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Sample records for multidetector ct angiographic

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

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

    2007-05-15

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

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

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

    2017-01-15

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

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

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

    2007-06-15

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

  4. Bilateral asymmetrical duplicated origin of vertebral arteries: Multidetector row CT angiographic study

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    C S Rameshbabu

    2014-01-01

    Full Text Available Bilateral duplicated origin of V-1 segment of vertebral arteries is an extremely rare vascular variant and only two such cases have been reported so far. Presence of this vascular abnormality was observed incidentally in a 36-year-old male patient, with a complaint of dizziness, evaluated by multidetector row computed tomography (CT angiography. Two limbs of the right vertebral artery arose from the right subclavian artery and fused to form a single vessel at the interval between fourth and fifth cervical vertebrae, which entered the foramen transversarium of fourth cervical vertebra. On the left side, the medial limb originated directly from the arch of aorta and the lateral limb from the left subclavian artery, and both united at the interval between fifth and sixth cervical vertebrae to form a single vessel which entered the foramen transversarium of fifth cervical vertebra. No other cerebrovascular pathology like aneurysm, fenestration, dissection, and stenosis was detected, which could be correlated with the symptoms of the patient. This rare congenital vascular anomaly has diagnostic and therapeutic implications in any intervention involving the vertebral artery.

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

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

    1999-11-01

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

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

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

  7. Right heart on multidetector CT

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    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

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

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

    2008-07-15

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

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

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

    2011-01-01

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

  10. Multidetector CT of the Pancreas

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    Rossella Graziani

    2008-07-01

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

  11. Multidetector CT of emergent biliary pathologic conditions.

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

    2013-01-01

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

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

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

    2005-07-01

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

  13. Multidetector CT angiography in Takayasu arteritis

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

    2011-02-15

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

  14. Wavelet-based calculation of cerebral angiographic data from time-resolved CT perfusion acquisitions

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    Havla, Lukas; Dietrich, Olaf [Ludwig-Maximilians-University Hospital Munich, Josef-Lissner-Laboratory for Biomedical Imaging, Institute for Clinical Radiology, Munich (Germany); Thierfelder, Kolja M.; Beyer, Sebastian E.; Sommer, Wieland H. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

    2015-08-15

    To evaluate a new approach for reconstructing angiographic images by application of wavelet transforms on CT perfusion data. Fifteen consecutive patients with suspected stroke were examined with a multi-detector CT acquiring 32 dynamic phases (∇t = 1.5s) of 99 slices (total slab thickness 99mm) at 80kV/200mAs. Thirty-five mL of iomeprol-350 was injected (flow rate = 4.5mL/s). Angiographic datasets were calculated after initial rigid-body motion correction using (a) temporally filtered maximum intensity projections (tMIP) and (b) the wavelet transform (Paul wavelet, order 1) of each voxel time course. The maximum of the wavelet-power-spectrum was defined as the angiographic signal intensity. The contrast-to-noise ratio (CNR) of 18 different vessel segments was quantified and two blinded readers rated the images qualitatively using 5pt Likert scales. The CNR for the wavelet angiography (501.8 ± 433.0) was significantly higher than for the tMIP approach (55.7 ± 29.7, Wilcoxon test p < 0.00001). Image quality was rated to be significantly higher (p < 0.001) for the wavelet angiography with median scores of 4/4 (reader 1/reader 2) than the tMIP (scores of 3/3). The proposed calculation approach for angiography data using temporal wavelet transforms of intracranial CT perfusion datasets provides higher vascular contrast and intrinsic removal of non-enhancing structures such as bone. (orig.)

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

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

    2009-03-15

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

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

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    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.)

  17. Esophageal injuries: Spectrum of multidetector row CT findings

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

    2006-09-15

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

  18. MULTIDETECTOR CT STUDY OF ANATOMICAL VARIANTS OF ETHMOID SINUS

    Institute of Scientific and Technical Information of China (English)

    李玉华; 薛建平; 朱铭

    2004-01-01

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

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

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

    2002-12-01

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

  20. Stress myocardial perfusion imaging with multidetector CT

    NARCIS (Netherlands)

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

    2014-01-01

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

  1. Stress myocardial perfusion imaging with multidetector CT

    NARCIS (Netherlands)

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

    2014-01-01

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

  2. Multidetector spiral CT arthrography of the shoulder

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    Lecouvet, Frederic E. [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)], E-mail: frederic.lecouvet@uclouvain.be; Simoni, Paolo; Koutaissoff, Sophie; Vande Berg, Bruno C.; Malghem, Jacques; Dubuc, Jean-Emile [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)

    2008-10-15

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

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

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

    2011-02-15

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

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Daniela Stoisa

    2009-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-11-15

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

  7. Scenes from the past: initial investigation of early jurassic vertebrate fossils with multidetector CT.

    Science.gov (United States)

    Bolliger, Stephan A; Ross, Steffen; Thali, Michael J; Hostettler, Bernhard; Menkveld-Gfeller, Ursula

    2012-01-01

    The study of fossils permits the reconstruction of past life on our planet and enhances our understanding of evolutionary processes. However, many fossils are difficult to recognize, being encased in a lithified matrix whose tedious removal is required before examination is possible. The authors describe the use of multidetector computed tomography (CT) in locating, identifying, and examining fossil remains of crocodilians (Mesosuchia) embedded in hard shale, all without removing the matrix. In addition, they describe how three-dimensional (3D) reformatted CT images provided details that were helpful for extraction and preparation. Multidetector CT can help experienced paleontologists localize and characterize fossils in the matrix of a promising rock specimen in a nondestructive manner. Moreover, with its capacity to generate highly accurate 3D images, multidetector CT can help determine whether the fossils warrant extraction and can assist in planning the extraction process. Thus, multidetector CT may well become an invaluable tool in the field of paleoradiology.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

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

    2007-04-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-06-15

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

  12. Prevalence of thoracolumbar vertebral fractures on multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-03-15

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

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

    Science.gov (United States)

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

    2008-01-01

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

  14. Can abdominal multi-detector CT diagnose spinal osteoporosis?

    Energy Technology Data Exchange (ETDEWEB)

    Papadakis, Antonios E.; Damilakis, John [University of Crete, Department of Medical Physics, Faculty of Medicine, P.O. Box 2208, Iraklion, Crete (Greece); Karantanas, Apostolos H. [University of Crete, Department of Radiology, Faculty of Medicine, P.O. Box 2208, Iraklion, Crete (Greece); Papadokostakis, Giorgos [University Hospital of Heraklion, Department of Orthopedics, Faculty of Medicine, P.O. Box 2208, Iraklion, Crete (Greece); Petinellis, Effie [University Hospital of Heraklion, Department of Radiotherapy, Faculty of Medicine, P.O. Box 2208, Iraklion, Crete (Greece)

    2009-01-15

    The aim of this study was to (1) generate quantitative CT (QCT) densitometric data based on routine abdominal multi-detector (MDCT) examinations and (2) investigate whether these data can be used to differentiate osteoporotic from healthy females. Twenty-five female patients (group A) with a history of radiotherapy were examined both with routine abdominal MDCT and standard QCT to generate a MDCT-to-QCT conversion equation. Twenty-one osteoporotic (group B) and 23 healthy female patients (group C) were also recruited in the study. Patients of groups B and C underwent routine abdominal MDCT examination for various clinical indications. Mean bone mineral density (BMD) in patients of group A was 103.4 mg/ml {+-} 32.8 with routine abdominal MDCT and 91.0 mg/ml {+-}28.5 with QCT. Quantitative CT BMD{sub QCT} values for patients in groups B and C were calculated utilizing the BMD{sub MDCT} values derived from routine abdominal MDCT data sets and the MDCT to QCT conversion equation: BMD{sub QCT}=0.78. BMD{sub MDCT}+10.13. The calculated QCT densitometric data adequately differentiated osteoporotic from healthy females (area under ROC curve 0.828, p=0.05). In conclusion, this study showed that in a group of female patients, QCT data derived from routine abdominal MDCT examinations discriminated osteoporotic from healthy subjects. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-04-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Timing-invariant reconstruction for deriving high-quality CT angiographic data from cerebral CT perfusion data.

    NARCIS (Netherlands)

    Smit, E.J.; Vonken, E.J.; Schaaf, I.C. van der; Mendrik, A.M.; Dankbaar, J.W.; Horsch, A.D.; Seeters, T. van; Ginneken, B. van; Prokop, M.

    2012-01-01

    PURPOSE: To suggest a simple and robust technique used to reconstruct high-quality computed tomographic (CT) angiographic images from CT perfusion data and to compare it with currently used CT angiography techniques. MATERIALS AND METHODS: Institutional review board approval was waived for this retr

  18. Timing-invariant reconstruction for deriving high-quality CT angiographic data from cerebral CT perfusion data.

    NARCIS (Netherlands)

    Smit, E.J.; Vonken, E.J.; Schaaf, I.C. van der; Mendrik, A.M.; Dankbaar, J.W.; Horsch, A.D.; Seeters, T. van; Ginneken, B. van; Prokop, M.

    2012-01-01

    PURPOSE: To suggest a simple and robust technique used to reconstruct high-quality computed tomographic (CT) angiographic images from CT perfusion data and to compare it with currently used CT angiography techniques. MATERIALS AND METHODS: Institutional review board approval was waived for this retr

  19. A head phantom study for intraocular dose evaluation of 64-slice multidetector CT examination in patients with suspected cranial trauma

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, Kosuke, E-mail: matsuk@mhs.mp.kanazawa-u.ac.jp [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Koshida, Kichiro [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Noto, Kimiya; Takata, Tadanori [Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Suzuki, Masayuki [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Shimono, Tetsunori [Department of Radiology, Hoshigaoka Koseinenkin Hospital, Hirakata, Osaka (Japan); Yamamoto, Tomoyuki [Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Matsui, Osamu [Department of Radiology, Faculty of Medicine, Kanazawa University, Kanazawa, Ishikawa (Japan)

    2011-08-15

    Purpose: In cases of suspected cranial trauma, cranial CT examinations should be performed to rule out pathology. There are some methods available for reducing intraocular doses; however, it is difficult for the operators to conduct the necessary measurements because of restrictions in time and patient mobility, especially in high-energy trauma cases. Therefore, we performed a head phantom study for intraocular dose evaluation of 64-slice multidetector CT examination in patients with suspected cranial trauma. Materials and methods: Assuming that the orbitomeatal (OM) line and bed were vertical, a head phantom was tilted from 10 degrees caudally to 25 degrees cranially at 5-degree intervals. At each tilted position, the phantom was examined using a 64-section multidetector CT device using three acquisition protocols. Intraocular doses during each examination were measured using small dosimeters. Results: Assuming that the OM line and bed were vertical, intraocular doses varied between 52 and 140%, 17-138%, and 90-142% during helical, non-helical, and helical CT angiographic examinations, respectively. Intraocular doses increased when the phantom was tilted cranially. Conclusion: If possible, the best way to reduce the intraocular dose is by angling the gantry cranially, tilting the head of each patient caudally and adopting a non-helical acquisition method. During procedure, the acquisition angle should be angled cranially more than 0 degrees based on the OM line. The estimation of intraocular dose using the acquisition angle and displayed volumetric CT dose index might be useful to evaluate the deterministic effect risks and to inform patients about the associated risks.

  20. First experiences with multidetector CT in traumatized children

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-15

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

  4. Diagnostic accuracy of 64-slice multidetector CT for detection of in-stent restenosis in an unselected, consecutive patient population

    Energy Technology Data Exchange (ETDEWEB)

    Haraldsdottir, Sigurdis, E-mail: sigurdisha@gmail.com [Boston Medical Center, 72 East Concord Street (Evans 124), Boston, MA, 02118 (United States); Gudnason, Thorarinn, E-mail: thorgudn@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Sigurdsson, Axel F., E-mail: axelfsig@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Gudjonsdottir, Jonina, E-mail: jonina@rd.is [Rontgen Domus Medica, Egilsgata 3, 101 Reykjavik (Iceland); Lehman, Sam J., E-mail: slehman@partners.org [Massachusetts General Hospital, 165 Cambridge Street, Suite 400, Boston, MA 02114 (United States); Eyjolfsson, Kristjan, E-mail: kristey@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Scheving, Sigurpall S., E-mail: sigurpal@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland); Gibson, C. Michael, E-mail: mgibson@perfuse.org [Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115 (United States); Hoffmann, Udo, E-mail: uhoffmann@partners.org [Massachusetts General Hospital, 165 Cambridge Street, Suite 400, Boston, MA 02114 (United States); Jonsdottir, Birna, E-mail: birna@rd.is [Rontgen Domus Medica, Egilsgata 3, 101 Reykjavik (Iceland); Andersen, Karl, E-mail: andersen@landspitali.is [Landspitali University Hospital, Hringbraut, 101 Reykjavik (Iceland)

    2010-11-15

    Objectives: To investigate the diagnostic accuracy of 64-slice multidetector computed tomography (64-CT) for detection of in-stent restenosis (ISR) in an unselected, consecutive patient population. Background: Detection of in-stent restenosis by cardiac CT would be a major advance for the evaluation of patients suspected of having ISR. However, the diagnostic accuracy of current generation 64-CT in this context is not fully established. Methods: We conducted a prospective study on patients with stable angina or acute coronary syndrome with no prior history of coronary artery disease. Six months after percutaneous coronary intervention (PCI) with stent placement they underwent a 64-CT scan (Toshiba Multi-Slice Aquilion 64) and consequently a repeat coronary angiography for comparison. Cardiac CT data sets were analyzed for the presence of in-stent restenosis by two independent expert readers blinded to the coronary angiographic data. Results: Ninety-three patients with a total of 140 stents were evaluated. Males comprised 82% of the study group and the mean age was 63 {+-} 10 years. The mean time from PCI to the repeat coronary angiography was 208 {+-} 37 days and the mean time from 64-CT to repeat coronary angiography was 3.7 {+-} 4.9 days. The restenosis rate according to coronary angiography was 26%. Stent diameter, strut thickness, heart rate and body mass index (BMI) significantly affected image quality. The sensitivity, specificity, positive and negative predictive values of 64-CT for detection of in-stent restenosis were 27%, 95%, 67% and 78%, respectively. Conclusions: Current generation, 64-slice CT, remains limited in its ability to accurately detect in-stent restenosis.

