated its efficacy as a promising, new, fast, accurate, safe and non-invasive imaging modality of choice in cases of trauma with suspected arterial injuries and as a useful screening modality in cases of PAOD for diagnosis and for grading.

  14. Imaging of peripheral arteries by 16-row multidetector computed tomography angiography: A feasible tool?

    International Nuclear Information System (INIS)

    Mishra, Anuj; Bhaktarahalli, Jahnavi Narayanaswamy; Ehtuish, Ehtuish F.

    2007-01-01

    Objective: To evaluate the efficacy of multidetector (16-row) computed tomography (MDCT) in imaging the upper and lower limb arterial tree in trauma and peripheral arterial occlusive disease (PAOD). Methods: Thirty-three patients underwent MDCT angiography (MDCTA) of the upper or the lower limb on 16-row MDCT scanner between November, 2004 and July, 2005. The findings were compared with the surgical outcome in cases with trauma and suspected arterial injuries or color Doppler correlation was obtained for patients of PAOD. Results: MDCTA allowed a comprehensive diagnostic work-up in all trauma cases with suspected arterial injuries. In the 23 cases of PAOD, MDCT adequately demonstrated the presence of stenosis or occlusion, its degree and extent, the presence of collaterals and plaques. Conclusion: Our experience of CT angiography (CTA) with 16-row MDCT scanner has clearly demonstrated its efficacy as a promising, new, fast, accurate, safe and non-invasive imaging modality of choice in cases of trauma with suspected arterial injuries and as a useful screening modality in cases of PAOD for diagnosis and for grading

  15. Study of the renal segmental arterial anatomy with contrast-enhanced multi-detector computed tomography.

    Science.gov (United States)

    Rocco, Francesco; Cozzi, Luigi Alberto; Cozzi, Gabriele

    2015-07-01

    To use triphasic multi-detector computed tomography (MDCT) to study the renal segmental arterial anatomy and its relationship with the urinary tract to plan nephron-sparing surgery (NSS). One hundred and fifty nine patients underwent abdominal contrast-enhanced MDCT. We evaluated renal arteries and parenchymal vasculature. In 61 patients, the arteries and the urinary tract were represented simultaneously. 86.60% presented a single renal artery; 13.4%, multiple arteries. All single renal arteries divided into anterior and posterior branch before the hilum. The anterior artery branched into a superior, middle, and inferior branch. In 43.14%, the inferior artery arose before the others; in 45.75%, the superior artery arose before the others; in 9.80%, the branches shared a common trunk. In 26.80%, the posterior artery supplies the entire posterior surface; in 73.20%, it ends along the inferior calyx. In 96.73%, the upper pole was vascularized by the anterior superior branch and the posterior artery: the "tuning fork". MDCT showed four vascular segments in 96.73% and five in 3.27%. MDCT showed two avascular areas: the first along the projection of the inferior calyx on the posterior aspect, the second between the branches of the "tuning fork". The arterial phase provides the arterial tree representation; the delayed phase shows arteries and urinary tract simultaneously. MDCT provides a useful representation of the renal anatomy prior to intervascular-intrarenal NSS.

  16. Role of multidetector computed tomography in evaluating incidentally detected breast lesions.

    Science.gov (United States)

    Moschetta, Marco; Scardapane, Arnaldo; Lorusso, Valentina; Rella, Leonarda; Telegrafo, Michele; Serio, Gabriella; Angelelli, Giuseppe; Ianora, Amato Antonio Stabile

    2015-01-01

    Computed tomography (CT) does not represent the primary method for the evaluation of breast lesions; however, it can detect breast abnormalities, even when performed for other reasons related to thoracic structures. The aim of this study is to evaluate the potential benefits of 320-row multidetector CT (MDCT) in evaluating and differentiating incidentally detected breast lesions by using vessel probe and 3D analysis software with net enhancement value. Sixty-two breast lesions in 46 patients who underwent 320-row chest CT examination were retrospectively evaluated. CT scans were assessed searching for the presence, location, number, morphological features, and density of breast nodules. Net enhancement was calculated by subtracting precontrast density from the density obtained by postcontrast values. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CT were calculated for morphological features and net enhancement. Thirty of 62 lesions were found to be malignant at histological examination and 32 were found to be benign. When morphological features were considered, the sensitivity, specificity, accuracy, PPV, and NPV of CT were 87%, 100%, 88%, 100%, and 50%, respectively. Based on net enhancement, CT reached a sensitivity, specificity, accuracy, PPV, and NPV of 100%, 94%, 97%, 94%, and 100%, respectively. MDCT allows to recognize and characterize breast lesions based on morphological features. Net enhancement can be proposed as an additional accurate feature of CT.

  17. Magnetic resonance imaging of pulmonary infection in immunocompromised children: comparison with multidetector computed tomography.

    Science.gov (United States)

    Ozcan, H Nursun; Gormez, Ayşegul; Ozsurekci, Yasemin; Karakaya, Jale; Oguz, Berna; Unal, Sule; Cetin, Mualla; Ceyhan, Mehmet; Haliloglu, Mithat

    2017-02-01

    Computed tomography (CT) is commonly used to detect pulmonary infection in immunocompromised children. To compare MRI and multidetector CT findings of pulmonary abnormalities in immunocompromised children. Seventeen neutropaenic children (6 girls; ages 2-18 years) were included. Non-contrast-enhanced CT was performed with a 64-detector CT scanner. Axial and coronal non-enhanced thoracic MRI was performed using a 1.5-T scanner within 24 h of the CT examination (true fast imaging with steady-state free precession, fat-saturated T2-weighted turbo spin echo with motion correction, T2-weighted half-Fourier single-shot turbo spin echo [HASTE], fat-saturated T1-weighted spoiled gradient echo). Pulmonary abnormalities (nodules, consolidations, ground glass opacities, atelectasis, pleural effusion and lymph nodes) were evaluated and compared among MRI sequences and between MRI and CT. The relationship between MRI sequences and nodule sizes was examined by chi- square test. Of 256 CT lesions, 207 (81%, 95% confidence interval [CI] 76-85%) were detected at MRI. Of 202 CT-detected nodules, 157 (78%, 95% CI 71-83%) were seen at motion-corrected MRI. Of the 1-5-mm nodules, 69% were detected by motion-corrected T2-weighted MRI and 38% by HASTE MRI. Sensitivity of MRI (both axial fat-saturated T2-weighted turbo spin echo with variable phase encoding directions (BLADE) images and HASTE sequences) to detect pulmonary abnormalities is promising.

  18. Magnetic resonance imaging of pulmonary infection in immunocompromised children: comparison with multidetector computed tomography

    International Nuclear Information System (INIS)

    Ozcan, H.N.; Gormez, Aysegul; Oguz, Berna; Haliloglu, Mithat; Ozsurekci, Yasemin; Ceyhan, Mehmet; Karakaya, Jale; Unal, Sule; Cetin, Mualla

    2017-01-01

    Computed tomography (CT) is commonly used to detect pulmonary infection in immunocompromised children. To compare MRI and multidetector CT findings of pulmonary abnormalities in immunocompromised children. Seventeen neutropaenic children (6 girls; ages 2-18 years) were included. Non-contrast-enhanced CT was performed with a 64-detector CT scanner. Axial and coronal non-enhanced thoracic MRI was performed using a 1.5-T scanner within 24 h of the CT examination (true fast imaging with steady-state free precession, fat-saturated T2-weighted turbo spin echo with motion correction, T2-weighted half-Fourier single-shot turbo spin echo [HASTE], fat-saturated T1-weighted spoiled gradient echo). Pulmonary abnormalities (nodules, consolidations, ground glass opacities, atelectasis, pleural effusion and lymph nodes) were evaluated and compared among MRI sequences and between MRI and CT. The relationship between MRI sequences and nodule sizes was examined by chi- square test. Of 256 CT lesions, 207 (81%, 95% confidence interval [CI] 76-85%) were detected at MRI. Of 202 CT-detected nodules, 157 (78%, 95% CI 71-83%) were seen at motion-corrected MRI. Of the 1-5-mm nodules, 69% were detected by motion-corrected T2-weighted MRI and 38% by HASTE MRI. Sensitivity of MRI (both axial fat-saturated T2-weighted turbo spin echo with variable phase encoding directions (BLADE) images and HASTE sequences) to detect pulmonary abnormalities is promising. (orig.)

  19. Comparative diagnostic performance of multidetector computed tomography and MRI for characterization of pancreatic cystic lesions

    International Nuclear Information System (INIS)

    Moon, Sung Min; Shin, Sang Soo; Park, Jin Gyoon; Jeong, Yong Yeon

    2015-01-01

    To compare the diagnostic performance of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in characterization of pancreatic cystic lesions. We conducted a retrospective study on 34 patients with histopathologically proven cystic pancreatic lesions who underwent both preoperative MDCT and MRI. CT and MRI were independently evaluated for differentiating mucinous vs. non-mucinous lesions, differentiating aggressive vs. non-aggressive lesion, analyzing morphological features, and evaluating specific leading diagnoses. Sensitivity, specificity, and accuracy were determined. Competency assessment of lesional morphology analysis was performed using the kappa values of the 2 tests. The sensitivity, specificity, and accuracy of MRI for differentiating mucinous vs. non-mucinous lesions were higher than CT (p = 0.03). For differentiating aggressiveness, the sensitivity of MRI was better than CT, but the specificity of CT was better than MRI. In evaluation of morphologic features, MRI showed better performance in characterization of septa and wall. Otherwise, the 2 modalities showed similarly good performance. MRI was better than CT in determining a specific diagnosis (58.8% vs. 47.2%, respectively). CT and MRI are reasonable diagnostic methods for characterization of pancreatic cystic lesions. However, MRI enables more confident assessment than CT in differentiating mucinous vs. non-mucinous lesions and characterization of the septa and wall

  20. Gastric cancer: texture analysis from multidetector computed tomography as a potential preoperative prognostic biomarker

    Energy Technology Data Exchange (ETDEWEB)

    Giganti, Francesco; Salerno, Annalaura; Marra, Paolo; Esposito, Antonio; Del Maschio, Alessandro; De Cobelli, Francesco [Department of Radiology and Centre for Experimental Imaging San Raffaele Scientific Institute, Milan (Italy); San Raffaele Vita-Salute University, Milan (Italy); Antunes, Sofia [San Raffaele Scientific Institute, Centre for Experimental Imaging, Milan (Italy); Ambrosi, Alessandro [San Raffaele Vita-Salute University, Milan (Italy); Nicoletti, Roberto [Department of Radiology and Centre for Experimental Imaging San Raffaele Scientific Institute, Milan (Italy); Orsenigo, Elena [San Raffaele Scientific Institute, Department of Surgery, Milan (Italy); Chiari, Damiano; Staudacher, Carlo [San Raffaele Vita-Salute University, Milan (Italy); San Raffaele Scientific Institute, Department of Surgery, Milan (Italy); Albarello, Luca [San Raffaele Scientific Institute, Pathology Unit, Milan (Italy)

    2017-05-15

    To investigate the association between preoperative texture analysis from multidetector computed tomography (MDCT) and overall survival in patients with gastric cancer. Institutional review board approval and informed consent were obtained. Fifty-six patients with biopsy-proved gastric cancer were examined by MDCT and treated with surgery. Image features from texture analysis were quantified, with and without filters for fine to coarse textures. The association with survival time was assessed using Kaplan-Meier and Cox analysis. The following parameters were significantly associated with a negative prognosis, according to different thresholds: energy [no filter] - Logarithm of relative risk (Log RR): 3.25; p = 0.046; entropy [no filter] (Log RR: 5.96; p = 0.002); entropy [filter 1.5] (Log RR: 3.54; p = 0.027); maximum Hounsfield unit value [filter 1.5] (Log RR: 3.44; p = 0.027); skewness [filter 2] (Log RR: 5.83; p = 0.004); root mean square [filter 1] (Log RR: - 2.66; p = 0.024) and mean absolute deviation [filter 2] (Log RR: - 4.22; p = 0.007). Texture analysis could increase the performance of a multivariate prognostic model for risk stratification in gastric cancer. Further evaluations are warranted to clarify the clinical role of texture analysis from MDCT. (orig.)

  1. Right top pulmonary vein: Evaluation with 64 section multidetector computed tomography

    International Nuclear Information System (INIS)

    Arslan, Gokhan; Dincer, Elvan; Kabaalioglu, Adnan; Ozkaynak, Can

    2008-01-01

    Purpose: To evaluate the incidence and anatomic features of the rare variant of the pulmonary veins named 'right top pulmonary vein' as depicted with 64 section multidetector computed tomography (MDCT). Materials and methods: MDCT of 610 patients obtained over 12 months period for diagnosis of suspected thoracic or cardiac pathology were routinely reviewed in transverse and 3D images. The frequency of right top pulmonary vein (RTPV) was determined and anatomic features were also documented. Results: Right top pulmonary vein (RTPV) is a supernumerary vein arising from the roof of the right part of the left atrium separately from the orifice of the right superior pulmonary vein. It crosses behind the intermediate bronchus and drains mainly posterior segment of the right upper lobe but also receives few subsegmental branches of superior segment of the right lower lobe. It was detected in 2.2% of patients (14/610). The mean diameter of RTPV was 5.1 mm. Conclusion: The RTPV is a rare venous drainage variation of pulmonary veins. It is important to be aware of this anatomic pattern for avoiding misinterpretation of pulmonary venographic findings, inadvertent ablation of pulmonary vein and perioperative bleeding during video assisted thorocoscopic lobectomy

  2. Influence of statin treatment on coronary atherosclerosis visualised using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Hans [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Klinikum Brandenburg, Department of Cardiology, Angiology, and Pulmonology, Brandenburg an der Havel (Germany); Frieler, Katja [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Medical Statistics, Berlin (Germany); Potsdam Institut fuer Klimaforschung, Potsdam (Germany); Schlattmann, Peter [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Medical Statistics, Berlin (Germany); Hamm, Bernd [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Dewey, Marc [Charite, Medical School, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Department of Radiology (Germany)

    2010-12-15

    Coronary angiography using multidetector computed tomography (MDCT) allows non-invasive assessment of non-calcified, calcified and mixed plaques. Progression of coronary plaques may be influenced by statins. Sixty-three consecutive patients underwent MDCT as a follow-up to their original CT angiography in a retrospective longitudinal study. MDCT was performed by using a voxel size of 0.5 x 0.35 x 0.35 mm{sup 3} at two time points 25 {+-} 3 months apart. Non-calcified, calcified and mixed coronary plaque components were analysed by using volumetric measurement. The influence of statin, low-density lipoprotein (LDL) and risk factors was assessed by using a linear random intercept model for plaque growth. The volumes of non-calcified, calcified and mixed coronary plaques significantly (P < 0.001) increased from baseline (medians/interquartile ranges = 21/15-39, 7/3-20 and 36/16-69 mm{sup 3}) to follow-up (29/17-44, 13/6-29 and 41/20-75 mm{sup 3}). Statins significantly slowed the growth of non-calcified plaques (statin coefficient {beta} = -0.0036, P = 0.01) but did not significantly affect the growth rate of mixed or calcified plaques. The effect of statin treatment on non-calcified plaques remained significant after adjusting for LDL levels and cardiac risk factors. Quantification using MDCT shows that progression of non-calcified coronary plaques may be slowed by statins. (orig.)

  3. Influence of statin treatment on coronary atherosclerosis visualised using multidetector computed tomography

    International Nuclear Information System (INIS)

    Hoffmann, Hans; Frieler, Katja; Schlattmann, Peter; Hamm, Bernd; Dewey, Marc

    2010-01-01

    Coronary angiography using multidetector computed tomography (MDCT) allows non-invasive assessment of non-calcified, calcified and mixed plaques. Progression of coronary plaques may be influenced by statins. Sixty-three consecutive patients underwent MDCT as a follow-up to their original CT angiography in a retrospective longitudinal study. MDCT was performed by using a voxel size of 0.5 x 0.35 x 0.35 mm 3 at two time points 25 ± 3 months apart. Non-calcified, calcified and mixed coronary plaque components were analysed by using volumetric measurement. The influence of statin, low-density lipoprotein (LDL) and risk factors was assessed by using a linear random intercept model for plaque growth. The volumes of non-calcified, calcified and mixed coronary plaques significantly (P 3 ) to follow-up (29/17-44, 13/6-29 and 41/20-75 mm 3 ). Statins significantly slowed the growth of non-calcified plaques (statin coefficient β = -0.0036, P = 0.01) but did not significantly affect the growth rate of mixed or calcified plaques. The effect of statin treatment on non-calcified plaques remained significant after adjusting for LDL levels and cardiac risk factors. Quantification using MDCT shows that progression of non-calcified coronary plaques may be slowed by statins. (orig.)

  4. Magnetic resonance imaging of pulmonary infection in immunocompromised children: comparison with multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ozcan, H.N.; Gormez, Aysegul; Oguz, Berna; Haliloglu, Mithat [Hacettepe University School of Medicine, Department of Radiology, Ankara (Turkey); Ozsurekci, Yasemin; Ceyhan, Mehmet [Hacettepe University School of Medicine, Department of Pediatric Infectious Disease, Ankara (Turkey); Karakaya, Jale [Hacettepe University School of Medicine, Department of Biostatistics, Ankara (Turkey); Unal, Sule; Cetin, Mualla [Hacettepe University School of Medicine, Department of Pediatric Hematology, Ankara (Turkey)

    2017-02-15

    Computed tomography (CT) is commonly used to detect pulmonary infection in immunocompromised children. To compare MRI and multidetector CT findings of pulmonary abnormalities in immunocompromised children. Seventeen neutropaenic children (6 girls; ages 2-18 years) were included. Non-contrast-enhanced CT was performed with a 64-detector CT scanner. Axial and coronal non-enhanced thoracic MRI was performed using a 1.5-T scanner within 24 h of the CT examination (true fast imaging with steady-state free precession, fat-saturated T2-weighted turbo spin echo with motion correction, T2-weighted half-Fourier single-shot turbo spin echo [HASTE], fat-saturated T1-weighted spoiled gradient echo). Pulmonary abnormalities (nodules, consolidations, ground glass opacities, atelectasis, pleural effusion and lymph nodes) were evaluated and compared among MRI sequences and between MRI and CT. The relationship between MRI sequences and nodule sizes was examined by chi- square test. Of 256 CT lesions, 207 (81%, 95% confidence interval [CI] 76-85%) were detected at MRI. Of 202 CT-detected nodules, 157 (78%, 95% CI 71-83%) were seen at motion-corrected MRI. Of the 1-5-mm nodules, 69% were detected by motion-corrected T2-weighted MRI and 38% by HASTE MRI. Sensitivity of MRI (both axial fat-saturated T2-weighted turbo spin echo with variable phase encoding directions (BLADE) images and HASTE sequences) to detect pulmonary abnormalities is promising. (orig.)

  5. Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis.

    Science.gov (United States)

    Zhu, Caisong; Liu, Wei; Yang, Jun; Yang, Jing; Shao, Kangwei; Yuan, Lixin; Chen, Hairong; Lu, Wei; Zhu, Ying

    2016-07-01

    The aim of the present study was to compare the multidetector computed tomography (MDCT) features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis (CLT). MDCT findings, including the size, solid percentage, calcification, margin, capsule, anteroposterior-transverse diameter ratio as well as the mode and the degree of enhancement of 137 thyroid nodules in 127 CLT cases were retrospectively analyzed. Furthermore, the correlation between MDCT findings and pathological results combined with the CT perfusion imaging was analyzed for the differences between benign and malignant nodules. A total of 77.5% (31/40) of malignant nodules were completely solid, and 33% (32/97) of benign nodules were predominantly cystic. Compared with the benign nodules, micro-calcification and internal calcification were more frequently observed in the malignant nodules (Pbenign and malignant nodules (P>0.05). MDCT features are useful in differentiating the benign and malignant nodules in CLT patients, and it may be essential for a radiologist to review the MDCT characteristics of nodules in the clinical practice.

  6. Underdiagnosis of Vertebral Collapse on Routine Multidetector Computed Tomography Scan of the Abdomen

    International Nuclear Information System (INIS)

    Obaid, H.; Husamaldin, Z.; Bhatt, R.

    2008-01-01

    Background: Vertebral fractures are commonly associated with osteoporosis and have significant morbidity and mortality rates. Osteoporotic vertebral fractures are presently considered as a treatable and preventable condition, and early detection is vital for further management. The evaluation of vertebral compression on multidetector computed tomography (MDCT) scans of the abdomen has, to our knowledge, not been reported before. Purpose: To assess the prevalence of vertebral collapse on routine abdominal CT scans, and to evaluate the usefulness of the multiplanar reconstruction (MPR) capability of MDCT scans in accurately identifying vertebral abnormalities such as vertebral collapse, spondylolisthesis, and retrolisthesis. Material and Methods: A retrospective review of 307 MDCT scans of the abdomen was carried out at a university teaching hospital. Identifiable patient information was anonymized for data protection. All images were reviewed on a picture archiving and communications system (PACS) using sagittal MPR and bone window for the assessment of the vertebrae. Data were collected from the Computerized Radiology Information System (CRIS). Results: Vertebral collapse was seen in 42 (13.6%) of the 307 patients undergoing routine MDCT of the abdomen. Multilevel and single-level collapses were seen in 24 and 18 patients, respectively. Spondylolisthesis was identified in 5.5% (n=17), and retrolisthesis was seen in 0.6% (n=2). All patients with vertebral fracture were older than 50 years. Women were more commonly affected than men. Conclusion: A significant number of patients with vertebral collapse were diagnosed using MPR on MDCT routine scans of the abdomen

  7. Incidence of pulmonary embolism and other chest findings in younger patients using multidetector computed tomography

    International Nuclear Information System (INIS)

    Heredia, Vasco; Ramalho, Miguel; Zapparoli, Mauricio; Semelka, Richard C.

    2010-01-01

    Background: Multidetector computed tomography (MDCT) has become the first-line modality for imaging patients with suspected pulmonary embolism (PE). The disadvantages of MDCT, the use of ionizing radiation and iodinated contrast agents, are a reasonable cause of concern, especially in young patients, and therefore it is critical to understand the likelihood of PE in these patients to evaluate a risk benefit analysis. Purpose: To calculate the incidence of PE and other chest findings on MDCT in a young adult population investigated for PE. Material and Methods: 387 consecutive patients (age 31.5±13.5 years) underwent chest MDCT for clinically suspected PE between January 2004 and August 2006. Incidence of PE and other chest findings were calculated with a confidence interval of 95% using binomial distribution. Results: PE incidence was 5%; negative PE with other chest findings was 60%. In 89% of the patients with other chest findings, these included findings of the pleura and/or lung parenchyma. The main patterns of disease were lung opacification suggesting pneumonia (41%), atelectasis (12.4%), and nodular/mass findings (17.5%). In 34% of the patients, there was no PE and no other findings present. Conclusion: There is a low incidence of PE in young patients imaged for PE with MDCT

  8. Evaluation of cardiovascular anomalies in patients with asymptomatic turner syndrome using multidetector computed tomography.

    Science.gov (United States)

    Lee, Sun Hee; Jung, Ji Mi; Song, Min Seob; Choi, Seok jin; Chung, Woo Yeong

    2013-08-01

    Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

  9. Complications of myocardial infarction on multidetector-row computed tomography of chest

    Energy Technology Data Exchange (ETDEWEB)

    Raj, V.; Karunasaagarar, K. [Department of Radiology, Papworth and Addenbrookes Hospital, Cambridge (United Kingdom); Rudd, J.H.F. [Division of Cardiovascular Medicine, University of Cambridge, Cambridge (United Kingdom); Screaton, N. [Department of Radiology, Papworth and Addenbrookes Hospital, Cambridge (United Kingdom); Gopalan, D., E-mail: deepa.gopalan@btopenworld.co [Department of Radiology, Papworth and Addenbrookes Hospital, Cambridge (United Kingdom)

    2010-11-15

    Myocardial infarction (MI) secondary to coronary artery disease remains the leading cause of death in the western world. The advent of early reperfusion therapy has substantially decreased in-hospital mortality and has improved the outcome in survivors of the acute phase of MI. Complications of MI include ischaemic, mechanical, arrhythmic, embolic and inflammatory disturbances. Although some of these complications may be infrequent, their importance is underscored because of the potential ability to correct them with early diagnosis and appropriate treatment. The majority of these complications will be detected on clinical examination and confirmed by echocardiography. Some patients may undergo non-electrocardiogram (ECG)-gated thoracic multidetector-row computed tomography (MDCT) due to non-specific presentation. In this group, it is imperative for the radiologist to be aware of and be confident in diagnosing the complications secondary to MI. This review illustrates the spectrum and imaging features of acute and chronic complications of MI that can be visualized on both ECG-gated cardiac and non-ECG-gated thoracic MDCT.

  10. Multidetector row computed tomography evaluation of the micropig kidney as a potential renal donor.

    Science.gov (United States)

    Yoon, Woong; Lee, Min Young; Ryu, Jung Min; Moon, Yong Ju; Lee, Sang Hun; Park, Jae Hong; Yun, Seung Pil; Jang, Min Woo; Park, Sung Su; Han, Ho Jae

    2010-03-01

    Multidetector row computed tomography (MDCT) provides anatomical information about the kidney and other internal organs. Presently, the suitability of 64-channel MDCT to assess the kidney of healthy micropigs was evaluated. Morphological evaluations of the kidney and the major renal vessels of six healthy micropigs were carried out using MDCT, recording kidney volume and the diameter and length of renal arteries and veins. The mean diameters and lengths of the renal artery were 0.44 +/- 0.05 and 4.51 +/- 0.55 cm on the right side and 0.46 +/- 0.06 and 3.36 +/- 0.27 cm on the left side, respectively. The mean diameters and lengths of the renal vein were 1.44 +/- 0.52 and 4.22 +/- 1.29 cm on the right side and 1.38 +/- 0.17 and 5.15 +/- 0.87 cm on the left side, respectively. The mean volume of the right kidney was 79.3 +/- 14.5 mL and of the left kidney was 78.0 +/- 13.9 mL. The data presented in this study suggest that the MDCT offers a noninvasive, rapid, and accurate method for the evaluation of the renal anatomy in living kidney donors. It also provides sufficient information about extra-renal anatomy important for donor surgery and determination of organ suitability.

  11. Blunt trauma of bone structures of the chest--computed tomography vs multidetector computed tomography.

    Science.gov (United States)

    Petrović, Kosta; Turkalj, Ivan; Stojanović, Sanja; Vucaj-Cirilović, Viktorija; Nikolić, Olivera; Stojiljković, Dragana

    2013-08-01

    Computerized tomography (CT), especially multidetector CT (MDCT), has had a revolutionary impact in diagnostic in traumatized patients. The aim of the study was to identify and compare the frequency of injuries to bone structures of the thorax displayed with 5-mm-thick axial CT slices and thin-slice (MDCT) examination with the use of 3D reconstructions, primarily multiplanar reformations (MPR). This prospective study included 61 patients with blunt trauma submitted to CT scan of the thorax as initial assessment. The two experienced radiologists inde pendently and separately described the findings for 5-mm-thick axial CT slices (5 mm CT) as in monoslice CT examination; MPR and other 3D reconstructions along with thin-slice axial sections which were available in modern MDCT technologies. After describing thin-slice examination in case of disagreement in the findings, the examiners redescribed thin-slice examination together which was ultimately considered as a real, true finding. No statistically significant difference in interobserver evaluation of 5 mm CT examination was recorded (p > 0.05). Evaluation of fractures of sternum with 5 mm CT and MDCT showed a statistically significant difference (p tool that can describe higher number of bone fractures of the chest in traumatized patients compared to 5 mm CT, especially in the region of sternum for which a statistical significance was obtained using MPR. Moreover, the importance of MDCT is also set by easier and more accurate determination of the level of bone injury.

  12. Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography

    International Nuclear Information System (INIS)

    Akin, Kayihan; Kosehan, Dilek; Topcu, Adem; Koktener, Asli

    2011-01-01

    The aim of this study was to evaluate the interindividual variations of the xiphoid process in a wide adult group using 64-row multidetector computed tomography (MDCT). Included in the study were 500 consecutive patients who underwent coronary computed tomography angiography. Multiplanar reconstruction (MPR), maximum intensity projection (MIP) images on coronal and sagittal planes, and three-dimensional volume rendering (VR) reconstruction images were obtained and used for the evaluation of the anatomic features of the xiphoid process. The xiphoid process was present in all patients. The xiphoid process was deviated ventrally in 327 patients (65.4%). In 11 of these 327 patients (2.2%), ventral curving at the end of the xiphoid process resembled a hook. The xiphoid process was aligned in the same axis as the sternal corpus in 166 patients (33.2%). The tip of the xiphoid process was curved dorsally like a hook in three patients (0.6%). In four patients (0.8%), the xiphoid process exhibited a reverse S shape. Xiphoidal endings were single in 313 (62.6%) patients, double in 164 (32.8%), or triple in 23 (4.6%). Ossification of the cartilaginous xiphoid process was fully completed in 254 patients (50.8 %). In total, 171 patients (34.2%) had only one xiphoidal foramen and 45 patients (9%) had two or more foramina. Sternoxiphoidal fusion was present in 214 of the patients (42.8%). Significant interindividual variations were detected in the xiphoid process. Excellent anatomic evaluation capacity of MDCT facilitates the detection of variations of the xiphoid process as well as the whole ribcage. (orig.)

  13. Enhanced multidetector-row computed tomography (MDCT) in the diagnosis of acute appendicitis and its severity

    International Nuclear Information System (INIS)

    Miki, Tesshou; Ogata, Seiji; Uto, Mitsunobu; Nakazono, Toshihiro; Urata, Miyuki; Ishibe, Ryouhei; Shinyama, Shin; Nakajo, Masayuki

    2005-01-01

    The purpose of this study was to examine the accuracy of enhanced multidetector-row computed tomography (MDCT) in diagnosing acute appendicitis and its severity. Contrast-enhanced MD-CT 3.5 mm thick images of 23 control patients (A), and 64 patients with surgically proven acute appendicitis including 8 catarrhal (B), 28 phiegmonous (C), and 28 gangrenous (D) appendicitis patients were respectively analyzed. The number of observed major computed tomography (CT) findings for each patient group were as follows: enlarged (≥6 mm in maximum diameter) appendix (A: 5, B: 8, C: 28, D: 28), enhancement of the appendiceal wall; hyper (A: 3, B: 8, C: 27, D: 20), iso (A: 15, B: 0, C: 1, D: 2), hypo (A-C: 0, D: 4), and patched (A-C: 0, D: 2) enhancement, appendicolith (A, B: 0, C: 7, D: 13), dirty fat sign (A: 3, B: 1, C: 21, D: 28), localized ascites (A: 2, B: 0, C: 2, D: 11), and abscess formation (A-C: 0, D: 5). From the combinations of these findings, we could differentiate acute appendicitis from the control normal appendix with an accuracy of 99% and could diagnose the severity of acute appendicitis with accuracies of 92% for catarrhal appendicitis, 84% for phlegmonous appendicitis, and 92% for gangrenous appendicitis. We could also visually reconstruct the entire forms and positions of the appendices from the successive CT findings because of the high-resolution thin-slice MDCT images. MDCT is highly accurate in the diagnosis of acute appendicitis and its severity. (author)

  14. Multidetector computed tomography angiography of the celiac trunk and hepatic arterial system: normal anatomy and main variants

    Energy Technology Data Exchange (ETDEWEB)

    Araujo-Neto, Severino Aires; Mello-Junior, Carlos Fernando de; Franca, Henrique Almeida; Duarte, Claudia Martina Araujo; Borges, Rafael Farias; Magalhaes, Ana Guardiana Ximenes de, E-mail: severinoaires@hotmail.com [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil)

    2016-01-15

    Although digital angiography remains as the gold standard for imaging the celiac arterial trunk and hepatic arteries, multidetector computed tomography in association with digital images processing by software resources represents a useful tool particularly attractive for its non invasiveness. Knowledge of normal anatomy as well as of its variations is helpful in images interpretation and to address surgical planning on a case-by-case basis. The present essay illustrates several types of anatomical variations of celiac trunk, hepatic artery and its main branches, by means of digitally reconstructed computed tomography images, correlating their prevalence in the population with surgical implications. (author)

  15. Blunt trauma of bone structures of the chest: Computed tomography vs multidetector computed tomography

    Directory of Open Access Journals (Sweden)

    Petrović Kosta

    2013-01-01

    Full Text Available Background/Aim. Computerized tomography (CT, especially multidetector CT (MDCT, has had a revolutionary impact in diagnostic in traumatized patients. The aim of the study was to identify and compare the frequency of injuries to bone structures of the thorax displayed with 5-mm-thick axial CT slices and thin-slice (MDCT examination with the use of 3D reconstructions, primarily multiplanar reformations (MPR. Methods. This prospective study included 61 patients with blunt trauma submitted to CT scan of the thorax as initial assessment. The two experienced radiologists independently and separately described the findings for 5-mmthick axial CT slices (5 mm CT as in monoslice CT examination; MPR and other 3D reconstructions along with thin-slice axial sections which were available in modern MDCT technologies. After describing thin-slice examination in case of disagreement in the findings, the examiners redescribed thinslice examination together which was ultimately considered as a real, true finding. Results. No statistically significant difference in interobserver evaluation of 5 mm CT examination was recorded (p > 0.05. Evaluation of fractures of sternum with 5 mm CT and MDCT showed a statistically significant difference (p < 0.05 in favor of better display of injury by MDCT examination. Conclusion. MDCT is a powerful diagnostic tool that can describe higher number of bone fractures of the chest in traumatized patients compared to 5 mm CT, especially in the region of sternum for which a statistical significance was obtained using MPR. Moreover, the importance of MDCT is also set by easier and more accurate determination of the level of bone injury.

  16. Detection of intracranial aneurysms with 64 channel multidetector row computed tomography: Comparison with digital subtraction angiography

    International Nuclear Information System (INIS)

    Pozzi-Mucelli, Fabio; Bruni, Stefano; Doddi, Marco; Calgaro, Antonio; Braini, Massimiliano; Cova, Maria

    2007-01-01

    Purpose: To compare the contribution of 64 channel multidetector row computed tomography angiography (64MDCT-angiography) with digital subtraction angiography (DSA) in the detection of intracranial aneurysms. Methods and materials: Twenty-nine patients (10 males and 19 females, age: 40-84 years; average: 61.9 years) with clinical and imaging findings strongly suggesting the presence of subaracnoid hemorrhage underwent 64MDCT-angiography and DSA with a short interval between the two examinations (less than 12 h-5 days). CT parameters were: 64 mm x 0.5 mm collimation, pitch-0.828 and helical pitch-53. DSA were performed with standard technique (four vessel catheterization) and multiple projections. Axial CT scans as well as maximum intensity projection, volume rendering and multiplanar reformations and angiographic views were independently reviewed by four readers (two for 64MDCT-angiography and two for DSA). Consensus was reached for discordant cases. DSA was considered as the standard of reference. Results: In 29 patients, 28 aneurysms were found (14 patients had 1 aneurysm, 4 patients had 2 aneurysms and 2 patients had 3 aneurysms; in 9 patients no aneurysm were found). 64MDCT-angiography detected 26/28 aneurysms. No false-positive sites were recognized. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were, respectively, 92.8, 100, 100, 99.4 and 99.5%. Conclusions: 64MDCT-angiography is helpful in detecting intracranial aneurysms with results similar to those of DSA but with less discomfort and risks for the patients and can be considered for the first line imaging technique. Conventional angiography is still needed in doubtful cases or negative MDCT-angiography associated with a strong clinical suspect

  17. Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors.

    Science.gov (United States)

    Türkvatan, Aysel; Akinci, Serkan; Yildiz, Sener; Olçer, Tülay; Cumhur, Turhan

    2009-04-01

    Currently, multidetector computed tomographic (MDCT) angiography has become a noninvasive alternative imaging modality to catheter renal angiography for the evaluation of renal vascular anatomy in living renal donors. In this study, we investigated the diagnostic accuracy of 16-slice MDCT in the preoperative assessment of living renal donors. Fifty-nine consecutive living renal donors (32 men, 27 women) underwent MDCT angiography followed by open donor nephrectomy. All MDCT studies were performed by using a 16-slice MDCT scanner with the same protocol consisting of arterial and nephrographic phases followed by conventional abdominal radiography. The MDCT images were assessed retrospectively for the number and branching pattern of the renal arteries and for the number and presence of major or minor variants of the renal veins. The results were compared with open surgical results. The sensitivity and specificity of MDCT for the detection of anatomic variants of renal arteries including the accessory arteries (n = 9), early arterial branching (n = 7) and major renal venous anomalies including the accessory renal veins (n = 3), late venous confluence (n = 4), circumaortic (n = 2) or retroaortic (n = 3) left renal veins were 100%. However, the sensitivity for identification of minor venous variants was 79%. All of three ureteral duplications were correctly identified at excretory phase conventional abdominal radiography. Sixteen-slice MDCT is highly accurate for the identification of anatomic variants of renal arteries and veins. Dual-phase MDCT angiography including arterial and nephrographic phases followed by conventional abdominal radiography enables complete assessment of renal donors without significant increase of radiation dose. However, the evaluation of minor venous variants may be problematic because of their small diameters and poor opacification.

  18. Acute Knee Trauma: Analysis of Multidetector Computed Tomography Findings and Comparison with Conventional Radiography

    International Nuclear Information System (INIS)

    Mustonen, A.O.T.; Kiuru, M.J.

    2005-01-01

    Purpose: To evaluate the multidetector computed tomography (MDCT) findings of acute knee trauma and to compare radiography with MDCT in patients referred ta level 1 trauma center. Material and Methods: During a 5-year period, a total of 415 MDCT examinations were performed on 409 patients with acute knee trauma to reveal complex fracture anatomy or rule out a fracture. MDCT and primary radiographs were re-evaluated with respect to fracture location and trauma mechanism. Tibial plateau fractures were further analyzed depending on anatomical location: anterior-medial, anterior-lateral, posterior-lateral, and posterior-medial regions. Maximal depression of the tibial articular surface was measured. Findings on the primary knee radiographs were compared with MDCT findings. Results: Of the 409 patients, 356 (87%) had a knee fracture. A total of 451 fractures were found in all anatomic regions: distal femur ( n = 49), proximal tibia ( n 307), patella ( n = 23), and proximal fibula ( n = 72). Primary radiographs were available in 316 (76%) cases. Of these, 225 (71%) had MDCT in order to reveal the fracture anatomy better, and 91 (29%) had a subsequent MDCT after negative plain radiographs. Overall sensitivity of radiography was 83%, while negative predictive value was 49%. On radiography, tibial plateau articular depression was underestimated in all regions except when the fracture consisted of the whole half of the anterior or posterior plateau. The three main injury mechanisms were traffic accident, a simple fall, and sport. In 49 cases (15%), primary radiographs were suboptimal due to positioning. Conclusion: In severely injured patients, diagnostically sufficient radiographs are difficult to obtain, and therefore a negative radiograph is not reliable in ruling out a fracture. In these patients, MDCT is a fast and accurate examination and is also recommended in patients with tibial plateau fractures or complex knee injuries in order to evaluate the fracture adequately

  19. Role of whole-body 64-slice multidetector computed tomography in treatment planning for multiple myeloma.

    Science.gov (United States)

    Razek, Ahmed Abdel Khalek Abdel; Ezzat, Amany; Azmy, Emad; Tharwat, Nehal

    2013-08-01

    The authors evaluated the role of whole-body 64-slice multidetector computed tomography (WB-MDCT) in treatment planning for multiple myeloma. This was a prospective study of 28 consecutive patients with multiple myeloma (19 men, nine women; age range, 51-73 years; mean age, 60 years) who underwent WB-MDCT and conventional radiography (CR) of the skeleton. The images were interpreted for the presence of bony lesions, medullary lesions, fractures and extraosseous lesions. We evaluated any changes in treatment planning as a result of WB-MDCT findings. WB-MDCT was superior to CR for detecting bony lesions (p=0.001), especially of the spine (p=0.001) and thoracic cage (p=0.006). WB-MDCT upstaged 14 patients, with a significant difference in staging (p=0.002) between WB-MDCT and CR. Medullary involvement either focal (n=6) or diffuse (n=3) had a positive correlation with the overall score (r=0.790) and stage (r=0.618) of disease. Spine fractures were better detected at WB-MDCT (n=4) than at CR (n=2). Extraosseous soft tissue lesions (n=7) were detected only at WB-MDCT. Findings detected at the WB-MDCT led to changes in the patient's treatment plan in 39% of cases. Upstaging of seven patients (25%) altered the medical treatment plan, and four of 28 (14%) patients required additional radiotherapy (7%) and vertebroplasty (7%). We conclude that WB-MDCT has an impact on treatment planning and prognosis in patients with multiple myeloma, as it has high rate of detecting cortical and medullary bone lesions, spinal fracture and extraosseous lesions. This information may alter treatment planning in multiple myeloma due to disease upstaging and detection of spine fracture and extraosseous spinal lesions.

  20. Evaluation of Left Atrial Volumes Using Multidetector Computed Tomography: Comparison with Echocardiography

    International Nuclear Information System (INIS)

    Gweon, Hye Mi; Kim, Sang Jin; Kim, Tae Hoon; Lee, Sang Min; Hong, Yoo Jin; Rim, Se Joong

    2010-01-01

    To prospectively assess the relationship between the two different measurement methods for the evaluation of left atrial (LA) volume using cardiac multidetector computed tomography (MDCT) and to compare the results between cardiac MDCT and echocardiography. Thirty-five patients (20 men, 15 women; mean age, 60 years) underwent cardiac MDCT angiography for coronary artery disease. The LA volumes were measured using two different methods: the two dimensional (2D) length-based (LB) method measured along the three-orthogonal planes of the LA and the 3D volumetric threshold-based (VTB) method measured according to the threshold 3D segmentation of the LA. The results obtained by cardiac MDCT were compared with those obtained by echocardiography. The LA end-systolic and end-diastolic volumes (LAESV and LAEDV) measured by the 2D-LB method correlated well with those measured by the 3DVTB method using cardiac MDCT (r = 0.763, r = 0.786, p = 0.001). However, there was a significant difference in the LAESVs between the two measurement methods using cardiac MDCT (p < 0.05). The LAESV measured by cardiac MDCT correlated well with measurements by echocardiography (r = 0.864, p = 0.001), however with a significant difference (p < 0.01) in their volumes. The cardiac MDCT overestimated the LAESV by 22% compared to measurements by echocardiography. A significant correlation was found between the two different measurement methods for evaluating LA volumes by cardiac MDCT. Further, cardiac MDCT correlates well with echocardiography in evaluating the LA volume. However, there are significant differences in the LAESV between the two measurement methods using cardiac MDCT and between cardiac MDCT and echocardiography

  1. The value of multidetector-row computed tomography for localization of obscure acute gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Wei-Chou [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Tsai, Shih-Hung [Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Chang, Wei-Kuo [Division of Gasteroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Liu, Chang-Hsien [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Tung, Ho-Jui [Department of Healthcare Administration, Asia University, Taichung, Taiwan (China); Hsieh, Chung-Bao [Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Huang, Guo-Shu; Hsu, Hsian-He [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Yu, Chih-Yung, E-mail: chougo2002@yahoo.com.tw [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China)

    2011-11-15

    Purpose: There are no simple guidelines on when to perform multidetector-row computed tomography (MDCT) for diagnosis of obscure acute gastrointestinal bleeding (AGIB). We used a risk scoring system to evaluate the diagnostic power of MDCT for patients with obscure AGIB. Materials and methods: Ninety-two patients with obscure AGIB who were referred for an MDCT scan after unsuccessful endoscopic treatment at presentation were studied. We recorded clinical data and calculated Blatchford score for each patient. Patients who required transfusion more than 500 mL of blood to maintain the vital signs were classified as high-risk patients. Two radiologists independently reviewed and categorized MDCT signs of obscure AGIB. Discordant findings were resolved by consensus. One-way ANOVA was used to compare clinical data between two groups; kappa statistics were used to estimate agreement on MDCT findings between radiologists. Results: Of the 92 patients, 62 (67.4%) were classified as high-risk patients. Blatchford scores of high-risk patients were significantly greater than those of low-risk patients. Sensitivity for MDCT diagnosing obscure AGIB was 81% in high-risk patients, as compared with 50% in the low-risk. When used in conjunction with selection of the cut-off value of 13 in Blatchford scoring system, the sensitivity and specificity of MDCT were 70.9% and 73.7%, respectively. Contrast extravasation was the most specific sign of AGIB (k = .87), recognition of which would have improved diagnostic accuracy. Conclusions: With the aid of Blatchford scoring system for evaluating the disease severity, MDCT can localize the bleeders of obscure AGIB more efficiently.

  2. Assessment of myocardial viability using multidetector computed tomography in patients with reperfused acute myocardial infarction

    International Nuclear Information System (INIS)

    Kim, T.; Choi, B.J.; Kang, D.K.; Sun, J.S.

    2012-01-01

    Aim: To assess the prognostic value of 64-section multidetector computed tomography (MDCT) to predict follow-up myocardial dysfunction and functional recovery after reperfusion therapy in patients with acute myocardial infarction (MI) as defined by echocardiography. Materials and methods: After reperfusion therapy for acute MI, 71 patients underwent two-phase contrast-enhanced MDCT and follow-up echocardiography. MDCT findings were compared with echocardiographic findings using kappa statistics. The areas under the receiver operating characteristic curves (AUCs) and the odds ratios (ORs) of early perfusion defects (EPD), delayed enhancement (DE), and residual perfusion defects (RPD) for predicting follow-up myocardial dysfunction and functional recovery were calculated on a segmental basis. Results: The presence of transmural EPD (EPD TM ) or RPD showed good agreement (k = 0.611 and 0.658, respectively) with follow-up myocardial dysfunction, while subendocardial EPD (EPD sub ) or subendocardial DE (DE sub ) showed fair agreement with follow-up myocardial dysfunction (k = 0.235 and 0.234, respectively). The AUC of RPD (0.796) was superior (p TM (0.761) and DE TM (0.771). The presence of EPD TM , DE TM , and RPD were significant, independent positive predictors of follow-up myocardial dysfunction (OR = 6.4, 1.9, and 9.8, respectively). EPD TM was a significant, independent negative predictor of myocardial functional recovery (OR = 0.13). Conclusion: Abnormal myocardial attenuation on two-phase MDCT after reperfusion therapy may provide promising information regarding myocardial viability in patients with acute MI.

  3. Diagnostic value of multidetector computed tomography for renal sinus fat invasion in renal cell carcinoma patients

    International Nuclear Information System (INIS)

    Kim, Cherry; Choi, Hyuck Jae; Cho, Kyoung-Sik

    2014-01-01

    Objective: Although renal sinus fat invasion has prognostic significance in patients with renal cell carcinomas (RCCs), there are no previous studies about the value of multidetector computed tomography (MDCT) about this issue in the current literature. Materials and methods: A total of 863 consecutive patients (renal sinus fat invasion in 110 patients (12.7%)) from single institutions with surgically-confirmed renal cell carcinoma who underwent MDCT between 2010 and 2012 were included in this study. The area under the curves (AUCs) of the receiver operating characteristic (ROC) analysis was used to compare diagnostic performance. Reference standard was pathologic examination. Weighted κ statistics were used to measure the level of interobserver agreement. Multivariate logistic regression model was used to find the predictors for renal sinus fat invasion. Image analysis was first performed with axial-only CT images. A second analysis was then performed with both axial and coronal CT images. A qualitative analysis was then conducted by two reviewers who reached consensus regarding tumor size, decreased perfusion, tumor margin, vessel displacement, and lymph node metastasis. The reference standard was pathologic evaluation. Results: The AUCs of the ROC analysis were 0.881 and 0.922 for axial-only images and 0.889 and 0.902 for combined images in both readers. The AUC of tumor size was 0.884, a similar value to that of the reviewers. In multivariate analysis, tumor size, a linear-nodular or nodular type of fat infiltration, and an irregular tumor margin were independent predicting factors for perinephric fat invasion. Conclusion: MDCT shows relatively high diagnostic performance in detecting perinephric fat invasion of RCC but suffers from a relatively low PPV related to low prevalence of renal sinus fat invasion. Applying tumor size alone we could get similar diagnostic performance to those of radiologists. Tumor size, fat infiltration with a nodular appearance, and

  4. Water as a contrast medium: a re-evaluation using the multidetector-row computed tomography.

    Science.gov (United States)

    Makarawo, Tafadzwa P; Negussie, Edsa; Malde, Sachit; Tilak, Jacqueline; Gayagoy, Jennifer; Watson, Jenna; Francis, Faiz; Lincoln, Denis; Jacobs, Michael J

    2013-07-01

    Water as an intraluminal negative contrast medium produces improved image quality with reduced artefact. However, rapid absorption of oral water in the bowel relative to speed and timing of image capturing has limited its clinical application. These findings predate advances in multidetector-row computed tomography (CT). To re-evaluate differences in image quality, we studied image clarity and luminal distention between the same group of patients who received both a pancreas protocol CT (PPCT) that uses oral water and a conventional positive oral contrast scan. We reviewed 66 patients who had previously undergone both a PPCT and an oral contrast abdominal CT. CT images were independently reviewed by two board-certified radiologists who scored degree of hollow viscus distention and visualization of mural detail using a Likert 5-point scale. Results were evaluated by using the Wilcoxon-signed rank test. Student's t test was applied to evaluate the differences in radiation dosage and Spearman's correlational test was used to evaluate interrater correlation between the radiologists. In comparing the mean radiation dosage, there was no statistical difference between the two protocols, and there was good interrater association with ratios of 0.595 and 0.51 achieved for the PPCT and conventional oral scan, respectively. The Wilcoxon signed-rank test showed statistical differences in the stomach (P contrast medium causing better or equal distention in the bowel and better or equal clarity than routine barium contrast. This calls for a need to reconsider the use of water as a contrast medium in clinical practice.

  5. Evaluation of multidetector computed tomography urography and ultrasonography for diagnosing bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Knox, M.K. [Nuffield Department of Surgery, University of Oxford, Oxford (United Kingdom); Cowan, N.C. [Nuffield Department of Surgery, University of Oxford, Oxford (United Kingdom); Department of Radiology, Churchill Hospital, Oxford OX3 7LJ (United Kingdom)], E-mail: nigel.cowan@nds.ox.ac.uk; Rivers-Bowerman, M.D.; Turney, B.W. [Nuffield Department of Surgery, University of Oxford, Oxford (United Kingdom)

    2008-12-15

    Aim: To evaluate and compare the diagnostic accuracy of multidetector computed tomography urography (CTU) and ultrasonography (US) for diagnosing bladder cancer. Materials and methods: A consecutive series of 143 patients over 40-years of age, presenting with macroscopic haematuria and without urinary tract infection underwent same-day CTU, US, and flexible cystoscopy. CTU and US were independently rated on a five-point scale for the presence of bladder cancer without knowledge of the reference standard of flexible or rigid cystoscopy and/or biopsy results. Diagnostic accuracy was assessed by receiver operating characteristic (ROC) analysis and likelihood ratios. Results: For CTU, a rating of 5 (definitely tumour) was highly specific for bladder cancer (96.5%, 95%CI: 91.3-99%), effectively confirming diagnosis (positive likelihood ratio 25.6, 95%CI: 9.7-67.4). For US, specificity was also high (94.7%, 95%CI: 88.9-98%) with a positive likelihood ratio of 13.1 (95%CI: 5.8-29.6). Sensitivity at this rating was substantially higher for CTU (89.7%, 95%CI: 72.7-97.8%) than US (69%, 95%CI: 49.2-84.7%). Standardized partial area (A{sub z}) under the ROC curve between 95-100% specificity, representing the average sensitivity in this range, was significantly greater (0.88 versus 0.61, p < 0.05) for CTU than US. Conclusion: The specificities of CTU and US for the diagnosis of bladder cancer were similar, but CTU was more sensitive. Although the sensitivity of CTU was not high enough to replace flexible cystoscopy in the diagnostic pathway, the high specificity enables direct referral to rigid cystoscopy, bypassing flexible cystoscopy and expediting diagnosis and treatment in those patients testing positive.

  6. Evaluation of multidetector computed tomography urography and ultrasonography for diagnosing bladder cancer

    International Nuclear Information System (INIS)

    Knox, M.K.; Cowan, N.C.; Rivers-Bowerman, M.D.; Turney, B.W.

    2008-01-01

    Aim: To evaluate and compare the diagnostic accuracy of multidetector computed tomography urography (CTU) and ultrasonography (US) for diagnosing bladder cancer. Materials and methods: A consecutive series of 143 patients over 40-years of age, presenting with macroscopic haematuria and without urinary tract infection underwent same-day CTU, US, and flexible cystoscopy. CTU and US were independently rated on a five-point scale for the presence of bladder cancer without knowledge of the reference standard of flexible or rigid cystoscopy and/or biopsy results. Diagnostic accuracy was assessed by receiver operating characteristic (ROC) analysis and likelihood ratios. Results: For CTU, a rating of 5 (definitely tumour) was highly specific for bladder cancer (96.5%, 95%CI: 91.3-99%), effectively confirming diagnosis (positive likelihood ratio 25.6, 95%CI: 9.7-67.4). For US, specificity was also high (94.7%, 95%CI: 88.9-98%) with a positive likelihood ratio of 13.1 (95%CI: 5.8-29.6). Sensitivity at this rating was substantially higher for CTU (89.7%, 95%CI: 72.7-97.8%) than US (69%, 95%CI: 49.2-84.7%). Standardized partial area (A z ) under the ROC curve between 95-100% specificity, representing the average sensitivity in this range, was significantly greater (0.88 versus 0.61, p < 0.05) for CTU than US. Conclusion: The specificities of CTU and US for the diagnosis of bladder cancer were similar, but CTU was more sensitive. Although the sensitivity of CTU was not high enough to replace flexible cystoscopy in the diagnostic pathway, the high specificity enables direct referral to rigid cystoscopy, bypassing flexible cystoscopy and expediting diagnosis and treatment in those patients testing positive

  7. Epicardial adipose tissue radiodensity is independently related to coronary atherosclerosis. A multidetector computed tomography study

    International Nuclear Information System (INIS)

    Pracon, R.; Kruk, M.; Kepka, C.

    2011-01-01

    Preliminary research indicates that epicardial adipose tissue (EAT) may display both anti- and proatherosclerotic properties. Because the varying radiodensities of selected human tissues assessed by multidetector computed tomography (MDCT) has been shown to reflect differences in biological characteristics, the present study investigated the hypothesis that the proatherosclerotic properties of EAT may be linked to its radiodensity. The study included 164 consecutive patients (82 females, mean age 58.8±11.1 years) with suspected coronary artery disease (CAD) undergoing MDCT coronary angiography. Coronary atherosclerosis was defined as: CAD (id est (ie), presence of at least 1 coronary stenosis ≥50%) and coronary artery calcium (CAC) determined by Agatston score. EAT radiodensity was assessed by MDCT and averaged -81.00±4.64 HU (Hounsfield unit (HU) scale). Mean CAC score was 96.0±220.0. Patients with CAD (n=36) showed higher EAT radiodensity than patients without CAD (-78.99±4.12 vs. -81.57±4.64 HU, P<0.01). In the multivariable model, only EAT radiodensity and age were independently associated with CAD (odds ratio (OR) 1.15, 95%confidence interval (CI) 1.04-1.28; OR 1.08, 95%CI 1.04-1.12; respectively). EAT radiodensity also correlated with CAC score (r=0.23, P<0.01). EAT radiodensity (P<0.001), age (P<0.001), sex (P=0.03), and past smoking (P<0.01) were independent correlates of CAC in the multivariable linear regression model. Increased EAT radiodensity is independently associated with coronary atherosclerosis, which may reflect the unfavorable, proatherosclerotic metabolic properties of more radiodense epicardial fat. (author)

  8. Diagnostic yield of multidetector computed tomography in patients with acute spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Rausch, Vanessa Hanna; Bannas, Peter; Well, Lennart; Regier, Marc; Adam, Gerhard; Henes, Frank Oliver Gerhard [Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology and Nuclearmedicine; Schoen, Gerhard [Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Medical Biometry and Epidemiology; Froelich, Andreas [Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Neuroradiology

    2017-04-15

    To determine the value of multidetector computed tomography (MDCT) in patients with acute spondylodiscitis. For data acquisition, we searched our radiological database for all patients who had undergone magnetic resonance imaging (MRI) for suspected spondylodiscitis between 2007 and 2015 (n = 325). For further analyses, we included all patients (n = 67) who initially underwent MDCT prior to MRI. Overall accuracy, sensitivity, specificity and positive and negative predictive values were calculated for MDCT and, separately, for contrast-enhanced CT (CECT, n = 36) and for non-enhanced CT (NECT, n = 31). MRI together with clinical evaluation served as the standard of reference. Results: In 34 of 43 patients with acute spondylodiscitis on MRI, correct diagnosis was already made by the initial MDCT scan. The specificity and positive predictive value were 100% for MDCT. The sensitivity was 79% and the negative predictive value was 72%. The overall accuracy was 87%. Accuracy was higher for CECT (89%) than for NECT (84%), however without statistical significance (p = 0.55). MDCT detected 90% of paravertebral abscesses (34/38), but only 6% of epidural abscesses (2/36). MDCT has moderate sensitivity, but high specificity for acute spondylodiscitis. Thus, if MDCT is positive for spondylodiscitis, treatment can be started without further delay. However, MRI should be added to both MDCT negative and positive cases to rule out complications such as epidural abscesses that cannot reliably be detected by MDCT. Key Points: Patients with acute spondylodiscitis are often initially suspected of having other differential diagnosis because of nonspecific symptoms. Therefore, MDCT is frequently performed prior to MRI in patients with acute spondylodiscitis. MDCT proved moderate sensitivity but high specificity for the diagnosis of acute spondylodiscitis. Paravertebral abscess is a strong indicator for the presence of spondylodiscitis on MDCT. However, MRI is crucial to rule out epidural

  9. The value of multidetector-row computed tomography for localization of obscure acute gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Chang, Wei-Chou; Tsai, Shih-Hung; Chang, Wei-Kuo; Liu, Chang-Hsien; Tung, Ho-Jui; Hsieh, Chung-Bao; Huang, Guo-Shu; Hsu, Hsian-He; Yu, Chih-Yung

    2011-01-01

    Purpose: There are no simple guidelines on when to perform multidetector-row computed tomography (MDCT) for diagnosis of obscure acute gastrointestinal bleeding (AGIB). We used a risk scoring system to evaluate the diagnostic power of MDCT for patients with obscure AGIB. Materials and methods: Ninety-two patients with obscure AGIB who were referred for an MDCT scan after unsuccessful endoscopic treatment at presentation were studied. We recorded clinical data and calculated Blatchford score for each patient. Patients who required transfusion more than 500 mL of blood to maintain the vital signs were classified as high-risk patients. Two radiologists independently reviewed and categorized MDCT signs of obscure AGIB. Discordant findings were resolved by consensus. One-way ANOVA was used to compare clinical data between two groups; kappa statistics were used to estimate agreement on MDCT findings between radiologists. Results: Of the 92 patients, 62 (67.4%) were classified as high-risk patients. Blatchford scores of high-risk patients were significantly greater than those of low-risk patients. Sensitivity for MDCT diagnosing obscure AGIB was 81% in high-risk patients, as compared with 50% in the low-risk. When used in conjunction with selection of the cut-off value of 13 in Blatchford scoring system, the sensitivity and specificity of MDCT were 70.9% and 73.7%, respectively. Contrast extravasation was the most specific sign of AGIB (k = .87), recognition of which would have improved diagnostic accuracy. Conclusions: With the aid of Blatchford scoring system for evaluating the disease severity, MDCT can localize the bleeders of obscure AGIB more efficiently.

  10. The role of multidetector computed tomography in evaluation of small bowel obstructions

    Directory of Open Access Journals (Sweden)

    Mehmet Fatih İnci

    2013-03-01

    Full Text Available Objective: The purpose of the study was to evaluate therole and additional diagnostic contribution of multi-detectorcomputed tomography (MDCT in patients with acuteabdominal pain caused by small bowel obstruction.Materials and methods: A total of 48 patients who admittedto our hospital with acute abdominal pain and underwentMDCT on suspicion of intestinal obstruction and hadabdominal surgery between January 2012 and October2012 were included to our study. MDCT images were interpretedby two experienced radiologist retrospectively.All clinical data and surgery notes also were evaluated.Patients had surgery due to penetrating or blunt abdominalinjury were excluded.Results: Of these 48 patients, 26 (54.1% were male and22 (45.9% were female. Patients’ ages ranged 25 to 71and mean age was 52±5.4 years. The causes of intestinalobstruction of patients were adhesions for 12 (46.1% patients,tumors for 7 (26.9% patients, external hernias for5 (19.2% patients, internal hernia for 1 (3.9% patient andintussusception for 1 (3.9% patient. A total concordancebetween the MDCT findings and definitive diagnosis wasfound in 26 of 23 cases and the sensitivity and specifityof MDCT in the diagnosis of small bowel obstruction werefound to be 88.5% and 90%, respectively.Conclusion: MDCT is a fast, effective and reliable imagingmethod for preoperative diagnosing small bowel obstructioncauses acute abdominal pain with the advantagesof MDCT such as multi-planar and three-dimensionalreformatted imaging.Key words: Acute abdominal pain, multi-detector computed tomography, small bowel obstruction

  11. Multidetector computed tomography predictors of late ventricular remodeling and function after acute myocardial infarction

    International Nuclear Information System (INIS)

    Lessick, Jonathan; Abadi, Sobhi; Agmon, Yoram; Keidar, Zohar; Carasso, Shemi; Aronson, Doron; Ghersin, Eduard; Rispler, Shmuel; Sebbag, Anat; Israel, Ora; Hammerman, Haim; Roguin, Ariel

    2012-01-01

    Background: Despite advent of rapid arterial revascularization as 1st line treatment for acute myocardial infarction (AMI), incomplete restoral of flow at the microvascular level remains a problem and is associated with adverse prognosis, including pathological ventricular remodeling. We aimed to study the association between multidetector row computed tomography (MDCT) perfusion defects and ventricular remodeling post-AMI. Methods: In a prospective study, 20 patients with ST-elevation AMI, treated by primary angioplasty, underwent arterial and late phase MDCT as well as radionuclide scans to study presence, size and severity of myocardial perfusion defects. Contrast echocardiography was performed at baseline and at 4 months follow-up to evaluate changes in myocardial function and remodeling. Results: Early defects (ED), late defects (LD) and late enhancement (LE) were detected in 15, 7 and 16 patients, respectively and radionuclide defects in 15 patients. The ED area (r = 0.74), and LD area (r = 0.72), and to a lesser extent LE area (r = 0.62) correlated moderately well with SPECT summed rest score. By univariate analysis, follow-up end-systolic volume index and ejection fraction were both significantly related to ED and LD size and severity, but not to LE size or severity. By multivariate analysis, end-systolic volume index was best predicted by LD area (p < 0.05) and ejection fraction by LD enhancement ratio. Conclusions: LD size and severity on MDCT are most closely associated with pathological ventricular remodeling after AMI and may thus play a role in early identification and treatment of this condition

  12. Multidetector computed tomography urography for diagnosing upper urinary tract urothelial tumour.

    Science.gov (United States)

    Cowan, Nigel C; Turney, Ben W; Taylor, Nia J; McCarthy, Catherine L; Crew, Jeremy P

    2007-06-01

    To evaluate multidetector computed tomography urography (MDCTU) for diagnosing upper urinary tract (UUT) urothelial tumour by comparison with retrograde ureteropyelography (RUP). MDCTU and RUP were used in a selected series of adult patients presenting with haematuria. Entry criteria were based on findings on intravenous urography and were chosen to ensure a high prevalence of UUT urothelial tumour to allow a valid retrospective comparison of the diagnostic techniques. MDCTU and RUP studies were scored for the presence and absence of UUT urothelial tumour by two radiologists, retrospectively and independently, and while unaware of the demographic and clinical information. The reference standards were the histopathology and clinical follow-up. MDCTU and RUP were used in 106 patients over a 24-month period. RUP was attempted in 151 of 212 UUTs; the corresponding MDCTU for each UUT was reviewed. MDCTU was a true-positive (TP) for urothelial tumour in 31, true-negative (TN) in 111, false-positive (FP) in eight and false-negative (FN) in one UUT, giving a sensitivity of 0.97, a specificity of 0.93, a positive predictive value (PPV) of 0.79 and a negative PV (NPV) of 0.99. RUP was technically successful and diagnostic in 96% of the UUTs (143/151). For diagnosing urothelial tumour, RUP was TP in 26, TN in 112, FP in four and FN in one UUT, giving a sensitivity of 0.97, specificity of 0.93, a PPV of 0.79 and NPV of 0.99. This study validates quantitatively the use of MDCTU for diagnosing UUT urothelial tumour.

  13. Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography

    Directory of Open Access Journals (Sweden)

    Ge Zhang

    2015-03-01

    Full Text Available PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT. MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52% or leukemia (51 patients; 48%. In patients with leukemia, 32 (62.7% had chronic lymphocytic leukemia, and 19 (37.3% had acute leukemias; of these, 10 (19.6% had acute myeloid leukemia, and 9 (17.6% had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017. Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2% patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia demonstrated predominantly homogeneous enhancement (both with p <0.017. For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%. CONCLUSION: Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes.

  14. Intensive-care unit lung infections: The role of imaging with special emphasis on multi-detector row computed tomography

    International Nuclear Information System (INIS)

    Romano, Luigia; Pinto, Antonio; Merola, Stefanella; Gagliardi, Nicola; Tortora, Giovanni; Scaglione, Mariano

    2008-01-01

    Nosocomial pneumonia is the most frequent hospital-acquired infection. In mechanically ventilated patients admitted to an intensive-care unit as many as 7-41% may develop pneumonia. The role of imaging is to identify the presence, location and extent of pulmonary infection and the presence of complications. However, the poor resolution of bedside plain film frequently limits the value of radiography as an accurate diagnostic tool. To date, multi-detector row computed tomography with its excellent contrast resolution is the most sensitive modality for evaluating lung parenchyma infections

  15. Anatomical variation of thyroid veins on contrast-enhanced multi-detector row computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tomita, Hayato, E-mail: m04149@yahoo.co.jp [Department of Radiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811 (Japan); Yamada, Takayuki; Murakami, Kenji; Hashimoto, Kazuki; Tazawa, Yoko; Kumano, Reiko [Department of Radiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811 (Japan); Nakajima, Yasuo [Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511 (Japan)

    2015-05-15

    Highlights: • This is the first study to demonstrate the anatomy of thyroid veins on contrasted-enhanced MDCT. • Identifying the thyroid vein on MDCT prior to selective venous sampling of parathyroid hormone provides clinical information to interventional radiologist. • Detecting especially the inferior thyroid veins with individual variability in numbers, locations, and lengths may have an effect on SVS for HPT and decrease the difficulty and time of the procedure. - Abstract: Objective: The objective of this study was to clarify the anatomical variation of thyroid veins into the systemic vein using contrast-enhanced multi-detector row computed tomography (MDCT). Design and methods: : The subjects were 80 patients (34 males and 46 females; mean age, 50.1 years; age range, 15–92 years) with neck diseases who underwent MDCT. The number and location of inflow points of the thyroid veins into the systemic vein, and the length from the junction of bilateral brachiocephalic veins to the orifice of inferior thyroid vein were investigated by reviewing the axial and coronal images. Results: All superior thyroid veins were detected. Right and left middle thyroid veins were identified in 39 and 29 patients, respectively. Right inferior thyroid veins, left inferior thyroid veins, and common trunks were detected in 43, 46, and 39 patients, respectively; in five patients, two left thyroid veins were identified. All left inferior thyroid veins and 34 common trunks flowed into the innominate vein, while right ones had some variations in inflow sites. Mean lengths were 3.01 ± 1.30 cm (range, 0.5–6.19) and 2.04 ± 0.91 cm (0.5–4.4) in the left inferior thyroid vein and common trunk, and 1.96 ± 1.05 cm (0.81–4.8) and 1.65 ± 0.69 cm (0.63–2.94) in the right one flowing into the right internal jugular vein and the innominate vein, respectively. Conclusions: The numbers and orifices of thyroid veins were identified at high rates on contrast-enhanced MDCT. This

  16. Precision of dosimetry-related measurements obtained on current multidetector computed tomography scanners

    International Nuclear Information System (INIS)

    Mathieu, Kelsey B.; McNitt-Gray, Michael F.; Zhang, Di; Kim, Hyun J.; Cody, Dianna D.

    2010-01-01

    Purpose: Computed tomography (CT) intrascanner and interscanner variability has not been well characterized. Thus, the purpose of this study was to examine the within-run, between-run, and between-scanner precision of physical dosimetry-related measurements collected over the course of 1 yr on three different makes and models of multidetector row CT (MDCT) scanners. Methods: Physical measurements were collected using nine CT scanners (three scanners each of GE VCT, GE LightSpeed 16, and Siemens Sensation 64 CT). Measurements were made using various combinations of technical factors, including kVp, type of bowtie filter, and x-ray beam collimation, for several dosimetry-related quantities, including (a) free-in-air CT dose index (CTDI 100,air ); (b) calculated half-value layers and quarter-value layers; and (c) weighted CT dose index (CTDI w ) calculated from exposure measurements collected in both a 16 and 32 cm diameter CTDI phantom. Data collection was repeated at several different time intervals, ranging from seconds (for CTDI 100,air values) to weekly for 3 weeks and then quarterly or triannually for 1 yr. Precision of the data was quantified by the percent coefficient of variation (%CV). Results: The maximum relative precision error (maximum %CV value) across all dosimetry metrics, time periods, and scanners included in this study was 4.33%. The median observed %CV values for CTDI 100,air ranged from 0.05% to 0.19% over several seconds, 0.12%-0.52% over 1 week, and 0.58%-2.31% over 3-4 months. For CTDI w for a 16 and 32 cm CTDI phantom, respectively, the range of median %CVs was 0.38%-1.14% and 0.62%-1.23% in data gathered weekly for 3 weeks and 1.32%-2.79% and 0.84%-2.47% in data gathered quarterly or triannually for 1 yr. Conclusions: From a dosimetry perspective, the MDCT scanners tested in this study demonstrated a high degree of within-run, between-run, and between-scanner precision (with relative precision errors typically well under 5%).

  17. True tracheal bronchus: Classification and anatomical relationship on multi-detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jeong; Kim, Young Tong; Jou, Sung Shick; Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of)

    2017-04-15

    To propose the imaging classification of true tracheal bronchus (TTB) on multi-detector computed tomography (MDCT), and to evaluate its anatomical relationship with surrounding structures. This study included 44 patients who were diagnosed with TTB on MDCT for 6 years. We classified TTB into five types, based on the existence of the right upper lobe bronchus originating from the right main bronchus and the number of segmental bronchi of TTB. We analyzed the site of origin and the running direction of TTB based on its anatomical relationship with surrounding structures and some ancillary findings. The imaging classification of TTB included Type I (47.7%), Type II (13.6%), Type III (11.4%), Type IV (25.0%), and Type V (2.0%). According to the site of origin of TTB, below the aortic arch (52.3%) and at the level of the aortic arch (43.1%) were the two main sites of origin, whereas the frequency of the site of origin above the azygos arch, at the level of the azygos arch, and below the azygos arch was 27.3%, 38.6%, and 34.1%, respectively. Considering both aortic and azygos arches, below the aortic arch and below the azygos arch were the most common sites of origin (27.3%). With respect to the running direction of TTB, in all cases, TTB passed below the azygos arch to the right upper lobe. There was no statistically significant (p > 0.05) difference in age or sex between types of TTB. Ancillary findings included tracheal stenosis (n = 2), narrowing of the right main bronchus (n = 2), luminal narrowing of TTB and bronchiectasis at the distal portion (n = 1), and a highly located azygos arch above the aortic arch (n = 2). The proposed imaging classification of TTB and its anatomical relationship with surrounding structures will improve our understanding of various imaging features and embryological development of TTB. Radiologists should pay careful attention to evaluation of the airway including the trachea on thoracic imaging.

  18. True tracheal bronchus: Classification and anatomical relationship on multi-detector computed tomography

    International Nuclear Information System (INIS)

    Kim, Hyun Jeong; Kim, Young Tong; Jou, Sung Shick; Lee, Woong Hee

    2017-01-01

    To propose the imaging classification of true tracheal bronchus (TTB) on multi-detector computed tomography (MDCT), and to evaluate its anatomical relationship with surrounding structures. This study included 44 patients who were diagnosed with TTB on MDCT for 6 years. We classified TTB into five types, based on the existence of the right upper lobe bronchus originating from the right main bronchus and the number of segmental bronchi of TTB. We analyzed the site of origin and the running direction of TTB based on its anatomical relationship with surrounding structures and some ancillary findings. The imaging classification of TTB included Type I (47.7%), Type II (13.6%), Type III (11.4%), Type IV (25.0%), and Type V (2.0%). According to the site of origin of TTB, below the aortic arch (52.3%) and at the level of the aortic arch (43.1%) were the two main sites of origin, whereas the frequency of the site of origin above the azygos arch, at the level of the azygos arch, and below the azygos arch was 27.3%, 38.6%, and 34.1%, respectively. Considering both aortic and azygos arches, below the aortic arch and below the azygos arch were the most common sites of origin (27.3%). With respect to the running direction of TTB, in all cases, TTB passed below the azygos arch to the right upper lobe. There was no statistically significant (p > 0.05) difference in age or sex between types of TTB. Ancillary findings included tracheal stenosis (n = 2), narrowing of the right main bronchus (n = 2), luminal narrowing of TTB and bronchiectasis at the distal portion (n = 1), and a highly located azygos arch above the aortic arch (n = 2). The proposed imaging classification of TTB and its anatomical relationship with surrounding structures will improve our understanding of various imaging features and embryological development of TTB. Radiologists should pay careful attention to evaluation of the airway including the trachea on thoracic imaging

  19. Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion

    Science.gov (United States)

    Ippolito, Davide; Drago, Silvia Girolama; Franzesi, Cammillo Talei; Fior, Davide; Sironi, Sandro

    2016-01-01

    AIM: To assess the diagnostic accuracy of multidetector-row computed tomography (MDCT) as compared with conventional magnetic resonance imaging (MRI), in identifying mesorectal fascia (MRF) invasion in rectal cancer patients. METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner (ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 mAs. Imaging data were reviewed as axial and as multiplanar reconstructions (MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images (DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed. RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91 (41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged (45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value (PPV) 80.4%, negative predictive value (NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images

  20. Multidetector Computed Tomography Arthrography of the Shoulder: Diagnostic Accuracy and Indications

    International Nuclear Information System (INIS)

    De Filippo, M.; Bertellini, A.; Sverzellati, N.; Pogliacomi, F.; Costantino, C.; Vitale, M.; Zappia, M.; Corradi, D.; Garlaschi, G.; Zompatori, M.

    2008-01-01

    Background: The presence of subcutaneous implants, such as permanent defibrillators, is an absolute contraindication to the use of magnetic resonance imaging (MRI). Moreover, MRI is unadvisable in subjects with metallic hardware near the area of study, as artifacts generated by such materials distort image quality. Purpose: To evaluate the diagnostic accuracy and indications of arthrography with multidetector computed tomography arthrography (arthro-MDCT) of the shoulder in patients with absolute or relative contraindications to MRI and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. Material and Methods: After intraarticular injection of iodixanol and volumetric acquisition, 70 shoulders in 70 patients (30 females, 40 males, age range 32-60 years) were examined with a 16-detector-row CT scanner. The patients had arthralgia but no radiologically detected fractures. They could not be studied by MRI because of absolute contraindications (subcutaneous electronic implants), surgical metal implants, or claustrophobia. In 28 of the 70 patients who had had previous shoulder surgery, the arthro-CT examination was preceded by an MRI on the same day. All examinations were interpreted by two experienced musculoskeletal radiologists. The findings were compared with arthroscopic findings carried out within 28 days of the CT study. Results: In the 42 non-operated patients, the comparison between arthro-MDCT and arthroscopy showed sensitivity and specificity ranging between 87% and 100%. In the 28 operated shoulders, arthro-MDCT had an accuracy of 94% compared with 25% with MRI. Interobserver agreement was almost perfect (κ=0.95) in the evaluation of all types of lesions, both on MDCT and MRI. When arthro-MDCT was compared with MRI in the postoperative patients by a McNemar test, a significant difference (P<0.05) was found between these two techniques. Conclusion: Arthro-MDCT of the shoulder is a safe technique that provides

  1. Multidetector Computed Tomography Arthrography of the Shoulder: Diagnostic Accuracy and Indications

    Energy Technology Data Exchange (ETDEWEB)

    De Filippo, M.; Bertellini, A.; Sverzellati, N.; Pogliacomi, F.; Costantino, C.; Vitale, M.; Zappia, M.; Corradi, D.; Garlaschi, G.; Zompatori, M. (Dept. of Clinical Sciences, Section of Radiological Sciences, Univ. of Parma, Parma Hospital, Parma (Italy))

    2008-06-15

    Background: The presence of subcutaneous implants, such as permanent defibrillators, is an absolute contraindication to the use of magnetic resonance imaging (MRI). Moreover, MRI is unadvisable in subjects with metallic hardware near the area of study, as artifacts generated by such materials distort image quality. Purpose: To evaluate the diagnostic accuracy and indications of arthrography with multidetector computed tomography arthrography (arthro-MDCT) of the shoulder in patients with absolute or relative contraindications to MRI and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. Material and Methods: After intraarticular injection of iodixanol and volumetric acquisition, 70 shoulders in 70 patients (30 females, 40 males, age range 32-60 years) were examined with a 16-detector-row CT scanner. The patients had arthralgia but no radiologically detected fractures. They could not be studied by MRI because of absolute contraindications (subcutaneous electronic implants), surgical metal implants, or claustrophobia. In 28 of the 70 patients who had had previous shoulder surgery, the arthro-CT examination was preceded by an MRI on the same day. All examinations were interpreted by two experienced musculoskeletal radiologists. The findings were compared with arthroscopic findings carried out within 28 days of the CT study. Results: In the 42 non-operated patients, the comparison between arthro-MDCT and arthroscopy showed sensitivity and specificity ranging between 87% and 100%. In the 28 operated shoulders, arthro-MDCT had an accuracy of 94% compared with 25% with MRI. Interobserver agreement was almost perfect (kappa=0.95) in the evaluation of all types of lesions, both on MDCT and MRI. When arthro-MDCT was compared with MRI in the postoperative patients by a McNemar test, a significant difference (P<0.05) was found between these two techniques. Conclusion: Arthro-MDCT of the shoulder is a safe technique that provides

  2. A computer-simulated liver phantom (virtual liver phantom) for multidetector computed tomography evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Funama, Yoshinori [Kumamoto University, Department of Radiological Sciences, School of Health Sciences, Kumamoto (Japan); Awai, Kazuo; Nakayama, Yoshiharu; Liu, Da; Yamashita, Yasuyuki [Kumamoto University, Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto (Japan); Miyazaki, Osamu; Goto, Taiga [Hitachi Medical Corporation, Tokyo (Japan); Hori, Shinichi [Gate Tower Institute of Image Guided Therapy, Osaka (Japan)

    2006-04-15

    The purpose of study was to develop a computer-simulated liver phantom for hepatic CT studies. A computer-simulated liver phantom was mathematically constructed on a computer workstation. The computer-simulated phantom was calibrated using real CT images acquired by an actual four-detector CT. We added an inhomogeneous texture to the simulated liver by referring to CT images of chronically damaged human livers. The mean CT number of the simulated liver was 60 HU and we added numerous 5-to 10-mm structures with 60{+-}10 HU/mm. To mimic liver tumors we added nodules measuring 8, 10, and 12 mm in diameter with CT numbers of 60{+-}10, 60{+-}15, and 60{+-}20 HU. Five radiologists visually evaluated similarity of the texture of the computer-simulated liver phantom and a real human liver to confirm the appropriateness of the virtual liver images using a five-point scale. The total score was 44 in two radiologists, and 42, 41, and 39 in one radiologist each. They evaluated that the textures of virtual liver were comparable to those of human liver. Our computer-simulated liver phantom is a promising tool for the evaluation of the image quality and diagnostic performance of hepatic CT imaging. (orig.)

  3. Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer

    International Nuclear Information System (INIS)

    Ogasawara, Yutaka; Doihara, Hiroyoshi; Shiraiwa, Misaki; Ishihara, Setsuko

    2008-01-01

    We evaluated the effectiveness of multidetector-row computed tomography (MD-CT) for detecting axillary lymph nodal status (ALNS) in patients with breast cancer. We reviewed 42 patients with breast cancer. A metastatic lymph node on MD-CT was defined as oval or round, with more than 5 mm on the short axis. We evaluated ALNS preoperatively by both palpation and MD-CT findings and performed sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection (ALND). For establishing the ALNS, MD-CT showed a sensitivity of 76.9%, a specificity of 96.6%, and an accuracy of 90.5%. On the basis of the MD-CT findings, misdiagnosis was made in 4 of the 42 patients, only one of which was false positive. On the other hand, one patient with a histologically negative sentinel lymph node (SLN) result had metastasis only in a non-SLN. Preoperative MD-CT showed a positive node in this patient. Multidetector-row computed tomography assists in identifying women who require ALND without SLNB, with sufficient positive predictive value. False-negative detection by SLNB could be avoided with careful interpretation of the axillary lymph nodes shown by MD-CT. (author)

  4. Diagnostic ability of Barrett's index to detect dysthyroid optic neuropathy using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, Mario L.R.; Goncalves, Allan C.P.; Silva, Carla T.M.; Moura, Janete P.; Ribeiro, Carolina S.; Gebrim, Eloisa M.M.S. [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Division of Ophthalmology; Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. of Endocrinology; Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Division of Radiology]. E-mail: mlrmonteiro@terra.com.br

    2008-07-01

    Objectives: The objective of this study was to evaluate the ability of a muscular index (Barrett's Index), calculated with multidetector computed tomography, to detect dysthyroid optic neuropathy in patients with Graves' orbitopathy. Methods: Thirty-six patients with Graves' orbitopathy were prospectively studied and submitted to neuro-ophthalmic evaluation and multidetector computed tomography scans of the orbits. Orbits were divided into two groups: those with and without dysthyroid optic neuropathy. Barrett's index was calculated as the percentage of the orbit occupied by muscles. Sensitivity and specificity were determined for several index values. Results: Sixty-four orbits (19 with and 45 without dysthyroid optic neuropathy) met the inclusion criteria for the study. The mean Barrett's index values ({+-}SD) were 64.47% {+-} 6.06% and 49.44% {+-} 10.94% in the groups with and without dysthyroid optic neuropathy, respectively (p<0.001). Barrett's index sensitivity ranged from 32% to 100%, and Barrett's index specificity ranged from 24% to 100%. The best combination of sensitivity and specificity was 79%/72% for BI=60% (odds ratio: 9.2). Conclusions: Barrett's Index is a useful indicator of dysthyroid optic neuropathy and may contribute to early diagnosis and treatment. Patients with a Barrett's index >60% should be carefully examined and followed for the development of dysthyroid optic neuropathy. (author)

  5. Volume and dimensions of angiographically normal coronary arteries assessed by multidetector computed tomography

    DEFF Research Database (Denmark)

    Sørensen, Samuel Kiil; Kühl, Jørgen Tobias; Fuchs, Andreas

    2017-01-01

    BACKGROUND: The objective of this study was to determine normal values for coronary artery volume (CAV) and individual vasculature and segment dimensions. METHODS: We examined 200 healthy volunteers with an Agatston score of 0 and a normal, high quality coronary CTA. Using 320 slice multidetector...... administration and left ventricular mass. The respective contribution of the left and right coronary vascularture is influenced by coronary dominance....

  6. Anatomical variants of celiac trunk, hepatic and renal arteries in a population of developing country using multidetector computed tomography angiography

    International Nuclear Information System (INIS)

    Arifuzzaman, M.; Naqvi, S.S.N.; Rasool, M.; Hussain, M.

    2017-01-01

    Background: Multidetector Computed Tomography (MDCT)s has become a major part in evaluation of hepatic and renal tumours. With improvements in MDCT, CT angiography has also improved and normal anatomy and its variants in patients undergoing operative or interventional procedures can be effectively studied. The purpose of this study was to evaluate the frequency of anatomical variation of celiac trunk, hepatic and renal arterial systems in patients undergoing multidetector CT (MDCT) angiography of the abdominal aorta. Methods: A descriptive, retrospective cross-sectional study was carried out on CT angiographies performed during the months of October till December 2015. Hepatic and renal arteries and celiac trunk were studied and normal and anatomical variations were noted. All patients with abnormalities affecting the vessels or a history of any vascular abnormality were excluded from the study. Results: Out of total 110 patients, 69.1% had normal and 30.9% had variant hepatic artery with Michel Type IV being the most common variant whereas 88.2% had normal celiac trunk and 8.2% had gastrosplenic trunk variant. Variation in renal arterial system was observed in 15.5% of the patients with two renal arteries on right and two on left being the most common type. Multiple variants were identified in 11.8% of the patients. Conclusion: The type and knowledge of anatomy is of prime importance for an optimum preoperative planning in surgical or radiological procedure. MDCT allows minimally invasive assessment of arterial anatomy with high quality 3D reconstruction images. (author)

  7. Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography

    Science.gov (United States)

    Dong, Zhi-hui; Yang, Zhi-gang; Chen, Tian-wu; Chu, Zhi-gang; Deng, Wen; Shao, Heng

    2011-01-01

    PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT). METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR) = 2.2; pchest (45/143 vs. 11/66 patients, RR = 1.9; ptraumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries. PMID:21789386

  8. Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves

    International Nuclear Information System (INIS)

    Habets, Jesse; Mali, Willem P.T.M.; Budde, Ricardo P.J.; Brink, Renee B.A. van den; Uijlings, Ruben; Spijkerboer, Anje M.; Chamuleau, Steven A.J.

    2012-01-01

    Patients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT. ECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of prosthetic heart valves. The best systolic and diastolic axial reconstructions were selected for coronary assessment. Each present coronary segment was scored for the presence of valve-related artefacts prohibiting coronary artery assessment. Scoring was performed in consensus by two observers. Eighty-two CT angiograms were performed on a 64-slice (n = 27) or 256-slice (n = 55) multidetector CT. Eighty-nine valves and five annuloplasty rings were present. Forty-three out of 1160 (3.7%) present coronary artery segments were non-diagnostic due to valve artefacts (14/82 patients). Valve artefacts were located in right coronary artery (15/43; 35%), left anterior descending artery (2/43; 5%), circumflex artery (14/43; 32%) and marginal obtuse (12/43; 28%) segments. All cobalt-chrome containing valves caused artefacts prohibiting coronary assessment. Biological and titanium-containing valves did not cause artefacts except for three specific valve types. Most commonly implanted prosthetic heart valves do not hamper coronary assessment on multidetector CT. Cobalt-chrome containing prosthetic heart valves preclude complete coronary artery assessment because of severe valve artefacts. circle Most commonly implanted prosthetic heart valves do not hamper coronary artery assessment circle Prosthetic heart valve composition determines the occurrence of prosthetic heart valve-related artefacts circle Bjoerk-Shiley and Sorin tilting disc valves preclude diagnostic coronary artery segment assessment. (orig.)

  9. Development of Computational Procedure for Assessment of Patient Dose in Multi-Detector Computed Tomography

    International Nuclear Information System (INIS)

    Park, Dong Wook

    2007-02-01

    Technological development to improve the quality and speed with which images are obtained have fostered the growth of frequency and collective effective dose of CT examination. Especially, High-dose x-ray technique of CT has increased in the concern of patient dose. However CTDI and DLP in CT dosimetry leaves something to be desired to evaluate patient dose. And even though the evaluation of effective dose in CT practice is required for comparison with other radiography, it's not sufficient to show any estimation because it's not for medical purpose. Therefore the calculation of effective dose in CT procedure is needed for that purpose. However modelling uncertainties will be due to insufficient information from manufacturing tolerances. Therefore the purpose of this work is development of computational procedure for assessment of patient dose through the experiment for getting essential information in MDCT. In order to obtain exact absorbed dose, normalization factors must be created to relate simulated dose values with CTDI air measurement. The normalization factors applied to the calculation of CTDI 100 using axial scanning and organ effective dose using helical scanning. The calculation of helical scanning was compared with the experiment of Groves et al.(2004). The result has a about factor 2 of the experiment. It seems because AEC is not simulated. In several studies, when AEC applied to a CT examination, approximately 20-30% dose reduction was appeared. Therefore the study of AEC simulation should be added and modified

  10. The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm

    International Nuclear Information System (INIS)

    Saba, Luca; Mallarini, Giorgio; Anzidei, Michele; Lucatelli, Pierleone

    2011-01-01

    Splenic artery aneurysm is the most frequent visceral artery aneurysm and rupture of the aneurysm is associated with a high mortality rate. It is important to discriminate between a true aneurysm and a pseudoaneurysm that may be caused by pancreatitis, iatrogenic and postoperative causes, trauma and peptic ulcer disease. Multidetector-row CT angiography (MDCTA) allows detailed visualization of the vascular anatomy and may allow identification of aneurysms and pseudoaneurysms that affect the splenic artery. The objective of this article is to provide a review of the general characteristics of splenic artery aneurysms and pseudoaneurysms and to describe the findings of MDCTA

  11. [The role of multidetector computer tomography in diagnosis of acute pancreatitis].

    Science.gov (United States)

    Lohanikhina, K Iu; Hordiienko, K P; Kozarenko, T M

    2014-10-01

    With the objective to improve the diagnostic semiotics of an acute pancreatitis (AP) 35 patients were examined, using 64-cut computeric tomograph Lightspeed VCT (GE, USA) with intravenous augmentation in arterial and portal phases. Basing on analysis of the investigations conducted, using multidetector computeric tomography (MDCT), the AP semiotics was systematized, which is characteristic for oedematous and destructive forms, diagnosed in 19 (44.2%) and 16 (45.8%) patients, accordingly. The procedure for estimation of preservation of the organ functional capacity in pancreonecrosis pres- ence was elaborated, promoting rising of the method diagnostic efficacy by 5.3 - 9.4%.

  12. The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Mallarini, Giorgio (Dept. of Radiology, Azienda Ospedaliero Universitaria (AOU), Cagliari (Italy)), email: lucasaba@tiscali.it; Anzidei, Michele; Lucatelli, Pierleone (Dept. of Radiological Sciences, Univ. of Rome La Sapienza, Rome (Italy))

    2011-06-15

    Splenic artery aneurysm is the most frequent visceral artery aneurysm and rupture of the aneurysm is associated with a high mortality rate. It is important to discriminate between a true aneurysm and a pseudoaneurysm that may be caused by pancreatitis, iatrogenic and postoperative causes, trauma and peptic ulcer disease. Multidetector-row CT angiography (MDCTA) allows detailed visualization of the vascular anatomy and may allow identification of aneurysms and pseudoaneurysms that affect the splenic artery. The objective of this article is to provide a review of the general characteristics of splenic artery aneurysms and pseudoaneurysms and to describe the findings of MDCTA

  13. Computer-aided detection of small pulmonary nodules in multidetector spiral computed tomography (MSCT) in children

    International Nuclear Information System (INIS)

    Honnef, D.; Behrendt, F.F.; Hohl, C.; Mahnken, A.H.; Guenther, R.W.; Das, M.; Mertens, R.; Stanzel, S.

    2008-01-01

    Purpose: Retrospective evaluation of computer-aided detection software (CAD) for automated detection (LungCAD, Siemens Medical solutions, Forchheim, Germany) and volumetry (LungCARE) of pulmonary nodules in dose-reduced pediatric MDCT. Materials and Methods: 30 scans of 24 children (10.4±5.9 years, 13 girls, 11 boys, 39.7±29.3 kg body weight) were performed on a 16-MDCT for tumor staging (n=18), inflammation (n=9), other indications (n=3). Tube voltage 120 kVp and effective mAs were adapted to body weight. Slice thickness 2 mm, increment 1 mm. A pediatric radiologist (U1), a CAD expert (U2) and an inexperienced radiologist (U3) independently analyzed the lung window images without and with the CAD as a second reader. In a consensus decision U1 and U2 were the reference standard. Results: Five examinations had to be excluded from the study due to other underlying lung disease. A total of 24 pulmonary nodules were found in all data sets with a minimal diameter of 0.35 mm to 3.81 mm (mean 1.7±0.85 mm). The sensitivities were as follows: U1 95.8% and 100% with CAD; U2 91.7% U3 66.7%. U2 and U3 did not detect further nodules with CAD. The sensitivity of CAD alone was 41.7% with 0.32 false-positive findings per examination. Interobserver agreement between U1/U2 regarding nodule detection with CAD was good (k=0.6500) and without CAD very good (k=0.8727). For the rest (U1/U3; U2/U3 with and without CAD), it was weak (k=0.0667-0.1884). Depending on the measured value (axial measurement, volume), there is a significant correlation (p=0.0026-0.0432) between nodule size and CAD detection. Undetected pulmonary nodules (mean 1.35 mm; range 0.35-2.61 mm) were smaller than the detected ones (mean 2.19 mm; range 1.35-3.81 mm). No significant correlation was found between CAD findings and patient age (p=0.9263) and body weight (p=0.9271) as well as nodule location (subpleural, intraparenchymal; p=1.0) and noise/SNR. (orig.)

  14. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

    International Nuclear Information System (INIS)

    Yamada, Yoshitake; Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Kuribayashi, Sachio; Abe, Takayuki; Ogawa, Kenji

    2013-01-01

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA -950 ) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P -950 . The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA -950 . (orig.)

  15. Congenital varitans and anomalies of the pancreas and pancreatic duct: Imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tuerkvatan, Aysel; Yener, Ouzlem [Dept. of Radiology, Tuerkiye Yueksek Ihtisas Hospital, Ankara (Turkmenistan); Erden, Aysel [Dept. of Radiology, Ankara University School of Medicine, Antalya (Turkmenistan); Tuerkoglu, Mehmet Akif [Dept. of General Surgery, Antalya University School of Medicine, Antalya (Turkmenistan)

    2013-12-15

    Though congenital anomalies of the pancreas and pancreatic duct are relatively uncommon and they are often discovered as an incidental finding in asymptomatic patients, some of these anomalies may lead to various clinical symptoms such as recurrent abdominal pain, nausea and vomiting. Recognition of these anomalies is important because these anomalies may be a surgically correctable cause of recurrent pancreatitis or the cause of gastric outlet obstruction. An awareness of these anomalies may help in surgical planning and prevent inadvertent ductal injury. The purpose of this article is to review normal pancreatic embryology, the appearance of ductal anatomic variants and developmental anomalies of the pancreas, with emphasis on magnetic resonance cholangiopancreaticography and multidetector computed tomography.

  16. Defining Anatomic Variants of the Coronary Artery in Taiwanese Subjects Using 64-Multidetector-Row Computed Tomography

    Directory of Open Access Journals (Sweden)

    Hung-Jung Wang

    2007-10-01

    Full Text Available The newly developed 64-multidetector-row computed tomography (MDCT prompted us to evaluate coronary angiography using this noninvasive method. We reviewed 281 images of MDCT coronary angiography in Taiwanese. The origins of the coronary arteries were identified from the luminal aspect of the aorta. We described them as seen from the aortic sinus looking toward the cardiac ventricle. The sinus facing the left ventricle was designated sinus 1, and that facing the right ventricle was designated sinus 2. Anatomic variants of the coronary artery were divided into five types according to the structure of the left anterior descending artery, right coronary artery, and left circumflex artery. Of the 281 patients, 275 (97.9% had the type I variant in which the right coronary artery originated from sinus 2. MDCT provides advantages in defining anatomic variation and helps in the planning of clinical therapy or surgery.

  17. Multidetector-row computed tomography coronary angiography. Optimization of image reconstruction phase according to the heart rate

    International Nuclear Information System (INIS)

    Nagatani, Yukihiro; Takahashi, Masashi; Takazakura, Ryutaro; Nitta, Norihisa; Murata, Kiyoshi; Ushio, Noritoshi; Matsuo, Shinro; Yamamoto, Takashi; Horie, Minoru

    2007-01-01

    The purpose of this study was to optimize the image reconstruction phase of multidetector-row computed tomography (MDCT) coronary angiography according to the heart rate is crucial. Scan data were reconstructed for 10 different phases in 58 sequential patients who under went 8-row cardiac MDCT. The obtained images were scored and compared in terms of motion artifacts and visibility of the vessels, and moreover, electrocardiogram (ECG) record-based evaluations were added for clarification of the temporal relationships among these 10 phases. In the cases with lower heart rates ( 65 beats/mm), they were obtained in the late systolic period. As the heart rate increased, the optimal image reconstruction phase changed from mid diastole to late systole. However, it is recommended to try to decrease the heart rate of patients before data acquisition. (author)

  18. Multidetector computed tomography findings of mesenteroaxial gastric volvulus combined with torsion of wandering spleen: A case report and literature review

    International Nuclear Information System (INIS)

    Youn, In Kyung; Ku, Young Mi; Lee, Su Lim

    2016-01-01

    Gastric volvulus, defined as an abnormal rotation of stomach, may be idiopathic or secondary to abnormal fixation of intraperitoneal visceral ligaments. Wandering spleen is a movable spleen resulting from absence or underdevelopment of the splenic supporting ligaments that suspend the spleen to its normal position in the left part of the supramesocolic compartment of the abdomen. Wandering spleen increases the risk of splenic torsion. Both gastric volvulus and splenic torsion are potentially life-threatening if not urgently managed with surgery. Prompt and accurate diagnosis based on multidetector computed tomography (MDCT) is crucial to prevent unforeseen complications. Gastric volvulus and coexistent torsion of wandering spleen is a very rare condition. Herein, we described a case of gastric volvulus associated with wandering spleen and intestinal non-rotation in a 15-year-old girl focusing on MDCT findings

  19. Multidetector computed tomography findings of mesenteroaxial gastric volvulus combined with torsion of wandering spleen: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Youn, In Kyung; Ku, Young Mi; Lee, Su Lim [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)

    2016-05-15

    Gastric volvulus, defined as an abnormal rotation of stomach, may be idiopathic or secondary to abnormal fixation of intraperitoneal visceral ligaments. Wandering spleen is a movable spleen resulting from absence or underdevelopment of the splenic supporting ligaments that suspend the spleen to its normal position in the left part of the supramesocolic compartment of the abdomen. Wandering spleen increases the risk of splenic torsion. Both gastric volvulus and splenic torsion are potentially life-threatening if not urgently managed with surgery. Prompt and accurate diagnosis based on multidetector computed tomography (MDCT) is crucial to prevent unforeseen complications. Gastric volvulus and coexistent torsion of wandering spleen is a very rare condition. Herein, we described a case of gastric volvulus associated with wandering spleen and intestinal non-rotation in a 15-year-old girl focusing on MDCT findings.

  20. Congenital coronary artery anomalies: diagnosis with 64 slice multidetector row computed tomography coronary angiography: A single Centre Study

    International Nuclear Information System (INIS)

    Srnivasan, K.G.; Gaikward, A.; Kannan, B.R.J.; Ritesh, K.; Ushanandini, K.P.