  5. Use of multidetector row CT with volume renderings in right lobe living liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Ishifuro, Minoru; Akiyama, Yuji; Kushima, Toshio [Department of Radiology, Hiroshima University Medical Hospital, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima 734-8551 (Japan); Horiguchi, Jun; Nakashige, Aya; Tamura, Akihisa; Marukawa, Kazushi; Fukuda, Hiroshi; Ono, Chiaki; Ito, Katsuhide [Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima 734-8551 (Japan)

    2002-10-01

    Multidetector row CT is a feasible diagnostic tool in pre- and postoperative liver partial transplantation. We can assess vascular anatomy and liver parenchyma as well as volumetry, which provide useful information for both donor selection and surgical planning. Disorders of the vascular and biliary systems are carefully observed in recipients. In addition, we evaluate liver regeneration of both the donor and the recipient by serial volumetry. We present how multidetector row CT with state-of-the-art three-dimensional volume renderings may be used in right lobe liver transplantation. (orig.)

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  7. Acute and chronic mesenteric ischemia: Multidetector CT and CT angiographic findings

    Directory of Open Access Journals (Sweden)

    Mohamed A. Amin

    2014-12-01

    Conclusion: MDCT and CTA are fast, safe, accurate and non-invasive imaging modalities of choice in patients with suspected mesenteric ischemia which are able to evaluate not only mesenteric vascular structures but also evaluate bowel wall changes and adjacent mesentery, thus detecting the primary cause of mesenteric ischemia that can lead to earlier diagnosis and intervention.

  8. Internal Hernias in the Era of Multidetector CT: Correlation of Imaging and Surgical Findings.

    Science.gov (United States)

    Doishita, Satoshi; Takeshita, Tohru; Uchima, Yasutake; Kawasaki, Masayasu; Shimono, Taro; Yamashita, Akiyoshi; Sugimoto, Michiko; Ninoi, Teruhisa; Shima, Hideki; Miki, Yukio

    2016-01-01

    Clinical diagnosis of internal hernias is challenging because of their nonspecific signs and symptoms. Many types of internal hernias have been defined: paraduodenal, small bowel mesentery-related, greater omentum-related, lesser sac, transverse mesocolon-related, pericecal, sigmoid mesocolon-related, falciform ligament, pelvic internal, and Roux-en-Y anastomosis-related. An internal hernia is a surgical emergency that can develop into intestinal strangulation and ischemia. Accurate preoperative diagnosis is crucial for appropriate management. Multidetector computed tomography (CT), with its thin-section axial images, high-quality multiplanar reformations, and three-dimensional images, currently plays an essential role in preoperative diagnosis of internal hernias. The diagnostic approach to internal hernias at multidetector CT includes detecting an intestinal closed loop, identifying the hernia orifice, and analyzing abnormal displacement of surrounding structures and key vessels around the hernia orifice and hernia sac. At each step, multidetector CT can depict pathognomonic findings. A saclike appearance suggests an intestinal closed loop in several types of internal hernias. Convergence, engorgement, and twisting of mesenteric vessels in the hernia orifice can be seen clearly at multidetector CT, especially with use of multiplanar reformations. For definitive diagnosis of an internal hernia, analysis of displacement of anatomic landmarks around the hernia orifice is particularly important, and thin-section images provide the required information. Detailed knowledge of the anatomy, etiology, and imaging landmarks of the various hernia types is also necessary. Familiarity with the appearances of internal hernias at multidetector CT allows accurate and specific preoperative diagnosis. (©)RSNA, 2015.

  9. Advances in multidetector CT diagnosis of pediatric pulmonary thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-04-15

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

  10. 320-Multidetector row whole-head dynamic subtracted CT angiography and whole-brain CT perfusion before and after carotid artery stenting: Technical note

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

  11. Multidetector-row CT duodenography in familial adenomatous polyposis: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A.; Halligan, S. E-mail: s.halligan@imperial.ac.uk; Moore, L.; Saunders, B.P.; Gallagher, M.; Phillips, R.K.S.; Bartram, C.I

    2004-10-01

    AIM: To investigate the feasibility of using multidetector-row computed tomography (CT) duodenography to stage duodenal polyposis in patients with familial adenomatous polyposis. MATERIALS AND METHODS: Six patients underwent multidetector-row CT duodenography before upper gastrointestinal endoscopy. A single-blinded radiologist used a surface shaded three-dimensional endoluminal fly though and two-dimensional axial and multiplanar reformats to assign a score for maximum polyp size and number based on the Spigelman classification. Comparison was made with the corresponding Spigelman scores obtained from subsequent endoscopy. RESULTS: CT duodenography was technically successful in five of six patients. The CT derived Spigelman score based on maximum polyp size was accurate in all five patients. The CT derived Spigelman score based on polyp number was accurate in only two cases: Polyp number was overestimated in one patient and underestimated in a further two. In retrospect, fine carpeting of tiny duodenal polyps was poorly visualized with CT. CONCLUSIONS: CT duodenography is technically feasible and accurately predicts maximum polyp size but CT estimates of polyp number are relatively inaccurate. CT duodenography potentially has a useful role for duodenal surveillance in those patients intolerant of conventional endoscopy.

  12. Pediatric renovascular hypertension in Thailand: CT angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Visrutaratna, Pannee; Srisuwan, Tanop; Sirivanichai, Chusak [Chiang Mai University, Department of Radiology, Faculty of Medicine, Chiang Mai (Thailand)

    2009-12-15

    Renovascular disease is an uncommon but important cause of hypertension in children. When unrecognized and untreated, renovascular hypertension in children can have serious complications. To review the causes of renovascular hypertension and computed tomography angiographic (CTA) findings in children and adolescents. Twenty-eight CTAs from January 2004 to March 2008 of 23 children and adolescents with hypertension were reviewed for the causes and CTA findings. Nine of the 23 children (39%) had abnormal renal arteries with or without abnormal abdominal aortas. Four of these children had Takayasu arteritis, one had moyamoya disease, and one had median arcuate ligament syndrome. One with chronic pyelonephritis had severe stenosis of the proximal right renal artery. The other two children had renal artery stenosis with a nonspecific cause. One child with a normal abdominal aorta and renal arteries had a right suprarenal mass. On pathological examination a ganglioneuroma was found. CTA can help in diagnosis of renovascular hypertension in children and adolescents. Although CTA is not a screening modality, it is appropriate in some situations. (orig.)

  13. Multidetector CT (MD-CT) in the diagnosis of uncertain open globe injuries.

    Science.gov (United States)

    Hoffstetter, P; Schreyer, A G; Schreyer, C I; Jung, E M; Heiss, P; Zorger, N; Framme, C

    2010-02-01

    To evaluate the significance of multislice CT for the diagnosis of uncertain penetrating globe injuries. Based on a retrospective chart review between 2002 and 2007, we identified 59 patients presenting with severe ocular trauma with uncertain rupture of the globe due to massive subconjunctival and/or anterior chamber hemorrhage. The IOP (intraocular pressure) was within normal range in all patients. High resolution multidetector CT (MD-CT) scans (16 slice scans) with axial and coronar reconstructions were performed in all patients. The affected eye was examined for signs of penetrating injury such as abnormal eye shape, scleral irregularities, lens dislocation or intravitreal hemorrhages. Four experienced radiologists read the CT scans independently. Beside the diagnosis, the relevant morphological criteria and the optimal plane orientation (axial or coronar) were specified. The sensitivity, specificity, and negative and positive predictive value were calculated. Additionally the interobserver variability was determined by applying the Cohen's kappa test. Surgical sclera inspections were performed in all cases as a standard of reference. The evaluations of the CT examination were compared with the surgery reports. 59 patients were evaluated (42 men, 17 women). The mean age was 29 years (range 7 - 91). In 17 patients a rupture of the globe was diagnosed during surgery. 12 of these 17 penetrating injuries (70.6 %) were classified correctly by MDCT, 5 of the 17 (29.4 %) were not detectable. 42 patients did not have an open globe injury. 41 of these patients were diagnosed correctly negative by MDCT, and one patient was classified false positive. This results in a sensitivity of 70 % with a specificity of 98 %. There was high inter-rater agreement with kappa values between 0.89 - 0.96. Most discrepancies were caused by wrong negative findings. The most frequent morphologic criteria for open globe injury were the deformation (n = 10) and the volume reduction (n = 7) of

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

  16. Dynamic Multidetector CT Findings of Left Atrial Myxomas Causing Mitral Valve Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ji Yeon [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kim, Dong Hun [Dept. of Radiology, Chosun University College of Medicine, Gwangju (Korea, Republic of); Seo, Hye Sun [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Her, Keun [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kim, Hee Kyung [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2011-07-15

    We report multidetector row CT (MDCT) findings of two left atrial myxomas causing mitral valve obstruction and dyspnea of patients. Cardiac MDCT showed well-defined left atrial masses attached to the interatrial septum and shifting of tumors into the left ventricle causing mitral valve obstruction during diastole in a 37-year-old male and in a 69-year-old female. Also, we observed intratumoral hemorrhage in the second case. Myxomas were resected and the patients were discharged without dyspnea.

  17. Multi-detector CT in the paediatric urinary tract

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-15

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

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

    Science.gov (United States)

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

    2006-12-01

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

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

    Science.gov (United States)

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

    2007-11-07

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  2. Multidetector-Row CT Findings of an Internal Supravesical Hernia: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-15

    A supravesical hernia occurs in the supravesical fossa and is either classified as an external or internal supravesical hernia. Most patients with internal supravesical hernias present with small bowel obstruction. Internal supravesical hernias are less common than external supravesical hernia. To date, there are few reports describing the radiological findings of supravesical hernias. To our knowledge, this is the first reported multidetector row CT (MDCT) depiction of this type of hernia. We report here on the MDCT findings of a patient with an internal supravesical hernia presenting with small bowel obstruction

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

    Science.gov (United States)

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

    2009-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  5. Multidetector CT and MRI findings in periportal space pathologies

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-01-15

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

  6. Virtual anthropology and forensic identification using multidetector CT.

    Science.gov (United States)

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

    2014-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

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

    Science.gov (United States)

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

    2012-01-01

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

  9. Integrated cardio-thoracic imaging with ECG-Gated 64-slice multidetector-row CT: initial findings in 133 patients

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-09-15

    The purpose of this study was to investigate the possibility of assessing the underlying respiratory disease as well as cardiac function during ECG-gated CT angiography of the chest with 64-slice multidetector-row CT (MDCT). One hundred thirty-three consecutive patients in sinus rhythm with known or suspected ventricular dysfunction underwent an ECG-gated CT angiographic examination of the chest without {beta}-blockers using the following parameters: (1) collimation: 32 x 0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.6-mm slices (Sensation 64; Siemens); rotation time: 0.33 s; pitch: 0.3; 120 kV; 200 mAs; ECG-controlled dose modulation (ECG-pulsing) and (2) 120 ml of a 35% contrast agent. Data were reconstructed: (1) to evaluate the underlying respiratory disease (1-mm thick lung and mediastinal scans reconstructed at 55% of the R-R interval; i.e., ''morphologic scans'') and (2) to determine right (RVEF) and left (LVEF) ventricular ejection fractions (short-axis systolic and diastolic images; Argus software; i.e., ''functional scans''). The mean heart rate was 73 bpm (range: 42-120) and the mean scan time was 18.11{+-}2.67 s (range: 10-27). A total of 123 examinations (92%) had both lung and mediastinal images rated as diagnostic scans, whereas 10 examinations (8%) had non-diagnostic images altered by the presence of respiratory-motion artifacts (n=4) or cyclic artifacts related to the use of a pitch value of 0.3 in patients with a very low heart rate during data acquisition (n=6). Assessment of right and left ventricular function was achievable in 124 patients (93%, 95% CI: 88-97%). For these 124 examinations, the mean RVEF was 46.10% ({+-}9.5; range: 20-72) and the mean LVEF was 58.23% ({+-}10.88; range: 20-83). In the remaining nine patients, an imprecise segmentation of the right and left ventricular cavities was considered as a limiting factor for precise calculation of end-systolic and end

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-02-15

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

  14. Detection of vascular injuries in patients with blunt pelvic trauma by using 64-channel multidetector CT.

    Science.gov (United States)

    Kertesz, Jennifer L; Anderson, Stephan W; Murakami, Akira M; Pieroni, Sabrina; Rhea, James T; Soto, Jorge A

    2009-01-01

    Vascular injuries are a major source of morbidity and mortality in patients with blunt pelvic trauma. Digital subtraction angiography (DSA) has traditionally been used to detect pelvic arterial injuries and to treat active arterial hemorrhage. Improvements in the technology of computed tomography (CT) have facilitated the implementation of CT angiography, which is beginning to replace DSA in the evaluation of patients with acute trauma. Pelvic CT angiography can reliably depict various pelvic arterial injuries and can help differentiate arterial hemorrhage from venous hemorrhage on the basis of multiphasic acquisitions, a method that may be used to tailor the subsequent clinical approach. With the use of a 64-channel multidetector CT scanner, multiphasic pelvic CT angiography can be integrated into the evaluation of trauma patients by using 1.25-mm reconstructed section thickness, pitch of 1:0.987, and gantry revolution time of 0.5 second to achieve near-isotropic results. A standard dose of 100 mL intravenous contrast material is injected at a rate of 5 mL/sec, and 30 mL saline solution, also at 5 mL/sec, is injected as a "chasing" bolus to follow the contrast material. (c) RSNA, 2009.