    2008-01-01

    Full text: Retrospective review of the congenital coronary artery (CA) anomalies detected by a 64-slice multidetector row computed tomographic (MDCT) angiography. The type of the anomaly, imaging characteristics, clinical relevance and the superiority of the MDCT over conventional coronary angiography are discussed. Multidetector row computed tomographic coronary angiography was carried out by the usual technique with 70 cc of non-ionic contrast agent and retrospective electrocardiogram gating. The volume data obtained were reconstructed in axial plane, along with volume-rendered three-dimensional reconstruction and virtual angioscopy in selected patients. The images were analysed by a radiologist, experienced in cardiac CT, and an experienced cardiologist. A retrospective review of the records was carried out, and subjects with congenital coronary anomalies were included in the study. Between 15 November 2005 and 27 February 2007, 1495 MDCT coronary angiograms were carried out. Eleven of them were found to have coronary anomalies. Five had absent left main CA. Two had interarterial course of the left main CA artery passing in between the right ventricular outflow tract and the root of aorta. In one patient, there was aberrant origin of right CA from the left aortic sinus with subsequent interarterial course and another one had aberrant origin of circumflex artery from the right aortic sinus. One patient each of congenitally absent circumflex artery and atresia of the right CA were found. Sixty-four slice MDCT coronary angiography provided accurate depiction of anomalous vessel origin and course along with the complex anatomical relation with the adjacent structures. CTcan be considered as a first-line imaging method for delineating coronary arterial anomalies.

  1. Research of z-axis geometric dose efficiency in multi-detector computed tomography

    International Nuclear Information System (INIS)

    Kim, You Hyun; Kim, Moon Chan

    2006-01-01

    With the recent prevalence of helical CT and multi-slice CT, which deliver higher radiation dose than conventional CT due to overbeaming effect in X-ray exposure and interpolation technique in image reconstruction. Although multi-detector and helical CT scanner provide a variety of opportunities for patient dose reduction, the potential risk for high radiation levels in CT examination can't be overemphasized in spite of acquiring more diagnostic information. So much more concerns is necessary about dose characteristics of CT scanner, especially dose efficient design as well as dose modulation software, because dose efficiency built into the scanner's design is probably the most important aspect of successful low dose clinical performance. This study was conducted to evaluate z-axis geometric dose efficiency in single detector CT and each level multi-detector CT, as well as to compare z-axis dose efficiency with change of technical scan parameters such as focal spot size of tube, beam collimation, detector combination, scan mode, pitch size, slice width and interval. The results obtained were as follows; 1. SDCT was most highest and 4 MDCT was most lowest in z-axis geometric dose efficiency among SDCT, 4, 8, 16, 64 slice MDCT made by GE manufacture. 2. Small focal spot was 0.67-13.62% higher than large focal spot in z-axis geometric dose efficiency at MDCT. 3. Large beam collimation was 3.13-51.52% higher than small beam collimation in z-axis geometric dose efficiency at MDCT. Z-axis geometric dose efficiency was same at 4 slice MDCT in all condition and 8 slice MDCT of large beam collimation with change of detector combination, but was changed irregularly at 8 slice MDCT of small beam collimation and 16 slice MDCT in all condition with change of detector combination. 5. There was no significant difference for z-axis geometric dose efficiency between conventional scan and helical scan, and with change of pitch factor, as well as change of slice width or interval for

  2. Diagnostic accuracy of contemporary multidetector computed tomography (MDCT) for the detection of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Notohamiprodjo, S.; Stahl, R.; Braunagel, M.; Kazmierczak, P.M.; Thierfelder, K.M.; Treitl, K.M.; Wirth, S. [University Hospital of Munich, LMU Munich, Institute for Clinical Radiology, Munich (Germany); Notohamiprodjo, M. [University Hospital Tuebingen, Eberhard Karls University Tuebingen, Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2017-08-15

    To evaluate the diagnostic accuracy of multidetector CT (MDCT) for detection of lumbar disc herniation with MRI as standard of reference. Patients with low back pain underwent indicated MDCT (128-row MDCT, helical pitch), 60 patients with iterative reconstruction (IR) and 67 patients with filtered back projection (FBP). Lumbar spine MRI (1.5 T) was performed within 1 month. Signal-to-noise ratios (SNR) of cerebrospinal fluid (CSF), annulus fibrosus (AF) and the spinal cord (SC) were determined for all modalities. Two readers independently rated image quality (IQ), diagnostic confidence and accuracy in the diagnosis of lumbar disc herniation using MRI as standard of reference. Inter-reader correlation was assessed with weighted κ. Sensitivity, specificity, precision and accuracy of MDCT for disc protrusion were 98.8%, 96.5%, 97.1%, 97.8% (disc level), 97.7%, 92.9%, 98.6%, 96.9% (patient level). SNR of IR was significantly higher than FBP. IQ was significantly better in IR owing to visually reduced noise and improved delineation of the discs. κ (>0.90) was excellent for both algorithms. MDCT of the lumbar spine yields high diagnostic accuracy for detection of lumbar disc herniation. IR improves image quality so that the provided diagnostic accuracy is principally equivalent to MRI. (orig.)

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

    International Nuclear Information System (INIS)

    Kim, Eun Young; Kang, Doo Kyoung; Sun, Joo Sung; Choi, So Yeon

    2013-01-01

    Evaluate the progression of coronary atherosclerotic plaque during follow-up, and its association with cardiovascular risk factors. Fifty-six atherosclerotic patients with plaque were enrolled in this retrospective study. Patient's plaque was detected on repeat 64-slice multidetector CT scans with a mean interval of 25 ± 10 months changes in calcified and non-calcified plaque volumes and cardiovascular risk factors were assessed over time. Absolute and relative changes in plaque volume were compared, and the association between rapid progression and cardiovascular risk factors was determined. Diameter of the stenosis, length, calcified and non-calcified lesion plaque volumes increased significantly on follow-up CT. Absolute and relative annual changes in plaque volumes were significantly greater in non-calcified plaque (median, 22.7 mm 3 , 90.4%) than in calcified plaque (median, 0.7 mm 3 , 0%). Obesity, smoking, hypertension, hypercholesterolemia, and low high-density lipoprotein were significant predictors of progression of non-calcified plaque. Progression of calcified plaque was not associated with any cardiovascular risk factors. Coronary plaque volume increased significantly on follow-up CT. The rate of progression is related to non-calcified plaque than to calcified plaque. Cardiovascular risk factors are independently associated with the rapid progression of non-calcified plaque volume, but not associated with the progression of calcified plaque.

  4. Accurate determination of high-risk coronary lesion type by multidetector cardiac computed tomography.

    Science.gov (United States)

    Alasnag, Mirvat; Umakanthan, Branavan; Foster, Gary P

    2008-07-01

    Coronary arteriography (CA) is the standard method to image coronary lesions. Multidetector cardiac computerized tomography (MDCT) provides high-resolution images of coronary arteries, allowing a noninvasive alternative to determine lesion type. To date, no studies have assessed the ability of MDCT to categorize coronary lesion types. The objective of this study was to determine the accuracy of lesion type categorization by MDCT using CA as a reference standard. Patients who underwent both MDCT and CA within 2 months of each other were enrolled. MDCT and CA images were reviewed in a blinded fashion. Lesions were categorized according to the SCAI classification system (Types I-IV). The origin, proximal and middle segments of the major arteries were analyzed. Each segment comprised a data point for comparison. Analysis was performed using the Spearman Correlation Test. Four hundred eleven segments were studied, of which 110 had lesions. The lesion distribution was as follows: 35 left anterior descending (LAD), 29 circumflex (Cx), 31 right coronary artery (RCA), 2 ramus intermedius, 8 diagonal, 4 obtuse marginal and 2 left internal mammary arteries. Correlations between MDCT and CA were significant in all major vessels (LAD, Cx, RCA) (p < 0.001). The overall correlation coefficient was 0.67. Concordance was strong for lesion Types II-IV (97%) and poor for Type I (30%). High-risk coronary lesion types can be accurately categorized by MDCT. This ability may allow MDCT to play an important noninvasive role in the planning of coronary interventions.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Young; Kang, Doo Kyoung; Sun, Joo Sung; Choi, So Yeon [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2013-12-15

    Evaluate the progression of coronary atherosclerotic plaque during follow-up, and its association with cardiovascular risk factors. Fifty-six atherosclerotic patients with plaque were enrolled in this retrospective study. Patient's plaque was detected on repeat 64-slice multidetector CT scans with a mean interval of 25 ± 10 months changes in calcified and non-calcified plaque volumes and cardiovascular risk factors were assessed over time. Absolute and relative changes in plaque volume were compared, and the association between rapid progression and cardiovascular risk factors was determined. Diameter of the stenosis, length, calcified and non-calcified lesion plaque volumes increased significantly on follow-up CT. Absolute and relative annual changes in plaque volumes were significantly greater in non-calcified plaque (median, 22.7 mm{sup 3}, 90.4%) than in calcified plaque (median, 0.7 mm{sup 3}, 0%). Obesity, smoking, hypertension, hypercholesterolemia, and low high-density lipoprotein were significant predictors of progression of non-calcified plaque. Progression of calcified plaque was not associated with any cardiovascular risk factors. Coronary plaque volume increased significantly on follow-up CT. The rate of progression is related to non-calcified plaque than to calcified plaque. Cardiovascular risk factors are independently associated with the rapid progression of non-calcified plaque volume, but not associated with the progression of calcified plaque.

  6. Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, Rainer; Froehner, Steffen; Wagner, Matthias; Brunner, Horst; Cherevatyy, Oleg; Christopoulos, Georgios [Herz- und Gefaessklinik GmbH, Department of Radiology, Bad Neustadt an der Saale (Germany); Brunn, Juergen; Gietzen, Frank; Kerber, Sebastian [Herz- und Gefaessklinik GmbH, Department of Cardiology, Bad Neustadt an der Saale (Germany); Fellner, Franz [Oberoesterreichische Landesnervenklinik, Department of Radiology, Linz (Austria)

    2005-06-01

    The objective of this study is to evaluate multidetector CT (MDCT) in detecting and characterizing anomalous coronary arteries. Forty-four patients with anomalies of the coronaries were selected from a total of 1758 individuals examined with ECG-gated 4- and 16-row MDCT including thin MIP, MPR and VRT post-processing. Twenty-eight patients showed origin and course anomalies of the central coronary segments, and in this subgroup 13 were judged as ''malignant'' because of interarterial courses between the aortic root and the pulmonary trunk, either of the right coronary artery (n=11) or the left coronary artery (n=2). Twelve non-hemodynamic anomalies were found, affecting the coronary origins only (n=10) or the peripheral vessels courses (n=2). Four arteriovenous fistulas were present, all of them with complex arterial feeders. Regardless of vessel anatomy, coronary opacification was always possible by means of the systemic contrast agent, and the aberrant coronary arteries were visualized synoptically in direct relation to the great mediastinal vessels. In contrast to MDCT, selective cannulation and final diagnosis was possible in only 11 of the 20 catheter angiograms performed (accuracy of 55.0%). In conclusion, its non-invasiveness and precise visualization makes MDCT the standard of reference for evaluating anomalous coronary arteries. (orig.)

  7. Prediction of optimal deployment projection for transcatheter aortic valve replacement: angiographic 3-dimensional reconstruction of the aortic root versus multidetector computed tomography.

    OpenAIRE

    Binder Ronald K; Leipsic Jonathon; Wood David; Moore Teri; Toggweiler Stefan; Willson Alex; Gurvitch Ronen; Freeman Melanie; Webb John G

    2012-01-01

    BACKGROUND Identifying the optimal fluoroscopic projection of the aortic valve is important for successful transcatheter aortic valve replacement (TAVR). Various imaging modalities including multidetector computed tomography (MDCT) have been proposed for prediction of the optimal deployment projection. We evaluated a method that provides 3 dimensional angiographic reconstructions (3DA) of the aortic root for prediction of the optimal deployment angle and compared it with MDCT. METHODS AND RES...

  8. Effect of Saline Pushing after Contrast Material Injection in Abdominal Multidetector Computed Tomography with the Use of Different Iodine Concentrations

    International Nuclear Information System (INIS)

    Tatsugami, F.; Matsuki, M.; Kani, H.; Tanikake, M.; Miyao, M.; Yoshikawa, S.; Narabayashi, I.

    2006-01-01

    Purpose: To investigate whether saline pushing after contrast material improves hepatic vascular and parenchymal enhancement, and to determine whether this technique permits decreased contrast material concentration. Material and Methods: 120 patients who underwent hepatic multidetector computed tomography were divided randomly into four groups (Groups A-D): receiving 100 ml of contrast material (300 mgI/ml) only (A) or with 50 ml of saline solution (B); or 100 ml of contrast material (350 mgI/ml) only (C) or with 50 ml of saline solution (D). Computed tomography (CT) values of the aorta in the arterial phase, the portal vein in the portal venous inflow phase, and the liver in the hepatic phase were measured. Visualization of the hepatic artery and the portal vein by 3D CT angiography was evaluated as well. Results: Although the enhancement values of the aorta were not improved significantly with saline pushing, they continued at a high level to the latter slices with saline pushing. The enhancement value of the portal vein increased significantly and CT portography was improved with saline pushing. The enhancement value of the liver was not improved significantly using saline pushing. In a comparison between groups B and C, the enhancement values of the aorta and portal vein and the visualization of CT arteriography and portography were not statistically different. Conclusion: The saline pushing technique can contribute to a decrease in contrast material concentration for 3D CT arteriography and portography

  9. Novel prediction model of renal function after nephrectomy from automated renal volumetry with preoperative multidetector computed tomography (MDCT).

    Science.gov (United States)

    Isotani, Shuji; Shimoyama, Hirofumi; Yokota, Isao; Noma, Yasuhiro; Kitamura, Kousuke; China, Toshiyuki; Saito, Keisuke; Hisasue, Shin-ichi; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Ukimura, Osamu; Gill, Inderbir S; Horie, Shigeo

    2015-10-01

    The predictive model of postoperative renal function may impact on planning nephrectomy. To develop the novel predictive model using combination of clinical indices with computer volumetry to measure the preserved renal cortex volume (RCV) using multidetector computed tomography (MDCT), and to prospectively validate performance of the model. Total 60 patients undergoing radical nephrectomy from 2011 to 2013 participated, including a development cohort of 39 patients and an external validation cohort of 21 patients. RCV was calculated by voxel count using software (Vincent, FUJIFILM). Renal function before and after radical nephrectomy was assessed via the estimated glomerular filtration rate (eGFR). Factors affecting postoperative eGFR were examined by regression analysis to develop the novel model for predicting postoperative eGFR with a backward elimination method. The predictive model was externally validated and the performance of the model was compared with that of the previously reported models. The postoperative eGFR value was associated with age, preoperative eGFR, preserved renal parenchymal volume (RPV), preserved RCV, % of RPV alteration, and % of RCV alteration (p volumetry and clinical indices might yield an important tool for predicting postoperative renal function.

  10. Prospective Electrocardiogram-Gated Multidetector Row Computed Tomography Coronary Angiography. Analysis of Quality Image and Radiation Dose

    International Nuclear Information System (INIS)

    Carrascosa, P.; Capunay, C.; Deviggiano, A.; Tajer, C.D.; Vallejos, J.; Goldsmit, A.; Garcia, M.J.

    2009-01-01

    Multidetector row computed tomography coronary angiography (MDCT-CA) has become a useful diagnostic tool for the direct quantification of coronary stenosis, for identifying coronary anomalies and for the assessment of coronary artery bypass grafts. Despite its clinical value has been questioned due to the effective radiation dose (ERD) received by each patient, radiation exposure is similar to other studies. However, different strategies are permanently tested in order to reduce the ERD maintaining adequate and diagnostic image quality. Objectives: To determine the image quality and effective radiation dose (ERD) of prospective electrocardiogram-gated multidetector row computed tomography coronary angiography (PMDCTCA) (the x-ray beam is turned on for only a short portion of diastole) compared to retrospective ECG gating (RMDCTCA) (the x-ray beam is turned on throughout the cardiac cycle) and a preliminary approach of its diagnostic accuracy compared to digital invasive coronary angiography (CA). Material and Methods: Fifty consecutive patients with suspected coronary artery disease and sinus rhythm were evaluated with PMDCT-CA and compared to a control group who underwent RMDCTCA. Image quality was analyzed by two reviewers. Interobserver concordance and ERD were determined. The diagnostic accuracy of PMDCT-CA compared to CA to detect coronary artery stenosis > 50% was assessed in 30 patients. Results: There were no significant differences in the image quality between both groups. Agreement between the reviewers for segment image quality scores was k = 0.92. Mean ERD was 3.5 mSv for PMDCT-CA compared to 9.7 and 12.9 mSv for RMDCT-CA with and without tube current modulation, respectively. Individual analysis including all segments showed that the sensitivity, specificity, positive predictive value and negative predictive value of PMDCT-CA for the detection of coronary stenosis were 94.74%, 81.82%, 90% and 90%, respectively. Conclusion: Our initial experience

  11. Multidetector Computed Tomography Assessment in Biliary Atresia for the Diagnosis of Portosystemic Collaterals before Liver Transplant

    International Nuclear Information System (INIS)

    Cadavid A, Lina; Barber, Ignasi; Bueno, Javier

    2011-01-01

    Introduction: Chronic liver disease increases portal vein pressure and modifies splanchnic circulation. This is particularly significant in infants with biliary atresia. Large collaterals steal portal flow and increase the risk of post transplant portal vein thrombosis. Objective: to describe different types of portosystemic collaterals prior to liver transplantation with low-dose multidetector CT (MDCT) in patients with biliary atresia. Material and methods: 13 patients with severe liver dysfunction due to biliary atresia underwent low-dose 64-MDCT before liver transplantation (effective tube current ranged from 20 to 120 mAs according to weight, with a kilo voltage of 80-120 for all CT). Hepatic arterial and portal venous phases were performed after IV contrast administration [1.5-2 ml/kg]. The mean age of the study group was1 year (range, 4 months to 3.6 years). Two radiologists reviewed the CT images to determine the grade and types of the portosystemic collaterals. Results: A total of 16 CT scans were obtained.the most common portosystemic collaterals found were esophageal (11), gastric submucosal (8), gastric adventitial (7, splenic (7), hemorrhoidal (10), mesenteric [dilated or tortuous branches of the inferior mesenteric vein (8)], retroperitoneal varices [gastro renal shunt (10), splenorenal shunt (4)] and dilated or tortuous left gastric vein (13). Conclusion: MDCT provides important information on venous system patency, presence of varices, and location of venous shunts in pediatric patients with biliary atresia going to liver transplant. in addition, it is critical to detect collaterals that are not evident on ultrasound in order to avoid the steal phenomenon that may lead to portal vein thrombosis and graft failure.

  12. Multidetector computed tomography for the assessment of adnexal Mass: Is unenhenced CT scan necessary?

    International Nuclear Information System (INIS)

    Jung, Sung Il; Park, Hee Sun; Kim, Young Jun; Jeon, Hae Jeong

    2014-01-01

    To compare the diagnostic performance and radiation dose between contrast-enhanced CT (ECT) alone, and combined unenhanced and contrast-enhanced CT (UE + ECT) for the assessment of adnexal mass. This retrospective study was approved by the Institutional Review Board. A total of 146 consecutive patients (mean age, 41.1 years) who underwent preoperative unenhanced and contrast-enhanced multidetector CT of the pelvis and had adnexal masses found at surgery were included. Two readers independently evaluated the likelihood of adnexal malignancy on a 5-point scale on two different imaging datasets (ECT alone and UE + ECT). The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic performance. Radiation dose to patients was calculated by the volume CT dose index (CTDIvol) and the dose length products (DLP) on each dataset. Of the total 178 adnexal masses, 133 masses were benign and 45 masses were malignant. For both readers, there is no significant difference of AUC values between ECT alone and UE + ECT for the detection of adnexal malignancy (reader 1, 0.93 vs. 0.95; reader 2, 0.92 vs. 0.91) (p > 0.05). The mean CTDIvol (12.6 ± 2.2 mGy) and DLP (641.2 ± 137.2 mGy) of ECT alone was significantly lower than the mean CTDIvol (21.5 ± 2.7 mGy) and DLP (923.6 ± 158.8 mGy) of UE + ECT (p < 0.0001). The use of unenhanced CT scan in addition to contrast-enhanced CT scan does not improve the detection of adnexal malignancy, but increases radiation exposure.

  13. Advanced Gastric Cancer and Perfusion Imaging Using a Multidetector Row Computed Tomography: Correlation with Prognostic Determinants

    International Nuclear Information System (INIS)

    Zhang, Huan; Pan, Zilai; Du, Lianjun; Yan, Chao; Ding, Bei; Song, Qi; Ling, Huawei; Chen, Kemin

    2008-01-01

    Objective : To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. Materials and Methods : A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. Result : The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). Conclusion : The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer

  14. Advanced Gastric Cancer and Perfusion Imaging Using a Multidetector Row Computed Tomography: Correlation with Prognostic Determinants

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Huan; Pan, Zilai; Du, Lianjun; Yan, Chao; Ding, Bei; Song, Qi; Ling, Huawei; Chen, Kemin [Jiaotong University, Jiaotong (China)

    2008-04-15

    Objective : To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. Materials and Methods : A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. Result : The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). Conclusion : The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.

  15. Multidetector computed tomography virtual hysterosalpingography in the investigation of the uterus and fallopian tubes

    International Nuclear Information System (INIS)

    Carrascosa, Patricia; Baronio, Mariano; Capunay, Carlos; Lopez, Elba Martin; Vallejos, Javier; Borghi, Mario; Sueldo, Carlos; Papier, Sergio

    2008-01-01

    Objective: To compare the efficacy of multidetector CT virtual hysterosalpingography (MDCT-VH) with conventional X-ray hysterosalpingography (HSG) in the evaluation of patients with diagnosis of infertility. Methods: Sixty patients with diagnosis of infertility scheduled to perform a HSG, were evaluated with 16-row (n = 50) and 64-row (n = 10) MDCT-VH. In 35 patients the examination was performed without a tenaculum. The HSGs were carried out using standard technique. The HSG and MDCT-VH findings were compared. The duration for both examinations and patient discomfort were documented. The sensitivity and specificity of MDCT-VH for the detection of uterine pathology and tubal obstruction were calculated using the exact binomial method. Agreement between the two methods was assessed by the Cohen's kappa method (k). Results: The mean duration for MDCT-VH (16 and 64-rows) was 5 ± 3 min, whereas for HSG was 28 ± 3. The MDCT-VH without a tenaculum was the procedure with less patient discomfort. Sensitivity, specificity and inter-method agreement for the detection of uterine pathology were 100%, 92% and k = 0.92 for 16-row MDCT-VH and 100%, 100% and k = 1 for 64-row MDCT-VH, respectively. Sensitivity and specificity for detection of tubal obstruction were 80% and 80% for 16-row MDCT-VH and 100% and 100% for 64-row MDCT-VH, respectively; inter-method agreement for the visualization of the tubes was k = 0.54 for 16-row MDCT-VH and k = 1 for 64-row MDCT-VH. Conclusion: This study demonstrated the feasibility of evaluating the female reproductive system by MDCT-VH. 64-Row MDCT-VH could be an alternative diagnostic technique in the infertility workup algorithm. A larger study is in progress to validate these encouraging results

  16. Multidetector computed tomography virtual hysterosalpingography in the investigation of the uterus and fallopian tubes

    Energy Technology Data Exchange (ETDEWEB)

    Carrascosa, Patricia [Diagnostico Maipu, Av. Maipu 1668, Vicente Lopez B1602ABQ, Buenos Aires (Argentina)], E-mail: patriciacarrascosa@diagnosticomaipu.com.ar; Baronio, Mariano [CEGYR, Viamonte 1438, Capital Federal C1055ABB (Argentina); Capunay, Carlos; Lopez, Elba Martin; Vallejos, Javier [Diagnostico Maipu, Av. Maipu 1668, Vicente Lopez B1602ABQ, Buenos Aires (Argentina); Borghi, Mario; Sueldo, Carlos; Papier, Sergio [CEGYR, Viamonte 1438, Capital Federal C1055ABB (Argentina)

    2008-09-15

    Objective: To compare the efficacy of multidetector CT virtual hysterosalpingography (MDCT-VH) with conventional X-ray hysterosalpingography (HSG) in the evaluation of patients with diagnosis of infertility. Methods: Sixty patients with diagnosis of infertility scheduled to perform a HSG, were evaluated with 16-row (n = 50) and 64-row (n = 10) MDCT-VH. In 35 patients the examination was performed without a tenaculum. The HSGs were carried out using standard technique. The HSG and MDCT-VH findings were compared. The duration for both examinations and patient discomfort were documented. The sensitivity and specificity of MDCT-VH for the detection of uterine pathology and tubal obstruction were calculated using the exact binomial method. Agreement between the two methods was assessed by the Cohen's kappa method (k). Results: The mean duration for MDCT-VH (16 and 64-rows) was 5 {+-} 3 min, whereas for HSG was 28 {+-} 3. The MDCT-VH without a tenaculum was the procedure with less patient discomfort. Sensitivity, specificity and inter-method agreement for the detection of uterine pathology were 100%, 92% and k = 0.92 for 16-row MDCT-VH and 100%, 100% and k = 1 for 64-row MDCT-VH, respectively. Sensitivity and specificity for detection of tubal obstruction were 80% and 80% for 16-row MDCT-VH and 100% and 100% for 64-row MDCT-VH, respectively; inter-method agreement for the visualization of the tubes was k = 0.54 for 16-row MDCT-VH and k = 1 for 64-row MDCT-VH. Conclusion: This study demonstrated the feasibility of evaluating the female reproductive system by MDCT-VH. 64-Row MDCT-VH could be an alternative diagnostic technique in the infertility workup algorithm. A larger study is in progress to validate these encouraging results.

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

    International Nuclear Information System (INIS)

    Vleuten, P.A. van der; Willems, T.P.; Goette, M.J.; Tio, R.A.; Greuter, M.J.; Zijlstra, F.; Oudkerk, M.

    2006-01-01

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

  18. Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography

    Directory of Open Access Journals (Sweden)

    Zhi-hui Dong

    2011-01-01

    Full Text Available PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT. METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR = 2.2; p<0.001. Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR=1.2; p<0.05 or flail chest (45/143 vs. 11/66 patients, RR=1.9; p<0.05 were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR= 1.7; p<0.01. Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR= 1.4; p<0.01. Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR=1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001. Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts. CONCLUSIONS: Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries.

  19. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Yoshitake [Keio University School of Medicine, Department of Diagnostic Radiology, Tokyo (Japan); Nippon Koukan Hospital, Department of Radiology, Kawasaki-shi, Kanagawa (Japan); Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Kuribayashi, Sachio [Keio University School of Medicine, Department of Diagnostic Radiology, Tokyo (Japan); Abe, Takayuki [Keio University School of Medicine, Center for Clinical Research, Tokyo (Japan); Ogawa, Kenji [Nippon Koukan Hospital, Department of Radiology, Kawasaki-shi, Kanagawa (Japan)

    2013-08-15

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA{sub -950}) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA{sub -950}. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA{sub -950}. (orig.)

  20. Comparison of 640-Slice Multidetector Computed Tomography Versus 32-Slice MDCT for Imaging of the Osteo-odonto-keratoprosthesis Lamina.

    Science.gov (United States)

    Norris, Joseph M; Kishikova, Lyudmila; Avadhanam, Venkata S; Koumellis, Panos; Francis, Ian S; Liu, Christopher S C

    2015-08-01

    To investigate the efficacy of 640-slice multidetector computed tomography (MDCT) for detecting osteo-odonto laminar resorption in the osteo-odonto-keratoprosthesis (OOKP) compared with the current standard 32-slice MDCT. Explanted OOKP laminae and bone-dentine fragments were scanned using 640-slice MDCT (Aquilion ONE; Toshiba) and 32-slice MDCT (LightSpeed Pro32; GE Healthcare). Pertinent comparisons including image quality, radiation dose, and scanning parameters were made. Benefits of 640-slice MDCT over 32-slice MDCT were shown. Key comparisons of 640-slice MDCT versus 32-slice MDCT included the following: percentage difference and correlation coefficient between radiological and anatomical measurements, 1.35% versus 3.67% and 0.9961 versus 0.9882, respectively; dose-length product, 63.50 versus 70.26; rotation time, 0.175 seconds versus 1.000 seconds; and detector coverage width, 16 cm versus 2 cm. Resorption of the osteo-odonto lamina after OOKP surgery can result in potentially sight-threatening complications, hence it warrants regular monitoring and timely intervention. MDCT remains the gold standard for radiological assessment of laminar resorption, which facilitates detection of subtle laminar changes earlier than the onset of clinical signs, thus indicating when preemptive measures can be taken. The 640-slice MDCT exhibits several advantages over traditional 32-slice MDCT. However, such benefits may not offset cost implications, except in rare cases, such as in young patients who might undergo years of radiation exposure.

  1. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Catherine Yang

    2013-07-01

    Full Text Available Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

  2. Reproducibility of multi-detector spiral computed tomography in detection of sub-segmental acute pulmonary embolism

    International Nuclear Information System (INIS)

    Brunot, S.; Corneloup, O.; Latrabe, V.; Montaudon, M.; Laurent, F.

    2005-01-01

    The aim of this study was to evaluate the inter-observer and intra-observer agreement of the diagnosis of sub-segmental acute pulmonary embolism (PE) in an inpatient population explored by 16 slice multi-detector spiral computed tomography (MDCT). Four hundred consecutive inpatients were referred for MDCT for the clinical suspicion of acute PE. One hundred and seventy seven (44.2%) had a known cardio-respiratory disease at the time of examination. Inter-observer and intra-observer agreements for the diagnosis of acute PE and of sub-segmental acute PE were assessed blind and independently by three experienced readers and by kappa statistics. Seventy-five patients were diagnosed as having acute PE findings (19.5%), and clots were located exclusively within sub-segmental arteries in nine patients (12%). When clots were limited to sub-segmental or more distal branches of the pulmonary arteries, kappa values were found to be moderate (0.56) to very good (0.85) for the diagnosis of sub-segmental acute PE, whereas for the diagnosis of acute PE in the whole population, kappa values ranged from 0.84 to 0.97. Intra-observer agreement was found to be perfect (kappa=1). MDCT is a reproducible technique for the diagnosis of sub-segmental acute PE as well as for acute PE. In this inpatient population, sub-segmental acute PE was not a rare event. (orig.)

  3. Measurement of spinal canal narrowing, interpedicular widening, and vertebral compression in spinal burst fractures: plain radiographs versus multidetector computed tomography

    International Nuclear Information System (INIS)

    Bensch, Frank V.; Koivikko, Mika P.; Koskinen, Seppo K.; Kiuru, Martti J.

    2009-01-01

    To assess the reliability of measurements of spinal canal narrowing, vertebral body compression, and interpedicular widening in burst fractures in radiography compared with multidetector computed tomography (MDCT). Patients who had confirmed acute vertebral burst fractures over an interval of 34 months underwent both MDCT and radiography. Measurements of spinal canal narrowing, vertebral body compression, and interpedicular widening from MDCT and radiography were compared. The 108 patients (30 female, 78 male, aged 16-79 years, mean 39 years) had 121 burst fractures. Eleven patients had multiple fractures, of which seven were not contiguous. Measurements showed a strong positive correlation between radiography and MDCT (Spearman's rank sum test: spinal canal narrowing k = 0.50-0.82, vertebral compression k = 0.55-0.72, and interpedicular widening k = 0.81-0.91, all P 0.25) and for interpedicular widening in the thoracic spine (k = 0.35, P = 0.115). The average difference in measurements between the modalities was 3 mm or fewer. Radiography demonstrates interpedicular widening, spinal canal narrowing and vertebral compression with acceptable precision, with the exception of those of the cervical spine. (orig.)

  4. Multidetector row computed tomography noninvasively assesses coronary reperfusion after thrombolytic therapy in patients with ST elevation myocardial infarction

    International Nuclear Information System (INIS)

    Shin, Dong-Il; Won, Yoo-Dong; Chang, Kiyuk

    2006-01-01

    The study objective was to assess the efficacy of 16-slice multidetector row computed tomography (MDCT) in estimating residual stenosis and successful reperfusion after thrombolysis in patients with ST-elevation myocardial infarction (STEMI). A total of 31 patients with STEMI underwent MDCT scanning within 6 h (mean 4.6±1.1) after thrombolysis and the results for detection of significant residual stenosis and distal flow of the infarct-related artery were compared with those from conventional coronary angiography (CCAG) performed within 24 h (mean 12.1±5.6) after the MDCT scan. Successful reperfusion was defined as Thrombolysis In Myocardial Infarction flow 2 or 3 on CCAG and full contrast enhancement of the distal artery landmarks on MDCT. A final analysis was performed using 24 patients (312 segments). MDCT had a positive predictive value of 73.3% and a negative predictive value of 95.1% for detecting significant residual stenosis. It accurately estimated 17 of 18 patients (94.4%) with successful reperfusion and 5 of 6 (83.3%) with failed reperfusion on the basis of comparison with CCAG. MDCT demonstrated high accuracy not only for the detecting residual stenosis, but also for assessing successful reperfusion after thrombolytic therapy in patients with STEMI. (author)

  5. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Araujo Neto, Severino Aires; Franca, Henrique Almeida; Mello Junior, Carlos Fernando de; Silva Neto, Eulampio Jose; Negromonte, Gustavo Ramalho Pessoa; Duarte, Claudia Martina Araujo; Cavalcanti Neto, Bartolomeu Fragoso; Farias, Rebeca Danielly da Fonseca, E-mail: severinoaires@hotmail.com [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil)

    2015-11-15

    Objective: To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery. Materials And Methods: Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients. Results: The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery. Conclusion: The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS. (author)

  6. Increased epicardial fat volume quantified by 64-multidetector computed tomography is associated with coronary atherosclerosis and totally occlusive lesions

    International Nuclear Information System (INIS)

    Ueno, Koji; Anzai, Toshihisa; Jinzaki, Masahiro

    2009-01-01

    The relationship between the epicardial fat volume measured by 64-slice multidetector computed tomography (MDCT) and the extension and severity of coronary atherosclerosis was investigated. Both MDCT and conventional coronary angiography (CAG) were performed in 71 consecutive patients who presented with effort angina. The volume of epicardial adipose tissue (EAT) was measured by MDCT. The severity of coronary atherosclerosis was assessed by evaluating the extension of coronary plaques in 790 segments using MDCT data, and the percentage diameter stenosis in 995 segments using CAG data. The estimated volume of EAT indexed by body surface area was defined as VEAT. Increased VEAT was associated with advanced age, male sex, degree of metabolic alterations, a history of acute coronary syndrome (ACS) and the presence of total occlusions, and showed positive correlation with the stenosis score r=0.28, P=0.02) and the atheromatosis score (r=0.67, P 3 /m 2 ) to be the strongest independent determinant of the presence of total occlusions odds ratio 4.64. P=0.02). VEAT correlates with the degree of metabolic alterations and coronary atheromatosis. Excessive accumulation of EAT might contribute to the development of ACS and coronary total occlusions. (author)

  7. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Yang, Catherine; Trad, Clovis Simao; Trad, Henrique Simao

    2013-01-01

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  8. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Catherine; Trad, Clovis Simao [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Trad, Henrique Simao, E-mail: hstrad@terra.com.br [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Universidade de Sao Paulo (HC-FMRPUSP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Mendonca, Silvana Machado [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2013-06-15

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  9. Imaging quality and effective radiation dose of prospective ECG-gated axial multidetector row computed tomography coronary angiography

    International Nuclear Information System (INIS)

    Capunay, C.; Carrascosa, P.; Vallejos, J.; Deviggiano, A.; Pollono, P.M.; Garcia, M.J.

    2011-01-01

    Objective. To determine the imaging quality and effective radiation dose (ERD) of prospective ECG-gated multidetector row computed tomography coronary angiography (PMDCTCA) compared to retrospective ECG-gating (RMDCT-CA). Materials and Methods. Forty-five PMDCT-CA scans were retrospectively reviewed for assessing imaging quality and ERD, and compared to 90 RMDCT-CA scans performed with (n=45) and without (n=45) tube current modulation, selected from our database on the basis of similar demographical characteristics. ERD was compared between all three groups. Imaging quality was assessed by two independent observers and compared to the imaging quality of the group of RMDCT-CA scans performed with tube current modulation. The interobserver variability was also determined. Results. There were no significant differences in imaging quality between the two groups. Interobserver variability was k=0.92 (95 % CI: 0.87-0.96). The ERD (mean ± SD) using PMDCT-CA was 2.88 ± 0.37 mSv compared to 10.50 ± 1.15 mSv (p [es

  10. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

    International Nuclear Information System (INIS)

    Araujo Neto, Severino Aires; Franca, Henrique Almeida; Mello Junior, Carlos Fernando de; Silva Neto, Eulampio Jose; Negromonte, Gustavo Ramalho Pessoa; Duarte, Claudia Martina Araujo; Cavalcanti Neto, Bartolomeu Fragoso; Farias, Rebeca Danielly da Fonseca

    2015-01-01

    Objective: To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery. Materials And Methods: Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients. Results: The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery. Conclusion: The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS. (author)

  11. Detection of attenuated plaque in stable angina with 64-multidetector computed tomography: a comparison with intravascular ultrasound.

    Science.gov (United States)

    Jinzaki, Masahiro; Okabe, Teruo; Endo, Ayaka; Kawamura, Akio; Koga, Seiko; Yamada, Minoru; Fukuda, Keiichi; Kuribayashi, Sachio

    2012-01-01

    To clarify multidetector computed tomography (MDCT) findings of attenuated plaque detected by intravascular ultrasound (IVUS). One hundred and fifty-four patients with stable angina underwent MDCT before IVUS. The attenuated plaque was identified in the targeted artery with IVUS, and the same artery was analyzed with MDCT for the presence of a high density area (HDA) >130 Hounsfield units (HU), and a low density area (LDA) HDA in attenuated plaque was compared with that in calcified plaque. Ten attenuated plaques and 15 calcified plaques were identified in 9 of 154 patients (males=9, 66.2 ± 9.5 years). Eight of the 10 attenuated plaques and all 15 calcified plaques were accompanied with a HDA on MDCT. The HDA ranged from 174 to 667 HU (mean 389.0 ± 148.3 HU) in the 8 attenuated plaques, and from 545 to 1,205 HU (mean 920.9 ± 215.9 HU) in 15 calcified plaques. There was a significant difference in CT density of the HDA between the attenuated and calcified plaque (PHDA. MDCT has the ability to demonstrate attenuated plaque as the combination of HDA (approximately 400 HU on average) and LDA HDA can be differentiated from calcified plaque by its lower CT density value.

  12. Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography

    International Nuclear Information System (INIS)

    Yeh, Jun Jun; Chen, Solomon Chih-Cheng; Teng, Wen-Bao; Chou, Chun-Hsiung; Hsieh, Shih-Peng; Lee, Tsung-Lung; Wu, Ming-Ting

    2010-01-01

    This study aimed to determine whether characteristics detected by multi-detector computed tomography (MDCT) were predictive of highly infectious, smear-positive, active pulmonary tuberculosis (PTB). Among 124 patients with active PTB, 84 had positive (group 1) and 40 had negative (group 2) smear results for acid-fast bacilli. Multiplanar MDCT, axial conventional CT and chest X-ray images were analysed retrospectively for morphology, number, and segmental (lobe) distribution of lesions. By multivariate analysis, consolidation over any segment of the upper, middle, or lingual lobes, cavitations, and clusters of nodules were associated with group 1, while centrilobular nodules were predictive of group 2. Using five independent variables associated with risk in group 1, a prediction model was created to distinguish between group 1 and group 2. ROC curve analysis showed an area under the curve of 0.951 ± 0.021 for this prediction model. With the ideal cutoff point score of 1, the sensitivity, specificity, and positive predictive values were 84.5%, 97.5%, and 98.0%, respectively. A model to predict smear-positive active PTB on the basis of findings from MDCT may be a useful tool for clinical decisions about isolating patients pending sputum smear results. (orig.)

  13. Comparison of the Multidetector-row Computed Tomographic Angiography Axial and Coronal Planes' Usefulness for Detecting Thoracodorsal Artery Perforators

    Science.gov (United States)

    Kim, Jong Gyu

    2012-01-01

    Background During the planning of a thoracodorsal artery perforator (TDAP) free flap, preoperative multidetector-row computed tomographic (MDCT) angiography is valuable for predicting the locations of perforators. However, CT-based perforator mapping of the thoracodorsal artery is not easy because of its small diameter. Thus, we evaluated 1-mm-thick MDCT images in multiple planes to search for reliable perforators accurately. Methods Between July 2010 and October 2011, 19 consecutive patients (13 males, 6 females) who underwent MDCT prior to TDAP free flap operations were enrolled in this study. Patients ranged in age from 10 to 75 years (mean, 39.3 years). MDCT images were acquired at a thickness of 1 mm in the axial, coronal, and sagittal planes. Results The thoracodorsal artery perforators were detected in all 19 cases. The reliable perforators originating from the descending branch were found in 14 cases, of which 6 had transverse branches. The former were well identified in the coronal view, and the latter in the axial view. The location of the most reliable perforators on MDCT images corresponded well with the surgical findings. Conclusions Though MDCT has been widely used in performing the abdominal perforator free flap for detecting reliable perforating vessels, it is not popular in the TDAP free flap. The results of this study suggest that multiple planes of MDCT may increase the probability of detecting the most reliable perforators, along with decreasing the probability of missing available vessels. PMID:22872839

  14. Measurement of cardiac ventricular volumes using multidetector row computed tomography: comparison of two- and three-dimensional methods

    International Nuclear Information System (INIS)

    Montaudon, M.; Laffon, E.; Berger, P.; Corneloup, O.; Latrabe, V.; Laurent, F.

    2006-01-01

    This study compared a three-dimensional volumetric threshold-based method to a two-dimensional Simpson's rule based short-axis multiplanar method for measuring right (RV) and left ventricular (LV) volumes, stroke volumes, and ejection fraction using electrocardiography-gated multidetector computed tomography (MDCT) data sets. End-diastolic volume (EDV) and end-systolic volume (ESV) of RV and LV were measured independently and blindly by two observers from contrast-enhanced MDCT images using commercial software in 18 patients. For RV and LV the three-dimensionally calculated EDV and ESV values were smaller than those provided by two-dimensional short axis (10%, 5%, 15% and 26% differences respectively). Agreement between the two methods was found for LV (EDV/ESV: r=0.974/0.910, ICC=0.905/0.890) but not for RV (r=0.882/0.930, ICC=0.663/0.544). Measurement errors were significant only for EDV of LV using the two-dimensional method. Similar reproducibility was found for LV measurements, but the three-dimensional method provided greater reproducibility for RV measurements than the two-dimensional. The threshold value supported three-dimensional method provides reproducible cardiac ventricular volume measurements, comparable to those obtained using the short-axis Simpson based method. (orig.)

  15. Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, Jun Jun [Pingtung Christian Hospital, Pingtung (China); Mei-Ho Institute of Technology, Pingtung (China); China Medical University, Taichung (China); Chen, Solomon Chih-Cheng [Pingtung Christian Hospital, Pingtung (China); National Taiwan University, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, Taipei (China); Teng, Wen-Bao; Chou, Chun-Hsiung; Hsieh, Shih-Peng; Lee, Tsung-Lung [Pingtung Christian Hospital, Pingtung (China); Wu, Ming-Ting [National Yang Ming University, Faculty of Medicine, School of Medicine, Taipei (China); Kaohsiung Veterans General Hospital, Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung (China)

    2010-09-15

    This study aimed to determine whether characteristics detected by multi-detector computed tomography (MDCT) were predictive of highly infectious, smear-positive, active pulmonary tuberculosis (PTB). Among 124 patients with active PTB, 84 had positive (group 1) and 40 had negative (group 2) smear results for acid-fast bacilli. Multiplanar MDCT, axial conventional CT and chest X-ray images were analysed retrospectively for morphology, number, and segmental (lobe) distribution of lesions. By multivariate analysis, consolidation over any segment of the upper, middle, or lingual lobes, cavitations, and clusters of nodules were associated with group 1, while centrilobular nodules were predictive of group 2. Using five independent variables associated with risk in group 1, a prediction model was created to distinguish between group 1 and group 2. ROC curve analysis showed an area under the curve of 0.951 {+-} 0.021 for this prediction model. With the ideal cutoff point score of 1, the sensitivity, specificity, and positive predictive values were 84.5%, 97.5%, and 98.0%, respectively. A model to predict smear-positive active PTB on the basis of findings from MDCT may be a useful tool for clinical decisions about isolating patients pending sputum smear results. (orig.)

  16. Accuracy of multidetector row computed tomography for the detection of transplant vasculopathy: comparison with invasive coronary angiography and intravascular ultrasound

    International Nuclear Information System (INIS)

    Carrascosa, P.; Capunay, C.; Carrascosa, J.; Perrone, S.; Deviggiano, A.; Lopez, E.M.; Lev, G.; Garcia, M.J.

    2009-01-01

    Objective: To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) for detection of luminal stenosis and cardiac allograft vasculopathy in comparison with coronary angiography (CA) and intravascular ultrasound (IVUS) respectively. Material and methods: Nineteen cardiac transplant patients scheduled for follow-up CA were included. MDCT coronary angiography was performed using a 16-row CT scanner within 7-14 days after CA and IVUS. Studies were analyzed by independent readers; two observers evaluated the CT datasets for the presence of coronary artery stenosis > 50% and allograft vasculopathy. Results: The sensitivity for detecting > 50% luminal stenosis was 80-88% and specificity, 98-99% and for detection of cardiac allograft vasculopathy, the sensitivity was 91-96% and specificity, 88-91%. Conclusion: In this preliminary series, our results indicate that MDCT coronary angiography was capable of detecting both significant coronary stenosis as well as diffuse intimal proliferation. This non-invasive procedure could be an alternative to CA and IVUS in the surveillance of heart transplant patients. (authors) [es

  17. Multidetector row computed tomography findings from ischemia to infarction of the large bowel

    International Nuclear Information System (INIS)

    Romano, Stefania; Romano, Luigia; Grassi, Roberto

    2007-01-01

    Objective: MDCT is performed as first imaging examination for patients with acute abdomen in most Emergency Departments. Clinical suspicion of ischemic colitis and infarction is related to specific findings, however, differential diagnosis as well as the staging for a confirmed ischemic affection may be critical. The individual signs from ischemia to infarction of large bowel is a captivating topic. In this study, we report our experience of the MDCT assessment of acute colonic disease from vascular mesenteric disorders. Materials and methods: We retrospectively reviewed the MDCT findings of 71 patients admitted to our attention for acute abdomen, with final proven diagnosis of colonic ischemia and/or infarction made by surgery and/or endoscopy. CT-scanning of the abdomen and pelvis was performed after i.v. contrast medium administration, using a multidetector row CT equipment. We correlated the presence of parietal disease, the evidence of mesenteric arterial or venous vessels occlusion, the parietal features as well as others findings, such as free fluid and/or air in peritoneal recess or in retroperitoneum, with the surgical and/or endoscopic findings. Results: Analysis of our data showed a segmental (84%) or complete (16%) involvement of the colon; 57 cases were related to ischemia, 14 to infarction. Inferior mesenteric vessels defect of opacification was noted in 10 cases. Various degree of wall thickening and parietal enhancement, peritoneal fluid, mural or portal-mesenteric pneumatosis were compared to evidence of mesenteric arterial or vein occlusion and to final proven diagnosis. A classification in a multi-stage grading for both decreased of arterial supply or impaired venous drainage disorders was done. Conclusions: A grading scale from ischemia to infarction affecting the large bowel from arterial or venous mesenteric vessels origin has been not previously reported in a series at our knowledge. MDCT findings may support the clinical evaluation of

  18. Multidetector-row computed tomography of thoracic aortic anomalies in dogs and cats: Patent ductus arteriosus and vascular rings

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2011-09-01

    Full Text Available Abstract Background Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. We postulated that accurate characterization of malformations of the aorta would benefit from 3-dimensional assessment. Therefore, multidetector-row computed tomography (MDCT was chosen as a 3-dimensional, new, and noninvasive imaging technique. The purpose of this study was to evaluate patients with 2 common diseases of the intrathoracic aorta, either patent ductus arteriosus or vascular ring anomaly, by contrast-enhanced 64-row computed tomography. Results Electrocardiography (ECG-gated and thoracic nongated MDCT images were reviewed in identified cases of either a patent ductus arteriosus or vascular ring anomaly. Ductal size and morphology were determined in 6 dogs that underwent ECG-gated MDCT. Vascular ring anomalies were characterized in 7 dogs and 3 cats by ECG-gated MDCT or by a nongated thoracic standard protocol. Cardiac ECG-gated MDCT clearly displayed the morphology, length, and caliber of the patent ductus arteriosus in 6 affected dogs. Persistent right aortic arch was identified in 10 animals, 8 of which showed a coexisting aberrant left subclavian artery. A mild dilation of the proximal portion of the aberrant subclavian artery near its origin of the aorta was present in 4 dogs, and a diverticulum analogous to the human Kommerell's diverticulum was present in 2 cats. Conclusions Contrast-enhanced MDCT imaging of thoracic anomalies gives valuable information about the exact aortic arch configuration. Furthermore, MDCT was able to characterize the vascular branching patterns in dogs and cats with a persistent right aortic arch and the morphology and size of the patent ductus arteriosus in affected dogs. This additional

  19. Anatomical variation of celiac axis, superior mesenteric artery, and hepatic artery: Evaluation with multidetector computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Maryam Farghadani

    2016-01-01

    Full Text Available Background: The celiac axis, superior mesenteric artery (SMA, and hepatic artery are the most important branches of abdominal aorta due to their vascularization field. The aim of our study was to evaluate the prevalence of different anatomical variation of celiac axis, SMA, hepatic artery, and its branches with multidetector computed tomography (MDCT angiography of upper abdomen arteries. Materials and Methods: MDCT of 607 kidney donor and traumatic patients that referred to MDCT unit at Al Zahra Hospital in Isfahan from 2012 to 2015 were retrospectively evaluated. We excluded patients with history of abdominal vascular surgery and hepatic or pancreatic surgery. Computed tomography images of the patient were obtained with 64-row MDCT scanner and anatomical variations were analyzed. Results: Three hundred and eighty-eight (63.9% of the 607 patients had classic arterial anatomy and 219 (36.1% patients had variant types. The most common type of variation was the origin of the right hepatic artery (RHA from SMA (9.6%, and the next common variation was the origin of the left hepatic artery (LHA from the left gastric artery (6.9%. Variations in the origin of the common hepatic artery (CHA were seen in 16 (2.6% patients. Buhler arc was identified in two patients. The RHA originated from the celiac axis in 11 (1.8% patients and from the aorta in 8 (1.3% patients. Trifurcation of CHA into gastroduodenal artery, RHA, and LHA was detected in 11 (1.8% patients. Conclusion: The results of the present study showed that anatomical variation occurs in a high percentage of patients. Detection of these variations can guide surgical and radiological interventional planning.