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

    Science.gov (United States)

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

    2011-01-01

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

  16. Angiographic and CT findings after intra-arterial cytostasis of colorectal liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, M.; Berger, T.; Boese-Landgraf, J.

    1986-10-01

    Between October 1983 and January 1986, sexteen patients with inoperable liver metastases from colorectal carcinomas were treated by single or cyclical intraarterial chemotherapy introduced either through an angiographic catheter or by means of a subcutaneously implanted access point (Port-A-Cath). Before each treatment cycle, the position of the catheter and the state of the vessels was examined by subtraction angiography in order to avoid complications and to confirm that the cytostatic agents were actually perfusing metastases, as shown by angio-CT. The complementary nature of the information obtained by these methods and their superiority over scintigraphy with /sup 99m/Tc macroaggregated albumin particles is documented and the most frequent complications of regional tumour therapy are described.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-10-15

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

  19. 64 multidetector CT findings of influenza A (H1N1) virus in patients with hematologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

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

    Science.gov (United States)

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

    2009-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

  2. Optimizing bowel preparation for multidetector row CT colonography: Effect of Citramag and Picolax

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A.; Halligan, S. E-mail: s.halligan@ic.ac.uk; Goh, V.; Morley, S.; Atkin, W.; Bartram, C.I

    2003-09-01

    AIM: To compare the adequacy and acceptability of Picolax and Citramag bowel cleansing agents for CT colonography. MATERIALS AND METHODS: Multidetector row CT colonography was performed in 124 subjects; 43 had been prepared with Picolax and 81 with Citramag. Datasets were assessed for retained fluid and solid residue, and overall adequacy of segmental visualization. Preparation acceptability was also assessed. RESULTS: There was significantly less retained fluid with Picolax. The odds of being in the next higher category for retained fluid when using Picolax were 0.33 (CI: 0.22-0.50, p<0.0001) when compared with Citramag, for all segments combined. However there was significantly more retained solid residue with Picolax. The odds of being in the next higher category for retained residue when using Picolax were 2.44 (CI: 1.41-4.24, p=0.002) when compared with Citramag, for all segments combined. There was no significant difference with respect to overall segmental visualization: the odds of a segment being adequately visualized when using Picolax were 1.52 (CI: 0.88-2.65, p=0.14) when compared with Citramag. There was no significant difference with respect to acceptability. CONCLUSION: Picolax results in a significantly drier colon than Citramag and associated with more retained residue. We found Picolax the more suitable preparation for CT colonography.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

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

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

    Science.gov (United States)

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

    2009-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-04-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-10-15

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

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

    Science.gov (United States)

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

    2007-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-07-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  13. Intrinsic carpal ligaments on MR and multidetector CT arthrography: comparison of axial and axial oblique planes

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ryan K.L.; Griffith, James F.; Ng, Alex W.H.; Law, Eric K.C. [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince Of Wales Hospital, Hong Kong (China); Tse, W.L.; Wong, Clara W.Y.; Ho, P.C. [The Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince Of Wales Hospital, Hong Kong (China)

    2017-03-15

    To compare axial and oblique axial planes on MR arthrography (MRA) and multidetector CT arthrography (CTA) to evaluate dorsal and volar parts of scapholunate (SLIL) and lunotriquetral interosseous (LTIL) ligaments. Nine cadaveric wrists of five male subjects were studied. The visibility of dorsal and volar parts of the SLIL and LTIL was graded semi-quantitatively (good, intermediate, poor) on MRA and CTA. The presence of a ligament tear was determined on arthrosocopy and sensitivity, specificity and accuracy of tear detection were calculated. Oblique axial imaging was particularly useful for delineating dorsal and volar parts of the LTIL on MRA with overall 'good' visibility increased from 11 % to 78 %. The accuracy of MRA and CTA in revealing SLIL and LTIL tear was higher using the oblique axial plane. The overall accuracy for detecting SLIL tear on CTA improved from 94 % to 100 % and from 89 % to 94 % on MRA; the overall accuracy of detecting LTIL tear on CTA improved from 89 % to 100 % and from 72 % to 89 % on MRA Oblique axial imaging during CT and MR arthrography improves detection of tears in the dorsal and volar parts of both SLIL and LTIL. (orig.)

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

    Science.gov (United States)

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

    2014-10-28

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-11-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-06-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Jing-Shan Gong; Jian-Min Xu

    2004-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-05-15

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

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

    Science.gov (United States)

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

    2007-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2010-02-01

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

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-03-15

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

  12. Suspected aortic dissection and other aortic disorders: multi-detector row CT in 373 cases in the emergency setting.

    Science.gov (United States)

    Hayter, Robert G; Rhea, James T; Small, Andrew; Tafazoli, Faranak S; Novelline, Robert A

    2006-03-01

    To retrospectively review the authors' experience with multi-detector row computed tomography (CT) for detection of aortic dissection in the emergency setting. The investigation was institutional review board approved, did not require informed patient consent, and was HIPAA compliant. In 373 clinical evaluations in the emergency setting, 365 patients suspected of having aortic dissection and/or other aortic disorders underwent multidetector CT. Criteria for acute aortic disorder were confirmed by using surgical and pathologic diagnoses or findings at clinical follow-up and any subsequent imaging as the reference standard. Positive cases were characterized according to type of disorder interpreted. Resulting sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated by using two-way contingency tables. All cases found to be negative for acute aortic disorders were grouped according to alternative CT findings. Sixty-seven (18.0%) of the 373 cases were interpreted as positive for acute aortic disorder. One hundred twelve acute aortic disorders were identified in these 67 cases: 23 acute aortic dissections, 14 acute aortic intramural hematomas, 20 acute penetrating aortic ulcers, 44 new or enlarging aortic aneurysms, and 11 acute aortic ruptures. Three hundred five (81.8%) cases were interpreted as negative for acute aortic disorder. In 48 negative cases, multidetector CT depicted alternative findings that accounted for the clinical presentation. Of these, three included both acute aortic disorders and alternative findings, and 45 included only alternative findings. One (0.3%) case was indeterminate for acute aortic disorder. Overall, 112 findings were interpreted as positive for acute aortic disorder, an alternative finding, or both at CT. No interpretations were false-positive, one was false-negative, 67 were true-positive, and 304 were true-negative. Sensitivity, specificity, PPV, NPV, and accuracy were

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2007-03-01

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

  15. Multidetector spiral CT renal angiography in the diagnosis of renal artery fibromuscular dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Sabharwal, Rohan [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia)]. E-mail: rohan50000@yahoo.com; Vladica, Philip [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia); Coleman, Patrick [Department of Renal Medicine, Westmead Hospital, Sydney, NSW (Australia)

    2007-03-15

    Objective: The aim of this study was to evaluate the role and detection rate of multidetector spiral CT renal angiography (CTA) as compared with conventional angiography (CA), the commonly accepted gold standard, in the diagnosis of renal artery fibromuscular dysplasia (FMD). In addition, the role of CTA reconstructions (multiplanar reformatted images (MPR), maximum intensity projections (MIP) and shaded-surface display (SSD)) in the detection of FMD was also evaluated. Materials and methods: CTA results were retrospectively reviewed in 21 hypertensive patients with CA-proven FMD. Clinical indications for referral included resistant hypertension (requiring greater than three antihypertensive medications), labile hypertension, hypertension in combination with renal impairment and the presence of abdominal bruits in the context of systemic hypertension. In some cases, these clinical indications were supplemented by positive results in other tests, including plasma renin assay, captopril scintigraphy and/or Doppler ultrasound. The findings of CA in these 21 patients were compared to CTA. Results: Mean patient age was 62.33 + 14.32 years (range 24-85 years). CTA identified all 42 main renal arteries (100%) and all 10 accessory renal arteries (100%) visualized on CA. In the diagnosis of FMD, CTA detected all 40 (100%) lesions detected by CA. No single CTA reconstruction technique was able to detect all lesions noted on corresponding CA, however, upon review of all CTA reconstructions (MPR, MIP and SSD) in each case, every lesion was correctly identified by CTA. Conclusion: Our experience suggests that CTA is a non-invasive, reliable and accurate method for the diagnosis of renal artery fibromuscular dysplasia. Moreover, in our experience CTA has many advantages as a diagnostic screening tool over CA, including accessibility, speed, lower complication profile, versatility and cost-effectiveness. CTA shows great potential as a guiding tool for directing subsequent

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-11-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-06-15

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

  19. Costs and clinical outcomes after coronary multidetector CT angiography in patients without known coronary artery disease: comparison to myocardial perfusion SPECT.

    Science.gov (United States)

    Min, James K; Kang, Ning; Shaw, Leslee J; Devereux, Richard B; Robinson, Matthew; Lin, Fay; Legorreta, Antonio P; Gilmore, Amanda

    2008-10-01

    To assess costs and clinical outcomes in individuals without known coronary artery disease (CAD) who underwent multidetector computed tomographic (CT) angiography compared with those in matched patients who underwent myocardial perfusion single photon emission computed tomography (SPECT). Data were captured from a deidentified, HIPAA-compliant data warehouse. We examined 1-year CAD costs (additional diagnostic coronary testing, CAD hospitalization, and coronary procedural and revascularization costs) and clinical outcomes in individuals without known CAD who underwent multidetector CT (n = 1647) compared with those in a matched cohort of patients who underwent myocardial perfusion SPECT (n = 6588). Cox proportional hazards models were employed for clinical outcome measures, including CAD hospitalization, myocardial infarction, and angina. Adjusted CAD costs in the multidetector CT group were 25.9% lower than in the myocardial perfusion SPECT group, by an average of $1075 (95% confidence interval [CI]: $243, $2570) per patient. Those in the multidetector CT group were more likely to undergo downstream testing with myocardial perfusion SPECT (odds ratio, 6.65; 95% CI: 5.05, 8.75; P < .001), while those in the myocardial perfusion SPECT group were more likely to undergo downstream testing with invasive angiography (odds ratio, 6.25; 95% CI: 4.35, 9.09; P < .001). The multidetector CT group was less likely to undergo coronary revascularization (hazard ratio, 0.76; 95% CI: 0.75, 0.77; P < .001) than the myocardial perfusion SPECT group. There was no significant difference between multidetector CT and myocardial perfusion SPECT groups for rates of myocardial infarction (0.4% for both) or CAD hospitalization (0.7% vs 1.1%, respectively), while rates of angina were significantly lower in the multidetector CT group (4.3% vs 6.4%, P < .001). Individuals without known CAD who underwent multidetector CT as an initial diagnostic test, compared with those who underwent

  20. High pitch CT in triple rule-out studies: Radiation dose and image quality compared to multidetector CT.

    Science.gov (United States)

    Fernández del Valle, A; Delgado Sánchez-Gracián, C; Oca Pernas, R; Grande Astorquiza, A; Bustos Fiore, A; Trinidad López, C; Tardáguila de la Fuente, G

    2015-01-01

    To compare the image quality and radiation dose from high pitch dual source CT (128-DSCT) versus those from retrospective acquisition with 64-row multidetector CT (64-MDCT) in triple rule-out studies. We retrospectively studied 60 patients with acute chest pain: 30 with a retrospective EKG acquisition with 64-MDCT and 30 with high pitch 128-DSCT. We quantitatively analyzed the image quality by calculating the vascular density, muscular density (DM), noise, vascular density/noise ratio (VDNR), and contrast/noise ratio (CNR). We qualitatively evaluated the artifacts in the vena cava, aorta, and coronary arteries. We estimated the effective dose (ED) of radiation by means of the dose-length product. There were no significant differences between 128-DSCT and 64-MDCT in the vascular density. The VDNR and CNR were higher on 128-DSCT than on 64-MDCT in the aorta (VDNR: 28.9 ± 11.7 vs. 20 ± 5.5; CNR: 24.4 ± 10.9 vs. 16.8 ± 5.4; P<.01), in the pulmonary arteries (VDNR: 25.5 ± 10 vs. 20.6 ± 6.5; CNR: 24.5 ± 5.4 vs. 17.4 ± 6.4; P<.01), and in the coronary arteries (VDNR: 25.9 ± 8.2 vs. 18.9 ± 4.9; CNR: 24.9 ± 8.2 vs. 15.6 ± 4.6; P<.01). There were fewer artifacts in the coronary arteries on 128-DSCT than on 64-MDCT (3 vs. 34 nondiagnostic segments; P<.001), and the ED in 128-DSCT was lower than in 64-MDCT (13.77 ± 4 vs. 2.77 ± 0.6 mSv; P<.001). In triple rule-out studies, high pitch 128-DSCT delivers a lower dose of radiation and provides better image quality than retrospective acquisition with 64-MDCT. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  1. Multiplanar reformations and minimum intensity projections using multi-detector row CT for assessing anomalies and disorders of the pancreaticobiliary tree

    OpenAIRE

    Kim, Hyun Cheol; Yang, Dal Mo; Jin, Wook; Ryu, Chang Woo; Ryu, Jung Kyu; Park, Sung Il; Park, Seong Jin; Shin, Hyeong Cheol; Kim, Il Young

    2007-01-01

    CT scan is regarded as the imaging modality of choice in patients with pancreaticobiliary ductal abnormalities. However, the axial orientation of the CT images provides only limited anatomical view of pancreaticobiliary ductal abnormalities. The technological advances of multi-detector row CT and three-dimensional image processing in workstations allows rapid image acquisition and a short postprocessing time. In particular, multiplanar reformations (MPR) and minimum intensity projections (Min...