  20. Head multidetector computed tomography: emergency medicine physicians overestimate the pretest probability and legal risk of significant findings.

    Science.gov (United States)

    Baskerville, Jerry Ray; Herrick, John

    2012-02-01

    This study focuses on clinically assigned prospective estimated pretest probability and pretest perception of legal risk as independent variables in the ordering of multidetector computed tomographic (MDCT) head scans. Our primary aim is to measure the association between pretest probability of a significant finding and pretest perception of legal risk. Secondarily, we measure the percentage of MDCT scans that physicians would not order if there was no legal risk. This study is a prospective, cross-sectional, descriptive analysis of patients 18 years and older for whom emergency medicine physicians ordered a head MDCT. We collected a sample of 138 patients subjected to head MDCT scans. The prevalence of a significant finding in our population was 6%, yet the pretest probability expectation of a significant finding was 33%. The legal risk presumed was even more dramatic at 54%. These data support the hypothesis that physicians presume the legal risk to be significantly higher than the risk of a significant finding. A total of 21% or 15% patients (95% confidence interval, ±5.9%) would not have been subjected to MDCT if there was no legal risk. Physicians overestimated the probability that the computed tomographic scan would yield a significant result and indicated an even greater perceived medicolegal risk if the scan was not obtained. Physician test-ordering behavior is complex, and our study queries pertinent aspects of MDCT testing. The magnification of legal risk vs the pretest probability of a significant finding is demonstrated. Physicians significantly overestimated pretest probability of a significant finding on head MDCT scans and presumed legal risk. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Multidetector-row helical computed tomography in the evaluation of cervical spine disorders; Tomografia computadorizada multislice no diagnostico das afeccoes da coluna cervical

    Energy Technology Data Exchange (ETDEWEB)

    Rosemberg, Laercio Alberto; Almeida, Milena Oliveira; Rios, Adriana Martins; Garbaccio, Viviane Ladeira; Kim, Nelson Ji Tae; Daniel, Mauro Miguel; Funari, Marcelo Buarque de Gusmao [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Imagem]. E-mail: laercio@einstein.br

    2003-07-01

    Multidetector-row computed tomography (MRCT) has advantages in comparison to conventional helical computed tomography, such as reduction of study time, lower radiation doses, fewer metallic artifacts and high quality multiplanar reformatting and three dimensional reconstructions. We reviewed 150 cervical spine examinations and selected the most illustrative cases including congenital anomalies, degenerative lesions, spinal infections, neoplasms, traumatic injuries and postoperative abnormalities. The quality of multiplanar reformatting and volume reconstructions of the MRCT made the detection and evaluation of most of cases with complex anatomy easier and more precise. (author)

  2. Automatic Bolus Tracking Versus Fixed Time-Delay Technique in Biphasic Multidetector Computed Tomography of the Abdomen

    International Nuclear Information System (INIS)

    Adibi, Atoosa; Shahbazi, Ali

    2014-01-01

    Bolus tracking can individualize time delay for the start of scans in spiral computed tomography (CT). We compared automatic bolus tracking method with fixed time-delay technique in biphasic contrast enhancement during multidetector CT of abdomen. Adult patients referred for spiral CT of the abdomen were randomized into two groups; in group 1, the arterial and portal phases of spiral scans were started 25 s and 55 s after the start of contrast material administration; in group 2, using the automatic bolus tracking software, repetitive monitoring scans were performed within the lumen of the descending aorta as the region of interest with the threshold of starting the diagnostic scans as 60 HU. The contrast enhancement of the aorta, liver, and spleen were compared between the groups. Forty-eight patients (23 males, 25 females, mean age=56.4±13.5 years) were included. The contrast enhancement of the aorta, liver, and spleen at the arterial phase was similar between the two groups (P>0.05). Regarding the portal phase, the aorta and spleen were more enhanced in the bolus-tracking group (P<0.001). The bolus tracking provided more homogeneous contrast enhancement among different patients than the fixed time-delay technique in the liver at portal phase, but not at the arterial phase. The automatic bolus-tracking method, results in higher contrast enhancement of the aorta and spleen at the portal phase, but has no effect on liver enhancement. However, bolus tracking is associated with reduced variability for liver enhancement among different patients

  3. Accessory Renal Artery Stenosis and Hypertension: Are These Correlated? Evaluation Using Multidetector-Row Computed Tomographic Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Saba, L.; Sanfilippo, R.; Montisci, R.; Conti, M.; Mallarini, G. (Dept. of Imaging Science and Dept. of Vascular Surgery, Policlinico Universitario, Cagliari (Italy))

    2008-04-15

    Background: Renal artery stenosis may produce hypertension, and this condition is referred to as renovascular hypertension (RVH). Purpose: To evaluate, by using multidetector-row spiral computed tomographic angiography (MDCTA), whether a relationship between accessory renal artery stenosis and hypertension may be hypothesized. Material and Methods: 214 patients (142 males, 72 females; mean age 66 years) who had previously undergone an MDCTA to study the abdominal vasculature were retrospectively studied. Patients with renal artery stenosis (RAS) were excluded from this analysis. The patients were studied by means of a four-detector-row CT, and scans were obtained after intravenous bolus administration of 110-140 ml of a nonionic contrast material with a 3-6 ml/s flow rate. As a second step, by means of statistical analysis, hypertension data were compared with findings of accessory artery stenosis. Two radiologists first independently reviewed the MDCTA images and then, in case of disagreement, in consensus. Interobserver agreement was calculated for all measurements. Results: The overall number of detected accessory renal arteries was 74 in 56 of the 214 patients. Accessory renal artery stenosis was detected in 21 of the 56 patients. There was a difference in the prevalence of hypertension between patients with (n = 21) and without (n = 35) accessory renal artery stenosis (P = 0.0187). Interobserver agreement was good (kappa value 0.733). Conclusion: Any statistical association between the presence of accessory renal artery stenosis and hypertension could not be disclosed. However, accessory renal artery stenosis, detected by MDCTA, is an important pathological sign that the radiologist has to assess in the light of its possible association with hypertension

  4. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference.

    Science.gov (United States)

    Yamada, Yoshitake; Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Abe, Takayuki; Kuribayashi, Sachio; Ogawa, Kenji

    2013-08-01

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA-950. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. • Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography. • Interobserver agreement for tomosynthesis was significantly higher than that for radiography. • Sensitivity increased with increasing LAA -950 in both tomosynthesis and radiography. • Tomosynthesis imparts a similar radiation dose to two projection chest radiography. • Radiation dose and cost of tomosynthesis are lower than those of MDCT.

  5. Volumetric analysis of coronary plaque characterization in patients with metabolic syndrome using 64-slice multi-detector computed tomography

    International Nuclear Information System (INIS)

    Arai, Kosuke; Ishii, Hideki; Amano, Tetasuya

    2010-01-01

    Metabolic syndrome (MetS) is associated with adverse cardiovascular events and mortality, where acute coronary syndrome significantly impacts on mortality and morbidity. In contrast, evidences have accumulated that the lipid-rich plaque might play a critical role in acute coronary syndrome. The study population consisted of 94 patients with suspected angina pectoris who underwent multi-detector computed tomography (MDCT). Of those, we identified 41 with MetS. In MDCT analysis, low-density plaque volume (LDPV) (42±28 vs 24±18 mm 3 , P=0.0003), moderate-density plaque volume (105±41 vs 82±33 mm(3), P=0.003), total plaque volume (164±70 vs 118±59 mm 3 ), P=0.0008) and %LDPV (24.2±10.0 vs 18.3±7.1%, P=0.01) were significantly increased in the MetS group compared to the non-MetS group. Multivariate linear regression analysis after adjusting for confounding variables revealed that MetS was significantly correlated with an increase in %LDPV (β=0.48, P=0.0001). Multivariate logistic regression analysis for lipid-rich plaque after adjusting for confounding variables indicated that MetS was significantly associated with lipid-rich plaque (odds ratio: 5.99, 95% confidence intervals: 1.94-18.6, P=0.002). Patients with MetS were strongly related to having a lipid-rich composition in their coronary plaque, as detected by MDCT. (author)

  6. Total body height estimation using sacrum height in Anatolian Caucasians: multidetector computed tomography-based virtual anthropometry

    Energy Technology Data Exchange (ETDEWEB)

    Karakas, Hakki Muammer [Inonu University Medical Faculty, Turgut Ozal Medical Center, Department of Radiology, Malatya (Turkey); Celbis, Osman [Inonu University Medical Faculty Turgut Ozal Medical Center, Department of Forensic Medicine, Malatya (Turkey); Harma, Ahmet [Inonu University Medical Faculty Turgut Ozal Medical Center, Department of Orthopaedics and Traumatology, Malatya (Turkey); Alicioglu, Banu [Trakya University Medical Faculty, Department of Radiology, Edirne (Turkey); Trakya University Health Sciences Institute, Department of Anatomy, Edirne (Turkey)

    2011-05-15

    Estimation of total body height is a major step when a subject has to be identified from his/her skeletal structures. In the presence of decomposed skeletons and missing bones, estimation is usually based on regression equation for intact long bones. If these bones are fragmented or missing, alternative structures must be used. In this study, the value of sacrum height (SH) in total body height (TBH) estimation was investigated in a contemporary population of adult Anatolian Caucasians. Sixty-six men (41.6 {+-} 14.9 years) and 43 women (41.1 {+-} 14.2 years) were scanned with 64-row multidetector computed tomography (MDCT) to obtain high-resolution anthropometric data. SH of midsagittal sections was electronically measured. The technique and methodology were validated on a standard skeletal model. Sacrum height was 111.2 {+-} 12.6 mm (77-138 mm) in men and 104.7 {+-} 8.2 (89-125 mm) in women. The difference between the two sexes regarding SH was significant (p < 0.0001). SH did not significantly correlate with age in men, whereas the correlation was significant in women (p < 0.03). The correlation between SH and the stature was significant in men (r = 0.427, p < 0.0001) and was insignificant in women. For men the regression equation was [Stature = (0.306 x SH)+137.9] (r = 0.54, SEE = 56.9, p < 0.0001). Sacrum height is not susceptible to sex, or to age in men. In the presence of incomplete male skeletons, SH helps to determine the stature. This study is also one of the initial applications of MDCT in virtual anthropometric research. (orig.)

  7. Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four-channel multidetector-row computed tomography

    International Nuclear Information System (INIS)

    Okumoto, Tadayuki; Yamada, Takayuki; Sato, Akihiro

    2009-01-01

    Accurate diagnosis of local invasion of hilar cholangiocarcinomas is challenging due to their small size and the anatomic complexity of the hepatic hilar region. On the other hand, the correct diagnosis of local invasion is essential for assuring the possibility of curative surgery. The purpose of this study was to evaluate the feasibility of four-channel multidetector-row computed tomography (MDCT) in the assessment of vascular and bile duct involvement, by which we could obtain useful information for the surgical management of hilar cholangiocarcinoma. The subjects were 18 patients for whom the extent of tumor invasion was surgically and pathologically confirmed. All patients underwent preoperative multiphasic CT scanning by MDCT. Arterial and portal dominant phases were acquired using a detector configuration of 1.25 mm x 4 mm, and both axial and multiplanar reconstructed images were interpreted. Longitudinal extension was evaluated up to second-order branches. Vascular invasion is considered to be the degree of tumor contiguity to the hepatic arteries and portal vein and was graded by CT. The longitudinal extension was correctly diagnosed in 14 patients (77.8%). Hepatic artery invasion was correctly diagnosed in 17 patients with sensitivity of 100% and specificity of 90%, respectively. Portal vein invasion was correctly diagnosed in 47 of 51 branches with sensitivity and specificity of 92.3% and 90.2%, respectively. Multiplanar reconstructed images contributed to the correct diagnosis for both vascular encasement and longitudinal tumor extension. In conclusion, MDCT is useful in preoperative evaluation of hilar cholangiocarcinoma, especially when combined with multiplanar reconstructed images. (author)

  8. Assessment of temporal resolution of multi-detector row computed tomography in helical acquisition mode using the impulse method.

    Science.gov (United States)

    Ichikawa, Katsuhiro; Hara, Takanori; Urikura, Atsushi; Takata, Tadanori; Ohashi, Kazuya

    2015-06-01

    The purpose of this study was to propose a method for assessing the temporal resolution (TR) of multi-detector row computed tomography (CT) (MDCT) in the helical acquisition mode using temporal impulse signals generated by a metal ball passing through the acquisition plane. An 11-mm diameter metal ball was shot along the central axis at approximately 5 m/s during a helical acquisition, and the temporal sensitivity profile (TSP) was measured from the streak image intensities in the reconstructed helical CT images. To assess the validity, we compared the measured and theoretical TSPs for the 4-channel modes of two MDCT systems. A 64-channel MDCT system was used to compare TSPs and image quality of a motion phantom for the pitch factors P of 0.6, 0.8, 1.0 and 1.2 with a rotation time R of 0.5 s, and for two R/P combinations of 0.5/1.2 and 0.33/0.8. Moreover, the temporal transfer functions (TFs) were calculated from the obtained TSPs. The measured and theoretical TSPs showed perfect agreement. The TSP narrowed with an increase in the pitch factor. The image sharpness of the 0.33/0.8 combination was inferior to that of the 0.5/1.2 combination, despite their almost identical full width at tenth maximum values. The temporal TFs quantitatively confirmed these differences. The TSP results demonstrated that the TR in the helical acquisition mode significantly depended on the pitch factor as well as the rotation time, and the pitch factor and reconstruction algorithm affected the TSP shape. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. Comparison of calcium scoring with 4-multidetector computed tomography (4-MDCT) and 64-MDCT: a phantom study.

    Science.gov (United States)

    Serafin, Zbigniew; Rusak, Grazyna; Strześniewski, Piotr; Laskowska, Katarzyna; Lasek, Władysław

    2012-01-01

    To determine differences in coronary artery calcium (CAC) measurement performed with the use of 2 generations of multidetector computed tomography (CT) scanners of the same manufacturer. Agatston Score (AS) and calcium mass (CM) were measured with a 4-row scanner (AS4 and CM4) and a 64-row scanner (AS64 and CM64) using a cardiac phantom with calcium inserts. The results of the AS measurements (mean ± SD) varied significantly between the equipment: 880.6 ± 30.1 (AS4) vs 586.5 ± 24.0 (AS64; P < 0.0001). The AS interscanner variability was 31.6% for the phantom and from 25.5% to 110.1% for particular inserts. Mean ± SD CM values were different as well: 192.8 ± 5.0 mg (CM4) vs 152.4 ± 2.6 mg (CM64; P < 0.0001). Determination of CM with 64-row CT was more accurate than that with an older scanner; the mean relative error was -9.1% and 15.0%, respectively (P < 0.0001). The CM interscanner variability was 23.3% for the phantom and from 19.0% to 122.8% for particular inserts. The interexamination variability ranged from 1.7% (CM64) to 5.6% (AS4). Coronary artery calcium scoring with the 64-row CT scanner is more accurate than with the 4-row device The difference between the results of AS and CM measurements carried out with both scanners is statistically significant.

  10. Influence of gating phase selection on the image quality of coronary arteries in multidetector row computed tomography

    International Nuclear Information System (INIS)

    Laskowska, K.; Marzec, M.; Serafin, Z.; Nawrocka, E.; Lasek, W.; WWisniewska-Szmyt, J.; Kubica, J.

    2005-01-01

    Motion artifacts caused by cardiac movement disturb the imaging of coronary arteries with multidetector-row spiral computed tomography. The aim of this study was to determine the phase of the heart rate which provides the best quality of coronary artery imaging in retrospective ECG-gated CT. Although 75% is usually the best reconstruction phase, the optimal phase should be established individually for the patient, artery, segment, and type of tomograph for the best imaging quality. Forty-five cardiac CT angiograms of 26 patients were retrospectively evaluated. The examinations were performed with a 4-detector-row tomograph. ECG-gated retrospective reconstructions were relatively delayed at 0%, 12.5%, 25%, 37.5%, 50%, 62.5%, 75%, and 87.5% of the cardiac cycle. Selected coronary arteries of the highest diagnostic quality were estimated in the eight phases of the cardiac cycle. Only arteries of very high image quality were selected for analysis: left coronary artery trunks (44 cases, incl. 37 stented), anterior interventricular branches (36, incl. 3 stented), circumflex branches (16), right coronary rtery branches (23), and posterior interventricular branches (4). The reconstruction phase had a statistically significant impact on the quality of imaging (p < 0.0003). Depending on the case, optimal imaging was noted in various phases, except in the 12.5 % phase. The 75% phase appeared to be the best of all those examined (p < 0.05), both in the group of arteries without stents (p < 0.0006) and in those stented (p < 0.05). In some cases of repeated examinations the best phases differed within the same patient. (author)

  11. Denver screening protocol for blunt cerebrovascular injury reduces the use of multi-detector computed tomography angiography.

    Science.gov (United States)

    Beliaev, Andrei M; Barber, P Alan; Marshall, Roger J; Civil, Ian

    2014-06-01

    Blunt cerebrovascular injury (BCVI) occurs in 0.2-2.7% of blunt trauma patients and has up to 30% mortality. Conventional screening does not recognize up to 20% of BCVI patients. To improve diagnosis of BCVI, both an expanded battery of screening criteria and a multi-detector computed tomography angiography (CTA) have been suggested. The aim of this study is to investigate whether the use of CTA restricted to the Denver protocol screen-positive patients would reduce the unnecessary use of CTA as a pre-emptive screening tool. This is a registry-based study of blunt trauma patients admitted to Auckland City Hospital from 1998 to 2012. The diagnosis of BCVI was confirmed or excluded with CTA, magnetic resonance angiography and, if these imaging were non-conclusive, four-vessel digital subtraction angiography. Thirty (61%) BCVI and 19 (39%) non-BCVI patients met eligibility criteria. The Denver protocol applied to our cohort of patients had a sensitivity of 97% (95% confidence interval (CI): 83-100%) and a specificity of 42% (95% CI: 20-67%). With a prevalence of BCVI in blunt trauma patients of 0.2% and 2.7%, post-test odds of a screen-positive test were 0.03 (95% CI: 0.002-0.005) and 0.046 (95% CI: 0.314-0.068), respectively. Application of the CTA to the Denver protocol screen-positive trauma patients can decrease the use of CTA as a pre-emptive screening tool by 95-97% and reduces its hazards. © 2013 Royal Australasian College of Surgeons.

  12. Usefulness and safety of propranolol injection into vein for acquisition of coronary multidetector-row computed tomography

    International Nuclear Information System (INIS)

    Sekine, Takako; Kodama, Takahide; Kondo, Takeshi

    2010-01-01

    A low heart rate (HR), associated with a prolonged slow filling phase (SF), is necessary to obtain a high quality coronary CT at a low radiation dose with conventional 64 multidetector-row computed tomography (MDCT). The purpose of our study was to confirm the safety of injecting propranolol (2-10 mg) into the vein for lowering heart rate in patients requiring MDCT and to document the effect of the drug on HR, PQ and SF. Of 1290 consecutive patients who were initially considered for enrollment in the coronary MDCT study, 40 patients with atrial fibrillations, 3 with atrial flutters, and 13 with artificial pacemakers were excluded. Of the remaining 1234 patients (M/F=714/520), 331 had already taken an oral beta-blocker before the CT examination, and were included in the study. In patients with no contraindications, propranolol was aggressively injected (2-10 mg) into the vein to reduce the HR. In patients not taking an oral beta blocker, 2 mg propranolol reduced the HR by -10±5 bpm and 10 mg, by -20±7 bpm. However, in patients taking an oral beta-blocker, the decrease in HR by propranolol was minimal (2 mg, -6±4 bpm; 10 mg, -10±6 bpm). Propranolol significantly prolonged the PQ interval (from 169±27 to 179±29 ms, P<0.0001), and SF (from 125±69 to 264±79 ms, P<0.0001). Adverse effects of propranolol injection were observed in only 3 [2 mild hypotension and 1 paroxysmal atrial fibrillation (recovered to sinus rhythm by DC counter shock)] of 3212 patients. All 3 patients became stable after 1 or 2 hours of rest and could return home. Propranolol injection was a relatively safe and useful method to reduce HR and prolong SF, necessary for obtaining high quality coronary MDCT with a low radiation dose. (author)

  13. Total body height estimation using sacrum height in Anatolian Caucasians: multidetector computed tomography-based virtual anthropometry

    International Nuclear Information System (INIS)

    Karakas, Hakki Muammer; Celbis, Osman; Harma, Ahmet; Alicioglu, Banu

    2011-01-01

    Estimation of total body height is a major step when a subject has to be identified from his/her skeletal structures. In the presence of decomposed skeletons and missing bones, estimation is usually based on regression equation for intact long bones. If these bones are fragmented or missing, alternative structures must be used. In this study, the value of sacrum height (SH) in total body height (TBH) estimation was investigated in a contemporary population of adult Anatolian Caucasians. Sixty-six men (41.6 ± 14.9 years) and 43 women (41.1 ± 14.2 years) were scanned with 64-row multidetector computed tomography (MDCT) to obtain high-resolution anthropometric data. SH of midsagittal sections was electronically measured. The technique and methodology were validated on a standard skeletal model. Sacrum height was 111.2 ± 12.6 mm (77-138 mm) in men and 104.7 ± 8.2 (89-125 mm) in women. The difference between the two sexes regarding SH was significant (p < 0.0001). SH did not significantly correlate with age in men, whereas the correlation was significant in women (p < 0.03). The correlation between SH and the stature was significant in men (r = 0.427, p < 0.0001) and was insignificant in women. For men the regression equation was [Stature = (0.306 x SH)+137.9] (r = 0.54, SEE = 56.9, p < 0.0001). Sacrum height is not susceptible to sex, or to age in men. In the presence of incomplete male skeletons, SH helps to determine the stature. This study is also one of the initial applications of MDCT in virtual anthropometric research. (orig.)

  14. Visual vs Fully Automatic Histogram-Based Assessment of Idiopathic Pulmonary Fibrosis (IPF) Progression Using Sequential Multidetector Computed Tomography (MDCT)

    Science.gov (United States)

    Colombi, Davide; Dinkel, Julien; Weinheimer, Oliver; Obermayer, Berenike; Buzan, Teodora; Nabers, Diana; Bauer, Claudia; Oltmanns, Ute; Palmowski, Karin; Herth, Felix; Kauczor, Hans Ulrich; Sverzellati, Nicola

    2015-01-01

    Objectives To describe changes over time in extent of idiopathic pulmonary fibrosis (IPF) at multidetector computed tomography (MDCT) assessed by semi-quantitative visual scores (VSs) and fully automatic histogram-based quantitative evaluation and to test the relationship between these two methods of quantification. Methods Forty IPF patients (median age: 70 y, interquartile: 62-75 years; M:F, 33:7) that underwent 2 MDCT at different time points with a median interval of 13 months (interquartile: 10-17 months) were retrospectively evaluated. In-house software YACTA quantified automatically lung density histogram (10th-90th percentile in 5th percentile steps). Longitudinal changes in VSs and in the percentiles of attenuation histogram were obtained in 20 untreated patients and 20 patients treated with pirfenidone. Pearson correlation analysis was used to test the relationship between VSs and selected percentiles. Results In follow-up MDCT, visual overall extent of parenchymal abnormalities (OE) increased in median by 5 %/year (interquartile: 0 %/y; +11 %/y). Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram. Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Δ) in OE and Δ 40th percentile (r=0.69; phistogram analysis at one year follow-up of IPF patients, whether treated or untreated: Δ 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Δ 80th percentile might reveal the course of reticular opacities. PMID:26110421

  15. Multidetector-row computed tomography for evaluating the branching angle of the celiac artery: a descriptive study

    International Nuclear Information System (INIS)

    Tokue, Hiroyuki; Tokue, Azusa; Tsushima, Yoshito

    2012-01-01

    We performed this study in order to investigate the shape of the origin of the celiac artery in maximum intensity projection (MIP) using routine 64 multidetector-row computed tomography (MDCT) data in order to plan for the implantation of an intra-arterial hepatic port system. A total of 1,104 patients with hepatocellular carcinoma were assessed with MDCT. In the definition of the branching angle, the anterior side of the abdominal aorta was considered the baseline, and the cranial and caudal sides were designated as 0 and 180 degrees, respectively. The angles between 0 and 90 degrees and between 90 and 180 degrees from the cranial side were considered upward and downward, respectively, and the branching angle of the celiac artery was classified every 30 degrees. The subclavian arterial route was used for the implantation of an intra-arterial hepatic port system in patients with branching angles of 150 degrees or more (sharp downward). The median branching angle was (median ± standard deviation) 135 ± 23 (range, 51–174) degrees. The branching was upward in 77 patients (7%) and downward in 1,027 patients (93%). The branching was downward with an angle of 120 to150 degrees in most patients (n = 613). The branching was sharply downward with an angle of 150 degrees or more in 177 patients (16%). A total of 10 patients were referred for interventional placement of an intra-arterial hepatic port system. The subclavian arterial route was used for implantation of an intra-arterial hepatic port system in 2 patients with sharp downward branching. The branching angle of the celiac artery can be easily determined by the preparation of MIP images from routine MDCT data. MIP may provide useful information for the selection of the catheter insertion route in order to avoid a sharp branching angle of the celiac artery

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

    International Nuclear Information System (INIS)

    Wiesner, Walter; Hauser, Andreas; Steinbrich, Wolfgang

    2004-01-01

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

  17. Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects.

    Science.gov (United States)

    Sakai, Toshinori; Sairyo, Koichi; Takao, Shoichiro; Nishitani, Hiromu; Yasui, Natsuo

    2009-10-01

    Epidemiological analysis using CTs. To investigate the true incidence of lumbar spondylolysis in the general population in Japan. Although there have been several reports on the incidence of lumbar spondylolysis, they had some weakness. One of them concerns the subjects investigated, because the incidence of lumbar spondylolysis varies considerably, and some patients are asymptomatic. In addition, most of the past studies used plain radiograph films or skeletal investigation. Therefore, the past reported incidence may not correspond to that of the general population. We reviewed the computed tomography (CT) scans of 2000 subjects (age: 20-92 years) who had undergone abdominal and pelvic CT on a single multidetector CT scanner for reasons unrelated to low back pain. We reviewed them for spondylolysis, spondylolytic spondylolisthesis, and spina bifida occulta (SBO) in the lumbosacral region. The grade (I-IV) of spondylolisthesis was measured using midsagittal reconstructions. Lumbar spondylolysis was found in 117 subjects (5.9%). Their male-female ratio was 2:1. Multiple-level spondylolysis was found in 5 subjects (0.3%). Among these 117 subjects, there were 124 vertebrae with spondylolysis. Of them, 112 (90.3%) corresponded to L5, and 26 (21.0%) had unilateral spondylolysis.SBO was found in 154 subjects. Of them, 25 had spondylolysis (16.2%), whereas, in 1846 subjects without SBO, 92 had spondylolysis (5.0%). The incidence of spondylolysis among the patients with SBO was significantly higher than that in subjects without SBO (Odd ratio was 3.7-fold).Of 124 vertebrae with spondylolysis, 75 (60.5%) showed low-grade (Meyerding grade I or II) spondylolisthesis, and no subject presented high-grade spondylolisthesis. Spondylolisthesis was found in 74.5% of the subjects with bilateral spondylolysis, and in 7.7% of those with unilateral spondylolysis. The incidence of lumbar spondylolysis in the Japanese general population was 5.9% (males: 7.9%, females: 3.9%).

  18. [Study of anatomy of the lateral attachment of the renal fascia in adult with multidetector computed tomography].

    Science.gov (United States)

    Qi, Rui; Zhou, Xianping; Yu, Jianqun; Chen, Weixia; Li, Zhenlin; Zhang, Chunle

    2012-08-01

    The present paper is aimed to observe the lateral attachment of the renal fascia (RF) in vivo with multidetector computed tomography (MDCT) scanning, and to discuss its diagnostic value. 121 healthy adults were adopted into this experiment. All images were obtained with MDCT and double phase enhancement scanning. Then we observed the lateral attachment of RF. In addition, we mad a fresh body specimen as anatomical basis. The study found that above the renal hilar plane (RHP), the anterior renal fascia laterally fused with the peritoneum of the liver on the right and the peritoneum of the spleen on the left,and the posterior renal fascia fused with the subdiaphragmatic fascia. The lateral attachment of the RF at the RHP and the lower renal pole(LRP)is divided into three types. The RF in Type I is about 47.9% (58/121) at the left RHP, while about 33.9% (41/121) at the right RHP. At the LRP of the kidney is about 55.3% (67/121) on the left, and about 42.1% (51/121) on the right. The RF in Type I is about 38.8% (47/121) on the left side at the RHP, about 26.4% (32/121) on the right side. At the LRP, left side about 27.3% (33/121), right side about 13.3%(16/121). The RF in Type III at the RHP is 13.3% (16/121) on the left side, and on the right side is about 39.7% (48/121). At the LRP, it is about 17.4% (21/121) on the left side, and about 44.6% (54/121) on the right side. MDCT can display the lateral attachment of the RF better as well as the outside connection of the retroperitoneal space.

  19. Multidetector-row computed tomography for evaluating the branching angle of the celiac artery: a descriptive study

    Directory of Open Access Journals (Sweden)

    Tokue Hiroyuki

    2012-12-01

    Full Text Available Abstract Background We performed this study in order to investigate the shape of the origin of the celiac artery in maximum intensity projection (MIP using routine 64 multidetector-row computed tomography (MDCT data in order to plan for the implantation of an intra-arterial hepatic port system. Methods A total of 1,104 patients with hepatocellular carcinoma were assessed with MDCT. In the definition of the branching angle, the anterior side of the abdominal aorta was considered the baseline, and the cranial and caudal sides were designated as 0 and 180 degrees, respectively. The angles between 0 and 90 degrees and between 90 and 180 degrees from the cranial side were considered upward and downward, respectively, and the branching angle of the celiac artery was classified every 30 degrees. The subclavian arterial route was used for the implantation of an intra-arterial hepatic port system in patients with branching angles of 150 degrees or more (sharp downward. Results The median branching angle was (median ± standard deviation 135 ± 23 (range, 51–174 degrees. The branching was upward in 77 patients (7% and downward in 1,027 patients (93%. The branching was downward with an angle of 120 to150 degrees in most patients (n = 613. The branching was sharply downward with an angle of 150 degrees or more in 177 patients (16%. A total of 10 patients were referred for interventional placement of an intra-arterial hepatic port system. The subclavian arterial route was used for implantation of an intra-arterial hepatic port system in 2 patients with sharp downward branching. Conclusions The branching angle of the celiac artery can be easily determined by the preparation of MIP images from routine MDCT data. MIP may provide useful information for the selection of the catheter insertion route in order to avoid a sharp branching angle of the celiac artery.

  20. Accessory Renal Artery Stenosis and Hypertension: Are These Correlated? Evaluation Using Multidetector-Row Computed Tomographic Angiography

    International Nuclear Information System (INIS)

    Saba, L.; Sanfilippo, R.; Montisci, R.; Conti, M.; Mallarini, G.

    2008-01-01

    Background: Renal artery stenosis may produce hypertension, and this condition is referred to as renovascular hypertension (RVH). Purpose: To evaluate, by using multidetector-row spiral computed tomographic angiography (MDCTA), whether a relationship between accessory renal artery stenosis and hypertension may be hypothesized. Material and Methods: 214 patients (142 males, 72 females; mean age 66 years) who had previously undergone an MDCTA to study the abdominal vasculature were retrospectively studied. Patients with renal artery stenosis (RAS) were excluded from this analysis. The patients were studied by means of a four-detector-row CT, and scans were obtained after intravenous bolus administration of 110-140 ml of a nonionic contrast material with a 3-6 ml/s flow rate. As a second step, by means of statistical analysis, hypertension data were compared with findings of accessory artery stenosis. Two radiologists first independently reviewed the MDCTA images and then, in case of disagreement, in consensus. Interobserver agreement was calculated for all measurements. Results: The overall number of detected accessory renal arteries was 74 in 56 of the 214 patients. Accessory renal artery stenosis was detected in 21 of the 56 patients. There was a difference in the prevalence of hypertension between patients with (n = 21) and without (n = 35) accessory renal artery stenosis (P = 0.0187). Interobserver agreement was good (kappa value 0.733). Conclusion: Any statistical association between the presence of accessory renal artery stenosis and hypertension could not be disclosed. However, accessory renal artery stenosis, detected by MDCTA, is an important pathological sign that the radiologist has to assess in the light of its possible association with hypertension

  1. Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists.

    Science.gov (United States)

    Neubauer, Jakob; Benndorf, Matthias; Reidelbach, Carolin; Krauß, Tobias; Lampert, Florian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Fiebich, Martin; Goerke, Sebastian M

    2016-01-01

    To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging. Three raters independently evaluated the resulting images for fractures and the level of confidence for each finding. Gold standard was evaluated by consensus reading of a high-dose MDCT. Pooled sensitivity was higher in RED-MDCT with 0.89 and RED-MDCT with 0.81 compared to radiography with 0.54 (P = radiography (P radiography. Readers are more confident in their reporting with the cross sectional modalities. Dose equivalent cross sectional computed tomography of the wrist could replace plain radiography for fracture diagnosis in the long run.

  2. Left atrial passive emptying function is preserved in patients with permanent atrial fibrillation--a 320-slice multidetector computed tomography study

    DEFF Research Database (Denmark)

    Agner, Bue Fridolin Ross; Kühl, Jørgen Tobias; Kofoed, Klaus Fuglsang

    2014-01-01

    OBJECTIVE: Left atrial (LA) mechanical function is thought to be virtually inexistent in patients with permanent atrial fibrillation (AF). Due to recent advances in multidetector computed tomography (MDCT) technology, it is now possible to acquire images of the entire heart in a single heartbeat....... The objective of this study was to compare individual components of LA function assessed by MDCT in patients with permanent AF and patients in sinus rhythm (SR). METHODS: 320-slice MDCT was performed in 30 patients with permanent AF. Measurements of LA volumes during the cardiac cycle were compared to 30......; 71 vs. 30 ml/m(2), p permanent AF have significantly increased LA volumes throughout the cardiac...

  3. Effect of field-of-view size on gray values derived from cone-beam computed tomography compared with the Hounsfield unit values from multidetector computed tomography scans.

    Science.gov (United States)

    Shokri, Abbas; Ramezani, Leila; Bidgoli, Mohsen; Akbarzadeh, Mahdi; Ghazikhanlu-Sani, Karim; Fallahi-Sichani, Hamed

    2018-03-01

    This study aimed to evaluate the effect of field-of-view (FOV) size on the gray values derived from conebeam computed tomography (CBCT) compared with the Hounsfield unit values from multidetector computed tomography (MDCT) scans as the gold standard. A radiographic phantom was designed with 4 acrylic cylinders. One cylinder was filled with distilled water, and the other 3 were filled with 3 types of bone substitute: namely, Nanobone, Cenobone, and Cerabone. The phantom was scanned with 2 CBCT systems using 2 different FOV sizes, and 1 MDCT system was used as the gold standard. The mean gray values (MGVs) of each cylinder were calculated in each imaging protocol. In both CBCT systems, significant differences were noted in the MGVs of all materials between the 2 FOV sizes ( P <.05) except for Cerabone in the Cranex3D system. Significant differences were found in the MGVs of each material compared with the others in both FOV sizes for each CBCT system. No significant difference was seen between the Cranex3D CBCT system and the MDCT system in the MGVs of bone substitutes on images obtained with a small FOV. The size of the FOV significantly changed the MGVs of all bone substitutes, except for Cerabone in the Cranex3D system. Both CBCT systems had the ability to distinguish the 3 types of bone substitutes based on a comparison of their MGVs. The Cranex3D CBCT system used with a small FOV had a significant correlation with MDCT results.

  4. Evaluation of left ventricular function and volume with multidetector-row computed tomography. Comparison with electrocardiogram-gated single photon emission computed tomography

    International Nuclear Information System (INIS)

    Suzuki, Takeya; Yamashina, Shohei; Nanjou, Shuji; Yamazaki, Junichi

    2007-01-01

    This study compared left ventricular systolic function and volume determined by multidetector-row computed tomography (MDCT) and electrocardiogram-gated single photon emission computed tomography (G-SPECT) Thirty-seven patients with coronary artery disease and non-cardiovascular disease underwent MDCT. In this study, left ventricular ejection fraction (EF), left ventricular end-diastolic volume (EDV) and left ventricular end-systolic volume (ESV) were calculated using only two-phase imaging with MDCT. Left ventricular function and volume were compared using measurements from G-SPECT. We conducted MDCT and G-SPECT virtually simultaneously. Both the EF and ESV evaluated by MDCT closely correlated with G-SPECT (r=0.763, P 65 bpm) during MDCT significantly influenced the difference in EF calculated from MDCT and G-SPECT (P<0.05). Left ventricular function can be measured with MDCT as well as G-SPECT. However, a heart rate over 65 bpm during MDCT negatively affects the EF correlation between MDCT and G-SPECT. (author)

  5. Minimizing Contrast Medium Doses to Diagnose Pulmonary Embolism with 80-kVp Multidetector Computed Tomography in Azotemic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Holmquist, F. (Dept. of Diagnostic Radiology, Malmoe Univ. Hospital, Univ. of Lund, Malmoe (Sweden)); Hansson, K.; Pasquariello, F. (Dept. of Internal Medicine, Lasarettet Trelleborg, Univ. of Lund, Trelleborg (Sweden)); Bjoerk, J. (Competence Center for Clinical Research, Univ. Hospital, Univ. of Lund, Lund (Sweden)); Nyman, U. (Dept. of Radiology, Lasarettet Trelleborg, Univ. of Lund, Trelleborg (Sweden))

    2009-02-15

    Background: In diagnosing acute pulmonary embolism (PE) in azotemic patients, scintigraphy and magnetic resonance imaging are frequently inconclusive or not available in many hospitals. Computed tomography is readily available, but relatively high doses (30-50 g I) of potentially nephrotoxic iodine contrast media (CM) are used. Purpose: To report on the diagnostic quality and possible contrast-induced nephropathy (CIN) after substantially reduced CM doses to diagnose PE in azotemic patients using 80-peak kilovoltage (kVp) 16-row multidetector computed tomography (MDCT) combined with CM doses tailored to body weight, fixed injection duration adapted to scan time, automatic bolus tracking, and saline chaser. Material and Methods: Patients with estimated glomerular filtration rate (eGFR) <50 ml/min were scheduled to undergo 80-kVp MDCT using 200 mg I/kg, and those with eGFR =50 ml/min, 120-kVp MDCT with 320 mg I/kg. Both protocols used an 80-kg maximum dose weight and a fixed 15-s injection time. Pulmonary artery density and contrast-to-noise ratio were measured assuming 70 Hounsfield units (HU) for a fresh clot. CIN was defined as a plasma creatinine rise >44.2 mumol/l from baseline. Results: 89/148 patients (63/68 females) underwent 80-/120-kVp protocols, respectively, with 95% of the examinations being subjectively excellent or adequate. Mean values in the 80-/120-kVp cohorts regarding age were 82/65 years, body weight 66/78 kg, effective mAs 277/117, CM dose 13/23 g I, pulmonary artery density 359/345 HU, image noise (1 standard deviation) 24/21 HU, contrast-to-noise ratio 13/13, and dose-length product 173/258 mGycm. Only 1/65 and 2/119 patients in the 80- and 120-kVp cohorts, respectively, with negative CT and no anticoagulation suffered non-fatal thromboembolism during 3-month follow-up. No patient developed CIN. Conclusion: 80-kVp 16-row MDCT with optimization of injection parameters may be performed with preserved diagnostic quality, using markedly reduced CM

  6. Computer-aided detection of lung nodules on multidetector CT in concurrent-reader and second-reader modes: A comparative study

    International Nuclear Information System (INIS)

    Matsumoto, Sumiaki; Ohno, Yoshiharu; Aoki, Takatoshi; Yamagata, Hitoshi; Nogami, Munenobu; Matsumoto, Keiko; Yamashita, Yoshiko; Sugimura, Kazuro

    2013-01-01

    Purpose: To compare the reading times and detection performances of radiologists in concurrent-reader and second-reader modes of computer-aided detection (CAD) for lung nodules on multidetector computed tomography (CT). Materials and Methods: Fifty clinical multidetector CT datasets containing nodules up to 20 mm in diameter were retrospectively collected. For the detection and rating of non-calcified nodules larger than 4 mm in diameter, 6 radiologists (3 experienced radiologists and 3 resident radiologists) independently interpreted these datasets twice, once with concurrent-reader CAD and once with second-reader CAD. The reference standard of nodules in the datasets was determined by the consensus of two experienced chest radiologists. The reading times and detection performances in the two modes of CAD were statistically compared, where jackknife free-response receiver operating characteristic (JAFROC) analysis was used for the comparison of detection performances. Results: Two hundreds and seven nodules constituted the reference standard. Reading time was significantly shorter in the concurrent-reader mode than in the second-reader mode, with the mean reading time for the 6 radiologists being 132 s with concurrent-reader CAD and 210 s with second-reader CAD (p < 0.01). JAFROC analysis revealed no significant difference between the detection performances in the two modes, with the average figure-of-merit value for the 6 radiologists being 0.70 with concurrent-reader CAD and 0.72 with second-reader CAD (p = 0.35). Conclusion: In CAD for lung nodules on multidetector CT, the concurrent-reader mode is more time-efficient than the second-reader mode, and there can be no significant difference between the two modes in terms of detection performance of radiologists

  7. Renal replacement lipomatosis: multidetector-row computed tomography findings in one case

    International Nuclear Information System (INIS)

    Calisir, C.; Can, C.; Kebapci, M.

    2007-01-01

    Replacement lipomatosis of the kidney is the result of severe atrophy of the renal parenchyma often caused by chronic calculus disease with secondary marked benign proliferation of fibrofatty tissue replacing atrophied renal parenchyma. Different radiological modalities have been used to illustrate this entity, with magnetic resonance imaging, ultrasound, intravenous pyelogram, and computed tomography (CT) used most frequently. We report multidedector CT (MDCT) findings of replacement lipomatosis in a 50-year-old woman. We think that it accurately provides a complete one-step diagnostic workup and appropriate pre-surgical planning for patients for whom there is a suspicion of replacement lipomatosis

  8. Findings in multidetector computed tomography in the diagnosis of hepatocellular carcinoma in patients with cirrhosis and correlation with pathology of liver explants

    International Nuclear Information System (INIS)

    Haberman, D.; Castignola, M.; Mela, M.; Paladini, H.; Santilli, J.P.; Gruz, F.; Gondolesi, G.

    2013-01-01

    Objectives: To describe the imagenological behavior of hepatocellular carcinoma in cirrhotic patients using a dynamic multidetector computed tomography (MDCT) technique, and correlate these findings with histological tumor grades. Materials and methods: A retrospective, descriptive observational study was conducted to evaluate 51 nodules in 32 liver transplant patients diagnosed with liver cirrhosis. The pathology of liver explants was used as a reference. Nodules with hepatocellular carcinoma histopathology were retrospectively analyzed by computed tomography scans performed pre-transplant. Using a dynamic multidetector computed tomography technique, we evaluated the most common imagenological behavior reported in the literature: arterial enhancement, washout, capsule, and intratumoral arterial vessels. Results: Forty-six of 51 (90%) tumors showed arterial enhancement. Of the 46 tumors with arterial enhancement, 39 (85%) had washout in portal-late phase. Five of 51 (10%) were hypovascular. Twenty-two of 51 (43%) had capsule and 12 of 51 (24%) showed intratumoral arterial vessels. The more frequent image combination was the combination of arterial enhancement and washout (39 of 51 tumors or 76%). The most frequent histological grade was II (35 of 51 tumors or 69%). Statistically significant relationships were found between histological grade tumors and imagenological behavior: arterial enhancement and hypovascular. Conclusion: In our population, arterial enhancement with washout in portal-late phases was observed in most of the tumors. Our results are consistent with previously reported studies, demonstrating the high reliability of this imaging pattern for the diagnosis of hepatocellular carcinoma. (authors) [es

  9. Effect of computer-aided detection as a second reader in multidetector-row CT colonography

    International Nuclear Information System (INIS)

    Mang, Thomas; Peloschek, Philipp; Plank, Christina; Maier, Andrea; Weber, Michael; Herold, Christian; Schima, Wolfgang; Graser, Anno; Bogoni, Luca

    2007-01-01

    Our purpose was to assess the effect of computer-aided detection (CAD) on lesion detection as a second reader in computed tomographic colonography, and to compare the influence of CAD on the performance of readers with different levels of expertise. Fifty-two CT colonography patient data-sets (37 patients: 55 endoscopically confirmed polyps ≥0.5 cm, seven cancers; 15 patients: no abnormalities) were retrospectively reviewed by four radiologists (two expert, two nonexpert). After primary data evaluation, a second reading augmented with findings of CAD (polyp-enhanced view, Siemens) was performed. Sensitivities and reading time were calculated for each reader without CAD and supported by CAD findings. The sensitivity of expert readers was 91% each, and of nonexpert readers, 76% and 75%, respectively, for polyp detection. CAD increased the sensitivity of expert readers to 96% (P = 0.25) and 93% (P = 1), and that of nonexpert readers to 91% (P = 0.008) and 95% (P = 0.001), respectively. All four readers diagnosed 100% of cancers, but CAD alone only 43%. CAD increased reading time by 2.1 min (mean). CAD as a second reader significantly improves sensitivity for polyp detection in a high disease prevalence population for nonexpert readers. CAD causes a modest increase in reading time. CAD is of limited value in the detection of cancer. (orig.)

  10. Simple area-based measurement for multidetector computed tomography to predict left ventricular size

    International Nuclear Information System (INIS)

    Schlett, Christopher L.; Kwait, Dylan C.; Mahabadi, Amir A.; Hoffmann, Udo; Bamberg, Fabian; O'Donnell, Christopher J.; Fox, Caroline S.

    2010-01-01

    Measures of left ventricular (LV) mass and dimensions are independent predictors of morbidity and mortality. We determined whether an axial area-based method by computed tomography (CT) provides an accurate estimate of LV mass and volume. A total of 45 subjects (49% female, 56.0 ± 12 years) with a wide range of LV geometry underwent contrast-enhanced 64-slice CT. LV mass and volume were derived from 3D data. 2D images were analysed to determine LV area, the direct transverse cardiac diameter (dTCD) and the cardiothoracic ratio (CTR). Furthermore, feasibility was confirmed in 100 Framingham Offspring Cohort subjects. 2D measures of LV area, dTCD and CTR were 47.3 ± 8 cm 2 , 14.7 ± 1.5 cm and 0.54 ± 0.05, respectively. 3D-derived LV volume (end-diastolic) and mass were 148.9 ± 45 cm 3 and 124.2 ± 34 g, respectively. Excellent inter- and intra-observer agreement were shown for 2D LV area measurements (both intraclass correlation coefficients (ICC) = 0.99, p 0.27). Compared with traditionally used CTR, LV size can be accurately predicted based on a simple and highly reproducible axial LV area-based measurement. (orig.)

  11. Multidetector Computed Tomography (MDCT in Gastrointestinal Obstruction: One Symptom Myriad Differentials

    Directory of Open Access Journals (Sweden)

    Geetika Sindhwani

    2017-10-01

    Full Text Available Introduction: Computed Tomography (CT is a highly sensitive modality with its multi-planar capabilities, used in evaluation of acute cases of intestinal obstruction. It delineates the level and helps to identify various etiologies of obstruction, where plain radiographs can only suggest signs of obstruction. It has an added advantage of detecting further complications, thus framing appropriate surgical approach. Aim: Our study aims at delineating variable CT spectrum of intestinal obstruction with highlight on atypical presentation. Materials and Methods: Retrospective hospital data based study was conducted in the Radiology Department of Shree Krishna Hospital, Anand, Gujarat, India, between 2014-2017 including 40 patients with mechanical causes of obstruction and excluding patients with non-mechanical causes of obstruction. Statistical analysis was done using percentages and proportions using MedCalc software version 17.6. Results: The age range of patients was from 5 days to 83 years and the maximum number of patients i.e., 7 (17.5% were in the age group of 41-50 years. Radiographic signs related to obstruction like air fluid levels, dilated bowel loops was seen in 26 out of 40 cases (sensitivity 60%. Small bowel obstruction dominated the case list with obstructed hernia as major causative factor. Conclusion: Study highlights the contribution of MDCT in early identification of underlying etiology and complications of obstruction with additional contribution in road mapping and framing appropriate and individualized treatment strategy for patients.

  12. Multidetector row computed tomography and ultrasound characteristics of caudal vena cava duplication in dogs.

    Science.gov (United States)

    Bertolini, Giovanna; Diana, Alessia; Cipone, Mario; Drigo, Michele; Caldin, Marco

    2014-01-01

    Caudal vena cava duplication has been rarely reported in small animals. The purpose of this retrospective study was to describe characteristics of duplicated caudal vena cava in a large group of dogs. Computed tomography (CT) and ultrasound databases from two hospitals were searched for canine reports having the diagnosis "double caudal vena cava." One observer reviewed CT images for 71 dogs and two observers reviewed ultrasound images for 21 dogs. In all CT cases, the duplication comprised two vessels that were bilaterally symmetrical and approximately the same calibre (similar to Type I complete duplication in humans). In all ultrasound cases, the duplicated caudal vena cava appeared as a distinct vessel running on the left side of the abdominal segment of the descending aorta and extending from the left common iliac vein to the left renal vein. The prevalence of caudal vena cava duplication was 0.46% for canine ultrasound studies and 2.08% for canine CT studies performed at these hospitals. Median body weight for affected dogs was significantly lower than that of unaffected dogs (P dogs, caudal vena cava duplication should be differentiated from other vascular anomalies when planning surgeries and for avoiding misdiagnoses. © 2014 American College of Veterinary Radiology.

  13. Analysis of Complex Coronary Plaque in Multidetector Computed Tomography: Comparison with Conventional Coronary Angiography

    International Nuclear Information System (INIS)

    Kim, Dong Hyun; Bang, Duck Won; Cho, Yoon Haeng; Suk, Eun Ha

    2011-01-01

    To delineate complex plaque morphology in patients with stable angina using coronary computed tomographic angiography (CTA). 36 patients with complex plaques proven by conventional coronary angiography (CAG), who had taken CTA for evaluation of typical angina, were enrolled in this study. Intravascular ultrasonography (IVUS) was performed in 14 patients (16 lesions). We compared CTA with CAG for plaque features and analyzed vascular cutoff, intraluminal filling defect in a patent vessel, irregularity of plaque, and ulceration. Also, the density of plaque was evaluated on CTA. CAG and CTA showed complex morphology in 44 cases (100%) and 34 cases, (77%), respectively, with features including abrupt vessel cutoff (27 vs. 16%, κ=0.57), intraluminal filling defect (32 vs. 30%, κ=0.77), irregularity (75 vs. 52%, κ=0.52), and ulceration (16 vs. 11%, κ=0.60). CTA indicated that the complex lesions were hypodense (mean 66 ± 21 Houndsfield Units). CTA is a very accurate and useful non-invasive imaging modality for evaluating complex plaque in patients with typical angina.

  14. Analysis of Complex Coronary Plaque in Multidetector Computed Tomography: Comparison with Conventional Coronary Angiography

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    Kim, Dong Hyun [Dept. of Radiology, Soonchunhyang University Hospital, Bucheon (Korea, Republic of); Bang, Duck Won; Cho, Yoon Haeng [Dept. of Internal Medicine, Soonchunhyang University Hospital, Bucheon (Korea, Republic of); Suk, Eun Ha [Dept. of Anesthyesiology and Pain Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2011-04-15

    To delineate complex plaque morphology in patients with stable angina using coronary computed tomographic angiography (CTA). 36 patients with complex plaques proven by conventional coronary angiography (CAG), who had taken CTA for evaluation of typical angina, were enrolled in this study. Intravascular ultrasonography (IVUS) was performed in 14 patients (16 lesions). We compared CTA with CAG for plaque features and analyzed vascular cutoff, intraluminal filling defect in a patent vessel, irregularity of plaque, and ulceration. Also, the density of plaque was evaluated on CTA. CAG and CTA showed complex morphology in 44 cases (100%) and 34 cases, (77%), respectively, with features including abrupt vessel cutoff (27 vs. 16%, {kappa}=0.57), intraluminal filling defect (32 vs. 30%, {kappa}=0.77), irregularity (75 vs. 52%, {kappa}=0.52), and ulceration (16 vs. 11%, {kappa}=0.60). CTA indicated that the complex lesions were hypodense (mean 66 {+-} 21 Houndsfield Units). CTA is a very accurate and useful non-invasive imaging modality for evaluating complex plaque in patients with typical angina.

  15. Assessment and diagnosis of acute bowel ischemia with multidetector computed tomography (MDCT)

    International Nuclear Information System (INIS)

    Sojka, B.; Gieszczyk-Paraniak, B.; Gibinska, J.; Konopka, M.

    2008-01-01

    Acute bowel ischemia (ABT) is a life-threatening condition which most often effects elderly patients. It requires an intensive treatment and quick diagnosis. Unfortunately ABI manifested not only by specific but also various nonspecific clinical or laboratory finding. The radiological symptoms of the bowel ischemia are also differentiated and often nonspecific while the specific findings are rather uncommon.That is why the knowledge of the bowel ischemia pathogenesis and possible CT findings is so important for the correct diagnosis. The our paper, we present the radiological findings of the acute bowel ischemia based on the analysis of the patients' abdominal -CT examination. The purpose of our study is to MDCT in patients with acute bowel ischemia. The material of this study consists of four computer tomography examinations - three of those an angio-CT and one abdominal - in patients with acute abdomen symptoms. The result revealed the mesenteric thrombosis in two cases, and mesenteric artery stenosis in one case. In one case, the thrombus was present in the abdominal aorta. In conclusion, we claim that the MDCT should be the modality of choice for the diagnosis of the acute bowel ischemia. (author)

  16. Distribution of Mitral Annular and Aortic Valve Calcium as Assessed by Unenhanced Multidetector Computed Tomography.

    Science.gov (United States)

    Koshkelashvili, Nikoloz; Codolosa, Jose N; Goykhman, Igor; Romero-Corral, Abel; Pressman, Gregg S

    2015-12-15

    Aging is associated with calcium deposits in various cardiovascular structures, but patterns of calcium deposition, if any, are unknown. In search of such patterns, we performed quantitative assessment of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a broad clinical sample. Templates were created from gated computed tomography (CT) scans depicting the aortic valve cusps and mitral annular segments in relation to surrounding structures. These were then applied to CT reconstructions from ungated, clinically indicated CT scans of 318 subjects, aged ≥65 years. Calcium location was assigned using the templates and quantified by the Agatston method. Mean age was 76 ± 7.3 years; 48% were men and 58% were white. Whites had higher prevalence (p = 0.03) and density of AVC than blacks (p = 0.02), and a trend toward increased MAC (p = 0.06). Prevalence of AVC was similar between men and women, but AVC scores were higher in men (p = 0.008); this difference was entirely accounted for by whites. Within the aortic valve, the left cusp was more frequently calcified than the others. MAC was most common in the posterior mitral annulus, especially its middle (P2) segment. For the anterior mitral annulus, the medial (A3) segment calcified most often. In conclusion, AVC is more common in whites than blacks, and more intense in men, but only in whites. Furthermore, calcium deposits in the mitral annulus and aortic valve favor certain locations. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Use of multidetector computed tomography angiography of upper limb circulation in patients undergoing coronary artery bypass grafting surgery

    Directory of Open Access Journals (Sweden)

    Hasan B Altinsoy

    2017-01-01

    Full Text Available Objective: This study aimed to evaluate the bilateral forehand circulation using a 64-channel multidetector computed tomography (MDCT as a noninvasive method to define criteria for an upper extremity arterial anatomy and pathology prior to the use of arterial conduits. Materials and Methods: Fifty-five patients with coronary artery disease who underwent total arterial coronary artery bypass grafting (CABG were randomly selected for this prospective study. MDCT angiography was performed for 110 examinations of forearm and hand arterial anatomy. Prior to MDCT, Allen tests were performed in all patients with a normal result, except four. Thirteen patients had diabetes mellitus (DM, 8 had peripheral artery occlusive disease, and 19 had a history of smoking. Results: All arteries, including axillary, ulnar artery (UA and radial artery (RA, were clearly visualized in all patients. Upper extremity anatomical and pathological results were examined in 16 patients (29.1%. Severely calcified RA and/or UA were found in 6 patients who had a moderate renal failure. Nearly total occlusion of the RA was detected in another two patients. Focal intimal RA calcification was recorded in 1 female and 3 male patients. Ten patients who had severe calcification or intimal sclerosis of the upper extremity arteries had DM. The remaining patients had normal forehand arterial circulation. A persistent median artery with the absence of radial and ulnar arteries and a high bifurcation of RA from the brachial artery was detected as an anatomic variation in seven patients (12.7%. Conclusions: The major advantages of MDCT angiography are its non-invasiveness and the ability to detect calcific subadventitial plaques, which are difficult to diagnose using conventional angiography. MDCT may be used as a safe and non-invasive method to assess RA and UA prior to harvesting the upper limb artery. Preoperative imaging of forehand arteries is a means to avoid unnecessary forearm

  18. Usefulness of multidetector computed tomography (MDCT) for the initial evaluation of multiple blunt trauma of the trunk

    International Nuclear Information System (INIS)

    Hagiwara, Shuichi; Ogino, Takashi; Isaka, Akira; Takahashi, Yuga; Nameki, Tarou; Kagoshima, Kaie; Yamada, Takurou; Ishihara, Kouichi; Iino, Yuichi

    2008-01-01

    Focused assessment with sonography for trauma (FAST) is useful for detecting hemoperitoneum (HE) in trauma patients in the emergency room (ER), but, patients' condition cannot be evaluated adequately by FAST alone. CT is useful for the diagnosis of multiple trauma, but has certain drawbacks. We evaluated the utility of multidetector computed tomography (MDCT) as the initial tool for proper diagnosis and treatment planning of multiple trauma patients. We retrospectively analyzed 128 cases treated in ER of Gunma University Hospital between April 1, 2005 and December 31, 2006, and they were hospital patients were hospitalized with blunt multiple trauma. We analyzed the sensitivity, specificity, and accuracy of FAST, compiled MDCT finding, lifesaving treatment, and outcome. Eight patients were FAST positive, and 7 of the 8 were scanned by MDCT. There were 120 patients were FAST negative patients, 23 of the 120 were MDCT-negative, despite visceral injury, however 9 of the 120 had visceral injury by MDCT findings. Damage control surgery without MDCT was performed in one case, but the patient died after surgery. Six of the patients in the HE-positive group had really HE. One of the 6 died while a waiting surgery, transcatheter arterial embolization (TAE) was performed in three patients, and one person out of the 3 died. The course of the remaining 2 patients was monitored, and they are alive. A patient in the HE-negative group with bladder rupture required surgery. There were 120 patients in the FAST-negative group. One of the 6 patients in the HE-positive subgroup died while a waiting surgery. One patient required chest and pericardial drainage. TAE was performed in 2 patients, and the remaining 6 were monitored and are alive. There were 23 FAST-negative patients patients who had visceral injury. Five of them required chest drainage, one received TAE, 17 were monitored, and all of the 23 are alive. There were 14 cases of pelvic fracture alone, and all of them were FAST

  19. Spinopelvic dissociation: multidetector computed tomographic evaluation of fracture patterns and associated injuries at a single level 1 trauma center.

    Science.gov (United States)

    Gupta, Pushpender; Barnwell, Jonathan C; Lenchik, Leon; Wuertzer, Scott D; Miller, Anna N

    2016-06-01

    The objective of the present study is to evaluate multidetector computed tomographic (MDCT) fracture patterns and associated injuries in patients with spinopelvic dissociation (SPD). Our institutional trauma registry database was reviewed from Jan. 1, 2006, to Sept. 30, 2012, specifically evaluating patients with sacral fractures. MDCT scans of patients with sacral fractures were reviewed to determine the presence of SPD. SPD cases were characterized into the following fracture patterns: U-shaped, Y-shaped, T-shaped, H-shaped, and burst. The following MDCT features were recorded: level of the horizontal fracture, location of vertical fracture, kyphosis between major fracture fragments, displacement of fracture fragment, narrowing of central spinal canal, narrowing of neural foramina, and extension into sacroiliac joints. Quantitative evaluation of the sacral fractures was performed in accordance with the consensus statement by the Spine Trauma Study Group. Medical records were reviewed to determine associated pelvic and non-pelvic fractures, bladder and bowel injuries, nerve injuries, and type of surgical intervention. Twenty-one patients had SPD, of whom 13 were men and eight were women. Mean age was 41.8 years (range 18.8 to 87.7). Five fractures (24 %) were U-shaped, six (29 %) H-shaped, four (19 %) Y-shaped, and six (29 %) burst. Nine patients (43 %) had central canal narrowing, and 19 (90 %) had neural foramina narrowing. Eleven patients (52 %) had kyphotic angulation between major fracture fragments, and seven patients (33 %) had either anterior (24 %) or posterior (10 %) displacement of the proximal fracture fragment. Fourteen patients (67 %) had associated pelvic fractures, and 20 (95 %) had associated non-pelvic fractures. Two patients (10 %) had associated urethral injuries, and one (5 %) had an associated colon injury. Seven patients (33 %) had associated nerve injuries. Six patients (29 %) had surgical fixation while 15 (71 %) were

  20. Multidetector computed tomography sizing of bioprosthetic valves: guidelines for measurement and implications for valve-in-valve therapies

    International Nuclear Information System (INIS)

    Rajani, R.; Attia, R.; Condemi, F.; Webb, J.; Woodburn, P.; Hodson, D.; Nair, A.; Preston, R.; Razavi, R.; Bapat, V.N.

    2016-01-01

    Aim: To describe a technique for bioprosthetic multidetector computed tomography (MDCT) sizing and to compare MDCT-derived values against manufacturer-provided sizing. Materials and methods: Fourteen bioprosthetic stented valves commonly used in the aortic valve position were evaluated using a Philips 256 MDCT system. All valves were scanned using a dedicated cardiac CT protocol with a four-channel electrocardiography (ECG) simulator. Measurements were made of major and minor axes and the area and perimeter of the internal stent using varying reconstruction kernels and window settings. Measurements derived from MDCT (MDCT ID) were compared against the stent internal diameter (Stent ID) as provided by the valve manufacturer and the True ID (Stent ID + insertion of leaflets). All data were collected and analysed using SPSS for Mac (version 21). Results: The mean difference between the MDCT ID and Stent ID was 0.6±1.9 mm (r=0.649, p=0.012) and between MDCT ID and True ID 2.1±2 mm (r=0.71, p=0.005). There was no difference in the major (p=0.90), minor (p=0.87), area (p=0.92), or perimeter (p=0.92) measurements when sharp, standard, and detailed stent kernels were used. Similarly, the measurements remained consistent across differing windowing levels. Conclusion: Bioprosthetic stented valves may be reliably sized using MDCT in patients requiring valve-in-valve (VIV) interventions where the valve type and size are unknown. In these cases, clinicians should be aware that MDCT has a tendency to overestimate the True ID size. - Highlights: • Cardiac CT is likely to be ideally suited for bioprosthetic aortic valve sizing for valve in valve procedures. • We compared MDCT sizing for 14 varying bioprosthetic aortic valves across varying window settings and reconstruction kernels. • We provide “normal” MDCT sizing for varying valves and show their relationship to surgical sizing. • Bioprosthetic valves may be reliably sized by MDCT but require adjustment owing to

  1. Comparison of the multidetector-row computed tomography findings of IgG4-related sclerosing cholangitis and extrahepatic cholangiocarcinoma

    International Nuclear Information System (INIS)

    Yata, M.; Suzuki, K.; Furuhashi, N.; Kawakami, K.; Kawai, Y.; Naganawa, S.

    2016-01-01

    Aim: To compare the multidetector-row computed tomography (MDCT) findings of IgG4-related sclerosing cholangitis (IgG4-SC) and extrahepatic cholangiocarcinoma (EH-CCA). Materials and methods: Two radiologists who had no knowledge of the patients' clinical information retrospectively evaluated the CT findings of patients with IgG4-SC (n=33) and EH-CCA (n=39) on a consensus basis. Another radiologist measured the biliary lesions. IgG4-SC was diagnosed using the Japan Biliary Association criteria (2012) or the Mayo Clinic's HISORt criteria. EH-CCA was diagnosed based on surgical findings. Results: Compared with EH-CCA, IgG4-SC exhibited the following findings significantly more frequently: (a) wall thickening alone, (b) concentric wall thickening, (c) smooth inner margins, (d) homogeneous attenuation in the arterial phase, (e) a lesion involving the intrapancreatic bile duct, (f) smooth outer margins, (g) fully visible lumen, (h) a funnel-shaped proximal bile duct, (i) skip lesions, and (j) abnormal pancreatic findings. Conversely, (k) dual-layered attenuation in all phases was significantly more common in EH-CCA. The specificity values of parameters (e–k) were >80%. Regarding dimensions, (l) the biliary lesions were longer in IgG4-SC than in EH-CCA. (m) The diameters of the dilated proximal common bile duct and (n) the dilated proximal intrahepatic bile duct were smaller in IgG4-SC than in EH-CCA. Conclusion: A number of CT findings are useful for differentiating between IgG4-SC and EH-CCA. CT findings (e–k) are particularly useful for this purpose. - Highlights: • Some CT findings are useful for differentiating between IgG4-SC and EH-CCA. • Homogeneous attenuation in all phases was more common in IgG4-SC than in EH-CCA. • Abnormal pancreatic findings showed high sensitivity and specificity values. • Dual-layered attenuation in all phases was more common in EH-CCA than in IgG4-SC.

  2. Limitations of airway dimension measurement on images obtained using multi-detector row computed tomography.

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Oguma

    Full Text Available OBJECTIVES: (a To assess the effects of computed tomography (CT scanners, scanning conditions, airway size, and phantom composition on airway dimension measurement and (b to investigate the limitations of accurate quantitative assessment of small airways using CT images. METHODS: An airway phantom, which was constructed using various types of material and with various tube sizes, was scanned using four CT scanner types under different conditions to calculate airway dimensions, luminal area (Ai, and the wall area percentage (WA%. To investigate the limitations of accurate airway dimension measurement, we then developed a second airway phantom with a thinner tube wall, and compared the clinical CT images of healthy subjects with the phantom images scanned using the same CT scanner. The study using clinical CT images was approved by the local ethics committee, and written informed consent was obtained from all subjects. Data were statistically analyzed using one-way ANOVA. RESULTS: Errors noted in airway dimension measurement were greater in the tube of small inner radius made of material with a high CT density and on images reconstructed by body algorithm (p<0.001, and there was some variation in error among CT scanners under different fields of view. Airway wall thickness had the maximum effect on the accuracy of measurements with all CT scanners under all scanning conditions, and the magnitude of errors for WA% and Ai varied depending on wall thickness when airways of <1.0-mm wall thickness were measured. CONCLUSIONS: The parameters of airway dimensions measured were affected by airway size, reconstruction algorithm, composition of the airway phantom, and CT scanner types. In dimension measurement of small airways with wall thickness of <1.0 mm, the accuracy of measurement according to quantitative CT parameters can decrease as the walls become thinner.

  3. Sixteen-slice multidetector computed tomographic virtual cystoscopy in the evaluation of a patient with suspected bladder tumor and history of bladder carcinoma operation.

    Science.gov (United States)

    Basak, Muzaffer; Ozkurt, Huseyin; Tanriverdi, Orhan; Cay, Esra; Aydin, Mustafa; Miroglu, Cengiz

    2009-01-01

    The purpose of this study was to evaluate the use of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with suspected bladder tumors and histories of bladder carcinoma operation. Thirty-six patients (29 men and 7 women) with a mean age of 66 years (range, 24-88 years) with suspected bladder tumors and histories of bladder carcinoma operation were included in this prospective study. Virtual cystoscopy was performed by 16-slice multidetector CT scanner. The bladder was filled with diluted contrast material solution through a Foley catheter. Then, all patients underwent conventional cystoscopy examination. Two reviewers found 18 lesions detected by virtual cystoscopy by consensus, whereas 19 lesions were depicted by conventional cystoscopy. At virtual and conventional cystoscopies, the conditions of 3 patients, 2 with chronic inflammations and 1 with foreign body reaction, were wrongly diagnosed as tumors. At conventional cystoscopy, one patient's result was wrongly interpreted as normal. In pathologic evaluation, all tumors were diagnosed as transitional cell carcinoma. Bladder tumor can be noninvasively diagnosed using virtual cystoscopy. Use of virtual cystoscopy should be considered inpatients who present with hematuria or have histories of bladder carcinoma operation and are for follow-up because of its lesser complication risk and its being a less invasive, easily applied procedure without need of anesthesia. In the future, owing to the development of the CT technology and image processing technique, virtual cystoscopy may have a part in the detection of bladder cancer.

  4. Bosniak category III cysts are more likely to be malignant than we expected in the era of multidetector computed tomography technology

    Directory of Open Access Journals (Sweden)

    Pal Bata

    2014-01-01

    Full Text Available Background: Complex indeterminate Bosniak category III renal cystic masses are traditionally considered to be malignant in 50%. Our aim was to retrospectively evaluate the attenuation characteristics in multiphase computed tomography (CT and to determinate the incidence of malignancy based on histological findings on all Bosniak category III renal cystic masses investigated in our department between April 3, 2007 and November 21, 2013. Materials and Methods: Quadriphasic multidetector CT images of nineteen patients (mean age: 56.5 ± 16.5 years with radiologically detected Bosniak category III lesions were reviewed retrospectively. All lesions were surgically removed, and the incidence of malignancy, based on pathological results was determined. Results: Calcification was present in four lesions (21%. The mean largest diameter was 48.7 ± 28.8 mm. All lesions were multilobulated and septated. Of the 19 removed lesions, 16 (84% were malignant, and 3 (16% were benign (one inflammatory cyst including a nephrolith, one cystic nephroma and one atypical angiomyolipoma. CT and histological findings of 19 Bosniak III cysts were correlated. Conclusion: Our study demonstrated much higher prevalence of malignancy (84% in radiologically detected Bosniak category III cysts than it has been described before. It may due to the era of modern multidetector CT technology and multiphase protocol.

  5. Performance of cone-beam computed tomography and multidetector computed tomography in diagnostic imaging of the midface: A comparative study on Phantom and cadaver head scans

    Energy Technology Data Exchange (ETDEWEB)

    Veldhoen, Simon [University Medical Center Hamburg, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Schoellchen, Maximilian; Hanken, H.; Precht, C.; Heiland, M. [University Medical Center Hamburg, Department of Oral- and Maxillofacial Surgery, Hamburg (Germany); Henes, F.O.; Adam, G.; Regier, M. [University Medical Center Hamburg, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Schoen, G. [University Medical Center Hamburg, Department of Medical Biometry and Epidemiology, Hamburg (Germany); Nagel, H.D. [Science and Technology for Radiology, Buchholz (Germany); Schumacher, U. [University Medical Center Hamburg, Institute of Anatomy, Hamburg (Germany)

    2017-02-15

    To compare multidetector computed tomography (MDCT) and cone-beam computed tomography (CBCT) regarding radiation, resolution, image noise, and image quality. CBCT and 256-MDCT were compared based on three scan protocols: Standard-dose (∼24 mGy), reduced-dose (∼9 mGy), and low-dose (∼4 mGy). MDCT images were acquired in standard- and high-resolution mode (HR-MDCT) and reconstructed using filtered back projection (FBP) and iterative reconstruction (IR). Spatial resolution in linepairs (lp) and objective image noise (OIN) were assessed using dedicated phantoms. Image quality was assessed in scans of 25 cadaver heads using a Likert scale. OIN was markedly higher in FBP-MDCT when compared to CBCT. IR lowered the OIN to comparable values in standard-mode MDCT only. CBCT provided a resolution of 13 lp/cm at standard-dose and 11 lp/cm at reduced-dose vs. 11 lp/cm and 10 lp/cm in HR-MDCT. Resolution of 10 lp/cm was observed for both devices using low-dose settings. Quality scores of MDCT and CBCT did not differ at standard-dose (CBCT, 3.4; MDCT, 3.3-3.5; p > 0.05). Using reduced- and low-dose protocols, CBCT was superior (reduced-dose, 3.2 vs. 2.8; low dose, 3.0 vs. 2.3; p < 0.001). Using the low-dose protocol, the assessed CBCT provided better objective and subjective image quality and equality in resolution. Similar image quality, but better resolution using CBCT was observed at higher exposure settings. (orig.)

  6. Clinico-statistical study of preoperative examination for the dental implant using multi-detector row computed tomography

    International Nuclear Information System (INIS)

    Sekiya, Keiko; Mori, Shintaro; Sekiya, Kotaro

    2008-01-01

    In April 2006, a new affiliated hospital opened at Nihon University School of Dentistry at Matsudo, and the latest model was introduced into the department of radiology. CT examinations for preoperative dental implant going on 64 multi-detector row CT, the number of cases has increased. CT examination is useful for preoperative dental implant, and many studies of concerning clinical studies using CT images have been reported. The purpose of this study was to the clinico-statistical studies of preoperative CT examinations for dental implant at our radiology department using 64 multi-detector row CT. The subjects consisted of 5174 regions in 1312 cases of preoperative CT examinations, between April 2006 and December 2007. CT machine used was the Aquilion TM 64 (Toshiba Medical Systems, Japan), and the workstation used was the ZIOSTATION (ZIOSOFT, Japan). All of CT examinations were performed the position of implant placement and disease examined from CT findings. The following results were obtained: The 1312 cases consisted of 426 males and 886 females. Patient age ranged from 16 yrs to 86 yrs old, the average age were 55.5 yrs old. Six hundred and seventy four cases were ordered at another private dental office not our hospital, and 638 cases were ordered at our hospital. The numbers of implant placement were on the average of 3.9, and the rate got higher with age. The lesions which detected by preoperative CT examination were maxillary sinusitis, periodontitis, ectopic calcification, and mucous retention cyst. (author)

  7. Focal Stenosis in Right Upper Lobe Bronchus in a Recurrently Wheezing Child Sequentially Studied by Multidetector-row Spiral Computed Tomography and Scintigraphy

    Directory of Open Access Journals (Sweden)

    I-Chen Chen

    2009-12-01

    Full Text Available Lower respiratory tract infections associated with wheezing are not uncommon in infants and young children. Among the wheezing-associated disorders, allergic etiologies are more commonly encountered than anatomic anomalies. We present a 3-year-old girl with a sudden attack of asthmatic symptoms including dyspnea, cyanosis and diffuse wheezing. Based on a history of choking, and atelectasis in the right upper lobe detected by chest films, flexible tracheobronchoscopy was arranged and incidentally detected a stenotic orifice in the right upper lobe bronchus. Multidetector-row spiral computed tomography and pulmonary scintigraphy subsequently also disclosed the focal stenosis. She suffered from recurrent wheezing, pneumonia and lung atelectasis during 1 year of follow-up. We emphasize the diagnosis, clinical course and management of focal stenosis in the right upper lobe bronchus.

  8. Dataset of calcified plaque condition in the stenotic coronary artery lesion obtained using multidetector computed tomography to indicate the addition of rotational atherectomy during percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Yasushi Akutsu

    2016-06-01

    Full Text Available Our data shows the regional coronary artery calcium scores (lesion CAC on multidetector computed tomography (MDCT and the cross-section imaging on MDCT angiography (CTA in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI. CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions.

  9. Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

    Directory of Open Access Journals (Sweden)

    Felipe Torres Pacheco

    2015-05-01

    Full Text Available Objective The potential of computed tomography angiography (CTA was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours. Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2% based on both clinical grounds and imaging follow-up (stroke group, with statistically significant arterial stenosis and vulnerable plaques on CTA. Intracranial large artery disease was demonstrated in 34% of patients in the stroke group. Partial territorial infarct prevailed (86% while artery-to-artery embolization was the most common stroke mechanism (52%. Conclusion Multidetector CTA was useful for the etiologic work-up of hyperacute ischemic stroke and facilitated the knowledge about the topographic pattern of brain infarct in accordance with its causative mechanism.

  10. Data acquisition for experiments with multi-detector arrays

    Indian Academy of Sciences (India)

    Experiments with multi-detector arrays have special requirements and place higher demands on computer data acquisition systems. In this contribution we discuss data acquisition systems with special emphasis on multi-detector arrays and in particular we describe a new data acquisition system, AMPS which we have ...

  11. Effects of dose reduction on multi-detector computed tomographic images in evaluating the maxilla and mandible for pre-surgical implant planning: a cadaveric study.

    Science.gov (United States)

    Koizumi, Hiroshi; Sur, Jaideep; Seki, Kenji; Nakajima, Koh; Sano, Tsukasa; Okano, Tomohiro

    2010-08-01

    To assess effects of dose reduction on image quality in evaluating maxilla and mandible for pre-surgical implant planning using cadavers. Six cadavers were used for the study using multi-detector computed tomography (CT) operated at 120 kV and the variable tube current of 80, 40, 20 and 10 mA. A slice thickness of 0.625 mm and pitch 1 were used. Multi-planar images perpendicular and parallel to dentitions were created. The images were evaluated by five oral radiologists in terms of visibility of the anatomical landmarks including alveolar crest, mandibular canal, floors of the maxillary sinus and nasal cavity, contours/cortical layer of jaw bones and the details of trabecular bone. Observers were asked to determine the quality of the images in comparison with 80 mA images based on the criteria: excellent, good, fair or non-diagnostic. The average scores of all observers were calculated for each specimen in all exposure conditions. The 40 mA images could visualize such landmarks and were evaluated to be same or almost equivalent in quality to the 80 mA images. Even the 20 mA images could be accepted just for diagnostic purpose for implant with substantial deterioration of the image quality. The 10 mA images may not be accepted because of the obscured contour caused by image noise. Significant dose reduction by lowering mA can be utilized for pre-surgical implant planning in multi-detector CT.

  12. Usefulness of multidetector-row computed tomography (MD-CT) for diagnosis and evaluation of cardiovascular anomalies in infants

    International Nuclear Information System (INIS)

    Kani, Hiroyuki; Narabayashi, Isamu; Tanikake, Masato; Matsuki, Mitsuru; Uesugi, Yasuo

    2005-01-01

    We examined the effectiveness of multidetector-row CT (MD-CT) in the diagnosis and evaluation of cardiovascular anomalies in infants. MD-CT was performed 34 times on 21 patients with cardiovascular anomalies. We performed three evaluations: 1) The assessment of the specificity of MD-CT in detecting the morphological features of cardiovascular anomalies. 2) The diameters of aortae with coronary artery (CoA), and the diameters of pulmonary artery, measured by using MD-CT were compared with those by angiography. 3) The amount of exposure to radiation was measured. 1) MD-CT can detect CoA, pulmonary arteriovenous anomalies among extracardiac anomalies in all the patients. The diagnostic accuracy for intracardiac anomalies was poor as only six of the 15 anomalies could be accurately diagnosed. 2) The diameters of aortae and pulmonary artery obtained using MD-CT showed a good correlation with those obtained using arteriography (r=0.97, 0.95). 3) The average dose-length product was 269.2 mGy·cm. And the average effective dose was 5.1 mSv. MD-CT is not suitable for the evaluation of intracardiac anomalies, but is extremely effective in the evaluation of extracardiac major vascular anomalies. On the basis of the amount of information and noninvasive nature, MD-CT should be used first before angiography. (author)

  13. Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Quanli; Yao, Qiong; Hu, Xihong [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China)

    2016-09-15

    Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40-97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66-100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography. (orig.)

  14. Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography

    International Nuclear Information System (INIS)

    Shen, Quanli; Yao, Qiong; Hu, Xihong

    2016-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40-97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66-100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography. (orig.)

  15. Multi-detector row computed tomographic evaluation of a rare type of complete vascular ring: Double aortic arch with atretic left arch distal to the origin of left subclavian artery

    Energy Technology Data Exchange (ETDEWEB)

    Hung, Ying Ying; Fu, Ching Yun; Wei, Hao Ji; Tsai, I Chen; Chen, Clayton Chi Chang [Taichung Veterans General Hospital, Taichung (China)

    2013-10-15

    Double aortic arch with an atretic left arch distal to the origin of left subclavian artery was diagnosed with multi-detector row computed tomography (MDCT) in two children with dysphagia. This rare type of complete vascular ring is clinically important because it may be confused with right aortic arch in mirror imaging. Anatomic details of this rare type of complete vascular ring demonstrated on MDCT facilitated appropriate surgical treatment.

  16. Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography

    Science.gov (United States)

    Khan, Sohail Ahmed; Sattar, Amjad; Khanzada, Usman; Adil, Syed Omair; Hussain, Munawar

    2017-01-01

    Study Design Descriptive cross-sectional study. Purpose To determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography. Overview of Literature There is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries. Methods A retrospective study was conducted on abdominopelvic computed tomography (CT) scans performed between January 1st 2015 and December 31st 2015 for various clinical indications. Patients with lower back pain, with a history of trauma or road traffic accident, or referred from orthopedic or neurosurgery departments were excluded to avoid any bias. CT scans were reviewed in axial, sagittal, and coronal planes using bone window settings for evaluating spondylolysis and spondylolisthesis. Results Of 4,348 patients recruited, spondylolysis and spondylolisthesis were identified in 266 (6.1%) and 142 (3.3%) patients, respectively. Age was significantly higher in both spondylolysis and spondylolisthesis patients than in those without spondylolysis and spondylolisthesis (47.19±15.45 vs. 42.5±15.96, pspondylolysis. Of patients who were >60 years old, both spondylolysis (p=0.018) and spondylolisthesis (p=0.025) were significantly more prevalent in females. Conclusions The prevalence of pars interarticularis fracture observed higher with gradual increase in the prevalence with advancing age. In particular, preponderance was significantly higher among older females. PMID:28670412

  17. Comparison of diagnostic value of multidetector computed tomography and X-ray in the detection of body packing

    Energy Technology Data Exchange (ETDEWEB)

    Bulakci, Mesut, E-mail: mesutbulakci@yahoo.com [Department of Radiology, Haseki Training and Research Hospital, 34096 Aksaray, Istanbul (Turkey); Kalelioglu, Tuba, E-mail: tubakarsakarya@hotmail.com [Department of Radiology, Haseki Training and Research Hospital, 34096 Aksaray, Istanbul (Turkey); Bulakci, Betul Bozkurt, E-mail: dr.betulbozkurt@gmail.com [Department of Family Medicine, Istanbul University, Istanbul Faculty of Medicine, 34390 Capa, Istanbul (Turkey); Kiris, Adem, E-mail: ademkiris@hotmail.com [Department of Radiology, Haseki Training and Research Hospital, 34096 Aksaray, Istanbul (Turkey)

    2013-08-15

    Objective: Radiologists and other clinicians are facing an increasing number of illegal drug-related medical conditions. We aimed to draw attention to this growing global problem and to highlight some of the important points related to diagnosis and follow-up of body packing. We compare the diagnostic performance of unenhanced multidetector CT (MDCT) and abdomen X-ray for the detection of drug-filled packets. Materials and methods: Sixty-seven suspects, who underwent both CT and X-ray examinations, have been included in the study. All MDCT and X-ray images were independently and retrospectively reviewed by two observers with different degrees of experience in abdomen imaging. Fifty-two of them were identified as body packers finally. Interobserver agreement, sensitivity, specificity, positive and negative predictive value were calculated. Results: Two types of packets with different characteristics were identified in all body packers. Type 1 packets (solid-state drug) were found in 41 patients and type 2 packets (liquid cocaine) in 11 patients. All statistical analyses concern the detection of any packets. That is, the whole evaluation has been performed per patient. Sensitivity/specificity values of type 1 and type 2 packets for MDCT were 100–98%/100–100% and 100–100%/100–100%, respectively. Besides, sensitivity/specificity values of type 1 and type 2 packets for X-ray were 93–90%/100–91% and 64–45%/73–71%, respectively. In addition, interobserver agreements for detection of any packets were excellent (κ = 0.96) and good (κ = 0.75) for interpretation of MDCT and X-ray, respectively. Conclusion: Unenhanced MDCT is a fast, accurate and easily used diagnostic tool with high sensitivity and specificity for the exact diagnosis of body packing.

  18. Study on children patient dose in single-detector and multi-detector row helical computed tomography

    International Nuclear Information System (INIS)

    Lu Heqing; Zhu Guoying; Zhuo Weihai; Liu Haikuan; Guo Changyi

    2008-01-01

    Objective: To study and evaluate the radiation dose of children patient in single-detector and multi-detector row helical CT scan. Methods: The head and body CT dose index of 21 CT scanners were tested. Then the values of CTDI w , CTDI vol and DLP were calculated combining with the parameters of routine head and chest scan for children of 0-1 year old group, 5 years old group, 10 years old group and adults. The effective doses of children of every age group and adults in routine head and chest scan were subsequently estimated from effective dose per DLP by age and the calculated values of DLP. Results: CTDI per mAs is greater in the head than that in the body. In head routine scan, the effective doses of 0-1 year old group,5 years old group and 10 year old group were 2.2, 1.3 and 1.1 mSv, respectively. In chest routine scan, the effective doses of 0-1 year old group,5 years old group and 10 years old group were 5.3, 3.1 and 3.4 mSv, respectively. Effective doses to children per mAs are equally 1.8 times higher than corresponding values for adults. The CTDI vol , DLP and effective dose to children in head routine scan for MDCT were greater those that for single-detector CT and dual- detector CT. The CTDI vol , DLP and effective dose to children in chest routine scan for MDCT and dual-detector row CT were smaller than that for single-detector row CT. Conclusions: Children me more radiation risk in CT examination as compared with adults. So we should strictly abide by justification of children CT examination, and optimize the parameters of CT scan rationally in order to reduce the radiation dose to children patient as much as possible. (authors)

  19. Computer-assisted lung nodule volumetry from multi-detector row CT: Influence of image reconstruction parameters

    International Nuclear Information System (INIS)

    Honda, Osamu; Sumikawa, Hiromitsu; Johkoh, Takeshi; Tomiyama, Noriyuki; Mihara, Naoki; Inoue, Atsuo; Tsubamoto, Mitsuko; Natsag, Javzandulam; Hamada, Seiki; Nakamura, Hironobu

    2007-01-01

    Purpose: To investigate differences in volumetric measurement of pulmonary nodules caused by changing the reconstruction parameters for multi-detector row CT. Materials and methods: Thirty-nine pulmonary nodules less than 2 cm in diameter were examined by multi-slice CT. All nodules were solid, and located in the peripheral part of the lungs. The resultant 48 parameters images were reconstructed by changing slice thickness (1.25, 2.5, 3.75, or 5 mm), field of view (FOV: 10, 20, or 30 cm), algorithm (high-spatial frequency algorithm or low-spatial frequency algorithm) and reconstruction interval (reconstruction with 50% overlapping of the reconstructed slices or non-overlapping reconstruction). Volumetric measurements were calculated using commercially available software. The differences between nodule volumes were analyzed by the Kruskal-Wallis test and the Wilcoxon Signed-Ranks test. Results: The diameter of the nodules was 8.7 ± 2.7 mm on average, ranging from 4.3 to 16.4 mm. Pulmonary nodule volume did not change significantly with changes in slice thickness or FOV (p > 0.05), but was significantly larger with the high-spatial frequency algorithm than the low-spatial frequency algorithm (p < 0.05), except for one reconstruction parameter. The volumes determined by non-overlapping reconstruction were significantly larger than those of overlapping reconstruction (p < 0.05), except for a 1.25 mm thickness with 10 cm FOV with the high-spatial frequency algorithm, and 5 mm thickness. The maximum difference in measured volume was 16% on average between the 1.25 mm slice thickness/10 cm FOV/high-spatial frequency algorithm parameters and overlapping reconstruction. Conclusion: Volumetric measurements of pulmonary nodules differ with changes in the reconstruction parameters, with a tendency toward larger volumes in high-spatial frequency algorithm and non-overlapping reconstruction compared to the low-spatial frequency algorithm and overlapping reconstruction

  20. Computerized tomography-guided neurolytic splanchnic nerve block

    International Nuclear Information System (INIS)

    Henriquet, Franco; De Martini, Giuseppe; Roy, Maria Teresa; Pretrolesi, Fabio; Martinoli, Carlo; Cariati, Maurizio; Fiorentini, Franco.

    1997-01-01

    Computerized tomography-guided neurolytic splanchnic nerve block is a technique for relieving abdominal cancer pain; the goal is the alcoholic neurolytic interruption of the sensitive structures in retroperitoneal space. Computerized tomography yields accurate anatomical detailing and the course for needle placement and alcohol spread. January, 1993, to July, 1996, twenty-one bilateral splanchnic nerve blocks were performed through the posterior access. Forty-eight hours after alcoholism. 14 patients (66%) had complete pain regression; 52% of the patients needed no analgesics for 6 to 54 days and only 9 patients (42%) needed another low opioid therapy. Complications included hypotension and diarrhea in all cases. One had a cardiac arrest and diet 8 days after the procedure. There were no other complications. The whole procedure usually lasted 60 min (range: 45 to 90 min). Splanchnic nerve neurolysis is a useful treatment in the patients with severe chronic abdominal pain. It is used as a second line treatment when large lesions change celia anatomy and complicate the percutaneous block of the celiac plexus. Endosulfan, Malathion and Methyl parathion, on the metabolic rate of the estuarine clam, Villorita cyprinoides var. cochinensis, have been investigated. The animals exposed to the lower sublethal concentrations of Endosulfan, Malthion and Methyl parathion consumed oxygen at the rate of 1.60, 1.98 and 2.09 ml. 0 2 g - 1 h -1 respectively, while at the higher concentrations of the pesticides, consumption of oxygen by the animal dropped to nearly half the control value. When compared to Malathion and Methyl parathion. Endosulfan induced animals recorded a greater reduction in her percentage deviation (from control) of oxygen consumption, possibly due to hypoxia induced by the pollutants

  1. Incidence of tracheobronchomalacia associated with pulmonary emphysema. Detection with paired inspiratory-expiratory multidetector computed tomography using a low-dose technique

    International Nuclear Information System (INIS)

    Inoue, Masanori; Hasegawa, Ichiro; Nakano, Keiko; Yamaguchi, Kazuhiro; Kuribayashi, Sachio

    2009-01-01

    The purpose of this study was to evaluate the frequency of tracheobronchomalacia (TBM) associated with pulmonary emphysema with paired inspiratory-expiratory multidetector computed tomography (MDCT) using a low-dose technique. This study included 56 consecutive patients (55 men, 1 woman; mean age 68.9 years) with pulmonary emphysema who had undergone paired inspiratory-expiratory CT scanning with a low-dose technique (40 mA). All images were retrospectively examined by two thoracic radiologists in a blinded fashion. The diagnosis of TBM was based on the standard criterion of >50% reduction in the cross-sectional area of the tracheobronchial lumen at the end-expiratory phase. A mild TBM criterion of >30% reduction was also reviewed. All patients underwent pulmonary function tests. The relation between the forced expiratory volume in 1 s (FEV 1.0% ) and TBM was statistically analyzed. Four (7.1%) and eight (14.3%) patients were diagnosed as TBM based on the standard and mild criteria, respectively. In four patients, the percentages of luminal narrowing were 63.4% and 51.2%, respectively for tracheomalacia and 59.2% and 62.0%, respectively, for bronchomalacia. The FEV 1.0% values between patients with and without TBM showed no statistical difference. The incidence of TBM associated with pulmonary emphysema was 7.1% with the standard criterion. It is possible that TBM has been underdiagnosed in a number of patients with pulmonary emphysema. (author)

  2. Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

    International Nuclear Information System (INIS)

    Knox, Matthew K.; Rivers-Bowerman, Michael D.; Bardgett, Harry P.; Cowan, Nigel C.

    2010-01-01

    To evaluate multidetector computed tomography (MDCT) with a triple-bolus contrast administration protocol for preoperative anatomical and functional assessment of living renal donors. Fifty-five potential living renal donors underwent MDCT of which 27 proceeded to donor nephrectomy. A triple-bolus contrast administration protocol was used for simultaneous acquisition of arterial, nephrographic, and excretory phases. MDCT images were independently reviewed in random order by two radiologists blinded to surgical anatomy findings. Diagnostic accuracy for anatomical variants was quantified by sensitivity and specificity. Differential renal function (DRF) was derived from MDCT for 54 patients and compared with technetium-99 m dimercaptosuccinic acid renography (Tc-99 m DMSA). All triple-bolus MDCT examinations were technically adequate. Accessory renal arteries and veins were identified at surgery in 33% (n = 9/27) and 22% (n = 6/27) of donor kidneys. The mean difference between MDCT-derived DRF and DMSA was 0.8% (95% CI 0.1-1.6) with 95% limits of agreement of -4.6% (95% CI -3.3 to -5.9) to 6.3% (95% CI 5.0-7.6). MDCT delivered a mean (SD, range) radiation dose of 9.5 (3.6, 3.6-17.3) mSv. MDCT with a triple-bolus contrast administration provides accurate anatomical and functional evaluation of living renal donors. (orig.)

  3. Contrast enhancement in multidetector-row computed tomography (MDCT) of the abdomen: intraindividual comparison of contrast media containing 300 mg versus 370 mg iodine per ml

    International Nuclear Information System (INIS)

    Behrendt, F.F.; Mahnken, A.H.; Keil, S.; Das, M.; Hohl, C.; Guenther, R.W.; Muehlenbruch, G.; Bauer, D.; Seidensticker, P.; Jost, E.; Wildberger, J.E.

    2008-01-01

    The purpose of this study was to intraindividually evaluate the difference in intraluminal vessel and parenchyma contrast enhancement of two different iodine concentrations in multidetector-row computed tomography (MDCT) of the abdomen. Eighty-three patients underwent baseline and follow-up MDCT-scanning (Somatom Sensation 16; Siemens, Forchheim, Germany) of the abdomen using contrast media containing 370 mg iodine/ml (protocol A; Ultravist 370, Bayer Schering Pharma, Berlin, Germany) and 300 mg iodine/ml (protocol B; Ultravist 300). The total iodine load (37 g iodine) and the iodine delivery rate (1.29 g iodine/s) were identical for both protocols. Contrast enhancement in the portal venous phase was measured in the abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney. Mean attenuation values were compared using paired t-test. Intraindividual comparison revealed no statistically significant differences of the mean attenuation values between protocols A and B for all anatomic sites: abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney (all P > 0.05). Given an injection protocol with constant total iodine load and constant iodine delivery rate, the iodine concentration of contrast media does not significantly influence abdominal contrast enhancement in the portal venous phase. (orig.)

  4. Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

    Energy Technology Data Exchange (ETDEWEB)

    Knox, Matthew K. [University of Calgary, Faculty of Medicine, UME Office, Health Sciences Centre, Calgary, Alberta (Canada); Rivers-Bowerman, Michael D. [University of British Columbia, Faculty of Medicine, MD Undergraduate Program, Diamond Health Care Centre, Vancouver, British Columbia (Canada); Bardgett, Harry P. [Bradford Teaching Hospitals, Department of Radiology, Bradford (United Kingdom); Cowan, Nigel C. [The Churchill Hospital, Department of Radiology, Oxford (United Kingdom)

    2010-11-15

    To evaluate multidetector computed tomography (MDCT) with a triple-bolus contrast administration protocol for preoperative anatomical and functional assessment of living renal donors. Fifty-five potential living renal donors underwent MDCT of which 27 proceeded to donor nephrectomy. A triple-bolus contrast administration protocol was used for simultaneous acquisition of arterial, nephrographic, and excretory phases. MDCT images were independently reviewed in random order by two radiologists blinded to surgical anatomy findings. Diagnostic accuracy for anatomical variants was quantified by sensitivity and specificity. Differential renal function (DRF) was derived from MDCT for 54 patients and compared with technetium-99 m dimercaptosuccinic acid renography (Tc-99 m DMSA). All triple-bolus MDCT examinations were technically adequate. Accessory renal arteries and veins were identified at surgery in 33% (n = 9/27) and 22% (n = 6/27) of donor kidneys. The mean difference between MDCT-derived DRF and DMSA was 0.8% (95% CI 0.1-1.6) with 95% limits of agreement of -4.6% (95% CI -3.3 to -5.9) to 6.3% (95% CI 5.0-7.6). MDCT delivered a mean (SD, range) radiation dose of 9.5 (3.6, 3.6-17.3) mSv. MDCT with a triple-bolus contrast administration provides accurate anatomical and functional evaluation of living renal donors. (orig.)

  5. [In vivo anatomical study of inferior attachment of renal fascia in adult with acute pancreatitis as shown on multidetector computed tomography].

    Science.gov (United States)

    Qi, Rui; Zhou, Xiangping; Yu, Jianqun; Li, Zhenlin

    2014-04-01

    This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.

  6. Cost-Effectiveness Analysis (CEA) of Intravenous Urography (IVU) and Unenhanced Multidetector Computed Tomography (MDCT) for Initial Investigation of Suspected Acute Ureterolithiasis

    International Nuclear Information System (INIS)

    Eikefjord, E.; Askildsen, J.E.; Roervik, J.

    2008-01-01

    Background: It is important to compare the cost and effectiveness of multidetector computed tomography (MDCT) and intravenous urography (IVU) to determine the most cost-effective alternative for the initial investigation of acute ureterolithiasis. Purpose: To analyze the task-specific variable costs combined with the diagnostic effect of MDCT and IVU for patients with acute flank pain, and to determine which is most cost effective. Material and Methods: 119 patients with acute flank pain suggestive of stone disease (ureterolithiasis) were examined by both MDCT and IVU. Variable costs related to medical equipment, consumption material, equipment control, and personnel were calculated. The diagnostic effect was assessed. Results: The variable costs of MDCT versus IVU were EUR 32 and EUR 117, respectively. This significant difference was mainly due to savings in examination time, higher annual examination frequency, lower material costs, and no use of contrast media. As for diagnostic effect, MDCT proved considerably more accurate in the diagnosis of stone disease than IVU and markedly more accurate concerning differential diagnoses. Conclusion: MDCT had lower differential costs and a higher capacity to determine correctly stone disease and differential diagnoses, as compared to IVU, in patients with acute flank pain. Consequently, MDCT is a dominant alternative to IVU when evaluated exclusively from a cost-effective perspective

  7. Sixteen multidetector row computed tomography of pulmonary veins: 3-months' follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

    International Nuclear Information System (INIS)

    Maksimovic, Ruzica; Cademartiri, Filippo; Pattynama, Peter M.T.; Scholten, Marcoen F.; Jordaens, Luc J.

    2005-01-01

    The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months' follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1±2.4 preprocedural versus 18.6±2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2±0.2 versus 1.2±0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1±2.5 mm versus 16.5±2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months' follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up. (orig.)

  8. Sixteen multidetector row computed tomography of pulmonary veins: 3-months' follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Maksimovic, Ruzica; Cademartiri, Filippo; Pattynama, Peter M.T. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Scholten, Marcoen F.; Jordaens, Luc J. [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands)

    2005-06-01

    The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months' follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1{+-}2.4 preprocedural versus 18.6{+-}2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2{+-}0.2 versus 1.2{+-}0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1{+-}2.5 mm versus 16.5{+-}2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months' follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up. (orig.)