  2. Multidetector CT findings of splenic artery aneurysm in children with chronic liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Ulu, Esra Meltem Kayahan; Kirbas, Ismail; Emiroglu, Feride Kural; Cakir, Banu; Harman, Ali; Coskun, Mehmet [Baskent University Faculty of Medicine, Department of Radiology, Ankara (Turkey); Bakar, Coskun [Baskent University Faculty of Medicine, Department of Public Health, Ankara (Turkey)

    2008-10-15

    Splenic artery aneurysm (SAA) is a well-known complication of chronic liver disease and portal hypertension in adults. The incidence of SAA in children undergoing selective hepatic angiography prior to liver transplantation is reported as 4%, but there are few systematic studies. To investigate the SAAs detected by multidetector CT angiography (MDCTA) among children with chronic liver disease. A total of 124 children (71 girls, 53 boys; mean age 118 months; age range 5 days to 204 months) with chronic liver disease underwent MDCTA to display the vascular anatomy and any vascular complications during the pretransplantation period. Of these children, 23 also underwent coeliac angiography. The digital subtraction angiography (DSA) and MDCTA findings were compared. SAAs were detected in 13 children (10.4%); none was detectable by US. All patients had more than one aneurysm; ten patients had more than three. In all except one patient, the SAAs were located only in the intraparenchymal branches of the splenic artery; in one patient they were located in the intraparenchymal segment and in the distal third of the splenic artery. The mean size of the aneurysms was 6.5 mm (range 2.5-18 mm). All patients with aneurysms had splenomegaly and vascular collaterals. Nine of the children with SAAs had portal vein pathologies (two occlusions, two stenoses, five dilatations). A statistically significant difference existed with regard to the size of spleen (P < 0.05) and patient age (P < 0.05) between children with SAAs and children without SAAs. There was an increased risk of SAAs in patients with portal vein pathologies. In 19 patients without SAAs on MDCTA, no SAAs were seen on DSA. It is likely that the incidence of SAA in children with chronic liver disease will increase with improved survival of children with long-standing portal hypertension and chronic liver disease. MDCTA with multiplanar reconstruction is a noninvasive and effective means of imaging paediatric patients with

  3. Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kitase, M.; Mizutani, M.; Tomita, H.; Kono, T.; Sugie, C.; Shibamoto, Y. [Nagoya City University, Nagoya, (Japan). Graduate School of Medical Sciences. Dept. of Radiology

    2007-07-15

    Full text: Background: The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of super selective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. Patients and Methods: Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. Results: The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with super selective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. Conclusions: In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  5. Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography

    DEFF Research Database (Denmark)

    Gutte, Henrik; Mortensen, Jann; Jensen, Claus Verner

    2009-01-01

    The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation-perfusion (V/Q) scintigraphy or pulmonary multidetector CT (MDCT) angiography. Both V/Q SPECT and MDCT angiography seem to have...... high diagnostic accuracy. However, only limited data directly comparing these 2 modalities are available. Hybrid gamma-camera/MDCT systems have been introduced and allow simultaneous 3-dimensional lung V/Q SPECT and MDCT angiography, suitable for diagnosing PE. The aim of our study was to compare...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-02-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-03-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-15

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

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

    Science.gov (United States)

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

    2012-09-01

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

  12. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-01

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

  15. Angiographic CT with intravenous contrast agent application for monitoring of intracranial flow diverting stents

    Energy Technology Data Exchange (ETDEWEB)

    Saake, Marc; Struffert, Tobias; Goelitz, Philipp; Ott, Sabine; Doerfler, Arnd [University of Erlangen-Nuremberg, Department of Neuroradiology, Erlangen (Germany); Seifert, Frank [University of Erlangen-Nuremberg, Department of Neurology, Erlangen (Germany); Ganslandt, Oliver [University of Erlangen-Nuremberg, Department of Neurosurgery, Erlangen (Germany)

    2012-07-15

    Intracranial flow diverting devices are increasingly used to treat cerebral aneurysms. A reliable, non-invasive follow-up modality would be desirable. Our aim was to compare intra-arterial digital subtraction angiography (ia DSA) to angiographic computed tomography with intravenous contrast agent application (iv ACT) in the visualisation of flow diverting devices and aneurysm lumina. Follow-up monitoring by iv ACT (n = 36) and ia DSA (n = 25) in 14 patients treated with flow diverting devices for intracranial aneurysms was evaluated retrospectively. Images were evaluated by two neuroradiologists in anonymous consensus reading regarding the device deployment, wall apposition, neck coverage of the aneurysm, opacification of the vessel and device lumen, as well as the degree of aneurysm occlusion. Corresponding ia DSA and iv ACT images were scored identically in all patients regarding the stent deployment, wall apposition and neck coverage, as well as the degree of aneurysm occlusion and patency status of the device and parent artery. Opacification of the parent vessel lumen and perfused parts of the aneurysm was considered slightly inferior for iv ACT in comparison with ia DSA (seven of 36 cases), without impact on diagnosis. We demonstrated the feasibility and diagnostic value of iv ACT in follow-up imaging of intracranial flow diverting devices. Due to its high spatial resolution and non-invasive character, this novel technique might become a valuable imaging modality in these patients. (orig.)

  16. Angiographic CT with intravenous contrast agent application for monitoring of intracranial flow diverting stents.

    Science.gov (United States)

    Saake, Marc; Struffert, Tobias; Goelitz, Philipp; Ott, Sabine; Seifert, Frank; Ganslandt, Oliver; Doerfler, Arnd

    2012-07-01

    Intracranial flow diverting devices are increasingly used to treat cerebral aneurysms. A reliable, non-invasive follow-up modality would be desirable. Our aim was to compare intra-arterial digital subtraction angiography (ia DSA) to angiographic computed tomography with intravenous contrast agent application (iv ACT) in the visualisation of flow diverting devices and aneurysm lumina. Follow-up monitoring by iv ACT (n = 36) and ia DSA (n = 25) in 14 patients treated with flow diverting devices for intracranial aneurysms was evaluated retrospectively. Images were evaluated by two neuroradiologists in anonymous consensus reading regarding the device deployment, wall apposition, neck coverage of the aneurysm, opacification of the vessel and device lumen, as well as the degree of aneurysm occlusion. Corresponding ia DSA and iv ACT images were scored identically in all patients regarding the stent deployment, wall apposition and neck coverage, as well as the degree of aneurysm occlusion and patency status of the device and parent artery. Opacification of the parent vessel lumen and perfused parts of the aneurysm was considered slightly inferior for iv ACT in comparison with ia DSA (seven of 36 cases), without impact on diagnosis. We demonstrated the feasibility and diagnostic value of iv ACT in follow-up imaging of intracranial flow diverting devices. Due to its high spatial resolution and non-invasive character, this novel technique might become a valuable imaging modality in these patients.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-04-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-05-15

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

  19. Accuracy of hydro-multidetector row CT in the local T staging of oesophageal cancer compared to postoperative histopathological results

    Energy Technology Data Exchange (ETDEWEB)

    Ba-Ssalamah, Ahmed; Matzek, Wolfgang; Baroud, Susanne; Bastati, Nina; Weber, Michael; Herold, Christian J. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Zacherl, Johannes; Schoppmann, Sebastian F. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Medical University of Vienna, Department of Surgery, Vienna (Austria); Hejna, Michael [Medical University of Vienna, Department of Radiology, Vienna (Austria); Medical University of Vienna, Department of Oncology, Vienna (Austria); Wrba, Fritz [Medical University of Vienna, Department of Radiology, Vienna (Austria); Medical University of Vienna, Department of Pathology, Vienna (Austria); Gore, Richard M. [University of Chicago Pritzker School of Medicine, Department of Radiology, Chicago, IL (United States)

    2011-11-15

    To evaluate the accuracy of multidetector computed tomography with water filling (Hydro-MDCT) in the T-staging of patients with oesophageal cancer. There were 131 consecutive patients who were preoperatively and prospectively examined in the prone position on arterial phase contrast-enhanced MDCT, after ingestion of 1,000-1,500 ml tap water and effervescent granules. Two readers staged the local tumour growth (T-staging) independently. They assessed tumour location, size, presence of stenosis, and morphology of the outer border of the oesophageal wall and perioesophageal fat planes on CT. CT findings were compared with histopathological results from resected specimens. Data were analyzed using the SPSS statistical package. Both readers obtained a high sensitivity of 95% and a high positive predictive value of 96%. Accurate local staging was achieved in 76.3% and 68.7% for readers 1 and 2, respectively. Inter-reader agreement was excellent (weighted {kappa} value of 0.93 and un-weighted {kappa} of 0.89). Using the hydro-technique and applying specific assessment criteria, MDCT appears to be an accurate, non-invasive diagnostic tool for local tumour staging of oesophageal cancer. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Symersky, Petr [Onze Lieve Vrouwe Gasthuis, Department of Cardiothoracic Surgery, Oosterpark 9, P.O box 95500, Amsterdam (Netherlands); Academic Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Budde, Ricardo P.J. [University Medical Center, Department of Radiology, Utrecht (Netherlands); Westers, Paul [Julius Center for Health Sciences and Primary Care, Department of Biostatistics, Utrecht (Netherlands); Mol, Bas A.J.M. de [Academic Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); University of Technology Eindhoven, Department of Biomedical Engineering, Eindhoven (Netherlands); Prokop, Mathias [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands)

    2011-10-15

    Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. A Medtronic Hall tilting disc (MH), and Carbomedics (CM), St Jude (SJM), and ON-X bileaflet valves underwent CT in an in-vitro model using retrospective gating with a 64 detector CT system in stationary and pulsatile conditions. Artifacts and radiopaque component volumes were quantified with thresholds based on surrounding structures and valvular components. Hypodense artifacts volumes (mm{sup 3}) were 1,029 {+-} 147, 535 {+-} 53, 371 {+-} 16, and 366 {+-} 18 for the SJM, MH, CM and ON-X valves (p < 0.001 except for the latter two valves p = 0.43). Hyperdense artifact volumes were 3,546 {+-} 141, 2,387 {+-} 103, 2,003 {+-} 102, and 3,033 {+-} 31 for the SJM, MH, CM and ON-X valve, respectively (all differences p < 0.001). Leaflet motion affected hypodense (F = 41.5, p < 0.001) and hyperdense artifacts (F = 53.7, p < 0.001). Closed and moving leaflets were associated with the least and the most artifacts respectively (p < 0.001, both artifact types). Both valve design and leaflet motion affect PHV-induced artifacts. Best imaging results may be expected for the CM valve during phases in which the leaflets are closed. (orig.)

  1. Cardiac carcinoid: tricuspid delayed hyperenhancement on cardiac 64-slice multidetector CT and magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Martos, R

    2012-02-01

    INTRODUCTION: Carcinoid heart disease is a rare condition in adults. Its diagnosis can be easily missed in a patient presenting to a primary care setting. We revised the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing this condition. MATERIALS AND METHODS: We studied a 65-year-old patient with carcinoid heart disease and right heart failure using transthoracic Doppler-echocardiogram, cardiac MDCT and MRI. Cardiac echocardiogram revealed marked thickening and retraction of the tricuspid leaflets with dilated right atrium and ventricle. Cardiac MDCT and MRI demonstrated fixation and retraction of the tricuspid leaflets with delayed contrast hyperenhancement of the tricuspid annulus. CONCLUSION: This case demonstrates fascinating imaging findings of cardiac carcinoid disease and highlights the increasing utility of contrast-enhanced MRI and cardiac MDCT in the diagnosis of this interesting condition.

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

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

    OpenAIRE

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

    2014-01-01

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

  5. Angiographic-CT-FDG-Pathologic Correlations of the Incidentally Discovered Adrenal Mass

    Directory of Open Access Journals (Sweden)

    Bi-Fang Lee

    2011-01-01

    Full Text Available During abdominal ultrasonography of a 37-year-old man a 3.2 cm hypoechoic mass in the right hepatic lobe was found incidentally. This prompted an abdominal CT, an FDG PET/CT, and an angiography to evaluate the nature of the mass. Laboratory data showed positive anti-HBs/anti-HBe, and negative HCV antibody. The alfa-fetoprotein and liver function tests were within normal limits. Contrast-enhanced CT found an enhanced hepatic tumor and primary hepatocellular carcinoma was suspected. PET/CT revealed no abnormal FDG accumulation in the right hepatic mass. The digital subtraction angiographies of the right inferior phrenic artery and right renal artery revealed a hypervascular tumor in the right adrenal gland. Therefore, a diagnosis of a right adrenal tumor was made. Serum aldosterone, serum cortisol, and urine vanillylmandelic acid, and catecholamine were all within normal limits. Laparoscopic right adrenalectomy was performed and adrenal cortical adenoma was diagnosed on a histological study.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-07-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-01

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

  9. Reduced image noise at low-dose multidetector CT of the abdomen with prior image constrained compressed sensing algorithm.

    Science.gov (United States)

    Lubner, Meghan G; Pickhardt, Perry J; Tang, Jie; Chen, Guang-Hong

    2011-07-01

    standard FBP low-dose multidetector CT abdominal images results in substantial noise reduction and improved image quality.

  10. Visualization of gastric varices using angiographic C-arm CT during retrograde transvenous sclerotherapy

    Directory of Open Access Journals (Sweden)

    Iwazawa Jin

    2010-01-01

    Full Text Available During retrograde transvenous sclerotherapy for gastric varices, sufficient opacification of the target varices on venography is essential for successful treatment. However, venography sometimes cannot identify target varices due to overlapping adjacent collateral vessels or leakage of contrast medium to other outflow veins. We report how C-arm CT images acquired using a flat-panel detector angiography system helped to identify target varices and predict the distribution of a sclerosant, which resulted in safer sclerotherapy and increased operator confidence.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-03-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-06

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-02

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

  15. A case of atypical caudate lobe hemangioma mimicking hepatocellular carcinoma:CT and angiographic manifestations

    Institute of Scientific and Technical Information of China (English)

    Hsin-Chi Chen; Chi-Ming Lee; Ching-Shyang Chen; Chih-Hsiung Wu

    2004-01-01

    We report a case of caudate lobe hemangioma with an atypical CT enhancement pattern. In the present case,hemangioma exhibited a very subtle discontinuous peripheral rim enhancement at the post-enhanced arterial phase, and the peripheral enhanced zone had a moderately increased enhancement degree and with widened enhancement thickness during the portal-phase and delayed-phase. The slow enhancement rate for this caudate lobe hemangioma was due to sluggish perfusion by the small feeding arteries of caudate lobe branches as demonstrated by angiography.

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

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

    2008-07-15

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

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

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

    2011-04-15

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

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

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

    2013-12-15

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

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

    Directory of Open Access Journals (Sweden)

    Jingjing Wang

    2016-01-01

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

  20. Cartilage lesions of the glenohumeral joint: diagnostic effectiveness of multidetector spiral CT arthrography and comparison with arthroscopy

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    Lecouvet, Frederic E.; Dorzee, Benjamin; Berg, Bruno C. vande; Malghem, Jacques [Cliniques Universitaires St Luc, Universite Catholique de Louvain, Department of Radiology, Brussels (Belgium); Dubuc, Jean E. [Cliniques Universitaires St Luc, Universite Catholique de Louvain, Department of Orthopaedic Surgery, Brussels (Belgium); Jamart, Jacques [Mont Godinne University Hospital, Center of Biostatistics, Yvoir (Belgium)

    2007-07-15

    This study assessed the diagnostic effectiveness of multidetector spiral CT arthrography (MDCTa) in detecting hyaline cartilage abnormalities of the shoulder joint, with correlation to arthroscopy. Shoulder MDCTa images prospectively obtained in 22 consecutive patients (mean age, 50 years; age range, 23-74 years; 12 female, 10 male) were evaluated for glenohumeral cartilage lesions. Two musculoskeletal radiologists independently analysed the cartilage surfaces of the humeral head and of the glenoid fossa in nine anatomical surface areas. Observations of MDCTa were compared to arthroscopic findings. The sensitivity and specificity of MDCTa for grade 2 (substance loss <50%) or higher and grade 3 (substance loss {>=}50%) or higher cartilage lesions, the Spearman correlation coefficient between arthrographic and arthroscopic grading, and K statistics for assessing Intra and Interobserver reproducibility were determined. At MDCTa, sensitivities and specificities ranged between 80% and 94% for the detection of grade 2 or higher cartilage lesions, and between 88% and 98% for the detection of grade 3 or higher cartilage lesions. Spearman correlation coefficients between MDCTa and arthroscopic grading of articular surfaces ranged between 0.532 and 0.651. Interobserver agreement was moderate for grading all articular surfaces ({kappa} = 0.457), but substantial to almost perfect for detecting lesions with substance loss ({kappa}, 0.618-0.876). In conclusion, MDCTa is accurate for the study of cartilage surface in the entire shoulder joint. This technique may beneficially impact patient's management by means of selecting the proper treatment approach. (orig.)

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

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

    2013-11-15

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

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

    Science.gov (United States)

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

    2008-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-15

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

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

    Science.gov (United States)

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

    2017-01-01

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

  5. Nonalcoholic Hepatic Steatosis Is a Strong Predictor of High-Risk Coronary-Artery Plaques as Determined by Multidetector CT.

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    Kazuhiro Osawa

    Full Text Available Nonalcoholic fatty liver disease is associated with a risk of coronary artery disease (e.g., diabetes mellitus, dyslipidemia, metabolic syndrome. We evaluated whether nonalcoholic hepatic steatosis is associated with high-risk plaques as assessed by multidetector computed tomography (CT.This retrospective study involved 414 participants suspected of having coronary artery disease. Nonalcoholic hepatic steatosis was defined as a liver-to-spleen fat ratio of <1.0 and the presence and appropriate characteristics of coronary-artery plaques as assessed by coronary CT angiography. High-risk plaques were identified, as were low-density plaques, positive remodeling, and spotty calcification.Compared with patients who did not have nonalcoholic hepatic steatosis, patients with nonalcoholic hepatic steatosis had more low-density plaques (21% vs. 44%, p<0.01, positive remodeling (41% vs. 58%, p = 0.01, and spotty calcification (12% vs. 36%, p<0.01. The number of high-risk plaques in patients with nonalcoholic hepatic steatosis was greater than in those without nonalcoholic hepatic steatosis (p<0.01. Patients with nonalcoholic hepatic steatosis were more likely to have high-risk plaques than were those with only an elevated level of visceral adipose tissue (≥86 cm2; 35% vs. 16%, p<0.01. Multivariate analyses that included nonalcoholic hepatic steatosis, amount of visceral adipose tissue, and the presence/absence of traditional risk factors demonstrated that nonalcoholic hepatic steatosis was an independent predictor of high-risk plaques (odds ratio: 4.60; 95% confidence interval: 1.94-9.07, p<0.01.Diagnosis of nonalcoholic hepatic steatosis may be of value when assessing the risk of coronary artery disease.

  6. Evaluation of middle cerebral artery stents using multidetector row CT angiography in vivo study: comparison of the three different kernels

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    Jang, Jin Hee; Lim, Yeon Soo; Lee, Youn Joo; Yoo, Won Jong; Sung, Mi Sook (Dept. of Radiology, Bucheon St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Bucheon (Korea, Republic of)), email: wjyu@catholic.ac.kr; Kim, Bum Soo (Dept. of Radiology, Seoul St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of))

    2012-05-15

    Background: There are very few reports assessing middle cerebral artery (MCA) stents using multidetector computed tomography (MDCT). Purpose: To assess MCA stents using multidetector CT angiography (CTA) in vivo evaluation: the differences in the CTA results according to the three different kernels. Material and Methods: We retrospectively evaluated 27 MCA stents from 26 patients who underwent CTA with 16- and 64-slice MDCT after percutaneous transluminal angioplasty and stenting (PTAS). By CTA, using medium-smooth kernel (B30), medium-sharp kernel (B50), and sharp kernel (B60), the lumen diameter, artificial luminal narrowing (ALN), and subjective visibility score of the stented vessels were evaluated. The subjective visibility score ranged from 1 (poor quality) to 5 (excellent) using a five-point scale. Results: There were excellent inter-observer agreements for the lumen diameter measurements (P < 0.001). The mean diameter of the stented vessels was 2.10 +- 0.31 mm on digital subtraction angiography (DSA), 0.93 +- 0.20 mm on CTA using B30, 1.18 +- 0.27 mm on CTA using B50, and 1.29 +- 0.29 mm on CTA using B60. The mean ALN was 55.7 +- 6.0% on CTA using B30, 43.8 +- 7.5% on CTA using B50, and 38.7 +- 8.3% on CTA using B60. CTA with higher kernels had a smaller ALN than images with smaller kernels. The median subjective visibility score on the CTA using B50 was 3, which was higher than for the other kernels. The differences in the lumen diameter, ALN, and the subjective visibility score of the stented vessels on CTA using the three different kernels was statistically significant (P < 0.001). Conclusion: The sharp kernel was better to assess the lumen diameter and ALN, but was inferior to the medium-sharp kernel for in-stent evaluation due to high image-to-noise. CTA with medium-sharp kernel showed good lumen visibility and acceptable ALN for MCA stents. This could therefore be a non-invasive, readily applicable clinical method for assessing MCA stent patency after

  7. Utility of double-contrast multidetector CT scans to assess cartilage thickness after tibial plafond fracture

    Directory of Open Access Journals (Sweden)

    Thaddeus P Thomas

    2009-11-01

    Full Text Available Thaddeus P Thomas1,2, Christopher J Van Hofwegen1, Donald D Anderson1,2, Thomas D Brown1,2, J Lawrence Marsh11Department of Orthopedics and Rehabilitation, 2Department of Biomedical Engineering, The University of Iowa, Iowa City, IA, USAAbstract: The pathophysiology of posttraumatic osteoarthritis (PTOA after intraarticular fractures is poorly understood. Pursuit of a better understanding of this disease is complicated by inability to accurately monitor its onset, progression and severity. Common radiographic methods used to assess PTOA do not provide sufficient image quality for precise cartilage measurements. Double-contrast multidetector computed tomography (MDCT is an alternative method that may be useful, since it produces high-quality images in normal ankles. The purpose of this study was to assess this technique’s performance in assessing cartilage maintenance in ankles with an intraarticular fracture. Thirty-six tibial plafond fractures were followed over two years, with 31 MDCTs being obtained four months after injury, and 22 MDCTs after two years. Unfortunately, clinical results with this technique were unreliable due to pathology (presumed arthrofibrosis and technical problems (pooling of contrast. The arthrofibrosis that developed in many patients inhibited proper joint access and contrast infiltration, although high-quality images were obtained in 11 patients. In this patient subset, in which focal regions of cartilage degeneration could be visualized, thickness could be measured with a high degree of fidelity. While thus useful in selected instances, double-contrast MDCT was too unreliable to be recommended to assess these particular types of injuries.Keywords: posttraumatic osteoarthritis, cartilage, imaging, fracture

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-15

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

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

    Science.gov (United States)

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

    2010-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-15

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

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

    Science.gov (United States)

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

    2006-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Tamir A. Hassan

    2015-12-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-15

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

  16. Does intravenous rtPA benefit patients in the absence of CT angiographically visible intracranial occlusion?

    Directory of Open Access Journals (Sweden)

    Sylaja P

    2009-01-01

    Full Text Available Background : In patients with acute stroke receiving intravenous tissue plasminogen activator (tPA, we postulated that the presence of intracranial occlusion on CT angiography (CTA modifies the benefit of thrombolysis. Materials and Methods : Using a retrospective cohort design, we identified patients with acute ischemic stroke in our CTA database between May 2002 and August 2007. All the patients had a CTA within 12 h of onset, a premorbid modified Rankin scale (mRS #1, and a baseline National Institute of Health Stroke Scale score(NIHSSf $6. The primary outcome was early effectiveness of tPA defined as an NIHSS score of #2 at 24 h or a 4-point NIHSS improvement at 24 h. Secondary outcome included mRS #1 at 90 days. The relationship between intracranial occlusion on CTA and benefit of tPA was assessed using a test for interaction. Results : A total of 287 patients met the criteria [occlusion present N =168; (98 with tPA; 70 without tPA and occlusion absent N = 119; (52 with tPA; 67 without tPA]. Those with intracranial occlusion were likely to have more severe strokes (NIHSS $15; P < 0.001 and abnormal brain imaging (ASPECTS #7; P < 0.001. For outcome of 4-point NIHSS score improvement at 24 h, benefit from tPA was observed only among patients with a visible occlusion (absolute difference in favor of tPA: 20.4% vs. 0.7%; P = 0.06. Conclusion : In patients with acute ischemic stroke, thrombolysis produced a better early clinical response among patients with intracranial occlusion, which needs to be confirmed in stroke thrombolysis trials.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2007-03-01

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

  19. Accuracy of single phase contrast enhanced multidetector CT colonography in the preoperative staging of colo-rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mainenti, Pier Paolo [IBB CNR, Via Pansini 5, 80131 Naples (Italy) and Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy)]. E-mail: pierpamainenti@hotmail.com; Cirillo, Luigi Carlo [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Hospital ' dei Pellegrini' , ASLNA 1, Via Portamedina 41, 80100 Naples (Italy); Camera, Luigi [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Persico, Francesco [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Cantalupo, Teresa [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Pace, Leonardo [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Palma, Giovanni Domenico De [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Persico, Giovanni [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Salvatore, Marco [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy)

    2006-12-15

    Aim: The optimal acquisition time for staging colo-rectal carcinoma with a contrast enhanced multidetector CT colonography (CE CTC) has not yet been established. A dual phase with both arterial and portal venous acquisition has been proposed. The purpose of our study is to assess the value of single portal venous phase CE CTC in the preoperative staging of colo-rectal carcinoma. Materials and methods: Fifty two (30 M, 22 F; aged 35-82 years) consecutive patients with a histologically proven diagnosis of colo-rectal adenocarcinoma or a highly suspected colo-rectal cancer on conventional colonoscopy underwent a four-slice CE CTC. The procedure was performed 70 s (portal phase) after the intravenous bolus (3 ml/s) administration of 120 ml iodinated non-ionic contrast agent (370 mg iodine/ml). Scans were performed using the following parameters: 2.5 mm beam collimation, pitch 1.25, 120 kV, 200 mAs, rotation time 0.75 s. Images were reconstructed with an effective thickness of 3.2 mm at intervals of 1.6 mm. Two radiologists independently evaluated the depth of tumour invasion into the colo-rectal wall (T), regional lymph node involvement (N), and extracolonic metastases (M). Disagreement was resolved by means of a consensus decision. The pathological results served as the standard of reference. Assessment was made of sensitivity, specificity and accuracy, as well as positive and negative predictive values were assessed. Results: CE CTC correctly staged the pT of 52/56 (93%) and the N of 40/56 (71%) lesions, as well as properly identifying 13/14 (93%) extracolonic findings. Conclusion: The single portal venous phase CE CTC scanning protocol enables satisfactory preoperative assessment of T, N and M staging in patients with colo-rectal cancer.