  9. Right atrial volume calculated by multi-detector computed tomography. Useful predictor of atrial fibrillation recurrence after pulmonary vein catheter ablation

    International Nuclear Information System (INIS)

    Kaneko, Kyouichi; Akutsu, Yasushi; Kodama, Yusuke

    2010-01-01

    We investigated whether right atrial (RA) volume could be used to predict the recurrence of atrial fibrillation (AF) after pulmonary vein catheter ablation (CA). We evaluated 65 patients with paroxysmal AF (mean age, 60+10 years, 81.5% male) and normal volunteers (57±14 years, 41.7% male). Sixty-four-slice multi-detector computed tomography was performed for left atrial (LA) and RA volume estimations before CA. The recurrence of AF was assessed for 6 months after the ablation. Both left and right atrial volumes were larger in the AF patients than the normal volunteers (LA: 99.7+33.2 ml vs. 59.7+17.4 ml; RA: 82.9+35.7 ml vs. 43.9+12 ml; P 100 ml) for predicting the recurrence of AF was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 69.4% in 34 of 49 patients without recurrence. The sensitivity with large RA volumes (>87 ml) was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 75.5% in 37 of 49 patients without recurrence. RA volume is a useful predictor of the recurrence of AF, similar to LA volume. (author)

  10. Efficacy of double arterial phase dynamic magnetic resonance imaging with the sensitivity encoding technique versus dynamic multidetector-row helical computed tomography for detecting hypervascular hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kumano, Seishi; Okada, Masahiro; Murakami, Takamichi; Uemura, Masahiko; Haraikawa, Toyoaki; Hirata, Masaaki; Kikuchi, Keiichi; Mochizuki, Teruhito; Kim, Tonsok

    2009-01-01

    The aim of this study was to evaluate the efficacy of double arterial phase dynamic magnetic resonance imaging (MRI) with the sensitivity encoding technique (SENSE dynamic MRI) for detection of hypervascular hepatocellular carcinoma (HCC) in comparison with double arterial phase dynamic multidetector-row helical computed tomography (dynamic MDCT). A total of 28 patients with 66 hypervascular HCCs underwent both double arterial SENSE dynamic MRI and dynamic MDCT. The diagnosis of HCC was based on surgical resection (n=7), biopsy (n=10), or a combination of CT during arterial portography (CTAP), CT during hepatic arteriography (CTA), and/or the 6-month follow-up CT (n=49). Based on alternative-free response receiving operating characteristic (ROC) analysis, the diagnostic performance for detecting HCC was compared between double arterial phase SENSE dynamic MRI and double arterial phase dynamic MDCT. The mean sensitivity, positive predictive value, and mean A Z values for hypervascular HCCs were 72%, 80%, and 0.79, respectively, for SENSE dynamic MRI and 66%, 92%, and 0.78, respectively, for dynamic MDCT. The mean sensitivity for double arterial phase SENSE dynamic MRI was higher than that for double arterial phase dynamic MDCT, but the difference was not statistically significant. Double arterial phase SENSE dynamic MRI is as valuable as double arterial phase dynamic MDCT for detecting hypervascular HCCs. (author)

  11. Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma

    International Nuclear Information System (INIS)

    Nishida, Y; Matsue, Y; Suehara, Y; Fukumoto, K; Fujisawa, M; Takeuchi, M; Ouchi, E; Matsue, K

    2015-01-01

    Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and −44.5 , −20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7% P=0.002) and extramedullary disease (10.4% vs 0% P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival

  12. Active extravasation of contrast within the hemorrhage (spot sign: a multidetector computed tomography finding that predicts growth and a worse prognosis in non-traumatic intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Marcos Rosa Junior

    2013-10-01

    Full Text Available Intracerebral hemorrhage (ICH causes high rates of disability and neurological sequelae Objective To evaluate spot signs as predictors of expansion and worse prognosis in non-traumatic ICH in a Brazilian cohort. Method We used multidetector computed tomography angiography to study 65 consecutive patients (40 men, 61.5%, with ages varying from 33 to 89 years (median age 55 years. Clinical and imaging findings were correlated with the findings based on the initial imaging. Results Of the individuals who presented a spot sign, 73.7% died (in-hospital mortality, whereas in the absence of a spot sign the mortality rate was 43.0%. Although expansion of ICH was detected in 75% of the patients with a spot sign, expansion was observed in only 9.0% of the patients who did not present a spot sign. Conclusions The spot sign strongly predicted expansion in non-traumatic ICH and an increased risk of in-hospital mortality.

  13. Functional imaging of larynx via 256-Slice Multi-Detector Computed Tomography in patients with laryngeal tumors: A faster, better and more reliable pre-therapeutic evaluation

    International Nuclear Information System (INIS)

    Celebi, Irfan; Basak, Muzaffer; Ucgul, Ayhan; Yildirim, Hakan; Oz, Aysel; Vural, Cetin

    2012-01-01

    Objective: To determine the clinical utility of using dynamic maneuvers during imaging of larynx via 256-Slice Multi-Detector Computed Tomography in the pre-therapeutic evaluation of laryngeal tumors. Materials and methods: A total of 27 patients (7 women, 20 men; aged 53–76 years) diagnosed with laryngeal squamous cell carcinoma were evaluated pre-therapeutically via contrast enhanced axial CT scans during consecutive phases of phonation (PP), inspiration (IP) and Valsalva maneuver (VP). Results: In 2 of 5 patients diagnosed with T1a glottic tumor, scans obtained during VP and PP were normal while the CT scans obtained during IP clearly showed a mass. In all patients (27/27) PP provided visualization of the ventricle, on coronal plane images and the pyriform sinus apices, on axial plane images. Involvement of the anterior commissure was best assessable on axial plane IP images (sensitivity 93%, specificity 92%). In cases of stage T1–T3 tumors use of dynamic maneuvers during laryngeal CT imaging showed the location and extension of the tumor better than the single phase CT scans did. We did not find a significant improvement in the pre-therapeutic evaluation in stage T4 tumors. Conclusion: Providing markedly clearer and more detailed evaluation of mucosal surfaces and deep structures of the larynx and mobility of the cords than do conventional scans, use of dynamic laryngeal maneuvers during laryngeal CT imaging seems to be an useful alternative in the pre-therapeutic assessment of laryngeal tumors.

  14. Association of apolipoprotein b/apolipoprotein A1 ratio and coronary artery stenosis and plaques detected by multi-detector computed tomography in healthy population.

    Science.gov (United States)

    Jung, Chang Hee; Hwang, Jenie Yoonoo; Shin, Mi Seon; Yu, Ji Hee; Kim, Eun Hee; Bae, Sung Jin; Yang, Dong Hyun; Kang, Joon-Won; Park, Joong-Yeol; Kim, Hong-Kyu; Lee, Woo Je

    2013-05-01

    Despite the noninvasiveness and accuracy of multidetector computed tomography (MDCT), its use as a routine screening tool for occult coronary atherosclerosis is unclear. We investigated whether the ratio of apolipoprotein B (apoB) to apolipoprotein A1 (apoA1), an indicator of the balance between atherogenic and atheroprotective cholesterol transport could predict occult coronary atherosclerosis detected by MDCT. We collected the data of 1,401 subjects (877 men and 524 women) who participated in a routine health screening examination of Asan Medical Center. Significant coronary artery stenosis defined as > 50% stenosis was detected in 114 subjects (8.1%). An increase in apoB/A1 quartiles was associated with increased percentages of subjects with significant coronary stenosis and noncalcified plaques (NCAP). After adjustment for confounding variables, each 0.1 increase in serum apoB/A1 was significantly associated with increased odds ratios (ORs) for coronary stenosis and NCAP of 1.23 and 1.18, respectively. The optimal apoB/A1 ratio cut off value for MDCT detection of significant coronary stenosis was 0.58, which had a sensitivity of 70.2% and a specificity of 48.2% (area under the curve, 0.61; 95% CI, 0.58-0.63, P < 0.001). Our results indicate that apoB/A1 ratio is a good indicator of occult coronary atherosclerosis detected by coronary MDCT.

  15. Multidetector-row computed tomography for prosthetic heart valve dysfunction: is concomitant non-invasive coronary angiography possible before redo-surgery?

    Energy Technology Data Exchange (ETDEWEB)

    Tanis, Wilco [Haga Teaching Hospital, Department of Cardiology, The Hague (Netherlands); Haga Teaching Hospital, The Hague (Netherlands); Sucha, Dominika; Habets, Jesse [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Laufer, Ward; Chamuleau, Steven [University Medical Center Utrecht, Department of Cardiology, Utrecht (Netherlands); Herwerden, Lex.A. van [University Medical Center Utrecht, Department of Cardiothoracic Surgery, Utrecht (Netherlands); Symersky, Petr [Vrije Universiteit, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Budde, Ricardo P.J. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands)

    2015-06-01

    Retrospective ECG-gated multidetector-row computed tomography (MDCT) is increasingly used for the assessment of prosthetic heart valve (PHV) dysfunction, but is also hampered by PHV-related artefacts/cardiac arrhythmias. Furthermore, it is performed without nitroglycerine or heart rate correction. The purpose was to determine whether MDCT performed before potential redo-PHV surgery is feasible for concomitant coronary artery stenosis assessment and can replace invasive coronary angiography (CAG). PHV patients with CAG and MDCT were identified. Based on medical history, two groups were created: (I) patients with no known coronary artery disease (CAD), (II) patients with known CAD. All images were scored for the presence of significant (>50 %) stenosis. CAG was the reference test. Fifty-one patients were included. In group I (n = 38), MDCT accurately ruled out significant stenosis in 19/38 (50 %) patients, but could not replace CAG in the remaining 19/38 (50 %) patients due to non-diagnostic image quality (n = 16) or significant stenosis (n = 3) detection. In group II (n = 13), MDCT correctly found no patients without significant stenosis, requiring CAG imaging in all. MDCT assessed patency in 16/19 (84 %) grafts and detected a hostile anatomy in two. MDCT performed for PHV dysfunction assessment can replace CAG (100 % accurate) in approximately half of patients without previously known CAD. (orig.)

  16. Assessment of left ventricular myocardial function using 16-slice multidetector-row computed tomography: comparison with magnetic resonance imaging and echocardiography

    International Nuclear Information System (INIS)

    Heuschmid, Martin; Rothfuss, Julia K.; Fenchel, Michael; Stauder, Norbert; Kuettner, Axel; Miller, Stephan; Claussen, Claus D.; Kopp, Andreas F.; Schroeder, Stephen; Burgstahler, Christof; Franow, Andreas; Kuzo, Ronald S.

    2006-01-01

    To assess functional parameters using multidetector-row computed tomography (MDCT) and echocardiography and to compare the results with magnetic resonance imaging (MRI). End-diastolic-volume (EDV), end-systolic-volume (ESV), stroke-volume (SV), ejection-fraction (EF), and myocardial mass (MM) were calculated based on CT data sets from 52 patients. Echocardiography was performed in 24 of the 52 patients. The results from MDCT and echocardiography were compared with MRI. A strong correlation between MDCT and MRI (r=0.66-0.90) was found for all parameters. Echocardiography revealed a low or moderate correlation (0.05-0.59). Compared to MRI the average differences with MDCT were for EDV 15.1 ml, ESV 10.6 ml, SV 4.5 ml, EF 1.8%, and MM 8.2 g, for EDV determined by echocardiography 36.2 ml, ESV 6.8 ml, and EF 13.9%. Bland-Altman analysis revealed acceptable limits of agreement between MRI and MDCT. MDCT enables reliable quantification of left ventricular function. Echocardiography was found to have only a moderate agreement of functional parameters with MRI. (orig.)

  17. Evaluation of right ventricular function with multidetector computed tomography: comparison with magnetic resonance imaging and analysis of inter- and intraobserver variability

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Mira; Teige, Florian; Schnapauff, Dirk; Hamm, Bernd; Dewey, Marc [Humboldt-Universitaet zu Berlin, Department of Radiology, Charite, Medical School, Berlin, PO Box 10098 (Germany)

    2009-02-15

    This study was performed to prospectively compare multidetector computed tomography (MDCT) with 16 simultaneous sections and magnetic resonance imaging (MRI) for the assessment of global right ventricular function in 50 patients. MDCT using a semiautomatic analysis tool showed good correlation with MRI for end-diastolic volume (EDV, r=0.83, p<0.001), end-systolic volume (ESV, r=0.86, p<0.001) and stroke volume (SV, r=0.74, p<0.001), but only a moderate correlation for the ejection fraction (EF, r=0.67, p<0.001). Bland Altman analysis revealed a slight, but insignificant overestimation of EDV (4.0 ml, p= 0.08) and ESV (2.4 ml, p=0.07), and underestimation of EF (0.1%, p=0.92) with MDCT compared with MRI. All limits of agreement between both modalities (EF: {+-}15.7%, EDV: {+-}31.0 ml, ESV: {+-}18.0 ml) were in a moderate but acceptable range. Interobserver variability of MDCT was not significantly different from that of MRI. For MDCT software, the post-processing time was significantly longer (19.6{+-}5.8 min) than for MRI (11.8{+-}2.6 min, p<0.001). Accurate assessment of right ventricular volumes by 16-detector CT is feasible but still rather time-consuming. (orig.)

  18. Evaluation of prosthetic valve obstruction on electrocardiographically gated multidetector-row computed tomography--identification of subprosthetic pannus in the aortic position.

    Science.gov (United States)

    Ueda, Tomohiro; Teshima, Hideki; Fukunaga, Shuji; Aoyagi, Shigeaki; Tanaka, Hiroyuki

    2013-01-01

    This study was performed to evaluate the diagnostic role of electrocardiographically gated multidetector-row computed tomography (MDCT) for prosthetic valve obstruction (PVO) in the aortic position. Between 2002 and 2006, 9 patients were diagnosed with PVO of an aortic bileaflet mechanical valve based on echocardiographic and cineradiographic criteria. These 9 patients were examined using MDCT before replacement of the mechanical valve, and intraoperative findings were compared to morphologic periprosthetic abnormalities observed on MDCT. CT attenuation (Hounsfield units; HU) of the periprosthetic abnormalities was measured to investigate the underlying cause of the PVO. MDCT showed subprosthetic masses extending beyond the prosthetic ring into the orifice of the valve. At reoperation, presence of subprosthetic pannus was confirmed in all of the 9 patients, but no periprosthetic thrombus was found. The mean CT attenuation of the subprosthetic pannus was 170 HU, and it was significantly greater than that obtained from the interventricular septum (108 HU; Ppannus causing PVO and the mean CT attenuation of subprosthetic pannus is significantly higher than that of the interventricular septum on MDCT.

  19. The effectiveness of postmortem multidetector computed tomography in the detection of fatal findings related to cause of non-traumatic death in the emergency department

    International Nuclear Information System (INIS)

    Takahashi, Naoya; Higuchi, Takeshi; Shiotani, Motoi; Hirose, Yasuo; Shibuya, Hiroyuki; Hashidate, Hideki; Yamanouchi, Haruo; Funayama, Kazuhisa

    2012-01-01

    To investigate the diagnostic performance of postmortem multidetector computed tomography (PMMDCT) for the detection of fatal findings related to causes of non-traumatic death in the emergency department (ED). 494 consecutive cases of clinically diagnosed non-traumatic death in ED involving PMMDCT were enrolled. The fatal findings were detected on PMMDCT and classified as definite or possible findings. These findings were confirmed by autopsy in 20 cases. The fatal findings were detected in 188 subjects (38.1%) including 122 with definite (24.7%) and 66 with possible finding (13.4%). Definite findings included 21 cases of intracranial vascular lesions, 84 with intra-thoracic haemorrhage, 13 with retroperitoneal haemorrhage and one with oesophagogastric haemorrhage. In three patients who had initially been diagnosed with non-traumatic death, PMMDCT revealed fatal traumatic findings. Two definite findings (two haemopericardiums) and seven possible findings (two intestinal obstructions, one each of multiple liver tumours central pulmonary artery dilatation, pulmonary congestion, peritoneal haematoma, and brain oedema) were confirmed by autopsy. The causes of death were not determined in cases with possible findings without autopsy. PMMDCT is a feasible tool for detecting morphological fatal findings in non-traumatic death in ED. It is important to know the ability and limitation of PMMDCT. (orig.)

  20. Multidetector-row computed tomography for prosthetic heart valve dysfunction: is concomitant non-invasive coronary angiography possible before redo-surgery?

    International Nuclear Information System (INIS)

    Tanis, Wilco; Sucha, Dominika; Habets, Jesse; Laufer, Ward; Chamuleau, Steven; Herwerden, Lex.A. van; Symersky, Petr; Budde, Ricardo P.J.

    2015-01-01

    Retrospective ECG-gated multidetector-row computed tomography (MDCT) is increasingly used for the assessment of prosthetic heart valve (PHV) dysfunction, but is also hampered by PHV-related artefacts/cardiac arrhythmias. Furthermore, it is performed without nitroglycerine or heart rate correction. The purpose was to determine whether MDCT performed before potential redo-PHV surgery is feasible for concomitant coronary artery stenosis assessment and can replace invasive coronary angiography (CAG). PHV patients with CAG and MDCT were identified. Based on medical history, two groups were created: (I) patients with no known coronary artery disease (CAD), (II) patients with known CAD. All images were scored for the presence of significant (>50 %) stenosis. CAG was the reference test. Fifty-one patients were included. In group I (n = 38), MDCT accurately ruled out significant stenosis in 19/38 (50 %) patients, but could not replace CAG in the remaining 19/38 (50 %) patients due to non-diagnostic image quality (n = 16) or significant stenosis (n = 3) detection. In group II (n = 13), MDCT correctly found no patients without significant stenosis, requiring CAG imaging in all. MDCT assessed patency in 16/19 (84 %) grafts and detected a hostile anatomy in two. MDCT performed for PHV dysfunction assessment can replace CAG (100 % accurate) in approximately half of patients without previously known CAD. (orig.)

  1. Lung MRI of invasive fungal infection at 3 Tesla: evaluation of five different pulse sequences and comparison with multidetector computed tomography (MDCT)

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Chenggong; Tan, Xiangliang; Li, Caixia; Wu, Yuankui; Hao, Peng; Xiong, Wei; Xu, Yikai [Southern Medical University, Department of Medical Imaging Center, Nanfang Hospital, Guangzhou, Guangdong (China); Wei, Qi; Feng, Ru; Xu, Jun [Southern Medical University, Department of Hematology, Nanfang Hospital, Guangzhou (China); Chan, Queenie [Philips Healthcare, New Territories (China)

    2014-09-18

    To evaluate the diagnostic performance of five MR sequences to detect pulmonary infectious lesions in patients with invasive fungal infection (IFI), using multidetector computed tomography (MDCT) as the reference standard. Thirty-four immunocompromised patients with suspected IFI underwent MDCT and MRI. The MR studies were performed using five pulse sequences at 3.0 T: T2-weighted turbo spin echo (TSE), short-tau inversion recovery (STIR), spectrally selective attenuated inversion recovery (SPAIR), T1-weighted high resolution isotropic volume excitation (e-THRIVE) and T1-weighted fast field echo (T1-FFE). The size, lesion-to-lung contrast ratio and the detectability of pulmonary lesions on MR images were assessed. Image quality and artefacts on different sequences were also rated. A total of 84 lesions including nodules (n = 44) and consolidation (n = 40) were present in 75 lobes. SPAIR and e-THRIVE images achieved high overall lesion-related sensitivities for the detection of pulmonary abnormalities (90.5 % and 86.9 %, respectively). STIR showed the highest lesion-to-lung contrast ratio for nodules (21.8) and consolidation (17.0), whereas TSE had the fewest physiological artefacts. MRI at 3.0 T can depict clinically significant pulmonary IFI abnormalities with high accuracy compared to MDCT. SPAIR and e-THRIVE are preferred sequences for the detection of infectious lesions of 5 mm and larger. (orig.)

  2. Myocardial enhancement pattern in patients with acute myocardial infarction on two-phase contrast-enhanced Ecg-gated multidetector-row computed tomography

    International Nuclear Information System (INIS)

    Ko, S.M.; Seo, J.B.; Hong, M.K.; Do, K.H.; Lee, S.H.; Lee, J.S.; Song, J.W.; Park, S.J.; Park, S.W.; Lim, T.H.

    2006-01-01

    Aim: To evaluate the myocardial enhancement pattern of the left ventricle on two-phase contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) images in patients with acute myocardial infarction (AMI). METHODS: Two-phase contrast-enhanced ECG-gated MDCT examinations were performed in 16 patients with AMI. The presence, location and pattern of myocardial enhancement were evaluated. MDCT findings were compared with the catheter angiographic results. RESULTS: Subendocardial (n=9) or transmural (n=6) area of early perfusion defects of the myocardium was detected in 15 of 16 patients (94%) on early-phase CT images. Variable delayed myocardial enhancement patterns on late-phase CT images were observed in 12 patients (75%): (1) subendocardial residual perfusion defect and subepicardial late enhancement (n=6); (2) transmural late enhancement (n=1); (3) isolated subendocardial late enhancement (n=1); and (4) isolated subendocardial residual perfusion defect (n=2). On catheter angiography, 14 of 15 corresponding coronary arteries showed significant stenosis. CONCLUSION: Variable abnormal myocardial enhancement pattern was seen on two-phase, contrast-enhanced ECG-gated MDCT in patients with AMI. Assessment of myocardial attenuation on CT angiography gives additional information of the location and extent of infarction

  3. Quantitative assessment of lung volumes using multi-detector row computed tomography (MDCT) in patients with chronic obstructive pulmonary disease (COPD)

    International Nuclear Information System (INIS)

    Lee, Sang Min; Hur, Jin; Kim, Tae Hoon; Kim, Sang Jin; Kim, Hyung Jung

    2008-01-01

    To evaluate the clinical value of the multi-detector row computed tomography (MDCT) in the quantitative assessment of lung volumes and to assess the relationship between the MDCT results and disease severity as determined by a pulmonary function test (PFT) in Chronic Obstructive Pulmonary Disease (COPD) patients. We performed a PFT and MDCT on 39 COPD patients. Using the GOLD classifications, we divided the patients into three groups according to disease severity; stage I (mild, n = 10), stage II (moderate, n = 15), and stage III (severe, n = 14). Using the pulmo-CT software program, we measured the proportion of lung volumes with attenuation values below -910 and -950 HU. The mean FEV1 (% of predicted) and FEV1/FVC was 82.2 ± 2% and 66.2 ± 3% in stage I, 53.5 ± 11% and 52 ± 6% in stage II, and 32.3 ± 7% and 44.2% ± 13% in stage III, respectively. Differences in lung volume percentage at each of the thresholds (-910 and -950 HU) among the 3 stages were statistically significant (ρ < 0.01, ρ < 0.01) and correlated well with the FEV1 and FEV1/FVC (r = -0.803, r -0.766, r = -0.817, and r = -0.795, respectively). The volumetric measurement obtained by MDCT provides an accurate means of quantifying pulmonary emphysema

  4. Non-obstructive low attenuation coronary plaque predicts three-year acute coronary syndrome events in patients with hypertension. Multidetector computed tomographic study

    International Nuclear Information System (INIS)

    Nakanishi, Koki; Shimada, Kenei; Fukuda, Shota

    2012-01-01

    Arterial hypertension is an established risk factor for acute coronary syndrome (ACS). Multidetector computed tomography (MDCT) is an accurate and less invasive technique for assessment of the degree of coronary artery luminal narrowing and characterization of coronary atherosclerosis. We therefore aimed to investigate the predictive power of MDCT for future ACS events and compared with traditional parameters in patients with hypertension. One hundred and thirty-four patients (93 men, mean age 70±11 years) with hypertension underwent MDCT for evaluation of coronary artery disease. MDCT analysis focused on the presence of plaques, the degree of stenosis, and the plaque characteristics. Traditional parameters included Framingham risk score, carotid intima-media thickness, and left ventricular mass index. During a mean follow-up of 39±10 months, ACS events occurred in 10 patients, including myocardial infarction (n=3) and unstable angina (n=7). Multivariate analysis identified total number of low attenuation plaques as an independent predictor of ACS events (p<0.001). We demonstrated that non-obstructive low attenuation coronary plaques on MDCT predicted more accurately future ACS events in patients with hypertension than traditional parameters. (author)

  5. Cochlear Implant Electrode Localization Using an Ultra-High Resolution Scan Mode on Conventional 64-Slice and New Generation 192-Slice Multi-Detector Computed Tomography.

    Science.gov (United States)

    Carlson, Matthew L; Leng, Shuai; Diehn, Felix E; Witte, Robert J; Krecke, Karl N; Grimes, Josh; Koeller, Kelly K; Bruesewitz, Michael R; McCollough, Cynthia H; Lane, John I

    2017-08-01

    A new generation 192-slice multi-detector computed tomography (MDCT) clinical scanner provides enhanced image quality and superior electrode localization over conventional MDCT. Currently, accurate and reliable cochlear implant electrode localization using conventional MDCT scanners remains elusive. Eight fresh-frozen cadaveric temporal bones were implanted with full-length cochlear implant electrodes. Specimens were subsequently scanned with conventional 64-slice and new generation 192-slice MDCT scanners utilizing ultra-high resolution modes. Additionally, all specimens were scanned with micro-CT to provide a reference criterion for electrode position. Images were reconstructed according to routine temporal bone clinical protocols. Three neuroradiologists, blinded to scanner type, reviewed images independently to assess resolution of individual electrodes, scalar localization, and severity of image artifact. Serving as the reference standard, micro-CT identified scalar crossover in one specimen; imaging of all remaining cochleae demonstrated complete scala tympani insertions. The 192-slice MDCT scanner exhibited improved resolution of individual electrodes (p implant imaging compared with conventional MDCT. This technology provides important feedback regarding electrode position and course, which may help in future optimization of surgical technique and electrode design.

  6. Sensitivity of endoscopic ultrasound, multidetector computed tomography, and magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum: a tertiary center experience.

    Science.gov (United States)

    Kushnir, Vladimir M; Wani, Sachin B; Fowler, Kathryn; Menias, Christine; Varma, Rakesh; Narra, Vamsi; Hovis, Christine; Murad, Faris M; Mullady, Daniel K; Jonnalagadda, Sreenivasa S; Early, Dayna S; Edmundowicz, Steven A; Azar, Riad R

    2013-04-01

    There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent endoscopic retrograde pancreatography and cross-sectional imaging. The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than the sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) (P pancreas divisum; IOA was moderate (κ = 0.43). Endoscopic ultrasound is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum.

  7. SENSITIVITY OF ENDOSCOPIC ULTRASOUND, MULTIDETECTOR COMPUTER TOMOGRAPHY AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY IN THE DIAGNOSIS OF PANCREAS DIVISUM: A TERTIARY CENTER EXPERIENCE

    Science.gov (United States)

    Kushnir, Vladimir M.; Wani, Sachin B.; Fowler, Kathryn; Menias, Christine; Varma, Rakesh; Narra, Vamsi; Hovis, Christine; Murad, Faris; Mullady, Daniel; Jonnalagadda, Sreenivasa S.; Early, Dayna S.; Edmundowicz, Steven A.; Azar, Riad R.

    2014-01-01

    OBJECTIVES There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: 1. Evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP) and multi-detector computed tomography (MDCT) for pancreas divisum. 2. Assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. METHODS For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography (ERP) who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent ERP and cross-sectional imaging. RESULTS The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) [ppancreas divisum; IOA was moderate (қ=0.43). CONCLUSIONS EUS is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum. PMID:23211370

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

  9. Epicardial adipose tissue and pericoronary fat thickness measured with 64-multidetector computed tomography: potential predictors of the severity of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Muhammed Bora Demircelik

    2014-06-01

    Full Text Available OBJECTIVE:The aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease.METHODS:The study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing <50% in diameter, Group 2; and obstructive atherosclerosis (luminal narrowing ≥50% in a single vessel or obstructive atherosclerosis in the left main coronary artery and/or multiple vessels, Group 3. Epicardial adipose tissue was defined as the adipose tissue between the surface of the heart and the visceral layer of the pericardium (visceral epicardium. Epicardial adipose tissue thickness (mm was determined in the right ventricular anterior free wall. The mean thickness of the pericoronary fat surrounding the three coronary arteries was used for the analyses.RESULTS:The average thickness over all three regions was 13.2 ± 2.1 mm. The pericoronary fat thickness was significantly increased in Group 3 compared with Groups 2 and 1. The epicardial adipose tissue thickness was significantly increased in Group 3 compared with Groups 2 and 1. A receiver operating characteristic curve for obstructive coronary artery disease was assessed to verify the optimum cut-off point for pericoronary fat thickness, which was 13.8 mm. A receiver operating characteristic curve for obstructive coronary artery disease was also assessed to verify the optimum cut-off point for epicardial adipose tissue, which was 6.8 cm.CONCLUSION:We showed that the epicardial adipose tissue and pericoronary fat thickness scores were higher in patients with obstructive coronary artery diseases.

  10. Epicardial adipose tissue and pericoronary fat thickness measured with 64-multidetector computed tomography: potential predictors of the severity of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Demircelik, Muhammed Bora; Gurel, Ozgul Malcok; Selcoki, Yusuf; Atar, Inci Asli; Eryonucu, Beyhan, E-mail: drdemircelik@yahoo.com [Turgut Ozal Univercity, Department of Cardiology, Ankara (Turkey); Bozkurt, Alper; Akin, Kayihan [Turgut Ozal Univercity, Department of Radiology, Ankara (Turkey); Yilmaz, Omer Caglar [Ankara Occupational Diseases Hospital, Department of Cardiology, Ankara (Turkey)

    2014-06-15

    Objective: the aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease. Methods: the study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing < 50% in diameter), Group 2; and obstructive atherosclerosis (luminal narrowing ≧ 50%) in a single vessel or obstructive atherosclerosis in the left main coronary artery and/or multiple vessels, Group 3. Epicardial adipose tissue was defined as the adipose tissue between the surface of the heart and the visceral layer of the pericardium (visceral epicardium). Epicardial adipose tissue thickness (mm) was determined in the right ventricular anterior free wall. The mean thickness of the pericoronary fat surrounding the three coronary arteries was used for the analyses. Results: the average thickness over all three regions was 13.2 ± 2.1 mm. The pericoronary fat thickness was significantly increased in Group 3 compared with Groups 2 and 1. The epicardial adipose tissue thickness was significantly increased in Group 3 compared with Groups 2 and 1. A receiver operating characteristic curve for obstructive coronary artery disease was assessed to verify the optimum cut-off point for pericoronary fat thickness, which was 13.8 mm. A receiver operating characteristic curve for obstructive coronary artery disease was also assessed to verify the optimum cut-off point for epicardial adipose tissue, which was 6.8 cm. Conclusion: we showed that the epicardial adipose tissue and pericoronary fat thickness scores were higher in patients with obstructive coronary artery diseases. (author)

  11. Epicardial adipose tissue and pericoronary fat thickness measured with 64-multidetector computed tomography: potential predictors of the severity of coronary artery disease

    International Nuclear Information System (INIS)

    Demircelik, Muhammed Bora; Gurel, Ozgul Malcok; Selcoki, Yusuf; Atar, Inci Asli; Eryonucu, Beyhan; Bozkurt, Alper; Akin, Kayihan; Yilmaz, Omer Caglar

    2014-01-01

    Objective: the aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease. Methods: the study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing < 50% in diameter), Group 2; and obstructive atherosclerosis (luminal narrowing ≧ 50%) in a single vessel or obstructive atherosclerosis in the left main coronary artery and/or multiple vessels, Group 3. Epicardial adipose tissue was defined as the adipose tissue between the surface of the heart and the visceral layer of the pericardium (visceral epicardium). Epicardial adipose tissue thickness (mm) was determined in the right ventricular anterior free wall. The mean thickness of the pericoronary fat surrounding the three coronary arteries was used for the analyses. Results: the average thickness over all three regions was 13.2 ± 2.1 mm. The pericoronary fat thickness was significantly increased in Group 3 compared with Groups 2 and 1. The epicardial adipose tissue thickness was significantly increased in Group 3 compared with Groups 2 and 1. A receiver operating characteristic curve for obstructive coronary artery disease was assessed to verify the optimum cut-off point for pericoronary fat thickness, which was 13.8 mm. A receiver operating characteristic curve for obstructive coronary artery disease was also assessed to verify the optimum cut-off point for epicardial adipose tissue, which was 6.8 cm. Conclusion: we showed that the epicardial adipose tissue and pericoronary fat thickness scores were higher in patients with obstructive coronary artery diseases. (author)

  12. Influence of the Quantity of Aortic Valve Calcium on the Agreement Between Automated 3-Dimensional Transesophageal Echocardiography and Multidetector Row Computed Tomography for Aortic Annulus Sizing.

    Science.gov (United States)

    Podlesnikar, Tomaz; Prihadi, Edgard A; van Rosendael, Philippe J; Vollema, E Mara; van der Kley, Frank; de Weger, Arend; Ajmone Marsan, Nina; Naji, Franjo; Fras, Zlatko; Bax, Jeroen J; Delgado, Victoria

    2018-01-01

    Accurate aortic annulus sizing is key for selection of appropriate transcatheter aortic valve implantation (TAVI) prosthesis size. The present study compared novel automated 3-dimensional (3D) transesophageal echocardiography (TEE) software and multidetector row computed tomography (MDCT) for aortic annulus sizing and investigated the influence of the quantity of aortic valve calcium (AVC) on the selection of TAVI prosthesis size. A total of 83 patients with severe aortic stenosis undergoing TAVI were evaluated. Maximal and minimal aortic annulus diameter, perimeter, and area were measured. AVC was assessed with computed tomography. The low and high AVC burden groups were defined according to the median AVC score. Overall, 3D TEE measurements slightly underestimated the aortic annulus dimensions as compared with MDCT (mean differences between maximum, minimum diameter, perimeter, and area: -1.7 mm, 0.5 mm, -2.7 mm, and -13 mm 2 , respectively). The agreement between 3D TEE and MDCT on aortic annulus dimensions was superior among patients with low AVC burden (AVC burden (≥3,025 arbitrary units). The interobserver variability was excellent for both methods. 3D TEE and MDCT led to the same prosthesis size selection in 88%, 95%, and 81% of patients in the total population, the low, and the high AVC burden group, respectively. In conclusion, the novel automated 3D TEE imaging software allows accurate and highly reproducible measurements of the aortic annulus dimensions and shows excellent agreement with MDCT to determine the TAVI prosthesis size, particularly in patients with low AVC burden. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  13. Detection of Cement Leakage After Vertebroplasty with a Non-Flat-Panel Angio Unit Compared to Multidetector Computed Tomography - An Ex Vivo Study

    International Nuclear Information System (INIS)

    Baumann, Clemens; Fuchs, Heiko; Westphalen, Kerstin; Hierholzer, Johannes

    2008-01-01

    The purpose of this study was to investigate the detection of cement leakages after vertebroplasty using angiographic computed tomography (ACT) in a non-flat-panel angio unit compared to multidetector computed tomography (MDCT). Vertebroplasty was performed in 19 of 33 cadaver vertebrae (23 thoracic and 10 lumbar segments). In the angio suite, ACT (190 o ; 1.5 o per image) was performed to obtain volumetric data. Another volumetric data set of the specimen was obtained by MDCT using a standard algorithm. Nine multiplanar reconstructions in standardized axial, coronal, and sagittal planes of every vertebra were generated from both data sets. Images were evaluated on the basis of a nominal scale with 18 criteria, comprising osseous properties (e.g., integrity of the end plate) and cement distribution (e.g., presence of intraspinal cement). MDCT images were regarded as gold standard and analyzed by two readers in a consensus mode. Rotational acquisitions were analyzed by six blinded readers. Results were correlated with the gold standard using Cohen's κ-coefficient analysis. Furthermore, interobserver variability was calculated. Correlation with the gold standard ranged from no correlation (osseous margins of the neuroforamen, κ = 0.008) to intermediate (trace of vertebroplasty canula; κ = 0.615) for criteria referring to osseous morphology. However, there was an excellent correlation for those criteria referring to cement distribution, with κ values ranging from 0.948 (paravertebral cement distribution) to 0.972 (intraspinal cement distribution). With a minimum of κ = 0.768 ('good correlation') and a maximum of κ = 0.91 ('excellent'), interobserver variability was low. In conclusion, ACT in an angio suite without a flat-panel detector depicts a cement leakage after vertebroplasty as well as MDCT. However, the method does not provide sufficient depiction of osseous morphology.

  14. Prediction of optimal deployment projection for transcatheter aortic valve replacement: angiographic 3-dimensional reconstruction of the aortic root versus multidetector computed tomography.

    Science.gov (United States)

    Binder, Ronald K; Leipsic, Jonathon; Wood, David; Moore, Teri; Toggweiler, Stefan; Willson, Alex; Gurvitch, Ronen; Freeman, Melanie; Webb, John G

    2012-04-01

    Identifying the optimal fluoroscopic projection of the aortic valve is important for successful transcatheter aortic valve replacement (TAVR). Various imaging modalities, including multidetector computed tomography (MDCT), have been proposed for prediction of the optimal deployment projection. We evaluated a method that provides 3-dimensional angiographic reconstructions (3DA) of the aortic root for prediction of the optimal deployment angle and compared it with MDCT. Forty patients undergoing transfemoral TAVR at St Paul's Hospital, Vancouver, Canada, were evaluated. All underwent preimplant 3DA and 68% underwent preimplant MDCT. Three-dimensional angiographic reconstructions were generated from images of a C-arm rotational aortic root angiogram during breath-hold, rapid ventricular pacing, and injection of 32 mL contrast medium at 8 mL/s. Two independent operators prospectively predicted perpendicular valve projections. The implant angle was chosen at the discretion of the physician performing TAVR. The angles from 3DA, from MDCT, the implant angle, and the postdeployment perpendicular prosthesis view were compared. The shortest distance from the postdeployment perpendicular prosthesis projection to the regression line of predicted perpendicular projections was calculated. All but 1 patient had adequate image quality for reproducible angle predictions. There was a significant correlation between 3DA and MDCT for prediction of perpendicular valve projections (r=0.682, Pregression line of predicted angles to the postdeployment prosthesis view was 5.1±4.6° for 3DA and 7.9±4.9° for MDCT (P=0.01). Three-dimensional angiographic reconstructions and MDCT are safe, practical, and accurate imaging modalities for identifying the optimal perpendicular valve deployment projection during TAVR.

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

    International Nuclear Information System (INIS)

    Gooley, Robert P.; Cameron, James D.; Soon, Jennifer; Loi, Duncan; Chitale, Gauri; Syeda, Rifath; Meredith, Ian T.

    2015-01-01

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

  16. Diffusion-weighted MR-imaging for the detection of pulmonary nodules at 1.5 Tesla: intraindividual comparison with multidetector computed tomography

    International Nuclear Information System (INIS)

    Regier, Marc; Schwarz, Dorothee; Henes, Frank Oliver; Groth, Michael; Begemann, Philipp G.C.; Adam, Gerhard; Kooijman, Hendrik

    2011-01-01

    To investigate the feasibility of diffusion-weighted imaging (DWI) MRI for detecting pulmonary nodules at 1.5 Tesla in comparison with standard multidetector computed tomography (MDCT). Twenty patients with disseminated cancer disease in which MDCT had assured the presence of at least one pulmonary nodule were examined using a respiratory-gated DWI MR-sequence. Grey scale inverted source images and coronal maximum intensity projection (MIP) images were consensually analysed by two experienced radiologists. Size and location of any nodule detected were assessed. Additionally, the readers evaluated each hemithorax for the presence of at least one nodule and applied a four-point conspicuity scale (1-hemithorax definitely affected; 4-hemithorax definitely not affected). MDCT data served as reference. At MDCT, a total of 71 pulmonary noduIes was found (size 3–5 mm, n = 16; 6–9 mm, n = 22; ≥10 mm, n = 33). For the DWI MR-sequence, a sensitivity of 86.4% was calculated for nodules ranging 6–9 mm and 97% for nodules ≥10 mm. In contrast, only 43.8% of lesions ≤5 mm was detected. The separate analysis of each hemithorax for the presence of at least one pulmonary nodule revealed a specificity rate, PPV and NPV of DWI-MR of 92.3%, 96% and 80%, respectively. The presented study is the first to confirm the diagnostic potential of DWI-MR in the detection of solid lung nodules. This technique allows for the detection of nodules ≥6 mm with reasonably high sensitivity rates (>86%). The observation of false positive findings decreases the accuracy of this approach compared with MDCT.

  17. Improved vessel morphology measurements in contrast-enhanced multi-detector computed tomography coronary angiography with non-linear post-processing

    International Nuclear Information System (INIS)

    Ferencik, Maros; Lisauskas, Jennifer B.; Cury, Ricardo C.; Hoffmann, Udo; Abbara, Suhny; Achenbach, Stephan; Karl, W. Clem; Brady, Thomas J.; Chan, Raymond C.

    2006-01-01

    Multi-detector computed tomography (MDCT) permits detection of coronary plaque. However, noise and blurring impair accuracy and precision of plaque measurements. The aim of the study was to evaluate MDCT post-processing based on non-linear image deblurring and edge-preserving noise suppression for measurements of plaque size. Contrast-enhanced MDCT coronary angiography was performed in four subjects (mean age 55 ± 5 years, mean heart rate 54 ± 5 bpm) using a 16-slice scanner (Siemens Sensation 16, collimation 16 x 0.75 mm, gantry rotation 420 ms, tube voltage 120 kV, tube current 550 mAs, 80 mL of contrast). Intravascular ultrasound (IVUS; 40 MHz probe) was performed in one vessel in each patient and served as a reference standard. MDCT vessel cross-sectional images (1 mm thickness) were created perpendicular to centerline and aligned with corresponding IVUS images. MDCT images were processed using a deblurring and edge-preserving noise suppression algorithm. Then, three independent blinded observers segmented lumen and outer vessel boundaries in each modality to obtain vessel cross-sectional area and wall area in the unprocessed MDCT cross-sections, post-processed MDCT cross-sections and corresponding IVUS. The wall area measurement difference for unprocessed and post-processed MDCT images relative to IVUS was 0.4 ± 3.8 mm 2 and -0.2 ± 2.2 mm 2 (p 2 , respectively. In conclusion, MDCT permitted accurate in vivo measurement of wall area and vessel cross-sectional area as compared to IVUS. Post-processing to reduce blurring and noise reduced variability of wall area measurements and reduced measurement bias for both wall area and vessel cross-sectional area

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  19. Assessment of coronary calcification using calibrated mass score with two different multidetector computed tomography scanners in the Copenhagen General Population Study

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, Andreas [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Groen, Jaap M. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Department of Medical Physics, OLVG, Amsterdam (Netherlands); Arnold, Ben A. [Image Analysis, 1380 Burkesville Road, Columbia, KY (United States); Nikolovski, Sasho [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Knudsen, Andreas D., E-mail: dehlbaek@gmail.com [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Kühl, J. Tobias [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Nordestgaard, Børge G. [Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, University of Copenhagen (Denmark); Greuter, Marcel J.W. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Kofoed, Klaus F. [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Department of Radiology, The Diagnostic Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark)

    2017-03-15

    Objective: Population studies have shown coronary calcium score to improve risk stratification in subjects suspected for cardiovascular disease. The aim of this work was to assess the validity of multidetector computed tomography (MDCT) for measurement of calibrated mass scores (MS) in a phantom study, and to investigate inter-scanner variability for MS and Agaston score (AS) recorded in a population study on two different high-end MDCT scanners. Materials and methods: A calcium phantom was scanned by a first (A) and second (B) generation 320-MDCT. MS was measured for each calcium deposit from repeated measurements in each scanner and compared to known physical phantom mass. Random samples of human subjects from the Copenhagen General Population Study were scanned with scanner A (N = 254) and scanner B (N = 253) where MS and AS distributions of these two groups were compared. Results: The mean total MS of the phantom was 32.9 ± 0.8 mg and 33.1 ± 0.9 mg (p = 0.43) assessed by scanner A and B respectively – the physical calcium mass was 34.0 mg. Correlation between measured MS and physical calcium mass was R{sup 2} = 0.99 in both scanners. In the population study the median total MS was 16.8 mg (interquartile range (IQR): 3.5–81.1) and 15.8 mg (IQR: 3.8–63.4) in scanner A and B (p = 0.88). The corresponding median total AS were 92 (IQR: 23–471) and 89 (IQR: 40–384) (p = 0.64). Conclusion: Calibrated calcium mass score may be assessed with very high accuracy in a calcium phantom by different generations of 320-MDCT scanners. In population studies, it appears acceptable to pool calcium scores acquired on different 320-MDCT scanners.

  20. Study on multi-detector computed tomography in the virtual endoscope mode to phantom of saliva gland duct application. Image quality evaluation of geometry

    International Nuclear Information System (INIS)

    Ozawa, Tomonori; Innami, Hisashi; Oyake, Reira; Shinohara, Yuki; Yamaaki, Fumi; Koizumi, Nobuhide; Okumura, Yasuhiko

    2009-01-01

    The diagnosis ability of the radiographic imaging has been greatly improved by the advent of multi-detector computed tomography (MDCT), Which is now a the prerequisite to the diagnosis and treatment of a variety of diseases. MDCT conducted in the virtual endoscope mode can be used for various image compositions, and the space in a structure such as the large intestines can be visualized similarly as with an actual endoscope. Using a phantom of a salivary gland duct, I performed the image analysis to determine whether this endoscope mode could able to be applied to the oral cavity. I searched for the optimum conditions and the best position for taking pictures, and evaluated whether the salivary gland ducts could be reproducibly imitated by the phantom. Modulation transfer function (MTF), Wiener spectrum (WS) analysis were used to examined the utility of MDCT in the virtual endoscope mode for use in the oral cavity. As a result, the following conclusions were made: The best image was obtained within 40 mm from the center part of the gantry by the MTF and the WS analyses. Decreases in the MTF and the WS as the decrease were seen at 20 mAs and 80 kV, and the decrease were seen in the sharpness of the image decreased as the value of the reconstruction function became smaller. The image was somewhat distorted when pictures were taken of the parallel or the direction of the slice by the inclination within 90 deg±15 deg as much as possible Z axially for running of the duct in the evaluation of internal reproducibility. The influence was admitted to go out easily in an inside form as the inside diameter became thin. The salivary gland phantom was evaluated geometrically by MDCT in the virtual endoscope mode, and the optimal conditions were obtained from the above-mentioned results. The utility of MDCT in the mode was thus suggested. (author)

  1. Threshold-dependent variability of coronary artery calcification measurements - implications for contrast-enhanced multi-detector row-computed tomography

    International Nuclear Information System (INIS)

    Moselewski, Fabian; Ferencik, Maros; Achenbach, Stephan; Abbara, Suhny; Cury, Ricardo C.; Booth, Sarah L.; Jang, Ik-Kyung; Brady, Thomas J.; Hoffmann, Udo

    2006-01-01

    Introduction: The present study investigated the threshold-dependent variability of coronary artery calcification (CAC) measurements and the potential to quantify CAC in contrast-enhanced multi-detector row-computed tomography (MDCT). Methods: We compared the mean CT attenuation of CAC to luminal contrast enhancement of the coronary arteries in 30 patients (n = 30) undergoing standard coronary contrast-enhanced spiral MDCT. The modified Agatston score [AS], calcified plaque volume [CV], and mineral mass [MM]) at four different thresholds (130, 200, 300, and 400 HU) were measured in 50 patients who underwent non-contrast-enhanced MDCT. Results: Mean CT attenuation of CAC was similar to the attenuation of the contrast-enhanced coronary lumen (CAC 297.1 ± 68.7 HU versus 295 ± 65 HU (p < 0.0001), respectively). Above a threshold of 300 HU CAC measurements significantly varied to standard measurements obtained at a threshold of 130 HU (p < 0.0001). The threshold-dependent variation of MM measurements was significantly smaller than for AS and CV (130 HU versus 400 HU: 63, 75, and 81, respectively; p < 0.001). These differences resulted in a change of age and gender based percentile category for AS in 78% of subjects. Discussion: We demonstrated that CAC measurements are threshold dependent with MM measurements having significantly less variation than AS or CV. Due to the similarity of mean CT attenuation of CAC and the contrast-enhanced coronary lumen accurate quantification of CAC may be difficult in standard coronary contrast-enhanced spiral MDCT

  2. Whole tumour first-pass perfusion using a low-dose method with 64-section multidetector row computed tomography in oesophageal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Chen Tianwu; Yang Zhigang; Dong Zhihui; Li Yuan; Yao Jin; Wang Qiling; Qian Lingling

    2011-01-01

    Purpose: To propose a low-dose method at tube current-time product of 50 mAs for whole tumour first-pass perfusion of oesophageal squamous cell carcinoma using 64-section multidetector row computed tomography (MDCT), and to assess the original image quality and accuracy of perfusion parameters. Materials and methods: Fifty-nine consecutive patients with confirmed oesophageal squamous cell carcinomas were enrolled into our study, and underwent whole tumour first-pass perfusion scan with 64-section MDCT at 50 mAs. Image data were statistically reviewed focusing on original image quality demonstrated by image-quality scores and signal-to-noise (S/N) ratios; and perfusion parameters including perfusion (PF, in ml/min/ml), peak enhanced density (PED, in HU), time to peak (TTP, in seconds) and blood volume (BV, in ml/100 g) for the tumour. To test the interobserver agreement of perfusion measurements, perfusion analyses were repeatedly performed. Results: Original image-quality scores were 4.71 ± 0.49 whereas S/N ratios were 5.21 ± 2.05, and the scores were correlated with the S/N ratios (r = 0.465, p < 0.0001). Mean values for PF, PED, TTP and BV of the tumour were 33.27 ± 24.15 ml/min/ml, 24.06 ± 9.87 HU, 29.42 ± 8.61 s, and 12.45 ± 12.22 ml/100 g, respectively. Intraclass correlation coefficient between the replicated measurements of each perfusion parameter was greater than 0.99, and mean difference of the replicated measurements of each parameter was close to zero. Conclusion: Whole tumour first-pass perfusion with 64-section MDCT at low-dose radiation could be reproducible to assess microcirculation in oesophageal squamous cell carcinoma without compromising subjective original image quality of the tumour.

  3. Preoperative differentiation between T1a and ≥T1b gallbladder cancer: combined interpretation of high-resolution ultrasound and multidetector-row computed tomography

    International Nuclear Information System (INIS)

    Joo, Ijin; Baek, Jee Hyun; Kim, Jung Hoon; Han, Joon Koo; Choi, Byung Ihn; Lee, Jae Young; Park, Hee Sun

    2014-01-01

    To determine the diagnostic value of combined interpretation of high-resolution ultrasound (HRUS) and multidetector-row computed tomography (MDCT) for preoperative differentiation between T1a and ≥T1b gallbladder (GB) cancer. Eighty-seven patients with pathologically confirmed GB cancers (T1a, n = 15; ≥T1b, n = 72), who preoperatively underwent both HRUS and MDCT, were included in this retrospective study. Two reviewers independently determined the T-stages of the GB cancers on HRUS and MDCT using a five-point confidence scale (5, definitely T1a; 1, definitely ≥T1b). For individual modality interpretation, the lesions with scores ≥4 were classified as T1a, and, for combined modality interpretation, the lesions with all scores ≥4 in both modalities were classified as T1a. The McNemar test was used to compare diagnostic performance. The diagnostic accuracy of differentiation between T1a and ≥T1b GB cancer was higher using combined interpretation (90.8 % and 88.5 % for reviewers 1 and 2, respectively) than individual interpretation of HRUS (82.8 % and 83.9 %) or MDCT (74.7 % and 82.8 %) (P < 0.05, reviewer 1). Combined interpretations demonstrated 100 % specificity for both reviewers, which was significantly higher than individual interpretations (P < 0.05, both reviewers). Combined HRUS and MDCT interpretation may improve the diagnostic accuracy and specificity for differentiating between T1a and ≥T1b GB cancers. circle Differentiating between T1a and ≥T1b gallbladder cancer can help surgical planning. (orig.)

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

    International Nuclear Information System (INIS)

    Greuter, Marcel J.W.; Dorgelo, Joost; Tukker, Wim G.J.; Oudkerk, Matthijs

    2005-01-01

    Acquisition time plays a key role in the quality of cardiac multidetector computed tomography (MDCT) and is directly related to the rotation time of the scanner. The purpose of this study is to examine the influence of heart rate and a multisector reconstruction algorithm on the image quality of coronary arteries of an anthropomorphic adjustable moving heart phantom on an ECG-gated MDCT unit. The heart phantom and a coronary artery phantom were used on a MDCT unit with a rotation time of 500 ms. The movement of the heart was determined by analysis of the images taken at different phases. The results indicate that the movement of the coronary arteries on the heart phantom is comparable to that in a clinical setting. The influence of the heart rate on image quality and artifacts was determined by analysis of several heart rates between 40 and 80 bpm where the movement of the heart was synchronized using a retrospective ECG-gated acquisition protocol. The resulting reformatted volume rendering images of the moving heart and the coronary arteries were qualitatively compared as a result of the heart rate. The evaluation was performed on three independent series by two independent radiologists for the image quality of the coronary arteries and the presence of artifacts. The evaluation shows that at heart rates above 50 bpm the influence of motion artifacts in the coronary arteries becomes apparent. In addition the influence of a dedicated multisector reconstruction technique on image quality was determined. The results show that the image quality of the coronary arteries is not only related to the heart rate and that the influence of the multisector reconstruction technique becomes significant above 70 bpm. Therefore, this study proves that from the actual acquisition time per heart cycle one cannot determine an actual acquisition time, but only a mathematical acquisition time. (orig.)

  5. Metallic artifacts from internal scaphoid fracture fixation screws: comparison between C-arm flat-panel, cone-beam, and multidetector computed tomography.

    Science.gov (United States)

    Finkenstaedt, Tim; Morsbach, Fabian; Calcagni, Maurizio; Vich, Magdalena; Pfirrmann, Christian W A; Alkadhi, Hatem; Runge, Val M; Andreisek, Gustav; Guggenberger, Roman

    2014-08-01

    The aim of this study was to compare image quality and extent of artifacts from scaphoid fracture fixation screws using different computed tomography (CT) modalities and radiation dose protocols. Imaging of 6 cadaveric wrists with artificial scaphoid fractures and different fixation screws was performed in 2 screw positions (45° and 90° orientation in relation to the x/y-axis) using multidetector CT (MDCT) and 2 flat-panel CT modalities, C-arm flat-panel CT (FPCT) and cone-beam CT (CBCT), the latter 2 with low and standard radiation dose protocols. Mean cartilage attenuation and metal artifact-induced absolute Hounsfield unit changes (= artifact extent) were measured. Two independent radiologists evaluated different image quality criteria using a 5-point Likert-scale. Interreader agreements (Cohen κ) were calculated. Mean absolute Hounsfield unit changes and quality ratings were compared using Friedman and Wilcoxon signed-rank tests. Artifact extent was significantly smaller for MDCT and standard-dose FPCT compared with CBCT low- and standard-dose acquisitions (all P 0.05). Both MDCT and FPCT standard-dose protocols showed equal ratings for screw bone interface, fracture line, and trabecular bone evaluation (P = 0.06, 0.2, and 0.2, respectively) and performed significantly better than FPCT low- and CBCT low- and standard-dose acquisitions (all P < 0.05). Good interreader agreement was found for image quality comparisons (Cohen κ = 0.76-0.78). Both MDCT and FPCT standard-dose acquisition showed comparatively less metal-induced artifacts and better overall image quality compared with FPCT low-dose and both CBCT acquisitions. Flat-panel CT may provide sufficient image quality to serve as a versatile CT alternative for postoperative imaging of internally fixated wrist fractures.

  6. Threshold-dependent variability of coronary artery calcification measurements - implications for contrast-enhanced multi-detector row-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Moselewski, Fabian [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Ferencik, Maros [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Achenbach, Stephan [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Internal Medicine II (Cardiology), University of Erlangen (Germany); Abbara, Suhny [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Cury, Ricardo C. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Booth, Sarah L. [Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St., Boston, MA 02114 (United States); Jang, Ik-Kyung [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Brady, Thomas J. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hoffmann, Udo [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)]. E-mail: uhoffman@partners.org

    2006-03-15

    Introduction: The present study investigated the threshold-dependent variability of coronary artery calcification (CAC) measurements and the potential to quantify CAC in contrast-enhanced multi-detector row-computed tomography (MDCT). Methods: We compared the mean CT attenuation of CAC to luminal contrast enhancement of the coronary arteries in 30 patients (n = 30) undergoing standard coronary contrast-enhanced spiral MDCT. The modified Agatston score [AS], calcified plaque volume [CV], and mineral mass [MM] at four different thresholds (130, 200, 300, and 400 HU) were measured in 50 patients who underwent non-contrast-enhanced MDCT. Results: Mean CT attenuation of CAC was similar to the attenuation of the contrast-enhanced coronary lumen (CAC 297.1 {+-} 68.7 HU versus 295 {+-} 65 HU (p < 0.0001), respectively). Above a threshold of 300 HU CAC measurements significantly varied to standard measurements obtained at a threshold of 130 HU (p < 0.0001). The threshold-dependent variation of MM measurements was significantly smaller than for AS and CV (130 HU versus 400 HU: 63, 75, and 81, respectively; p < 0.001). These differences resulted in a change of age and gender based percentile category for AS in 78% of subjects. Discussion: We demonstrated that CAC measurements are threshold dependent with MM measurements having significantly less variation than AS or CV. Due to the similarity of mean CT attenuation of CAC and the contrast-enhanced coronary lumen accurate quantification of CAC may be difficult in standard coronary contrast-enhanced spiral MDCT.

  7. First-line sonographic diagnosis of pneumothorax in major trauma: accuracy of e-FAST and comparison with multidetector computed tomography.

    Science.gov (United States)

    Ianniello, Stefania; Di Giacomo, Vincenza; Sessa, Barbara; Miele, Vittorio

    2014-09-01

    Combined clinical examination and supine chest radiography have shown low accuracy in the assessment of pneumothorax in unstable patients with major chest trauma during the primary survey in the emergency room. The aim of our study was to evaluate the diagnostic accuracy of extended-focused assessment with sonography in trauma (e-FAST), in the diagnosis of pneumothorax, compared with the results of multidetector computed tomography (MDCT) and of invasive interventions (thoracostomy tube placement). This was a retrospective case series involving 368 consecutive unstable adult patients (273 men and 95 women; average age, 25 years; range, 16-68 years) admitted to our hospital's emergency department between January 2011 and December 2012 for major trauma (Injury Severity Score ≥ 15). We evaluated the accuracy of thoracic ultrasound in the detection of pneumothorax compared with the results of MDCT and invasive interventions (thoracostomy tube placement). Institutional review board approval was obtained prior to commencement of this study. Among the 736 lung fields included in the study, 87 pneumothoraces were detected with thoracic CT scans (23.6%). e-FAST detected 67/87 and missed 20 pneumothoraces (17 mild, 3 moderate). The diagnostic performance of ultrasound was: sensitivity 77% (74% in 2011 and 80% in 2012), specificity 99.8%, positive predictive value 98.5%, negative predictive value 97%, accuracy 97.2% (67 true positive; 668 true negative; 1 false positive; 20 false negative); 17 missed mild pneumothoraces were not immediately life-threatening (thickness less than 5 mm). Thoracic ultrasound (e-FAST) is a rapid and accurate first-line, bedside diagnostic modality for the diagnosis of pneumothorax in unstable patients with major chest trauma during the primary survey in the emergency room.

  8. Multidetector-Row Computed Tomography in the Evaluation of Transjugular Intrahepatic Portosystemic Shunt Performed with Expanded-Polytetrafluoroethylene-Covered Stent-Graft

    International Nuclear Information System (INIS)

    Fanelli, Fabrizio; Bezzi, Mario; Bruni, Antonio; Corona, Mario; Boatta, Emanuele; Lucatelli, Pierleone; Passariello, Roberto

    2011-01-01

    We assessed, in a prospective study, the efficacy of multidetector spiral computed tomography (MDCT) in the evaluation of transjugular intrahepatic portosystemic shunt (TIPS) patency in patients treated with the Viatorr (Gore, Flagstaff, AZ) expanded-polytetrafluoroethylene (e-PTFE)-covered stent-graft. Eighty patients who underwent TIPS procedure using the Viatorr self-expanding e-PTFE stent-graft were evaluated at follow-up of 1, 3, 6, and 12 months with clinical and laboratory tests as well as ultrasound–color Doppler (USCD) imaging. In case of varices, upper gastrointestinal endoscopy was also performed. In addition, the shunt was evaluated using MDCT at 6 and 12 months. In all cases of abnormal findings and discrepancy between MDCT and USCD, invasive control venography was performed. MDCT images were acquired before and after injection of intravenous contrast media on the axial plane and after three-dimensional reconstruction using different algorithms. MDCT was successfully performed in all patients. No artefacts correlated to the Viatorr stent-graft were observed. A missing correlation between UCSD and MDCT was noticed in 20 of 80 (25%) patients. Invasive control venography confirmed shunt patency in 16 (80%) cases and shunt malfunction in 4 (20%) cases. According to these data, MDCT sensitivity was 95.2%; specificity was 96.6%; and positive (PPV) and negative predictive values (NPV) were 90.9 and 98.2%, respectively. USCD sensitivity was 90%; specificity was 75%; and PPV and NPV were 54.5 and 95.7%, respectively. A high correlation (K value = 0.85) between MDCT and invasive control venography was observed. On the basis of these results, MDCT shows superior sensitivity and specificity compared with USCD in those patients in whom TIPS was performed with the Viatorr stent-graft. MDCT can be considered a valid tool in the follow-up of these patients.

  9. Validation of multi-detector computed tomography as a non-invasive method for measuring ovarian volume in macaques (Macaca fascicularis).

    Science.gov (United States)

    Jones, Jeryl C; Appt, Susan E; Werre, Stephen R; Tan, Joshua C; Kaplan, Jay R

    2010-06-01

    The purpose of this study was to validate low radiation dose, contrast-enhanced, multi-detector computed tomography (MDCT) as a non-invasive method for measuring ovarian volume in macaques. Computed tomography scans of four known-volume phantoms and nine mature female cynomolgus macaques were acquired using a previously described, low radiation dose scanning protocol, intravenous contrast enhancement, and a 32-slice MDCT scanner. Immediately following MDCT, ovaries were surgically removed and the ovarian weights were measured. The ovarian volumes were determined using water displacement. A veterinary radiologist who was unaware of actual volumes measured ovarian CT volumes three times, using a laptop computer, pen display tablet, hand-traced regions of interest, and free image analysis software. A statistician selected and performed all tests comparing the actual and CT data. Ovaries were successfully located in all MDCT scans. The iliac arteries and veins, uterus, fallopian tubes, cervix, ureters, urinary bladder, rectum, and colon were also consistently visualized. Large antral follicles were detected in six ovaries. Phantom mean CT volume was 0.702+/-SD 0.504 cc and the mean actual volume was 0.743+/-SD 0.526 cc. Ovary mean CT volume was 0.258+/-SD 0.159 cc and mean water displacement volume was 0.257+/-SD 0.145 cc. For phantoms, the mean coefficient of variation for CT volumes was 2.5%. For ovaries, the least squares mean coefficient of variation for CT volumes was 5.4%. The ovarian CT volume was significantly associated with actual ovarian volume (ICC coefficient 0.79, regression coefficient 0.5, P=0.0006) and the actual ovarian weight (ICC coefficient 0.62, regression coefficient 0.6, P=0.015). There was no association between the CT volume accuracy and mean ovarian CT density (degree of intravenous contrast enhancement), and there was no proportional or fixed bias in the CT volume measurements. Findings from this study indicate that MDCT is a valid non

  10. Estimation of aortic time-enhancement curve in pharmacokinetic analysis. Dynamic study by multi-detector row computed tomography

    International Nuclear Information System (INIS)

    Yamaguchi, Isao; Kidoya, Eiji; Higashimura, Kyoji; Hayashi, Hiroyuki; Suzuki, Masayuki

    2007-01-01

    This paper presents an introduction to the development of software that provides a physiologic model of contrast medium enhancement by incorporating available physiologic data and contrast medium pharmacokinetics to predict an organ-specific aortic time-enhancement curve (TEC) in computed tomography (CT) with various contrast medium injection protocols in patients of various heights, weights, cardiac output levels, and so on. The physiologic model of contrast medium enhancement was composed of six compartments for early contrast enhancement pharmacokinetics. Contrast medium is injected via the antecubital vein and distributed to the right side of the heart, the pulmonary compartment, the left side of the heart, and the aorta. It then circulates back to the right side of the heart via the systemic circulation. A computer-based, compartmental model of the aortic system was generated using human physiologic parameters and six differential equations to describe the transport of contrast medium. Aortic TEC generated by the computer-based physiologic model of contrast medium enhancement showed validity and agreement with clinical data and findings published previously. A computer-based physiologic model that may help predict organ-specific CT contrast medium enhancement for different injection protocols was developed. Such a physiologic model may have multiple clinical applications. (author)

  11. Imaging pitfalls, normal anatomy, and anatomical variants that can simulate disease on cardiac imaging as demonstrated on multidetector computed tomography

    International Nuclear Information System (INIS)

    Terpenning, Silanath; White, Charles S

    2015-01-01

    Advances in computed tomography have led to continuous improvement in cardiac imaging. Dedicated postprocessing capabilities, faster scan times, and cardiac gating methods reveal details of normal cardiac anatomy and anatomic variants that can mimic pathologic conditions. This article will review normal cardiac anatomy and variants that can mimic disease. Radiologists should be familiar with normal cardiac anatomy and anatomic variants to avoid misinterpretation of normal findings for pathologic processes

  12. Comparison of gated blood pool SPECT and spiral multidetector computed tomography in the assessment of right ventricular functional parameters. Validation with first-pass radionuclide angiography

    International Nuclear Information System (INIS)

    Lee, Jung S.; Kim, Seong-Jang; Kim, In-Ju; Kim, Yong-Ki; Choo, Ki S.; Lee, Jun S.

    2007-01-01

    The aim of this study was to compare gated blood pool single photon emission computed tomography (SPECT) (GBPS) and multidetector row computed tomography (MDCT) for the determination of right ventricular ejection fraction (RVEF) and right ventricular volumes (RVV) and to compare first-pass radionuclide angiography (FP-RNA) as the gold standard. Twenty consecutive patients (11 men, 9 women) referred for MDCT for the evaluation of the presence of coronary artery disease underwent FP-RNA and GBPS. The mean right ventricular end-diastolic volume (EDV) calculated with GBPS revealed a statistically significant lower value than that of MDCT. The mean right ventricular end-systolic volume (ESV) calculated with GBPS was also lower than that of MDCT. A comparison of right ventricular EDV from GBPS and MDCT yielded a correlation coefficient of 0.5972. Right ventricular ESV between GBPS and MDCT showed a correlation coefficient of 0.5650. The mean RVEFs calculated with FP-RNA (39.8%±4.0%), GBPS (43.7%±6.9%), and MDCT (40.4%±7.7%) showed no statistical differences (Kruskal-Wallis statistics 4.538, P=0.1034). A comparison of RVEFs from FP-RNA and GBPS yielded a correlation coefficient of 0.7251; RVEFs between FP-RNA and MDCT showed a correlation coefficient of 0.6166 and between GBPS and MDCT showed a correlation coefficient of 0.6367. The RVEF, EDV, and ESV calculated by GBPS had good correlation with those obtained with MDCT. In addition, there were no statistical differences of RVEF calculated from FP-RNA, GBPS, and MDCT. However, with regard to RVV, EDV and ESV from GBPS revealed statistically significantly lower values than those of MDCT. Although reasonable correlations among these modalities were obtained, the agreement among these three modalities was not good enough for interchangeable use in the clinical setting. Also, these results should be confirmed in patients with cardiac diseases in future larger population-based studies. (author)

  13. Use of multidetector-row computed tomography scan to detect pannus formation in prosthetic mechanical aortic valves.

    Science.gov (United States)

    Aladmawi, Mohamed A; Pragliola, Claudio; Vriz, Olga; Galzerano, Domenico

    2017-04-01

    Obstruction of a mechanical aortic valve by pannus formation at the subvalvular level is a major long-term complication of aortic valve replacement (AVR). In fact, pannus is sometime difficult to differentiate from patient-prosthesis mismatch or valve thrombosis. In most cases cine-angiography and echocardiography, either transthoracic or transesophageal, cannot correctly visualize the complication when the leaflets show a normal mobility. Recent technological refinements made this difficult diagnosis possible by ECG-gated computed tomography (CT) scan which shows adequate images in 90% of the cases and can differentiate pannus from fresh and organized thrombus.

  14. Multidetector computed tomography of the head in acute stroke: predictive value of different patterns of the dense artery sign revealed by maximum intensity projection reformations for location and extent of the infarcted area

    Energy Technology Data Exchange (ETDEWEB)

    Gadda, Davide; Vannucchi, Letizia; Niccolai, Franco; Neri, Anna T.; Carmignani, Luca; Pacini, Patrizio [Ospedale del Ceppo, U.O. Radiodiagnostica, Pistoia (Italy)

    2005-12-01

    Maximum intensity projections reconstructions from 2.5 mm unenhanced multidetector computed tomography axial slices were obtained from 49 patients within the first 6 h of anterior-circulation cerebral strokes to identify different patterns of the dense artery sign and their prognostic implications for location and extent of the infarcted areas. The dense artery sign was found in 67.3% of cases. Increased density of the whole M1 segment with extension to M2 of the middle cerebral artery was associated with a wider extension of cerebral infarcts in comparison to M1 segment alone or distal M1 and M2. A dense sylvian branch of the middle cerebral artery pattern was associated with a more restricted extension of infarct territory. We found 62.5% of patients without a demonstrable dense artery to have a limited peripheral cortical or capsulonuclear lesion. In patients with a 7-10 points on the Alberta Stroke Early Programme Computed Tomography Score and a dense proximal MCA in the first hours of ictus the mean decrease in the score between baseline and follow-up was 5.09{+-}1.92 points. In conclusion, maximum intensity projections from thin-slice images can be quickly obtained from standard computed tomography datasets using a multidetector scanner and are useful in identifying and correctly localizing the dense artery sign, with prognostic implications for the entity of cerebral damage. (orig.)

  15. The use of maxillary sinus dimensions in gender determination: a thin-slice multidetector computed tomography assisted morphometric study.

    Science.gov (United States)

    Ekizoglu, Oguzhan; Inci, Ercan; Hocaoglu, Elif; Sayin, Ibrahim; Kayhan, Fatma Tulin; Can, Ismail Ozgur

    2014-05-01

    Gender determination is an important step in identification. For gender determination, anthropometric evaluation is one of the main forensic evaluations. In the present study, morphometric analysis of maxillary sinuses was performed to determine gender. For morphometric analysis, coronal and axial paranasal sinus computed tomography (CT) scan with 1-mm slice thickness was used. For this study, 140 subjects (70 women and 70 men) were enrolled (age ranged between 18 and 63). The size of each subject's maxillary sinuses was measured in anteroposterior, transverse, cephalocaudal, and volume directions. In each measurement, the size of the maxillary sinus is significantly small in female gender (P discrimination analysis was performed, the accuracy rate was detected as 80% for women and 74.3% for men with an overall rate of 77.15%. With the use of 1-mm slice thickness CT, morphometric analysis of maxillary sinuses will be helpful for gender determination.

  16. Multidetector CT of the colon

    International Nuclear Information System (INIS)

    Luboldt, W.; Hoepffner, N.; Holzer, K.

    2003-01-01

    Multidetector technology, enabling faster imaging, higher spatial resolution and reduction in radiation dose, increases the role of CT in colonic diagnostic. The higher spatial resolution in the z-direction also changes the way to analyze the images. Instead of reading axial sections, now the colon can be systematically assessed in 3D by scrolling through multiplanar reconstructions or in CT colonography by virtual endoscopy. With ongoing improvements in computer-aided diagnosis CT colonography becomes an alternative to fiberoptic colonocopy for screening (http://www.multiorganscreening.org). In this article we propose a CT examination protocol for the colon, describe the typical imaging findings of different colonic diseases, and summarize the current status of CT colonography. (orig.)

  17. Multidetector computed tomography (MDCT) evaluation of myocardial viability: intraindividual comparison of monomeric vs. dimeric contrast media in a rabbit model

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H. [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)]|[RWTH Aachen University, Applied Medical Engineering, Helmholtz Institute, Aachen (Germany)]|[University Hospital, RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany); Jost, Gregor; Sieber, Martin; Seidensticker, Peter R.; Pietsch, Hubertus [Bayer-Schering Pharma AG, Berlin (Germany); Bruners, Philipp [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)]|[RWTH Aachen University, Applied Medical Engineering, Helmholtz Institute, Aachen (Germany); Guenther, Rolf W. [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)

    2009-02-15

    To evaluate the influence of different types of iodinated contrast media on the assessment of myocardial viability, acute myocardial infarction (MI) was surgically induced in six rabbits. Over a period of 45 min, contrast-enhanced cardiac MDCT (64 x 0.6 mm, 80 kV, 680mAs{sub eff.}) was repeatedly performed using a contrast medium dose of 600 mg iodine/kg body weight. Animals received randomized iopromide 300 and iodixanol 320, respectively. Attenuation values of healthy and infarcted myocardium were measured. The size of MI was computed and compared with nitroblue tetrazolium (NBT)-stained specimen. The highest attenuation differences between infarcted and healthy myocardium occurred during the arterial phase with 140.0{+-}3.5 HU and 141.0{+-}2.2 HU for iopromide and iodixanol, respectively. For iodixanol the highest attenuation difference on delayed contrast-enhanced images was achieved 3 min post injection (73.5 HU). A slightly higher attenuation difference was observed for iopromide 6 min after contrast medium injection (82.2 HU), although not statistically significant (p=0.6437). Mean infarct volume as measured by NBT staining was 33.5%{+-}13.6%. There was an excellent agreement of infarct sizes among NBT-, iopromide- and iodixanol-enhanced MDCT with concordance-correlation coefficients ranging from {rho}{sub (c)=} 0.9928-0.9982. Iopromide and iodixanol both allow a reliable assessment of MI with delayed contrast-enhanced MDCT. (orig.)

  18. Preoperative assessment of vascular anatomy by multidetector computed tomography before laparoscopic colectomy for transverse colon cancer: report of a case.

    Science.gov (United States)

    Kawamoto, Aya; Inoue, Yasuhiro; Okigami, Masato; Yasuda, Hiromi; Okugawa, Yoshinaga; Hiro, Junichiro; Toiyama, Yuji; Tanaka, Koji; Uchida, Keiichi; Mohri, Yasuhiko; Kusunoki, Masato

    2015-02-01

    Although the safety of laparoscopic surgery for colon cancer has been reported in many randomized controlled trials, concerns about the difficulty of surgery for transverse colon cancer has not been fully resolved, mainly because of the variation in the vascular anatomy of mesenteric vessels, which leads to difficulty in determining the optimal operative procedure and the extent of lymph node dissection. We present the case of a patient with transverse colon cancer who underwent laparoscopic surgery after preoperative assessment using a combination of endoscopic clipping and three-dimensional computed tomography angiography (3DCTA). A 68-year-old man was diagnosed with transverse colon cancer, and laparoscopic surgery has been planned. 3DCTA showed right-middle and left-middle colic arteries arising independently from the superior mesenteric artery. The relationship between the clip and vessels showed that the right-middle colic artery was the feeding artery of the tumor. Operative findings were consistent with 3DCTA findings, and transverse colectomy with lymph node dissection was successfully performed.

  19. Four-channel multidetector-row computed tomography in the evaluation of facial fractures - optimized parameters for acquisition and multiplanar reformation

    International Nuclear Information System (INIS)

    Omid, P. M.

    2002-08-01

    The first part of this thesis is designed to give the reader a comprehensive survey on the complex basic principles of computed tomography (CT), from the early beginning to the recent development of multidetector-row CT (MD-CT). Attention is focused on imaging of trauma in general and on imaging of facial fractures in particular. The second part of this thesis describes a clinical study performed to optimize acquisition protocols and multiplanar reformation (MPR) algorithms for the evaluation of facial fractures using MD-CT, which has not been yet described in literature. For this study, a cadaver head with artificial blunt facial trauma was examined using a 4-channel MD-CT scanner. The influence of acquisition parameters (collimation: 2x0.5 mm/4x1 mm/4x2.5 mm; tube current: 120 mAs/90 mAs/60 mAs), image reconstruction algorithms (standard vs. ultra-high resolution (UHR) modes; reconstructed slice thicknesses: 0.5 mm/1 mm/3 mm; increment: 0.3 mm/0.6 mm/1.5 mm), and reformation algorithms (slice thicknesses: 0.5 mm/1 mm/3 mm; overlap: 0.5 mm/1 mm/3 mm) on detectability of facial fractures in MPRs with MD-CT was analyzed. Effects of algorithms and parameters on image noise, artifacts and delineation of soft tissues were evaluated. The results of this study reliably demonstrate that fracture detection was significantly higher with thin MPRs (0.5/0.5 mm, 1/0.5 mm, 1/1 mm) (p = 0 .014) acquired with 2x0.5 mm collimation (p = 0 .046), in UHR mode (p .0005) with 120 mAs (p = 0 .025). Inter-observer variability showed very good agreement (κ > = 0 .942). Non-UHR mode, lower mAs and thick MPRs (3/0.5 mm, 3/1 mm, 3/0.5 mm) showed significantly decreased detectability. (author)

  20. Phantom-Calibrated versus Automatic Coronary Artery Mass Quantification with Multidetector-Row Computed Tomography: In Vitro and In Vivo Study

    Energy Technology Data Exchange (ETDEWEB)

    Serafin, Z.; Lasek, W.; Laskowska, K. (Dept. of Radiology and Diagnostic Imaging, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland))

    2008-11-15

    Background: Coronary artery calcium scoring is used as a method for cardiovascular risk stratification and monitoring of coronary heart disease. Automatic software-based calcium mass calculation has been proposed to improve the performance of the procedure. Purpose: To compare two algorithms of calcium mass measurement, automatic and phantom calibrated, with respect to correlation, measurement error, and accuracy in vitro and in vivo. Material and Methods: A cardiac phantom with calcium cylinder inserts was scanned with sequential non-overlapping collimation 4x2.5 mm, at 120 kV and 165 mAs. Fifty adults (37 men; mean age 46.2 years) were examined with the same settings using prospective electrocardiographic triggering to detect and quantify coronary artery calcifications. Calculations were performed with two methods: software-based automatic calcium mass measurement (ACM) and phantom-calibrated calcium mass measurement (CCM). Results: The total phantom calcium masses measured with ACM and CCM were 175.0+-13.8 mg and 163.0+-4.4 mg, respectively (P<0.0001), and ACM produced a higher mean error (4.5 vs. 3.2; P<0.05). Results of ACM and CCM were strongly correlated to each other (R=0.73-0.96; P<0.0001). Mean image noise in the patient study was 8.72+-1.68 HU. Results of patient calcium scoring with ACM and CCM were significantly different (median 70.3 mg and 59.7 mg, respectively; P<0.0001), with a mean systematic error of 17.5% (limit of agreement between 14.6% and 20.4%). The use of ACM resulted in an altered quartile classification for 14% of patients, as compared to CCM; all of these patients were classified into a higher category. Conclusion: Our data indicate that multidetector-row computed tomography coronary calcium mass determination based on dedicated phantom calibration shows lower measurement error than an automatic software-based calculation method. The tested automatic software does not yet seem to be a reliable option for calcium mass measurement

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-01-15

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

  2. Phantom-Calibrated versus Automatic Coronary Artery Mass Quantification with Multidetector-Row Computed Tomography: In Vitro and In Vivo Study

    International Nuclear Information System (INIS)

    Serafin, Z.; Lasek, W.; Laskowska, K.

    2008-01-01

    Background: Coronary artery calcium scoring is used as a method for cardiovascular risk stratification and monitoring of coronary heart disease. Automatic software-based calcium mass calculation has been proposed to improve the performance of the procedure. Purpose: To compare two algorithms of calcium mass measurement, automatic and phantom calibrated, with respect to correlation, measurement error, and accuracy in vitro and in vivo. Material and Methods: A cardiac phantom with calcium cylinder inserts was scanned with sequential non-overlapping collimation 4x2.5 mm, at 120 kV and 165 mAs. Fifty adults (37 men; mean age 46.2 years) were examined with the same settings using prospective electrocardiographic triggering to detect and quantify coronary artery calcifications. Calculations were performed with two methods: software-based automatic calcium mass measurement (ACM) and phantom-calibrated calcium mass measurement (CCM). Results: The total phantom calcium masses measured with ACM and CCM were 175.0±13.8 mg and 163.0±4.4 mg, respectively (P<0.0001), and ACM produced a higher mean error (4.5 vs. 3.2; P<0.05). Results of ACM and CCM were strongly correlated to each other (R=0.73-0.96; P<0.0001). Mean image noise in the patient study was 8.72±1.68 HU. Results of patient calcium scoring with ACM and CCM were significantly different (median 70.3 mg and 59.7 mg, respectively; P<0.0001), with a mean systematic error of 17.5% (limit of agreement between 14.6% and 20.4%). The use of ACM resulted in an altered quartile classification for 14% of patients, as compared to CCM; all of these patients were classified into a higher category. Conclusion: Our data indicate that multidetector-row computed tomography coronary calcium mass determination based on dedicated phantom calibration shows lower measurement error than an automatic software-based calculation method. The tested automatic software does not yet seem to be a reliable option for calcium mass measurement

  3. Characteristics of patients with a significant stenosis in a conventional coronary angiogram with a normal multi-detector computed tomographic coronary angiogram

    International Nuclear Information System (INIS)

    Jeong, Hae Chang; Ahn, Youngkeun; Jeong, Myung Ho

    2009-01-01

    Multi-detector computed tomography (MDCT) has high diagnostic value for detecting or excluding coronary artery stenosis. However, conventional coronary angiograms (CCA) are occasionally required in patients having persistent chest pain with normal MDCT. We retrospectively analyzed 90 patients who underwent CCA due to persistent chest pain with normal MDCT. The patients were classified into patients having more than 50% diameter stenosis in CCA (false negative, group I: n=14, 62.6±7.5 years, 7 males) and those having less than 50% diameter stenosis (true negative, group II: n=76, 52.1±12.0 years, 42 males). Significant stenosis was observed in 9 patients at the left anterior descending artery, 4 at the right coronary artery, and 1 at the left circumflex artery in group I. Group I patients were older than group II patients (63±8 versus 52±12 years, P<0.001). There were more patients with hypertension and smoking in group I (64.3% versus 7.9%, 35.7% versus 3.9%, P<0.001, P<0.001, respectively). The levels of uric acid and homocysteine were higher in group I than in group II (5.7±1.5 versus 4.6±1.2 mg/dL, 9.6±3.1 versus 7.4±2.5 mol/L, P=0.008, P=0.010, respectively). There were more ST or T changes in the electrocardiograms in group I (35.7% versus 1.3%) (P<0.001). In multivariate analysis, a history of hypertension, uric acid levels, and ischemic evidence in the electrocardiogram were independent factors for a false negative of MDCT (odds ratio 11.11, 4.76, 1.81, 95% confidence interval 4.67 to 10.00, 1.41 to 1.61, 1.05 to 3.33, P=0.009, P=0.012, P=0.046, respectively). In certain situations, the findings of coronary stenosis by MDCT do not always correlate with that of CCA. (author)

  4. Value and impact factors of multidetector computed tomography in diagnosis of preoperative lymph node metastasis in gastric cancer: A PRISMA-compliant systematic review and meta-analysis.

    Science.gov (United States)

    Luo, Mingxu; Lv, You; Guo, Xiuyu; Song, Hongmei; Su, Guoqiang; Chen, Bo

    2017-08-01

    Multidetector computed tomography (MDCT) exhibited wide ranges of sensitivities and specificities for lymph node assessment of gastric cancer (GC) in several individual studies. This present meta-analysis was carried out to evaluate the value of MDCT in diagnosis of preoperative lymph node metastasis (LNM) and to explore the impact factors that might explain the heterogeneity of its diagnostic accuracy in GC. A comprehensive search was conducted to collect all the relevant studies about the value of MDCT in assessing LNM of GC within the PubMed, Cochrane library and Embase databases up to Feb 2, 2016. Two investigators independently screened the studies, extracted data, and evaluated the quality of included studies. The sensitivity, specificity, and area under ROC curve (AUC) were pooled to estimate the overall accuracy of MDCT. Meta-regression and subgroup analysis were carried out to identify the possible factors influencing the heterogeneity of the accuracy. A total of 27 studies with 6519 subjects were finally included. Overall, the pooled sensitivity, specificity, and AUC were 0.67 (95% CI: 0.56-0.77), 0.86 (95% CI: 0.81-0.90), and 0.86 (95% CI: 0.83-0.89), respectively. Meta-regression revealed that MDCT section thickness, proportion of serosal invasion, and publication year were the main significant impact factors in sensitivity, and MDCT section thickness, multiplanar reformation (MPR), and reference standard were the main significant impact factors in specificity. After the included studies were divided into 2 groups (Group A: studies with proportion of serosa-invasive GC subjects ≥50%; Group B: studies with proportion of serosa-invasive GC subjects <50%), the pooled sensitivity in Group A was significantly higher than in Group B (0.84 [95% CI: 0.75-0.90] vs 0.55 [95% CI: 0.41-0.68], P < .01). For early gastric cancer (EGC), the pooled sensitivity, specificity, and AUC were 0.34 (95% CI: 0.15-0.61), 0.91 (95% CI: 0.84-0.95), and 0.83 (95% CI: 0

  5. Role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in diagnosis and management of pancreatic cancer; comparison with multidetector row computed tomography, magnetic resonance imaging and endoscopic ultrasonography.

    Science.gov (United States)

    Ergul, N; Gundogan, C; Tozlu, M; Toprak, H; Kadıoglu, H; Aydin, M; Cermik, T F

    2014-01-01

    We aimed to analyze the contribution of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging to the diagnosis and management of pancreatic cancer compared with multidetector row computed tomography (MDCT), magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS). We retrospectively scanned the data of 52 patients who were referred for FDG PET/CT imaging for evaluation of pancreatic lesions greater than 10mm. The diagnostic performances of 4 imaging methods and the impact of PET/CT on the management of pancreatic cancer were defined. Pancreatic adenocarcinoma was diagnosed in 33 of 52 patients (63%), 15 patients had benign diseases of pancreas (29%), and 4 patients were normal (8%). Sensitivity and NPV of EUS and PET/CT were equal (100%) and higher than MDCT and MRI. Specificity, PPV and NPV of PET/CT were significantly higher than MDCT. However, sensitivities of two imaging methods were not significantly different. There was no significant difference between PET/CT and MRI and EUS for these values. When the cut-off value of SUVmax was 3.2, the most effective sensitivity and specificity values were obtained. PET/CT contributed to the management of pancreatic cancer in 30% of patients. FDG PET/CT is a valuable imaging method for the diagnosis and management of pancreatic cancer, especially when applied along with EUS as first line diagnostic tools. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  6. Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography.

    Science.gov (United States)

    Caro-Domínguez, Pablo; Compton, Gregory; Humpl, Tilman; Manson, David E

    2016-09-01

    The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children.

  7. Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography

    International Nuclear Information System (INIS)

    Caro-Dominguez, Pablo; Manson, David E.; Compton, Gregory; Humpl, Tilman

    2016-01-01

    The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children. (orig.)

  8. Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Caro-Dominguez, Pablo; Manson, David E. [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada); Compton, Gregory [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada); Epworth Hospital, Epworth Medical Imaging, Richmond, VIC (Australia); Humpl, Tilman [University of Toronto, Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON (Canada)

    2016-09-15

    The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children. (orig.)

  9. Multi-detector computed tomography radiation doses in the follow-up of paediatric neurosurgery patients in KwaZulu-Natal: A dosimetric audit

    Directory of Open Access Journals (Sweden)

    Christopher T. Sikwila

    2014-05-01

    Full Text Available Background: Multi-detector computed tomography (MDCT is the preferred modality for follow-up of paediatric neurosurgery patients. Serial imaging, however, has the disadvantage of an ionising radiation burden, which may be mitigated using the ‘as low as reasonably achievable’ (ALARA principle. Objectives: The primary objectives were to determine the radiation dose exposure in paediatric patients subjected to MDCT imaging following neurosurgery and to compare these values with references in current literature. Our secondary objective was to assess the relationship between radiation dose and clinical scenario. Method: Retrospective descriptive data were collected from all paediatric postsurgical patients (n = 169 between the ages of 0 and 12 years who had their first followed-up scan in the year 2010 and were followed up for six months or less. Dose-length product (DLP and current-time product were collected from the picture archiving and communication system. Demographic data including radiology reports were collected from the hospital information system. The effective doses (ED were calculated from the corresponding DLP using age-adjusted conversion factors. For purposes of comparison with other studies, median dosimetric values were calculated and the children were grouped into three age ranges, namely younger than 3 years, 3–7 years and 8–12 years old. Results: The highest median radiation doses were noted in patients being followed-up for intracranial abscesses (1183 mGy cm in the 8–12 year age group, most of whom were female. The lowest radiation doses were for intracranial shunt follow-ups (447 mGy cm. Median values for DLP, ED and current-time product (mAs were comparable to reference doses in all three age groups. However, our study showed a much broader distribution of values with higher upper limits relative to reference values. Indications for follow-up included shunts (n = 110; 65%, intracranial abscess (n = 31; 18%, subdural

  10. Multi-detector computed tomography radiation doses in the follow-up of paediatric neurosurgery patients in KwaZulu-Natal: A dosimetric audit

    Directory of Open Access Journals (Sweden)

    Christopher T. Sikwila

    2014-04-01

    Full Text Available Background: Multi-detector computed tomography (MDCT is the preferred modality for follow-up of paediatric neurosurgery patients. Serial imaging, however, has the disadvantage of an ionising radiation burden, which may be mitigated using the ‘as low as reasonably achievable’ (ALARA principle. Objectives: The primary objectives were to determine the radiation dose exposure in paediatric patients subjected to MDCT imaging following neurosurgery and to compare these values with references in current literature. Our secondary objective was to assess the relationship between radiation dose and clinical scenario.Method: Retrospective descriptive data were collected from all paediatric postsurgical patients (n = 169 between the ages of 0 and 12 years who had their first followed-up scan in the year 2010 and were followed up for six months or less. Dose-length product (DLP and current-time product were collected from the picture archiving and communication system. Demographic data including radiology reports were collected from the hospital information system. The effective doses (ED were calculated from the corresponding DLP using age-adjusted conversion factors. For purposes of comparison with other studies, median dosimetric values were calculated and the children were grouped into three age ranges, namely younger than 3 years, 3–7 years and 8–12 years old.Results: The highest median radiation doses were noted in patients being followed-up for intracranial abscesses (1183 mGy cm in the 8–12 year age group, most of whom were female. The lowest radiation doses were for intracranial shunt follow-ups (447 mGy cm. Median values for DLP, ED and current-time product (mAs were comparable to reference doses in all three age groups. However, our study showed a much broader distribution of values with higher upper limits relative to reference values. Indications for follow-up included shunts (n = 110; 65%, intracranial abscess (n = 31; 18%, subdural

  11. Evaluation of diffuse large B-cell lymphoma patients with 64-slice multidetector computed tomography versus 18FDG positron emission tomography/computed tomography in initial staging and restaging after treatment.

    Science.gov (United States)

    Gómez León, Nieves; Vega, Gema; Rodríguez-Vigil Junco, Beatriz; Suevos Ballesteros, Carlos

    2018-04-25

    To prospectively compare the accuracy in initial staging and end-of-treatment restaging of diffuse large B-cell lymphoma (DLBCL) between 64-slice multidetector computed tomography (64MDCT) and 18FDG positron emission tomography/computed tomography (18FGD PET/CT) with intravenous contrast injection. Randomised and blind controlled clinical multicentric trial that included biopsy-proven DLBCL patients. Seventy-two patients from five different hospitals in the region of Madrid, Spain, were enrolled in the study between January 2012 and June 2015. Thirty-six were randomly allocated to 18FDG PET/TC and the other 36 to 64MDCT for initial staging and end-of-treatment restaging. A nuclear medicine physician and a radiologist independently analysed 18FDG PET/TC images and reached an agreement post-hoc. 64MDCT images were separately evaluated by a different radiologist. Every set of images was compared to the reference standard that included clinical data, complementary tests and follow-up. The study was approved by participating centres' ethics committees and written informed consent was obtained from all the participants. A good agreement was observed between both diagnostic techniques and the reference standard in initial staging [18FDG PET/CT (k=0.5) and 64MDCT (k=0.6)], although only the 18FDG PET/TC showed a good agreement with the reference standard for the end-of-treatment restaging (k=0.7). In DLBCL, both 18FDG PET/TC and 64MDCT have shown good agreement with the reference standard in initial staging. Nevertheless, 18FDG PET/CT has shown to be superior to 64MDCT in end-of-treatment response assessment. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  12. Comparison of the radiation dose from cone beam computed tomography and multidetector computed tomography in examinations of the hand; Vergleich der Strahlendosis von Cone-Beam Computertomografie und Multidetektor Computertomografie in Untersuchungen der Hand

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, J.; Neubauer, C.; Gerstmair, A.; Krauss, T.; Kotter, E.; Langer, M. [University Medical Center Freiburg (Germany). Dept. of Radiology; Reising, K. [University Medical Center Freiburg (Germany). Dept. of Orthopedics and Trauma Surgery; Zajonc, H. [University Medical Center Freiburg (Germany). Dept. of Plastic and Hand Surgery; Fiebich, M.; Voigt, J. [University of Applied Sciences, Giessen (Germany). Inst. of Medical Physics and Radiation Protection

    2016-05-15

    Comparison of radiation dose of cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) in examinations of the hand. Dose calculations were carried out by means of Monte Carlo simulations in MDCT and CBCT. A corpse hand was examined in a 320-row MDCT scanner and a dedicated extremities CBCT scanner with standard protocols and multiple low-dose protocols. The image quality of the examinations was evaluated by 5 investigators using a Likert scale from 1 (very good) to 5 (very poor) regarding depiction of cortical bone, cancellous bone, joint surfaces, soft tissues and artifacts. For a sum of ratings of all structures < 50 a good overall image quality was expected. The studies with at least good overall image quality were compared with respect to the dose. The dose of the standard examination was 13.21 (12.96 to 13.46 CI) mGy in MDCT and 7.15 (6.99 to 7.30 CI) mGy in CBCT. The lowest dose in a study with good overall image quality was 4.54 (4.43 to 4.64 CI) mGy in MDCT and 5.72 (5.59 to 5.85 CI) mGy in CBCT. Although the dose of the standard protocols in the CBCT is lower than in the MDCT, the MDCT can realize a good overall image quality at a lower dose than the CBCT. Dose optimization of CT examination protocols for the hand is useful in both modalities, the MDCT has an even greater potential for optimization.

  13. Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid (Gd-EOB-DTPA)-Enhanced Magnetic Resonance Imaging and Multidetector-Row Computed Tomography for the Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ye, Feng; Liu, Jun; Ouyang, Han

    2015-08-01

    The purpose of this meta-analysis was to compare the diagnostic accuracy of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and multidetector-row computed tomography (MDCT) for hepatocellular carcinoma (HCC).Medline, Cochrane, EMBASE, and Google Scholar databases were searched until July 4, 2014, using combinations of the following terms: gadoxetic acid disodium, Gd-EOB-DTPA, multidetector CT, contrast-enhanced computed tomography, and magnetic resonance imaging. Inclusion criteria were as follows: confirmed diagnosis of primary HCC by histopathological examination of a biopsy specimen; comparative study of MRI using Gd-EOB-DTPA and MDCT for diagnosis of HCC; and studies that provided quantitative outcome data. The pooled sensitivity and specificity of the 2 methods were compared, and diagnostic accuracy was assessed with alternative-free response receiver-operating characteristic analysis.Nine studies were included in the meta-analysis, and a total of 1439 lesions were examined. The pooled sensitivity and specificity for 1.5T MRI were 0.95 and 0.96, respectively, for 3.0T MRI were 0.91 and 0.96, respectively, and for MDCT were 0.74 and 0.93, respectively. The pooled diagnostic odds ratio for 1.5T and 3.0T MRI was 242.96, respectively, and that of MDCT was 33.47. To summarize, Gd-EOB-DTPA-enhanced MRI (1.5T and 3.0T) has better diagnostic accuracy for HCC than MDCT.

  14. Visualization of pulmonary vein stenosis after radio frequency ablation for treatment of atrial fibrillation using multidetector computed tomography with retrospective gating; Darstellung von Pulmonalvenenstenosen nach Radiofrequenzablation zur Behandlung von Vorhofflimmern unter Verwendung der Multidetektor Computertomographie mit retrospektivem Gating

    Energy Technology Data Exchange (ETDEWEB)

    Trabold, T.; Kuettner, A.; Heuschmid, M.; Kopp, A.F.; Claussen, C.D. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Univ. Tuebingen (Germany); Burgstahler, C.; Mewis, C.; Schroeder, S.; Kuehlkamp, V. [Medizinische Klinik III, Abt. fuer Kardiologie, Univ. Tuebingen (Germany)

    2003-01-01

    Purpose: With the number of radio frequency ablations (RFA) for treatment of chronic atrial fibrillation increasing, the diagnostic evaluation for RFA associated pulmonary vein stenosis is getting more important. This study investigates the feasibility of the visualization of pulmonary vein stenosis using non-invasive multidetector computed tomography. Materials and Methods: Twenty-eight patients were examined following RFA-treatment. A 4-slice (20 patients) and a 16-slice (8 patients) multidetector CT scanner (SOMATOM Volume Zoom and Sensation 16, Siemens, Forchheim, Germany) with retrospective gating was used to assess the pulmonary veins. Lesion severity was determined on a semi-quantitative scale (< 30%, 30 - 50%, > 50%). Results: CT was performed without any complications in all patients. Diagnostic image quality could be obtained in all examinations. The pulmonary veins showed lesions < 30% in four patients, lesions of 30 - 50% in five patients and a stenosis > 50% in one patient. Eighteen patients showed no lesions. Conclusion: Multidetector CT of the pulmonary veins seems to be able to visualize high-grade and low-grade lesions, but larger catheter-controlled studies are needed for further assessment of the diagnostic accuracy and clinical reliability of this noninvasive method. (orig.) [German] Ziel: Mit steigender Anzahl von Radiofrequenzablationen (RFA) zur Behandlung des chronischen Vorhofflimmerns wird die Diagnostik von RFA assoziierten Pulmonalvenenstenosen zunehmend wichtiger. Ziel dieser Studie war es, die Moeglichkeit der Darstellung von Pulmonalvenenstenosen mittels der nichtinvasiven Multidetektor-Computertomographie zu untersuchen. Material und Methoden: 28 Patienten wurden im Anschluss an eine RFA-Behandlung untersucht. Die Untersuchung wurde an einem 4-Zeilen- (20 Patienten) bzw. 16-Zeilen- (8 Patienten) Multidetektor-CT (SOMATOM Volume Zoom bzw. Sensation 16, Siemens, Forchheim, Germany) mit retrospektivem Gating durchgefuehrt. Der

  15. Evaluation of secondary spontaneous pneumothorax with multidetector CT

    International Nuclear Information System (INIS)

    Hilliard, N.J.; Marciniak, S.J.; Babar, J.L.; Balan, A.