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

    Science.gov (United States)

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

    2013-08-01

    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). Fifty clinical multidetector CT datasets containing nodules up to 20mm in diameter were retrospectively collected. For the detection and rating of non-calcified nodules larger than 4mm 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. 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 132s with concurrent-reader CAD and 210s with second-reader CAD (preader CAD and 0.72 with second-reader CAD (p=0.35). 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. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

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

    Science.gov (United States)

    Ota, Hideki; Seiji, Kazumasa; Kawabata, Masahiro; Satani, Nozomi; Omata, Kei; Ono, Yoshikiyo; Iwakura, Yoshitsugu; Morimoto, Ryo; Matsuura, Tomonori; Kudo, Masataka; Tominaga, Junya; Satoh, Fumitoshi; Ito, Sadayoshi; Takase, Kei

    2016-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-04-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-15

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

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  8. Use of multidetector-row CT colonography for detection of colorectal neoplasia in patients referred via the Department of Health '2-week-wait' initiative

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A.; Halligan, S. E-mail: s.halligan@ic.ac.uk; Saunders, B.P.; Morley, S.; Riesewyk, C.; Atkin, W.; Bartram, C.I

    2003-11-01

    AIM: Patients referred under the Department of Health 2-week wait initiative with symptoms of colorectal cancer frequently undergo whole-colon examination. We investigated the use of computed tomography (CT) colonography as an alternative to colonoscopy in this scenario. MATERIALS AND METHODS: Fifty-four consecutive patients, referred via the 2-week wait initiative and scheduled for colonoscopy, consented to undergo multidetector CT colonography immediately before endoscopy. The site and morphology of any polyp or cancer detected by CT was noted and comparison made with subsequent colonoscopy. RESULTS: Colonoscopy detected polyps or cancer in 29 patients (53.7%). CT colonography prospectively detected 18 of 41 (44%) polyps of 1-5 mm, three of four (75%) polyps of 6-9 mm, four of four (100%) polyps 10 mm or larger, and five of six (83%) cancers. The missed cancer occurred early in the series and was a perceptive error. The overall sensitivity, specificity, positive predictive value and negative predictive value of CT colonography for cancer and polyps 10 mm or greater on a per patient basis were 90, 100, 100 and 98%, respectively. CT detected one renal cancer and one colonic cancer, initially missed due to incomplete colonoscopy. CONCLUSION: CT colonography is a robust technique for investigation of symptomatic patients. The learning curve must be overcome for optimal performance.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-04-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-03-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-11-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-01-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

  9. Severity of acute pulmonary embolism: evaluation of a new spiral CT angiographic score in correlation with echocardiographic data

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    Mastora, Ioana; Remy-Jardin, Martine; Masson, Pascal; Remy, Jacques [Department of Radiology, University Center Hospital Calmette, Boulevard Jules Leclerc, 59037 Lille Cedex (France); Medical Research Group ' ' Equipe d' Accueil no. 2682' ' , Boulevard Jules Leclerc, 59037 Lille Cedex (France); Galland, Eric; Bauchart, Jean-Jacques [Department of Cardiology, University Center Cardiology Hospital; Boulevard Jules Leclerc, 59037 Lille Cedex (France); Delannoy, Valerie [Department of Medical Statistics, University of Lille, Place de Verdun, 59037 Lille Cedex (France)

    2003-01-01

    The purpose of this study was to investigate whether the severity of acute pulmonary embolism (PE) could be quantitatively assessed with spiral CT angiography (SCTA). Thirty-six consecutive patients without underlying cardiopulmonary disease and high clinical suspicion of PE underwent prospectively thin-collimation SCTA and echocardiography at the time of the initial diagnosis (T0) and after initial therapy (T1; mean interval of time T1-T2: 32 days). The CT severity score was based on the percentage of obstructed surface of each central and peripheral pulmonary arterial section using a 5-point scale (1: <25%; 2: 25-49%; 3: 50-74%; 4: 75-99%; 5: 100%). The sum of the detailed scores attributed to 5 mediastinal, 6 lobar and 20 segmental arteries per patient led to the determination of central, peripheral and global CT severity scores and subsequent determination of percentages of obstruction of the pulmonary circulation. Echocardiographic severity criteria included the presence of signs of acute cor pulmonale and/or systolic pulmonary hypertension (>40 mm Hg). The SCTA depicted acute PE in all patients at T0 with complete resolution of endovascular clots in 10 patients at T1. At T0, the mean percentage of obstruction of the pulmonary arterial bed was significantly higher in the 22 patients with echocardiographic signs of severity (56{+-}13 vs 28{+-}32%; p<0.001). A significant reduction in the mean percentage of pulmonary artery obstruction was observed in the 19 patients with resolution of echocardiographic criteria of severity between T0 and T1 T0: 57{+-}14%; T1: 7{+-}11%; p<0.001. The threshold value for severe PE on CT angiograms was 49% (sensitivity: 0.773; specificity: 0.214). The mean ({+-}SD) pulmonary artery pressure was significantly higher in the 26 patients with more than 50% obstruction of the pulmonary artery bed (45{+-}15 mm Hg) than in the 10 patients with less than 50% obstruction of pulmonary artery bed at T0 (31{+-}11 mm Hg; p<0.01). The CT

  10. Intra-individual comparison of patient acceptability of multidetector-row CT colonography and double-contrast barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)]. E-mail: csytaylor@yahoo.co.uk; Halligan, S. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Burling, D. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bassett, P. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bartram, C.I. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)

    2005-02-01

    AIMS: To compare the subjective acceptability of CT colonography in comparison with barium enema in older symptomatic patients, and to ascertain preferences for future colonic investigation. MATERIALS AND METHODS: The study population comprised 78 persons aged 60 years or over with symptoms suggestive of colorectal neoplasia, who underwent CT colonography followed the same day by barium enema. A 25-point questionnaire was administered after each procedure and an additional follow-up questionnaire a week later. Responses were compared using Wilcoxon matched pairs testing, Mann-Whitney test statistics and binomial exact testing. RESULTS: Participants suffered less physical discomfort during CT colonography (p=0.03) and overall satisfaction was greater compared with barium enema (p=0.03). On follow-up, respondents reported significantly better tolerance of CT colonography (p=0.002), and were less prepared to undergo barium enema again (p<0.001). Of 52 subjects expressing an opinion, all preferred CT to barium enema. CONCLUSION: Patient satisfaction was higher with CT colonography than barium enema. CT colonography caused significantly less physical discomfort and was overwhelmingly preferred by patients.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

  12. Multidetector CT urography in urogenital tuberculosis: use of reformatted images for the assessment of the radiological findings. A pictorial essay.

    Science.gov (United States)

    Gaudiano, Caterina; Tadolini, Marina; Busato, Fiorenza; Vanino, Elisa; Pucci, Simone; Corcioni, Beniamino; Golfieri, Rita

    2017-04-08

    Urogenital tuberculosis (UGTB) is the most common form of extrapulmonary TB and is responsible for a destructive inflammation of the renal parenchyma and urinary tract often leading to the loss of kidney function. For these reasons, the early diagnosis of this disease, once considered disappeared in developed countries, is very important to establish a prompt and efficient treatment. However, the subtle and non-specific symptoms, often represented by recurrent and persistent lower urinary tract symptoms, can confound and delay the diagnosis. Therefore, an adequate and comprehensive imaging study is necessary in patients with persistent urinary tract infections not responding to the antibiotics and can suggest the hypothesis although bacteriological and/or histologic analysis is required for a definitive diagnosis. In the past years, intravenous urography (IVU) has allowed a comprehensive study of the urinary excretory tract, promoting the knowledge of the radiological findings of this disease. Nowadays, computed tomography urography (CTU), with the implementation of multidetector (MD) technology, has replaced IVU in all its indications; the MDCTU improves the assessment of renal and urinary tract lesions using reformatted images [such as multiplanar reconstruction (MPR) and maximum intensity projection (MIP)]. Therefore, our paper aims to provide a guide for radiologist for searching the classic signs of UGTB on MDCTU, encouraging the use of the MPR and MIP reformatted images.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-15

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

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

    Directory of Open Access Journals (Sweden)

    Ringe Kristina

    2012-07-01

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

  16. Hereditary haemorrhagic telangiectasia: study of hepatic vascular alterations with multi-detector row helical CT and reconstruction programs; Telangiectasia emorragica ereditaria: TC multidetettore multifasica e programmi di ricostruzione nello studio delle alterazioni vascolari epatiche

    Energy Technology Data Exchange (ETDEWEB)

    Memeo, Maurizio; Stabile Ianora, Amato Antonio; Scaldapane, Arnaldo; Rotondo, Antonio; Angelelli, Giuseppe [Policlinico Universitario, Bari (Italy). DiMIMP Sezione di Diagnostica per Immagini; Suppressa, Patrizia; Cirulli, Anna; Sabba' , Carlo [Policlinico Universitario, Bari (Italy). Centro Interdipartimentale per lo studio dell' HHT

    2005-02-01

    Purpose: To evaluate hepatic alterations in patients affected by Hereditary Haemorrhagic Telangiectasia (HHT) by using multidetector row helical CT (MDCT) and new reconstruction programs. Materials and methods: An MDCT multiphasic study of the liver was performed in 105 consecutive patients: 89 considered to be affected by HHT and 16 with suspicion of disease alone. The scan delay was determined by using a test bolus of contrast material. The CT examination was performed with a triphasic technique (double arterial phase and portal venous phase). multiplanar and angiographic reconstructions were then obtained, and the images checked for the presence of shunts, hepatic perfusion disorders, vascular lesions (telangiectasis and large confluent vascular masses), indirect signs of portal hypertension, and anatomical vascular variants. Results: Hepatic vascular alterations were found in 78/105 cases (67/89) patients affected by HHT and 11/16 patients with clinical suspicion alone). Therefore HHT diagnosis was excluded in 5 patients. 78/100 (78%) patients with HHT had intrahepatic vascular alterations: arterioportal shunts in 40/78 (51.2%) arteriosystemic shunts in 16/78 (20.5%) and both shunt types in 22/78 (28.3%). Intraparenchymal perfusion disorders were found in 46/78 (58.9%) patients. Telangiectasis were recognised in 50/78 (64.1%) patients. Large confluent vascular masses (LCVMs) were identified in 20/78 (25.6%) patients. indirect signs of portal hypertension were found in 46/78 (58.9%) cases. Variant hepatic arterial anatomy was present in 38/100 cases (38%). Conclusions: Multiphasic MDCT and the new reconstruction programs enable the identification and characterisation of the complex vascular alterations typical of HHT. [Italian] Scopo: Valutare le alterazioni epatiche nei pazienti affetti da Telangiectasia Emorraica Ereditaria (TEE) utilizzando una TC multidetettore (TCMD) ed in nuovi programmi di ricostruzione. Materiale e metodi: E' stato eseguito uno

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

  18. Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis: Assessment of cross-sectional and longitudinal vessel reconstructions

    Energy Technology Data Exchange (ETDEWEB)

    Cury, Ricardo C. [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)]. E-mail: rcury@partners.org; Ferencik, Maros [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Achenbach, Stephan [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Division of Cardiology, Massachusetts General Hospital, Boston, MA (United States); Department of Internal Medicine II, University of Erlangen (Germany); Pomerantsev, Eugene [Division of Cardiology, Massachusetts General Hospital, Boston, MA (United States); Nieman, Koen [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Moselewski, Fabian [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Division of Cardiology, Massachusetts General Hospital, Boston, MA (United States); Abbara, Suhny [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Jang, Ik-Kyung [Division of Cardiology, Massachusetts General Hospital, Boston, MA (United States); Brady, Thomas J. [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Hoffmann, Udo [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)