    2013-01-01

    The purpose of this article is to review the underlying causes of secondary pneumothoraces as observed on multidetector computed tomography (MDCT). Using examples from our institutional experience, we shall illustrate important diagnostic features to indicate the underlying lung disease. Understanding the varied range of conditions is important for accurate diagnosis and facilitation of patient management

  16. High-definition multidetector computed tomography for evaluation of coronary artery stents: comparison to standard-definition 64-detector row computed tomography.

    Science.gov (United States)

    Min, James K; Swaminathan, Rajesh V; Vass, Melissa; Gallagher, Scott; Weinsaft, Jonathan W

    2009-01-01

    The assessment of coronary stents with present-generation 64-detector row computed tomography scanners that use filtered backprojection and operating at standard definition of 0.5-0.75 mm (standard definition, SDCT) is limited by imaging artifacts and noise. We evaluated the performance of a novel, high-definition 64-slice CT scanner (HDCT), with improved spatial resolution (0.23 mm) and applied statistical iterative reconstruction (ASIR) for evaluation of coronary artery stents. HDCT and SDCT stent imaging was performed with the use of an ex vivo phantom. HDCT was compared with SDCT with both smooth and sharp kernels for stent intraluminal diameter, intraluminal area, and image noise. Intrastent visualization was assessed with an ASIR algorithm on HDCT scans, compared with the filtered backprojection algorithms by SDCT. Six coronary stents (2.5, 2.5, 2.75, 3.0, 3.5, 4.0mm) were analyzed by 2 independent readers. Interobserver correlation was high for both HDCT and SDCT. HDCT yielded substantially larger luminal area visualization compared with SDCT, both for smooth (29.4+/-14.5 versus 20.1+/-13.0; P<0.001) and sharp (32.0+/-15.2 versus 25.5+/-12.0; P<0.001) kernels. Stent diameter was higher with HDCT compared with SDCT, for both smooth (1.54+/-0.59 versus1.00+/-0.50; P<0.0001) and detailed (1.47+/-0.65 versus 1.08+/-0.54; P<0.0001) kernels. With detailed kernels, HDCT scans that used algorithms showed a trend toward decreased image noise compared with SDCT-filtered backprojection algorithms. On the basis of this ex vivo study, HDCT provides superior detection of intrastent luminal area and diameter visualization, compared with SDCT. ASIR image reconstruction techniques for HDCT scans enhance the in-stent assessment while decreasing image noise.

  17. Quantitative computer-aided diagnostic algorithm for automated detection of peak lesion attenuation in differentiating clear cell from papillary and chromophobe renal cell carcinoma, oncocytoma, and fat-poor angiomyolipoma on multiphasic multidetector computed tomography.

    Science.gov (United States)

    Coy, Heidi; Young, Jonathan R; Douek, Michael L; Brown, Matthew S; Sayre, James; Raman, Steven S

    2017-07-01

    To evaluate the performance of a novel, quantitative computer-aided diagnostic (CAD) algorithm on four-phase multidetector computed tomography (MDCT) to detect peak lesion attenuation to enable differentiation of clear cell renal cell carcinoma (ccRCC) from chromophobe RCC (chRCC), papillary RCC (pRCC), oncocytoma, and fat-poor angiomyolipoma (fp-AML). We queried our clinical databases to obtain a cohort of histologically proven renal masses with preoperative MDCT with four phases [unenhanced (U), corticomedullary (CM), nephrographic (NP), and excretory (E)]. A whole lesion 3D contour was obtained in all four phases. The CAD algorithm determined a region of interest (ROI) of peak lesion attenuation within the 3D lesion contour. For comparison, a manual ROI was separately placed in the most enhancing portion of the lesion by visual inspection for a reference standard, and in uninvolved renal cortex. Relative lesion attenuation for both CAD and manual methods was obtained by normalizing the CAD peak lesion attenuation ROI (and the reference standard manually placed ROI) to uninvolved renal cortex with the formula [(peak lesion attenuation ROI - cortex ROI)/cortex ROI] × 100%. ROC analysis and area under the curve (AUC) were used to assess diagnostic performance. Bland-Altman analysis was used to compare peak ROI between CAD and manual method. The study cohort comprised 200 patients with 200 unique renal masses: 106 (53%) ccRCC, 32 (16%) oncocytomas, 18 (9%) chRCCs, 34 (17%) pRCCs, and 10 (5%) fp-AMLs. In the CM phase, CAD-derived ROI enabled characterization of ccRCC from chRCC, pRCC, oncocytoma, and fp-AML with AUCs of 0.850 (95% CI 0.732-0.968), 0.959 (95% CI 0.930-0.989), 0.792 (95% CI 0.716-0.869), and 0.825 (95% CI 0.703-0.948), respectively. On Bland-Altman analysis, there was excellent agreement of CAD and manual methods with mean differences between 14 and 26 HU in each phase. A novel, quantitative CAD algorithm enabled robust peak HU lesion detection

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

    International Nuclear Information System (INIS)

    Wolf, Florian; Ourednicek, Petr; Loewe, Christian; Richter, Bernhard; Goessinger, Heinz David; Gwechenberger, Marianne; Plank, Christina; Schernthaner, Ruediger Egbert; Toepker, Michael; Lammer, Johannes; Feuchtner, Gudrun M.

    2010-01-01

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

  19. The utility of multi-detector computed tomography in the diagnosis of malignant pleural effusion in the patients with ovarian cancer

    International Nuclear Information System (INIS)

    Kim, Kyung Won; Choi, Hyuck Jae; Kang, Sokbom; Park, Sang-Yoon; Jung, Dae Chul; Cho, Jeong Yeon; Cho, Kyung-Sik; Kim, Seung Hyup

    2010-01-01

    Purpose: The purpose of this study was to retrospectively assess possible clinical predictors of malignant pleural effusion in patients with ovarian cancer. Materials and methods: This review was performed on 38 ovarian cancer patients that showed pleural effusion in a CT scan and who underwent thoracocentesis before treatment. CT scans were obtained using a 4-channel multi-detector CT scanner. Fisher's exact test was used to determine the probability of malignant pleural effusion as a function of; amount of ascites, lymph node enlargement, amount of pleural effusion, pleural nodules, and pleural thickening. Results: Sixteen (42.1%) of the 38 patients had malignant pleural effusion and malignant pleural effusion amounts were greater than those with nonmalignant effusion. Pleural nodules were more frequently found in the malignant pleural effusion group (eight [50%] patients) than in the nonmalignant group (zero [0%] patient) (p < 0.001). Supradiaphragmatic lymph node enlargement (with short axis diameter 1 cm or more) was more frequent in malignant group (12 [75%] patients) than in the nonmalignant group (two [9.1%] patients) (p < 0.001). Conclusion: The probability of malignant pleural effusion in patients with ovarian cancer was found to be correlated with the amount of pleural effusion, the presence of pleural nodules, and supradiaphragmatic lymph node enlargement.

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

    International Nuclear Information System (INIS)

    Belge, Benedicte; Pasquet, Agnes; Vanoverschelde, Jean-Louis J.; Coche, Emmanuel; Gerber, Bernhard L.

    2006-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-15

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

  2. Combined presence of aortic valve calcification and mitral annular calcification as a marker of the extent and vulnerable characteristics of coronary artery plaque assessed by 64-multidetector computed tomography.

    Science.gov (United States)

    Utsunomiya, Hiroto; Yamamoto, Hideya; Kunita, Eiji; Kitagawa, Toshiro; Ohashi, Norihiko; Oka, Toshiharu; Yamazato, Ryo; Horiguchi, Jun; Kihara, Yasuki

    2010-11-01

    We examined the association of aortic valve calcification (AVC) and mitral annular calcification (MAC) to coronary atherosclerosis using 64-multidetector computed tomography (MDCT). Valvular calcification is considered a manifestation of atherosclerosis. The impact of multiple heart valve calcium deposits on the distribution and characteristics of coronary plaque is unknown. We evaluated 322 patients referred for 64-MDCT, and assessed valvular calcification and the extent of calcified (CAP), mixed (MCAP), and noncalcified coronary atherosclerotic plaque (NCAP) in accordance with the 17-coronary segments model. We assessed the vulnerable characteristics of coronary plaque with positive remodeling, low-density plaque (CT density ≤38 Hounsfield units), and the presence of adjacent spotty calcification. In 49 patients with both AVC and MAC, the segment numbers of CAP and MCAP were larger than in those with a lack of valvular calcification and an isolated AVC (pNCAP. Moreover, it was also related to the presence of coronary plaque with all three vulnerable characteristics (OR 4.87, 95%CI 1.85-12.83, p=0.001). The combined presence of AVC and MAC is highly associated with the presence, extent, and vulnerable characteristics of coronary plaque identified by 64-MDCT. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Multidetector-row computed tomography in the preoperative diagnosis of intestinal complications caused by clinically unsuspected ingested dietary foreign bodies: a case series emphasizing the use of volume rendering techniques

    Energy Technology Data Exchange (ETDEWEB)

    Teixeira, Augusto Cesar Vieira; Torres, Ulysses dos Santos; Oliveira, Eduardo Portela de; Gual, Fabiana; Bauab Junior, Tufik, E-mail: usantor@yahoo.com.br [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Serv. de Radiologia e Diagnostico por Imagem; Westin, Carlos Eduardo Garcia [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Cirurgia Geral; Cardoso, Luciana Vargas [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Setor de Tomografia Computadorizada

    2013-11-15

    Objective: the present study was aimed at describing a case series where a preoperative diagnosis of intestinal complications secondary to accidentally ingested dietary foreign bodies was made by multidetector-row computed tomography (MDCT), with emphasis on complementary findings yielded by volume rendering techniques (VRT) and curved multiplanar reconstructions (MPR). Materials and Methods: The authors retrospectively assessed five patients with surgically confirmed intestinal complications (perforation and/or obstruction) secondary to unsuspected ingested dietary foreign bodies, consecutively assisted in their institution between 2010 and 2012. Demographic, clinical, laboratory and radiological data were analyzed. VRT and curved MPR were subsequently performed. Results: preoperative diagnosis of intestinal complications was originally performed in all cases. In one case the presence of a foreign body was not initially identified as the causal factor, and the use of complementary techniques facilitated its retrospective identification. In all cases these tools allowed a better depiction of the entire foreign bodies on a single image section, contributing to the assessment of their morphology. Conclusion: although the use of complementary techniques has not had a direct impact on diagnostic performance in most cases of this series, they may provide a better depiction of foreign bodies' morphology on a single image section. (author)

  4. Analysis of bone mellow density in adults of domestic local area using multi-detector computed tomography: Focus on correlation about eating habits, lifestyle, physical features and social characteristics

    International Nuclear Information System (INIS)

    Lee, Tae Hui; Kim, Tae Hyung; So, Woon Young; Lim, Hei Gyeom; Lim, Cheong Hwan; Park, Myeong Hwan; Cheon, Myung Ki

    2016-01-01

    This study analyzed the correlation between BMD (bone mineral density) value calculated in the MDCT(multidetector computed tomography) and lifestyle, physical features and social characteristics. From July 15 2015 to June 6 2016, we converted from HU (hounsfield unit) value measured by using MDCT to T-score for BMD of 141 patients (male: 63, female: 78) in W medical center. We measured the 2nd, 3rd and 4th lumbar spine and analyzed the correlation between gender differences in BMD and lifestyle, physical features and social characteristics. Statistical significance was validated using independent sample T test with one way Anova. Gender BMD was confirmed that a statistically significant difference (p<0.05). BMD values decreased with increasing age but for the statistically men, there was no significant difference from 20s to 50s, it only showed a significant difference in 20s and 60s (p<0.001). For the statistically women, there was no significant difference from 20s to 40s. but since 50s BMD was decreased rapidly, which showed a significant difference(p<0.001). women showed significant differences for the menstruation and menopause, childbirth, alcohol, cereals and greasy food in bone mineral density (p<0.05) but there were no significant differences in men. The bone mineral density values calculated by the MDCT and lifestyle, physical features and social characteristics correlation analysis method is considered to be used as a basis for estimating the state in BMD and osteoporosis management

  5. Analysis of bone mellow density in adults of domestic local area using multi-detector computed tomography: Focus on correlation about eating habits, lifestyle, physical features and social characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae Hui [Wonju Medical Center, Wonju (Korea, Republic of); Kim, Tae Hyung; So, Woon Young; Lim, Hei Gyeom [Kangwon National University Graduate School, Wonju (Korea, Republic of); Lim, Cheong Hwan [Hanseo University, Seosan (Korea, Republic of); Park, Myeong Hwan [Daegu Health College, Daegu (Korea, Republic of); Cheon, Myung Ki [Soongsil University, Seoul (Korea, Republic of)

    2016-12-15

    This study analyzed the correlation between BMD (bone mineral density) value calculated in the MDCT(multidetector computed tomography) and lifestyle, physical features and social characteristics. From July 15 2015 to June 6 2016, we converted from HU (hounsfield unit) value measured by using MDCT to T-score for BMD of 141 patients (male: 63, female: 78) in W medical center. We measured the 2nd, 3rd and 4th lumbar spine and analyzed the correlation between gender differences in BMD and lifestyle, physical features and social characteristics. Statistical significance was validated using independent sample T test with one way Anova. Gender BMD was confirmed that a statistically significant difference (p<0.05). BMD values decreased with increasing age but for the statistically men, there was no significant difference from 20s to 50s, it only showed a significant difference in 20s and 60s (p<0.001). For the statistically women, there was no significant difference from 20s to 40s. but since 50s BMD was decreased rapidly, which showed a significant difference(p<0.001). women showed significant differences for the menstruation and menopause, childbirth, alcohol, cereals and greasy food in bone mineral density (p<0.05) but there were no significant differences in men. The bone mineral density values calculated by the MDCT and lifestyle, physical features and social characteristics correlation analysis method is considered to be used as a basis for estimating the state in BMD and osteoporosis management.

  6. Evidence for lower variability of coronary artery calcium mineral mass measurements by multi-detector computed tomography in a community-based cohort-Consequences for progression studies

    International Nuclear Information System (INIS)

    Hoffmann, Udo; Siebert, Uwe; Bull-Stewart, Arabella; Achenbach, Stephan; Ferencik, Maros; Moselewski, Fabian; Brady, Thomas J.; Massaro, Joseph M.; O'Donnell, Christopher J.

    2006-01-01

    Purpose: To compare the measurement variability for coronary artery calcium (CAC) measurements using mineral mass compared with a modified Agatston score (AS) or volume score (VS) with multi-detector CT (MDCT) scanning, and to estimate the potential impact of these methods on the design of CAC progression studies. Materials and methods: We studied 162 consecutive subjects (83 women, 79 men, mean age 51 ± 11 years) from a general Caucasian community-based cohort (Framingham Heart Study) with duplicate runs of prospective electrocardiographically-triggered MDCT scanning. Each scan was independently evaluated for the presence of CAC by four experienced observers who determined a 'modified' AS, VS and mineral mass. Results: Of the 162 subjects, CAC was detected in both scans in 69 (42%) and no CAC was detected in either scan in 72 (45%). Calcium scores were low in the 21/162 subjects (12%) for whom CAC was present in one but not the other scan (modified AS 0.96). However, the mean interscan variability was significantly different between mineral mass, modified AS, and VS (coefficient of variation 26 ± 19%, 41 ± 28% and 34 ± 25%, respectively; p < 0.04), with significantly smaller mean differences in pair-wise comparisons for mineral mass compared with modified AS (p < 0.002) or with VS (p < 0.03). The amount of CAC but not heart rate was an independent predictor of interscan variability (r = -0.638, -0.614 and -0.577 for AS, VS, and mineral mass, respectively; all p < 0.0001). The decreased interscan variability of mineral mass would allow a sample size reduction of 5.5% compared with modified AS for observational studies of CAC progression and for randomized clinical trials. Conclusion: There is significantly reduced interscan variability of CAC measurements with mineral mass compared with the modified AS or VS. However, the measurement variability of all quantification methods is predicted by the amount of CAC and is inversely correlated to the extent of partial

  7. Dose-reduced 16-slice multidetector-row spiral computed tomography in children with bronchoscopically suspected vascular tracheal stenosis - initial results

    International Nuclear Information System (INIS)

    Honnef, D.; Wildberger, J.E.; Das, M.; Hohl, C.; Mahnken, A.; Guenther, R.W.; Staatz, G.; Schnoering, H.; Vazquez-Jimenez, J.

    2006-01-01

    Purpose: To evaluate the diagnostic accuracy of contrast-enhanced dose-reduced 16-slice multidetector-row CT (MDCT) in newborns and infants with fiberoptic bronchoscopically suspected vascular-induced tracheal stenosis. Materials and Methods: 12 children (4 days to 3 years, 1.2-13.5 kg body weight) were examined using i.v. contrast-enhanced 16-slice MDCT (SOMATOM Sensation 16, Forchheim, Germany) without breath-hold and under sedation (11/12). All MDCTs were performed with a dose reduction. The beam collimation was 16 x 0.75 mm, except in the case of one child. MPRs along the tracheal axis in the x-, y- and z-directions and volume-rendering-reconstructions (VRTs) were calculated based on a secondary raw data set in addition to conventional axial slices. 2 radiologists used a three-point grade scale to evaluate the image quality, motion, and contrast media artifacts as well as the usefulness of the 2D- and 3D-reconstructions for determining the diagnosis. Statistical analysis was performed on the basis of a Kappa test. Results: In all cases the cause of the fiberoptic bronchoscopically suspected tracheal stenosis was revealed: compression due to the brachiocephalic trunk (n=7), double aortic arch (n=2), lusorian artery (n=1), vascular compression of the left main bronchus (n=2). In 3 patients further thoracic anomalies, such as tracheobronchial (n=2), and vascular (n=2) and vertebral (n=1) anomalies were found. The attenuation in the anomalous vessels was 307±140 HU. The image noise was 9.8±1.9 HU. The mean dose reduction was 82.7±3.2% compared to a standard adult thoracic CT. All examinations were rated as diagnostically good (median 1, range 1, k=1). 3D images did not show any stair artifacts (median 2, range 1-2, k=1). The image noise was minor to moderate and hardly any motion artifacts were seen (median 1, range 1-2, k=0.8). Contrast media artifacts were rated zero to minor (median 1.5, range 1-2, k=0.676). MPRs (median 1, range 1, k=1) and VRTs (median 1

  8. The detectability of the origin of the inferior phrenic artery by paging method on multidetector-row CT angiography

    International Nuclear Information System (INIS)

    Terayama, Koshi

    2005-01-01

    We evaluated the ability to detect the origin of the inferior phrenic artery (IPA) by paging method on multidetector-row computed tomography (CT) angiography. In 104 patients who underwent multidetector-row CT, detectability of the origin of the IPA was assessed. In addition, in 30 patients in whom arteriographic study was performed, the IPA findings on multidetector-row CT were compared with those on arteriography. In 100 patients (96%) the origin of the right IPA was demonstrated with multidetector-row CT and in 93 patients (89%) the origin of the left IPA was demonstrated. CT angiographic findings concurred with arteriographic findings in all 30 patients (100%) who underwent arteriographic study. In conclusion, paging method on multidetector-row CT angiography provides valuable anatomical information regarding IPA. (author)

  9. Fatal paradoxical pulmonary air embolism complicating percutaneous computed tomography-guided needle biopsy of the lung

    International Nuclear Information System (INIS)

    Chakravarti, Rajesh; Singh, Virendra; Isaac, Rethish; John, Joseph

    2004-01-01

    A 63-year-old man with left upper zone haziness on chest X-ray and an infiltrative lesion with a pleural mass in the left upper lobe on CT scan was scheduled for CT-guided percutaneous trans-thoracic needle biopsy. During the procedure, the patient had massive haemoptysis and cardiorespiratory arrest and could not be revived. Post-mortem CT showed air in the right atrium, right ventricle, pulmonary artery and also in the left atrium and aorta. A discussion on paradoxical air embolism following percutaneous trans-thoracic needle biopsy is presented Copyright (2004) Blackwell Publishing Asia Pty Ltd

  10. Diagnostic yield and complications of transthoracic computed tomography-guided biopsies

    DEFF Research Database (Denmark)

    Vagn-Hansen, Chris Aksel; Pedersen, Malene Roland Vils; Rafaelsen, Søren Rafael

    2016-01-01

    , the tissue material was found to be sufficient. In 32% of the biopsies, a complication arose, mostly pneumothorax (30%), but chest drainage was needed in only 15% of the 520 cases. Patients with more than ten cigarette pack-years had a complication risk that was twice as high at that of patients with fewer...... packyears. We found that the risk of pneumothorax increased the further the lesion was from the skin surface, the smaller the lesions were and when the patient was biopsied in a lateral position. We also found a higher risk of complications in females than in males. CONCLUSIONS: CT-guided biopsy...... is an excellent tool for analysing pulmonary lesions. The present study clearly shows that the risk of developing a pneumothorax is significantly increased among smokers and former smokers with more than ten pack-years....

  11. Doses of Coronary Study in 64 Channel Multi-Detector Computed Tomography : Reduced Radiation Dose According to Varity of Examnination Protocols

    International Nuclear Information System (INIS)

    Kim, Moon Chan

    2009-01-01

    To compare radiation dose for coronary CT angiography (CTA) obtained with 6 examination protocols such as a retrospectively ECG gated helical scan, a prospectively ECG gated sequential scan, low kVp technique, and cardiac dose modulation technique. Coronary CTA was performed by using 6 current clinical protocols to evaluate effective dose and organ dose in primary beam area with anthropomorphic female phantom and glass dosimetric system in 64 channel multi-detector CT. After acquiring topograms of frontal and lateral projection with 80 kVp and 10 mA, main coronary scan was done with 0.35 sec tube rotation time, 40 mm collimation (0.625 mm x 64 ea), small scan field of view (32 cm diameter), 105 mm scan length. Heart beat rate of phantom was maintained 60 bpm in ECG gating. In constant mAs technique 120 kVp, 600 mA was used, and 100 kVp for low kVp technique. In a retrospectively ECG gated helical CT technique 0.22 pitch was used, peak mA (600 mA) was adopted in range of 40-80% of R-R interval and 120 mA (80% reduction) in others with cardiac dose modulation. And 210 mAs was used without cardiac dose modulation. In a prospectively ECG gated sequential CT technique data were acquired at 75% R-R interval (middle diastolic phase in cardiac cycle), and 120 msec additional padding of the tube-on time was used. For effective dose calculation region specific conversion factor of dose length product in thorax was used, which was recommended by EUR 16262. The mean effective dose for conventional coronary CTA without cardiac dose modulation in a retrospectively ECG gated helical scan was 17.8 mSv, and mean organ dose of heart was 103.8 mGy. With low kVp and cardiac dose modulation the mean effective dose showed 54.5% reduction, and heart dose showed 52.3% reduction, compared with that of conventional coronary CTA. And at the sequential scan(SnapShot pulse mode) under prospective ECG gating the mean effective dose was 4.9 mSv, this represents an 72.5% reduction compared with

  12. Multidetector CT evaluation of the postoperative pancreas.

    Science.gov (United States)

    Yamauchi, Fernando I; Ortega, Cinthia D; Blasbalg, Roberto; Rocha, Manoel S; Jukemura, José; Cerri, Giovanni G

    2012-01-01

    Several pancreatic diseases may require surgical treatment, with most of these procedures classified as resection or drainage. Resection procedures, which are usually performed to remove pancreatic tumors, include pancreatoduodenectomy, central pancreatectomy, distal pancreatectomy, and total pancreatectomy. Drainage procedures are usually performed to treat chronic pancreatitis after the failure of medical therapy and include the Puestow and Frey procedures. The type of surgery depends not only on the patient's symptoms and the location of the disease, but also on the expertise of the surgeon. Radiologists should become familiar with these surgical procedures to better understand postoperative changes in anatomic findings. Multidetector computed tomography is the modality of choice for identifying normal findings after surgery, postoperative complications, and tumor recurrence in patients who have undergone pancreatic surgery. RSNA, 2012

  13. [Sigmoid endometriosis: a diagnostic dilemma on multidetector CT].

    Science.gov (United States)

    Telegrafo, Michele; Lorusso, Valentina; Rubini, Giuseppe; Rella, Leonarda; Pezzolla, Angela; Stabile Ianora, Amato Antonio; Moschetta, Marco

    2013-01-01

    Intestinal endometriosis represents a common condition that occurs particularly in women of reproductive age. The gastrointestinal tract is the third most common localization of endometriosis, after the ovaries and the peritoneum, and recto-sigmoid tract is involved in 70% of cases. Recto-sigmoid endometriosis has to be differentiated from other diseases of large bowel, especially in patients without a history of endometriosis. We report a case of sigmoid endometriosis which represented a diagnostic dilemma on multidetector computed tomography.

  14. Pulmonary nodules: sensitivity of maximum intensity projection versus that of volume rendering of 3D multidetector CT data

    NARCIS (Netherlands)

    Peloschek, Philipp; Sailer, Johannes; Weber, Michael; Herold, Christian J.; Prokop, Mathias; Schaefer-Prokop, Cornelia

    2007-01-01

    PURPOSE: To prospectively compare maximum intensity projection (MIP) and volume rendering (VR) of multidetector computed tomographic (CT) data for the detection of small intrapulmonary nodules. MATERIALS AND METHODS: This institutional review board-approved prospective study included 20 oncology

  15. Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

    OpenAIRE

    Pacheco, Felipe Torres; Littig, Ingrid Aguiar; Gagliardi, Rubens Jose; Rocha, Antônio Jose da

    2015-01-01

    Objective The potential of computed tomography angiography (CTA) was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours). Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2%) based on both clinical ...

  16. Patent foramen ovale: detection with nongated multidetector CT.

    Science.gov (United States)

    Revel, Marie-Pierre; Faivre, Jean-Baptiste; Letourneau, Thierry; Henon, Hilde; Leys, Didier; Delannoy-Deken, Valérie; Remy-Jardin, Martine; Remy, Jacques

    2008-10-01

    To evaluate nongated multidetector computed tomography (CT) in the detection of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) in comparison with transesophageal echocardiography (TEE). The study was approved by the institutional review board, and informed consent was obtained from all patients. One hundred five patients (57 men, 48 women; mean age, 53 years) with a recent stroke underwent TEE and multidetector CT on the same day. After injection of a diluted iodinated contrast material, a series of 2.4-mm-thick transverse images centered on the fossa ovalis were acquired in conjunction with release of the Valsalva maneuver. Two independent radiologists considered PFO present if left atrial enhancement was detected visually before enhancement of the pulmonary veins or if an early peak of left atrial enhancement was found at time-attenuation curve analysis. PFO was detected with 98% specificity (95% confidence interval [CI]: 0.91, 0.99). Overall sensitivity was 55% (95% CI: 0.38, 0.70), ranging from 28% for shunts classified as grade 1 at TEE to 91% for those classified as grade 4 at TEE. Interreader agreement was good (kappa = 0.81). Visual assessment was better than time-attenuation curve analysis, which enabled detection of only 15 of the 40 cases of PFO. Multidetector CT depicted only 22% of cases of ASA. The mean effective radiation dose was 2.3 mSv. Nongated multidetector CT can be used to diagnose high-grade shunts through a PFO, with 91% sensitivity and 98% specificity. Thus, PFO detection, in addition to routine CT evaluation of the lungs, could be indicated in patients with unexplained hypoxemia. (c) RSNA, 2008.

  17. Early characterization of atherosclerotic coronary plaques with multidetector computed tomography in patients with acute coronary syndrome. A comparative study with intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Iriart, Xavier; Dos-Santos, Pierre [Universite Bordeaux 2, Inserm U. 441 Atherosclerose, Bordeaux (France); Brunot, Sebastien [CHU de Bordeaux, Hopital du Haut-Leveque, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Unite de Soins Intensifs Cardiologiques, Pessac (France); Unite d' Imagerie Thoracique et Cardiovasculaire, Hopital Cardiologique, Pessac (France); Coste, Pierre; Leroux, Lionel [Universite Bordeaux 2, Inserm U. 441 Atherosclerose, Bordeaux (France); Unite de Soins Intensifs Cardiologiques, Pessac (France); Montaudon, Michel [Universite Bordeaux 2, Inserm U. 885 F 33076, Bordeaux (France); CHU de Bordeaux, Hopital du Haut-Leveque, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Labeque, Jean-Noel; Jais, Catherine [Unite de Soins Intensifs Cardiologiques, Pessac (France); Laurent, Francois [Universite Bordeaux 2, Inserm U. 885 F 33076, Bordeaux (France); CHU de Bordeaux, Hopital du Haut-Leveque, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Unite d' Imagerie Thoracique et Cardiovasculaire, Hopital Cardiologique, Pessac (France)

    2007-10-15

    We compared 16-slice computed tomography (CT) with intravascular ultrasound (IVUS) in their ability to identify the culprit lesion, and to assess plaque characterization and vascular remodelling in acute coronary syndrome (ACS). Twenty patients were prospectively studied. Coronary plaque identification and characterization were compared using 16-slice CT and 40-MHz catheter-based IVUS. Minimum lumen area (MLA), cross-sectional vessel area (CVA) and vessel remodelling were determined for each comparable lesion. One hundred and sixty-nine segments were compared and 84 plaques analysed. Sixteen-slice CT detected 95% of culprit lesions (19/20). No feature suggestive of plaque rupture was detected by 16-slice CT. Attenuation measurements within all lesions revealed different values for hypoechoic (38 {+-} 33 HU), hyperechoic (94 {+-} 44 HU), and calcified plaques (561 {+-} 216 HU), (P < 0.001). Agreement between 16-slice CT and IVUS on measuring MLA and CVA was evaluated using Bland-Altman analysis. Pearson and intra-class coefficient (ICC) were 0.81 and 0.70 for MLA, and 0.81 and 0.36 for CVA, for 16-slice CT and IVUS, respectively. Agreement between both techniques for vessel positive remodelling was moderate (kappa = 0.54, P < 0.001). Sixteen-slice CT has shown moderate accuracy in quantifying and characterizing coronary plaques compared with IVUS. Spatial resolution of 16-slice CT remains a major limitation, however, to accurately assess the complex lesions involved in ACS. (orig.)

  18. Gd-EOB-DTPA-enhanced 3.0-Tesla MRI findings for the preoperative detection of focal liver lesions: Comparison with iodine-enhanced multi-detector computed tomography

    Science.gov (United States)

    Park, Hyong-Hu; Goo, Eun-Hoe; Im, In-Chul; Lee, Jae-Seung; Kim, Moon-Jib; Kwak, Byung-Joon; Chung, Woon-Kwan; Dong, Kyung-Rae

    2012-12-01

    The safety of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic-acid (Gd-EOB-DTPA) has been confirmed, but more study is needed to assess the diagnostic accuracy of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in patients with a hepatocellular carcinoma (HCC) for whom surgical treatment is considered or with a metastatic hepatoma. Research is also needed to examine the rate of detection of hepatic lesions compared to multi-detector computed tomography (MDCT), which is used most frequently to localize and characterize a HCC. Gd-EOB-DTPA-enhanced MRI and iodine-enhanced MDCT imaging were compared for the preoperative detection of focal liver lesions. The clinical usefulness of each method was examined. The current study enrolled 79 patients with focal liver lesions who preoperatively underwent MRI and MDCT. In these patients, there was less than one month between the two diagnostic modalities. Imaging data were taken before and after contrast enhancement in both methods. To evaluate the images, we analyzed the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) in the lesions and the liver parenchyma. To compare the sensitivity of the two methods, we performed a quantitative analysis of the percentage signal intensity of the liver (PSIL) on a high resolution picture archiving and communication system (PACS) monitor (paired-samples t-test, p DTPA-enhanced MRI findings and the iodine-enhanced MDCT by using an adjusted x2 test. The SNRs, CNRs, and PSIL all had a greater detection rate in Gd-EOB-DTPA enhanced MRI than in iodine-enhanced MDCT. Hepatocyte-selective uptake was observed 20 minutes after the injection in the focal nodular hyperplasia (FNH, 9/9), adenoma (9/10), and highly-differentiated HCC (grade G1, 27/30). Rim enhancement was detected in all metastases (30/30). During the arterial and the delayed phases, good overall agreement between the gadoxetic-acid-enhanced MR and CT was observed (x2 test, p DTPA-enhanced MRI had a higher

  19. The Role Of Multidetector Computed Tomography In The Early Diagnosis Of Invasive Pulmonary Aspergıllosis In Patients With Febrile Neutropenia Undergoing Hematopoietic Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Nazan Çiledağ

    2012-03-01

    Full Text Available OBJECTIVE: To evaluate the vessel involvement and the role of multidedector computed tomograpy (MDCT in the early diagnosis of invasive pulmonary aspergillosis (IPA at MDCT in autologous bone morrow transplantation patients with febrile neutropenia and antibiotic-resistant fever of unknown origin with clinically suspected IPA. METHODS: 74 pulmonary MDCT examinations of 37 consecutive hematopoietic stem cell transplantation patients with febrile neutropenia with clinically suspected IPA were retrospectively evaluated. RESULTS: The diagnosis of IPA was made according to according to the Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Consensus Group criteria and 0, 14, 11 patients were diagnosed as proven, probable, possible IPA, respectively. Among 25 cases accepted as probable and possible IPA, all patients had pulmonary MDCT findings consistent with IPA. Remaining 12 patients were accepted as having fever of unknown origin (FUO and in these 12, MDCT showed patent vessel. In patients with probable/possible IPA, 72 focal pulmonary lesions were detected. In 41 of 72 (57%, vascular occlusion was detected. The CT halo sign was present in 25 of 41 (61% lesions. A clinical improvement, resolution of fever was observed following antifungal therapy in 19 (76% of 25 patients with probable/possible IPA. Six (25% patients diagnosed as IPA died during follow-up. Transplant related mortality at day 100 in patients with IPA and FUO were found to be 24% and 0%, respectively. CONCLUSION: In conclusion, MDCT has a potential role in early diagnosis of IPA by detection of vessel occlusion.

  20. Ultra-high resolution C-Arm CT arthrography of the wrist: Radiation dose and image quality compared to conventional multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Werncke, Thomas, E-mail: Werncke.Thomas@mh-hannover.de [Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover (Germany); Sonnow, Lena; Meyer, Bernhard C. [Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover (Germany); Lüpke, Matthias [University of Veterinary Medicine Hannover, Institute for General Radiology and Medical Physics, Bischofsholer Damm 15, 30173 Hannover (Germany); Hinrichs, Jan; Wacker, Frank K.; Falck, Christian von [Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover (Germany)

    2017-04-15

    Objective: Objective of this phantom and cadaveric study was to compare the effective radiation dose (ED) and image quality (IQ) between C-arm computed tomography (CACT) using an ultra-high resolution 1 × 1 binning with a standard 16-slice CT (MDCT) arthrography of the wrist. Methods: ED was determined with thermoluminescence dosimetry using an anthropomorphic phantom and different patient positions. Imaging was conducted in 10 human cadaveric wrists after tri-compartmental injection of diluted iodinated contrast material and a wire phantom. IQ of MDCT was compared with CACT reconstructed with a soft (CACT1) and sharp (CACT2) kernel. High and low contrast resolution was determined. Three radiologists assessed IQ of wrist structures and occurrence of image artifacts using a 5-point Likert scale. Results: ED of MDCT was comparable to standard CACT (4.3 μSv/3.7 μSv). High contrast resolution was best for CACT2, decreased to CACT1 and MDCT. Low contrast resolution increased between CACT2 and MDCT (P < 0.001). IQ was best for CACT2 (1.3 ± 0.5), decreased to CACT1 (1.9 ± 0.6) and MDCT (3.5 ± 0.6). Non-compromising artifacts were only reported for CACT. Conclusions: The results of this phantom and cadaveric study indicate that ultra-high resolution C-Arm CT arthrography of the wrist bears the potential to outperform MDCT arthrography in terms of image quality and workflow at the cost of mildly increasing image artifacts while radiation dose to the patient is comparably low for both, MDCT and C-Arm CT.

  1. Efficacy of pre-scan beta-blockade and impact of heart rate on image quality in patients undergoing coronary multidetector computed tomography angiography

    International Nuclear Information System (INIS)

    Shapiro, Michael D.; Pena, Antonio J.; Nichols, John H.; Worrell, Stewart; Bamberg, Fabian; Dannemann, Nina; Abbara, Suhny; Cury, Ricardo C.; Brady, Thomas J.; Hoffmann, Udo

    2008-01-01

    Objective: While beta-blockers are routinely administered to patients prior to coronary computed tomography angiography (CTA), their effectiveness is unknown. We therefore assessed the efficacy of beta-blockade with regards to heart rate (HR) control and image quality in an unselected patient cohort. Methods: We studied 150 consecutive patients (104 men/46 female; mean age, 56 ± 13 years) referred for coronary CTA. Intravenous metoprolol (5-20 mg) was administered to patients with a HR >65 beats per minute (bpm). The goal HR was defined as an average HR <65 bpm without a single measurement above 68 bpm. Results: Overall, 45% (68/150) of patients met the HR criteria for beta-blocker administration of which 76% (52/68) received metoprolol (mean dose 12 ± 10 mg). Of the 52 patients who received beta-blocker versus the 98 who did not, 18 (35%) versus 62 (64%) patients achieved the goal HR, respectively. All patients who achieved the target HR had an evaluable CTA while five patients who did not achieve the target HR had at least one non-evaluable coronary artery due to motion artifact. There was also a significant reduction in any motion artifact among those who achieved the goal HR as compared to those who did not (p = 0.001). Logistic regression revealed an increase in the odds of stair step artifact of 11.6% (95% CI: 2.4% decrease, 27.5% increase) per 1 bpm increase in the standard deviation of scan HR. Conclusion: Overall, efficacy of beta-blocker administration to reach target HR is limited. Improvements in CT scanner temporal resolution are mandatory to achieve consistently high image quality independent of HR and beta-blocker administration

  2. Efficacy of pre-scan beta-blockade and impact of heart rate on image quality in patients undergoing coronary multidetector computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Shapiro, Michael D. [Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Pena, Antonio J.; Nichols, John H. [Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Worrell, Stewart [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Bamberg, Fabian [Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Dannemann, Nina [Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Abbara, Suhny; Cury, Ricardo C.; Brady, Thomas J. [Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Hoffmann, Udo [Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston MA (United States)], E-mail: uhoffmann@partners.org

    2008-04-15

    Objective: While beta-blockers are routinely administered to patients prior to coronary computed tomography angiography (CTA), their effectiveness is unknown. We therefore assessed the efficacy of beta-blockade with regards to heart rate (HR) control and image quality in an unselected patient cohort. Methods: We studied 150 consecutive patients (104 men/46 female; mean age, 56 {+-} 13 years) referred for coronary CTA. Intravenous metoprolol (5-20 mg) was administered to patients with a HR >65 beats per minute (bpm). The goal HR was defined as an average HR <65 bpm without a single measurement above 68 bpm. Results: Overall, 45% (68/150) of patients met the HR criteria for beta-blocker administration of which 76% (52/68) received metoprolol (mean dose 12 {+-} 10 mg). Of the 52 patients who received beta-blocker versus the 98 who did not, 18 (35%) versus 62 (64%) patients achieved the goal HR, respectively. All patients who achieved the target HR had an evaluable CTA while five patients who did not achieve the target HR had at least one non-evaluable coronary artery due to motion artifact. There was also a significant reduction in any motion artifact among those who achieved the goal HR as compared to those who did not (p = 0.001). Logistic regression revealed an increase in the odds of stair step artifact of 11.6% (95% CI: 2.4% decrease, 27.5% increase) per 1 bpm increase in the standard deviation of scan HR. Conclusion: Overall, efficacy of beta-blocker administration to reach target HR is limited. Improvements in CT scanner temporal resolution are mandatory to achieve consistently high image quality independent of HR and beta-blocker administration.

  3. Right heart on multidetector CT

    Science.gov (United States)

    Gopalan, D

    2011-01-01

    Right ventricular function plays an integral role in the pathogenesis and outcome of many cardiovascular diseases. Imaging the right ventricle has long been a challenge because of its complex geometry. In recent years there has been a tremendous expansion in multidetector row CT (MDCT) and its cardiac applications. By judicious modification of contrast medium protocol, it is possible to achieve good opacification of the right-sided cardiac chambers, thereby paving the way for exploring the overshadowed right heart. This article will describe the key features of right heart anatomy, review MDCT acquisition techniques, elaborate the various morphological and functional information that can be obtained, and illustrate some important clinical conditions associated with an abnormal right heart. PMID:22723537

  4. ROLE OF MULTIDETECTOR CT IN EVALUATION OF NECK LESIONS

    Directory of Open Access Journals (Sweden)

    Reena Mathur

    2016-06-01

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

  5. The role of multi-detector computed

    Directory of Open Access Journals (Sweden)

    Nasr Mohamed Mohamed Osman

    2016-03-01

    Conclusion: MDCT is the modality of choice in evaluation and grading of renal trauma with high sensitivity (90–100%. CT detects site and extension of renal trauma and assesses the excretory function. CT is advantageous for the selection of best patient treatment.

  6. Imaging patterns of hepatic steatosis on multidetector CT: Pearls and pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Kani, K.K., E-mail: khalatbarik@yahoo.com [Department of Radiology, Body Imaging, University of Washington Medical Center, Seattle, WA (United States); Moshiri, M.; Cuevas, C.; Lee, J.H.; Mitsumori, L.M.; Kolokythas, O. [Department of Radiology, Body Imaging, University of Washington Medical Center, Seattle, WA (United States)

    2012-04-15

    Fatty liver disease is an important cause of chronic liver disease in Western countries. The purpose of this article is to describe and illustrate the diagnostic criteria and various morphological patterns of fatty liver disease on multidetector computed tomography (MDCT) with an emphasis on potential limitations and diagnostic pitfalls.

  7. [Computed tomography of the heart

    DEFF Research Database (Denmark)

    Kristensen, T.S.; Kofoed, K.F.; der, Recke P. von

    2009-01-01

    Noninvasive evaluation of the coronary arteries by multi-detector row computed tomography is a promising new alternative to conventional invasive coronary angiography. This article describes the technical background, methods, limitations and clinical applications and reviews current literature...... that compares the diagnostic accuracy of multi-detector row computed tomography with that of coronary angiography Udgivelsesdato: 2009/4/6...

  8. Multidetector calibration for mass spectrometers

    International Nuclear Information System (INIS)

    Bayne, C.K.; Donohue, D.L.; Fiedler, R.

    1994-06-01

    The International Atomic Energy Agency's Safeguards Analytical Laboratory has performed calibration experiments to measure the different efficiencies among multi-Faraday detectors for a Finnigan-MAT 261 mass spectrometer. Two types of calibration experiments were performed: (1) peak-shift experiments and (2) peak-jump experiments. For peak-shift experiments, the ion intensities were measured for all isotopes of an element in different Faraday detectors. Repeated measurements were made by shifting the isotopes to various Faraday detectors. Two different peak-shifting schemes were used to measure plutonium (UK Pu5/92138) samples. For peak-jump experiments, ion intensities were measured in a reference Faraday detector for a single isotope and compared with those measured in the other Faraday detectors. Repeated measurements were made by switching back-and-forth between the reference Faraday detector and a selected Faraday detector. This switching procedure is repeated for all Faraday detectors. Peak-jump experiments were performed with replicate measurements of 239 Pu, 187 Re, and 238 U. Detector efficiency factors were estimated for both peak-jump and peak-shift experiments using a flexible calibration model to statistically analyze both types of multidetector calibration experiments. Calculated detector efficiency factors were shown to depend on both the material analyzed and the experimental conditions. A single detector efficiency factor is not recommended for each detector that would be used to correct routine sample analyses. An alternative three-run peak-shift sample analysis should be considered. A statistical analysis of the data from this peak-shift experiment can adjust the isotopic ratio estimates for detector differences due to each sample analysis

  9. Multidetector CT of blunt cervical spine trauma in adults.

    Science.gov (United States)

    Dreizin, David; Letzing, Michael; Sliker, Clint W; Chokshi, Falgun H; Bodanapally, Uttam; Mirvis, Stuart E; Quencer, Robert M; Munera, Felipe

    2014-01-01

    A number of new developments in cervical spine imaging have transpired since the introduction of 64-section computed tomographic (CT) scanners in 2004. An increasing body of evidence favors the use of multidetector CT as a stand-alone screening test for excluding cervical injuries in polytrauma patients with obtundation. A new grading scale that is based on CT and magnetic resonance (MR) imaging findings, the cervical spine Subaxial Injury Classification and Scoring (SLIC) system, is gaining acceptance among spine surgeons. Radiographic measurements described for the evaluation of craniocervical distraction injuries are now being reevaluated with the use of multidetector CT. Although most patients with blunt trauma are now treated nonsurgically, evolution in the understanding of spinal stability, as well as the development of new surgical techniques and hardware, has driven management strategies that are increasingly favorable toward surgical intervention. It is therefore essential that radiologists recognize findings that distinguish injuries with ligamentous instability or a high likelihood of nonfusion that require surgical stabilization from those that are classically stable and can be treated with a collar or halo vest alone. The purpose of this article is to review the spectrum of cervical spine injuries, from the craniocervical junction through the subaxial spine, and present the most widely used grading systems for each injury type. ©RSNA, 2014.

  10. MARS - a multidetector array for reaction studies

    International Nuclear Information System (INIS)

    Ball, G.C.; Davies, W.G.; Forster, J.S.

    1988-03-01

    The proposal for MARS, a Multidetector Array for Reaction Studies is presented. MARS consists of a large, high-vacuum vessel enclosing an array of 128 scintillation detectors for use in studies of heavy-ion collisions at TASCC. The instrument will be funded and owned jointly by AECL and NSERC

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

    International Nuclear Information System (INIS)

    Tuerkvatan, Aysel; Oezdemir, Mustafa; Cumhur, Turhan; Oelcer, Tuelay

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-15

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

  13. Multidetector row CT for imaging the paediatric tracheobronchial tree

    International Nuclear Information System (INIS)

    Papaioannou, Georgia; Young, Carolyn; Owens, Catherine M.

    2007-01-01

    The introduction of multidetector row computed tomography (MDCT) scanners has altered the approach to imaging the paediatric thorax. In an environment where the rapid acquisition of CT data allows general hospitals to image children instead of referring them to specialist paediatric centres, it is vital that general radiologists have access to protocols appropriate for paediatric applications. Thus a dramatic reduction in the delivered radiation dose is ensured with optimal contrast bolus delivery and timing, and inappropriate repetition of the scans is avoided. This article focuses on the main principles of volumetric CT imaging that apply generically to all MDCT scanners. We describe the reconstruction techniques for imaging the paediatric thorax and the low-dose protocols used in our institution on a 16-slice detector CT scanner. Examples of the commonest clinical applications are also given. (orig.)

  14. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT

    International Nuclear Information System (INIS)

    Smith, S.L.; Rajan, P.S.

    2004-01-01

    Pancreatic adenocarcinoma is the fourth most frequent cause of cancer-related death. The incidence is increasing and the overall survival has altered little in recent years. Moreover, patients usually present late with inoperable disease and curative resection by standard pancreatico-duodenectomy (Whipple's procedure) is associated with significant morbidity. It should only be attempted in that small group of patients lacking radiological evidence of advanced disease. Despite the recent advances in body magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS), computed tomography (CT) is the mainstay of staging in most centres and the recent development of multidetector CT machines (MDCT) has raised hope of an improvement in preoperative staging. This review focuses on the CT of pancreatic adenocarcinoma with particular emphasis on examination technique and on those criteria that determine resectability

  15. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Smith, S.L. E-mail: simon.smith@ipsh-tr.anglox.nhs.uk; Rajan, P.S

    2004-01-01

    Pancreatic adenocarcinoma is the fourth most frequent cause of cancer-related death. The incidence is increasing and the overall survival has altered little in recent years. Moreover, patients usually present late with inoperable disease and curative resection by standard pancreatico-duodenectomy (Whipple's procedure) is associated with significant morbidity. It should only be attempted in that small group of patients lacking radiological evidence of advanced disease. Despite the recent advances in body magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS), computed tomography (CT) is the mainstay of staging in most centres and the recent development of multidetector CT machines (MDCT) has raised hope of an improvement in preoperative staging. This review focuses on the CT of pancreatic adenocarcinoma with particular emphasis on examination technique and on those criteria that determine resectability.

  16. Double Chooz Improved Multi-Detector Measurements

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    The Double Chooz experiment (DC) is a reactor neutrino oscillation experiment running at Chooz nuclear power plant (2 reactors) in France. In 2011, DC first reported indication of non-zero θ13 with the far detector (FD) located at the maximum of oscillation effects (i.e. disappearance), thus challenging the CHOOZ non-observation limit. A robust observation of θ13 followed in 2012 by the Daya Bay experiments with multiple detector configurations. Since 2015 DC runs in a multi-detector configuration making thus the impact of several otherwise dominating systematics reduce strongly. DC’s unique almost "iso-flux" site, allows the near detector (ND) to become a direct accurate non-oscillation reference to the FD. Our first multi-detector results at MORIOND-2016 showed an intriguing deviation of θ13 with respect to the world average. We will address this issue in this seminar. The combined "reactor-θ13" measurement is expected to ...

  17. Multidetector-row CT finding of gastric cystic lymphangioma: A case report

    International Nuclear Information System (INIS)

    Kang, Tae Wook; Lee, Soon Jin; Song, Hye Jong

    2008-01-01

    Cystic lymphangioma is a rare benign submucosal tumor of the stomach thought to originate from sequestered lymphatic tissue that fails to communicate with the normal lymphatic system. The most commonly used method of evaluation for cystic lymphangioma of the stomach is an endoscopic ultrasonography. We report the multidetector-row computed tomography findings of a cystic lymphangioma of the stomach in a 46-year-old man along with a literature review

  18. Imaging of Acute Mesenteric Ischemia Using Multidetector CT and CT Angiography in a Porcine Model

    OpenAIRE

    Rosow, David E.; Sahani, Dushyant; Strobel, Oliver; Kalva, Sanjeeva; Mino-Kenudson, Mari; Holalkere, Nagaraj S.; Alsfasser, Guido; Saini, Sanjay; Lee, Susanna I.; Mueller, Peter R.; Castillo, Carlos Fernández-del