    2006-03-15

    Background: Sixteen-slice multi-detector computed tomography (MDCT) permits reliable noninvasive detection of significant coronary stenosis based on qualitative visual assessment. The purpose of this study was to determine the accuracy of MDCT to quantify the degree of coronary stenosis as compared to quantitative coronary angiography (QCA) using two different reconstruction methods. Methods: We studied 69 coronary artery lesions from 38 consecutive patients that underwent 16-slice MDCT as a part of research study, which enrolled consecutive subjects scheduled for clinically indicated invasive coronary angiography. Nine coronary artery lesions with motion artifacts, heavily calcified plaques or stents were excluded from the analysis. The degree of stenosis was calculated by two independent readers non-blinded to the location of the stenosis, but blinded to the results of the QCA. MDCT luminal diameters were measured in cross-sectional multi-planar reformatted (CS-MPR) images created perpendicular to the centerline of the vessel and in 5 mm thin-slab maximum intensity projections (MIP) parallel to the long axis of the vessel. Both MDCT methods were compared against QCA. Results: The mean degree of stenosis as measured by MDCT was closely correlated to QCA for both methods (CS-MPR versus QCA: 61 {+-} 23% versus 64 {+-} 29%; r {sup 2} = 0.83, p < 0.001 and MIP versus QCA: 64 {+-} 22% versus 64 {+-} 29%; r {sup 2} = 0.84, p < 0.001 for MIP. Bland-Altman analysis demonstrated a negative bias of the degree of stenosis of -2.8 {+-} 12% using CS-MPR and a minimally positive bias of 0.6 {+-} 12% for MIP. In stratified analysis for lesion severity (mild, 0-40%; moderate, 41-70% or severe, >70%) the agreement between both CS-MPR and MIP was high when compared to QCA ({kappa} = 0.74 and 0.71, respectively). Conclusion: Multi-detector spiral CT permits accurate quantitative assessment of the degree of coronary stenosis in selected data sets of sufficient quality using both

  19. Early and Delayed Myocardial Enhancement in Myocardial Infarction Using Two-Phase Contrast-Enhanced Multidetector-Row CT

    Science.gov (United States)

    Kim, Young-Whan; Han, Seong-Wook; Seo, Joon-Beom

    2007-01-01

    Objective The purpose of this study was to describe the myocardial enhancement patterns in patients with myocardial infarction using two-phase contrast-enhanced multidetector-row computed tomography (MDCT). Materials and Methods Twenty-three patients with clinically proven myocardial infarction (17 acute myocardial infarction [AMI] and 6 chronic myocardial infarction [CMI]) were examined with two-phase contrast-enhanced ECG-gated MDCT. The presence, location, and patterns of myocardial enhancement on two-phase MDCT images were compared with infarcted myocardial territories determined by using electrocardiogram, echocardiography, thallium-201 single photon emission computed tomography, catheter and MDCT coronary angiography. Results After clinical assessment, the presence of myocardial infarctions were found in 27 territories (19 AMI and 8 CMI) of 23 patients. Early perfusion defects were observed in 30 territories of all 23 patients. Three territories not corresponding to a myocardial infarction were detected in three patients with AMI and were associated with artifacts. Fourteen of perfusion defects were in the left anterior descending artery territory, four in the left circumflex artery territory, and nine in the right coronary artery territory. Delayed enhancement was observed in 25 territories (17 AMI and 8 CMI) of 21 patients. Delayed enhancement patterns were variable. Transmural early perfusion defects (n =12) were closely associated with transmural late enhancement (n = 5) and subendocardial residual defect with subepicardial late enhancement (n = 5). Conclusion Myocardial infarction showed early perfusion defects and variable delayed enhancement patterns on two-phase contrast-enhanced MDCT. Delayed enhancement technique of MDCT could provide additional information of the location and extent of infarcted myocardium, and could be useful to plan appropriate therapeutic strategies in patients with AMI. PMID:17420626

  20. Early and Delayed Myocardial Enhancement in Myocardial Infarction Using Two-Phase Contrast-Enhanced Multidetector-Row CT

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Sung-Min; Kim, Young-Whan; Han, Seong-Wook [University of Keimyung College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of); Seo, Joon-Beom [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2007-04-15

    The purpose of this study was to describe the myocardial enhancement patterns in patients with myocardial infarction using two-phase contrast enhanced multidetector-row computed tomography (MDCT). Twenty-three patients with clinically proven myocardial infarction (17 acute myocardial infarction [AMI] and 6 chronic myocardial infarction [CMI]) were examined with two-phase contrast-enhanced ECG-gated MDCT. The presence, location, and patterns of myocardial enhancement on two phase MDCT images were compared with infarcted myocardial territories determined by using electrocardiogram, echocardiography, thallium-201 single photon emission computed tomography, catheter and MDCT coronary angiography. After clinical assessment, the presence of myocardial infarctions were found in 27 territories (19 AMI and 8 CMI) of 23 patients. Early perfusion defects were observed in 30 territories of all 23 patients. Three territories not corresponding to a myocardial infarction were detected in three patients with AMI and were associated with artifacts. Fourteen of perfusion defects were in the left anterior descending artery territory, four in the left circumflex artery territory, and nine in the right coronary artery territory. Delayed enhancement was observed in 25 territories (17 AMI and 8 CMI) of 21 patients. Delayed enhancement patterns were variable. Transmural early perfusion defects (n =12) were closely associated with transmural late enhancement (n = 5) and subendocardial residual defect with subepicardial late enhancement (n = 5). Myocardial infarction showed early perfusion defects and variable delayed enhancement patterns on two-phase contrast-enhanced MDCT. Delayed enhancement technique of MDCT could provide additional information of the location and extent of infarcted myocardium, and could be useful to plan appropriate therapeutic strategies in patients with AMI.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

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

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

    2010-03-15

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

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

    Science.gov (United States)

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

    2007-05-07

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  5. Autopsy case of a giant aneurysm of the anterior communicating artery. Correlation of CT findings and angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Shinmura, Fujio; Takayasu, Kenji; Ohiwa, Yasuyuki; Sakata, Ryuichi; Ariwa, Rokuro

    1983-06-01

    A 64-year-old female was admitted to the hospital with a history of three previous subarachnoid hemorrhages. Neurological examinations revealed incontinentia urinae, gait disturbance, recent memory disturbance and motor weakness on the left side. Plain X-ray films showed a ring-like calcification in the right frontal region. A plain CT scan showed a ring-shaped iso- and high-density area in the intra hemispheric region, the intra bilateral anterior horn of the lateral ventricle, the intra septum pellucidum, and the intra anterior part of the third ventricle. Left carotid angiography showed a large aneurysmal shadow arising from the anterior communicating artery and another from the left middle cerebral artery. In the venous phase the venous angle was supero-posteriorly shifted, and the septal vein was elevated. She died unexpectedly with a status epilepticus of unknown origin. An autopsy specimen revealed that a giant aneurysm occupied the intra ventricular space, the anterior horn of the lateral ventricle, and the right thalamic region. Also, there was a large berry aneurysm arising from the middle cerebral artery. A coronary section through the giant aneurysm showed a markedly compressed left lateral ventricle, right thalamus, and hypothalamus, while the third ventricle had shifted toward the left side.

  6. CT angiographic analysis of carotid artery stenosis: comparison of manual assessment, semiautomatic vessel analysis, and digital subtraction angiography.

    Science.gov (United States)

    Silvennoinen, H M; Ikonen, S; Soinne, L; Railo, M; Valanne, L

    2007-01-01

    To compare multisection CT angiography (CTA) analyzed with source/maximum intensity projection (MIP) images as well as semiautomated vessel analysis software with intra-arterial digital subtraction angiography (DSA) in detection and grading of carotid artery bifurcation stenosis. Consecutive patients with sonography evidence of a marked internal carotid artery stenosis underwent both carotid CTA and DSA (37 patients, 73 vessels). In CTA, the grade of stenosis was determined using axial source and MIP images as well as vessel analysis. The scans were blind-analyzed by 2 neuroradiologists using the NASCET criteria. Correlation of CTA source/MIP images versus DSA estimates of stenosis (R = 0.95) was higher than for the vessel analysis method versus DSA (R = 0.89). Compared with DSA, CTA source/MIP images underestimated high (78.2% versus 86.4%, P grades of stenosis (57.3% versus 63.1%, P grade stenosis, sensitivity and specificity of source/MIP image CTA were 75% and 96%, respectively, whereas for the vessel analysis method, they were 47% and 96%, respectively. For moderate stenosis, the source/MIP image CTA sensitivity and specificity were 88% and 82%, respectively, and for vessel analysis method, 62% and 82%, respectively. CTA detected all 4 occlusions. In evaluation of carotid stenosis, CTA provides an adequate, less invasive alternative with a high correlation to conventional DSA, though it tends to underestimate clinically relevant grades of stenosis. Its accuracy is not improved by semiautomated analysis. The data support the use of CTA in confirming carotid occlusion.

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-15

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

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

    Science.gov (United States)

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

    2008-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-01-15

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

  11. The vascularized groin lymph node flap (VGLN): Anatomical study and flap planning using multi-detector CT scanner. The golden triangle for flap harvesting.

    Science.gov (United States)

    Zeltzer, Assaf A; Anzarut, Alexander; Braeckmans, Delphine; Seidenstuecker, Katrin; Hendrickx, Benoit; Van Hedent, Eddy; Hamdi, Moustapha

    2017-09-01

    A growing number of surgeons perform lymph node transfers for the treatment of lymphedema. When harvesting a vascularized lymph node groin flap (VGLNF) one of the major concerns is the potential risk of iatrogenic lymphedema of the donor-site. This article helps understanding of the lymph node distribution of the groin in order to minimize this risk. Fifty consecutive patients undergoing abdominal mapping by multi-detector CT scanner were included and 100 groins analyzed. The groin was divided in three zones (of which zone II is the safe zone) and lymph nodes were counted and mapped with their distances to anatomic landmarks. Further node units were plotted and counted. The average age was 48 years. A mean number of nodes of 6.5/groin was found. In zone II, which is our zone of interest a mean of 3.1 nodes were counted with a mean size of 7.8 mm. In three patients no nodes were found in zone II. In five patients nodes were seen in zone II but were not sufficient in size or number to be considered a lymph node unit. On average the lymph node unit in zone II was found to be 48.3 mm from the pubic tubercle when projected on a line from the pubic tubercle to the anterior superior iliac spine, 16.0 mm caudal to this line, and 20.4 mm above the groin crease. On average the lymph node unit was a mean of 41.7 mm lateral to the SCIV-SIEV confluence. This study provides increased understanding of the lymphatic anatomy in zone II of the groin flap and suggests a refined technique for designing the VGLNF. As with any flap there is a degree of individual patient variability. However, having information on the most common anatomy and flap design is of great value. © 2017 Wiley Periodicals, Inc.

  12. Diagnostic accuracy of three-dimensional contrast-enhanced MR angiography at 3-T for acute pulmonary embolism detection: comparison with multidetector CT angiography.

    Science.gov (United States)

    Zhang, Long Jiang; Luo, Song; Yeh, Benjamin M; Zhou, Chang Sheng; Tang, Chun Xiang; Zhao, Yan'e; Li, Lin; Zheng, Ling; Huang, Wei; Lu, Guang Ming

    2013-10-12

    Three-dimensional contrast-enhanced MR pulmonary angiography (MRPA) is a suitable option for pulmonary embolism (PE) detection. However, there have been few reports on the diagnostic accuracy of MRPA for PE detection in a 3-T MR system. The purpose of this study was to evaluate the accuracy of MRPA in a 3-T MR system to detect acute PE with multidetector CT pulmonary angiography (CTPA) as reference standard. Twenty-seven patients (18 males and 9 females, mean age 38.9±14.4 years) underwent both MRPA and CTPA within 3 days (range, 0-3 days) for evaluating PE. Pulmonary emboli in MRPA were independently analyzed on a per-patient and per-lobe basis by two radiologists. CTPA was regarded as reference standard, which was evaluated by another two radiologists in consensus. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for PE detection were calculated. Weighted κ values were calculated to evaluate agreement between readers. Twenty-four patients had PE in 55 lung lobes in CTPA, while 3 patients had no PE detected. Readers 1 and 2 correctly detected 47 and 46 lung lobes having clots in 24 and 23 patients, corresponding to sensitivities, specificities, PPV, NPV, and accuracies of 100%, 100%, 100%, 100%, 100%; 100%, 66.7%, 96.0%, 100%, 96.4% on a per-patient basis and 85.5%, 100%, 100%, 90.9%, 94.1%; 83.6%, 93.7%, 90.2%, 89.2%, 89.6% on a per-lobe basis; respectively. Excellent inter-reader agreement (κ values=1.00 and 0.934; both Pcontrast-enhanced MRPA with a 3-T MR system is a suitable alternative modality to CTPA to detect PE on a per-patient basis based on this small cohort study. © 2013.

  13. Volume-rendered hemorrhage-responsible arteriogram created by 64 multidetector-row CT during aortography: utility for catheterization in transcatheter arterial embolization for acute arterial bleeding.

    Science.gov (United States)

    Minamiguchi, Hiroki; Kawai, Nobuyuki; Sato, Morio; Ikoma, Akira; Sanda, Hiroki; Nakata, Kouhei; Tanaka, Fumihiro; Nakai, Motoki; Sonomura, Tetsuo; Murotani, Kazuhiro; Hosokawa, Seiki; Nishioku, Tadayoshi

    2014-01-01

    Aortography for detecting hemorrhage is limited when determining the catheter treatment strategy because the artery responsible for hemorrhage commonly overlaps organs and non-responsible arteries. Selective catheterization of untargeted arteries would result in repeated arteriography, large volumes of contrast medium, and extended time. A volume-rendered hemorrhage-responsible arteriogram created with 64 multidetector-row CT (64MDCT) during aortography (MDCTAo) can be used both for hemorrhage mapping and catheter navigation. The MDCTAo depicted hemorrhage in 61 of 71 cases of suspected acute arterial bleeding treated at our institute in the last 3 years. Complete hemostasis by embolization was achieved in all cases. The hemorrhage-responsible arteriogram was used for navigation during catheterization, thus assisting successful embolization. Hemorrhage was not visualized in the remaining 10 patients, of whom 6 had a pseudoaneurysm in a visceral artery; 1 with urinary bladder bleeding and 1 with chest wall hemorrhage had gaze tamponade; and 1 with urinary bladder hemorrhage and 1 with uterine hemorrhage had spastic arteries. Six patients with pseudoaneurysm underwent preventive embolization and the other 4 patients were managed by watchful observation. MDCTAo has the advantage of depicting the arteries responsible for hemoptysis, whether from the bronchial arteries or other systemic arteries, in a single scan. MDCTAo is particularly useful for identifying the source of acute arterial bleeding in the pancreatic arcade area, which is supplied by both the celiac and superior mesenteric arteries. In a case of pelvic hemorrhage, MDCTAo identified the responsible artery from among numerous overlapping visceral arteries that branched from the internal iliac arteries. In conclusion, a hemorrhage-responsible arteriogram created by 64MDCT immediately before catheterization is useful for deciding the catheter treatment strategy for acute arterial bleeding.

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

    Science.gov (United States)

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

    2010-07-01

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

  15. Is aortic atherothrombotic disease detected using multidetector-row CT associated with an increased risk of early ischemic lesion recurrence after acute ischemic stroke?

    Science.gov (United States)

    Ko, Youngchai; Kim, Wook-Joo; Jang, Myung Suk; Yang, Mi Hwa; Park, Jung Hyun; Choi, Sang Il; Chun, Eun Ju; Lee, Soo Joo; Han, Moon-Ku; Bae, Hee-Joon

    2012-03-01

    Multidetector-row CT (MDCT) is emerging as a new tool for diagnosing aortic atherothrombotic disease (AAD). We elucidated whether MDCT-detected AAD is associated with an increased risk of early ischemic lesion recurrence on diffusion-weighted MRI after ischemic stroke. A consecutive series of patients with acute ischemic stroke confirmed using diffusion-weighted MRI who were hospitalized within 48 hours after symptom onset and underwent MDCT were identified in a prospective stroke registry database. AAD on MDCT was defined as the presence of plaque formation that was noncalcified and ≥4 mm thick, ulcerative, or soft and thrombosed (vulnerable) in the proximal aortic arch. Ischemic lesion recurrence on diffusion-weighted MRI was defined as the occurrence of any new lesion separate from the index lesion on follow-up diffusion-weighted MRI performed within 14 days after symptom onset. A total of 138 patients was selected. MDCT detected AAD in 24 of 138 (17.4%); ≥4 mm thickness in 17 of 138 (12.3%); ulcerated plaque in 20 of 138 (14.5%); and vulnerable plaque in 16 of 138 (11.6%). With respect to diffusion-weighted MRI lesion recurrence, the crude ORs (95% CIs) were as follows: AAD, 3.56 (1.43-8.89); vulnerable plaque, 3.21 (1.11-9.30); ulcerated plaque, 3.37 (1.27-8.95); and ≥4 mm thickness of the noncalcified plaque, 4.23 (1.11-16.19). These results remained significant after adjustments for potential confounders were made. This study shows that AAD detected by MDCT increases the risk of early ischemic lesion recurrence after acute ischemic stroke, thus supporting the role of MDCT in diagnosing AAD and assessing its contribution to recurrence.

  16. Exposure (mAs) optimisation of a multi-detector CT protocol for hepatic lesion detection: Are thinner slices better?

    Science.gov (United States)

    Dobeli, Karen Leigh; Lewis, Sarah Jane; Meikle, Steven Richard; Thiele, David Lewis; Brennan, Patrick Christopher

    2014-04-01

    The purpose of this work was to determine the exposure-optimised slice thickness for hepatic lesion detection with CT. A phantom containing spheres (diameter 9.5, 4.8 and 2.4 mm) with CT density 10 HU below the background (50 HU) was scanned at 125, 100, 75 and 50 mAs. Data were reconstructed at 5-, 3- and 1-mm slice thicknesses. Noise, contrast-to-noise ratio (CNR), area under the curve (AUC) as calculated using receiver operating characteristic analysis and sensitivity representing lesion detection were calculated and compared. Compared with the 125 mAs/5 mm slice thickness setting, significant reductions in AUC were found for 75 mAs (P mAs (P mAs (P mAs at all three slice thicknesses (P mAs exposures was approximately 10, 30 and 50% higher, respectively, than that at 125 mAs exposure. CNRs decreased in an irregular manner with reductions in exposure and slice thickness. This study demonstrated no advantage to using slices below 5 mm thickness, and consequently thinner slices are not necessarily better. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-01-15

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

  19. Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Ringl, Helmut; Schernthaner, Ruediger; Philipp, Marcel O.; Metz-Schimmerl, Sylvia; Czerny, Christian; Weber, Michael; Steiner-Ringl, Andrea; Peloschek, Philipp; Herold, Christian J.; Schima, Wolfgang [Medical University of Vienna, Department of Radiology, Vienna (Austria); Gaebler, Christian [Medical University of Vienna, Department of Trauma-Surgery, Vienna (Austria)

    2009-10-15

    The purpose of this study was to retrospectively assess the detection rate of skull-base fractures for three different three-dimensional (3D) reconstruction methods of cranial CT examinations in trauma patients. A total of 130 cranial CT examinations of patients with previous head trauma were subjected to 3D reconstruction of the skull base, using solid (SVR) and transparent (TVR) volume-rendering technique and maximum intensity projection (MIP). Three radiologists independently evaluated all reconstructions as well as standard high-resolution multiplanar reformations (HR-MPRs). Mean fracture detection rates for all readers reading rotating reconstructions were 39, 36, 61 and 64% for SVR, TVR, MIP and HR-MPR respectively. Although not significantly different from HR-MPR with respect to sensitivity (P = 0.9), MIP visualised 18% of fractures that were not reported in HR-MPR. Because of the relatively low detection rate using HR-MPRs alone, we recommend reading MIP reconstructions in addition to the obligatory HR-MPRs to improve fracture detection. (orig.)

  20. Comparison of dynamic contrast-enhanced 3T MR and 64-row multidetector CT angiography for the localization of spinal dural arteriovenous fistulas.

    Science.gov (United States)

    Oda, S; Utsunomiya, D; Hirai, T; Kai, Y; Ohmori, Y; Shigematsu, Y; Iryo, Y; Uetani, H; Azuma, M; Yamashita, Y

    2014-02-01

    For the localization of spinal dural arteriovenous fistulas, it is not determined whether dynamic contrast-enhanced MRA is more reliable than multidetector CTA. The aim of this study was to compare the agreement between intra-arterial DSA, dynamic contrast-enhanced MRA at 3T, and 64-row multidetector CTA for the localization of spinal dural arteriovenous fistulas. We enrolled 12 consecutive patients (11 men, 1 woman; age range, 46-83 years; mean, 65 years) who underwent preoperative dynamic contrast-enhanced MRA at 3T and 64-row multidetector CTA. The spinal dural arteriovenous fistula location was confirmed by intra-arterial DSA as the reference standard. Two reviewers independently evaluated the level of the artery feeding the spinal dural arteriovenous fistula on the basis of continuity between the feeder and abnormal spinal vessels on 3T dynamic contrast-enhanced MRA and 64-row multidetector CTA images. Interobserver and intermodality agreement was determined by calculation of the κ coefficient. On DSA, the vessel feeding the spinal dural arteriovenous fistula was the intercostal artery (7 cases), the lumbar artery (3 cases), and the internal iliac artery or the ascending pharyngeal artery (1 case each). For the fistula level, interobserver agreement was excellent for 3T dynamic contrast-enhanced MRA (κ = 0.97; 95% CI, 0.92-1.00) and very good for 64-row multidetector CTA (κ = 0.84; 95% CI, 0.72-0.96). Intermodality agreement with DSA was good for 3T dynamic contrast-enhanced MRA (κ = 0.78; 95% CI, 0.49-1.00) and moderate for 64-row multidetector CTA (κ = 0.41; 95% CI, 0.020-0.84). For the localization of spinal dural arteriovenous fistulas, 3T dynamic contrast-enhanced MRA may be more reliable than 64-row multidetector CTA.

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

    Institute of Scientific and Technical Information of China (English)

    戚乐; 戴平丰; 丁建平; 向军益

    2011-01-01

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

  2. The emerging role of multidetector row CT angiography in the diagnosis of cervical arterial dissection: preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Elijovich, Lucas [NYU Medical Center, Department of Neurology, New York, NY (United States); Kazmi, Khuram [NYU Medical Center, Department of Neurology, New York, NY (United States); NYU Medical Center, Department of Radiology, New York, NY (United States); Gauvrit, Jean Y. [NYU Medical Center, Department of Radiology, New York, NY (United States); Hopital Salengro, Department of Neuroradiology, Lille (France); Law, Meng [NYU Medical Center, Department of Radiology, New York, NY (United States)

    2006-09-15

    Cervical artery dissection is an important cause of ischemic stroke, particularly in young patients. The diagnosis can be made with invasive catheter angiography or non-invasive imaging, either with MRI in conjunction with MR angiography (MRA) or CT angiography (CTA). Both modalities have been shown to have a high specificity and sensitivity. New developments such as multi-slice CTA (MSCTA) are emerging as an alternative methods for imaging the cervical and intracranial arteries. However, the contribution of modern MSCTA to carotid artery dissection has not been reported. We present a retrospective series of seven patients in whom both MSCTA and cervical axial T1 MRI and MRA were performed in the acute to subacute setting of internal carotid artery dissection. Carotid artery dissection was identified in all seven patients by MSCTA. The combination of MRI and MRA identified dissection in five of the seven patients. Additionally, a pseudoaneurysm was identified by MSCTA that was missed by MRI and MRA. Our findings confirm that MSCTA is a complementary technique in comparison to cervical axial T1 MRI and cervical MRA for diagnosing carotid artery dissection, and at times may provide additional information that can impact patient management. (orig.)

  3. Computed Tomography (CT) -- Sinuses

    Medline Plus

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Agid, R.; Lee, S.K.; Willinsky, R.A.; Farb, R.I.; TerBrugge, K.G. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario (Canada)

    2006-11-15

    To evaluate the clinical role of CT angiography (CTA) in patients with acute subarachnoid hemorrhage (SAH) for treatment decision-making. Consecutive patients with acute SAH had CTA using a 64-slice scanner for initial clinical decision-making. Image processing included multiplanar volume reformatted (MPVR) maximum intensity projections (MIP) and 3D volume-rendered reconstructions. CTAs were used for (1) evaluating the cause of SAH, and (2) triaging aneurysm-bearing patients to the more appropriate management, either surgical clipping or endovascular coiling. CTA findings were confirmed by neurosurgical exploration or catheter angiography (digital subtraction angiography, DSA). Successful coiling provided evidence that triaging to endovascular treatment was correct. Included in the study were 73 patients. CTA findings were confirmed by DSA or neurosurgical operation in 65 patients, and of these 65, 47 had aneurysmal SAH, 3 had vasculitis, 1 had arterial dissection and 14 had no underlying arterial abnormality. The cause of SAH was detected with CTA in 62 out of the 65 patients (95.4%, sensitivity 94%, specificity 100%). CTA revealed the aneurysm in 46 of 47 patients (98%, sensitivity 98%, specificity 100%, positive predictive value 100%, negative predictive value 82.3%), 1 of 3 vasculitides and 1 of 1 dissection. Of the 46 patients with aneurysm, 44 (95.7%) were referred for treatment based on CTA. In 2 patients (2 of 46, 4.4%) CTA was not informative enough to choose treatment requiring DSA. Of the 44 patients, 27 (61.4%) were referred to endovascular treatment and successful coiling was achieved in 25 (25 of 27, 92.6%). CTA using a 64-slice scanner is an accurate tool for detecting and characterizing aneurysms in acute SAH. CTA is useful in the decision process whether to coil or clip an aneurysm. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Rezia Udinoor Peedikayil

    2016-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-15

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

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

    Institute of Scientific and Technical Information of China (English)

    奚彬; 盛伟华; 唐建伟; 黄松; 宋黎涛

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Savić Živorad N.

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mingyue Luo

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

  11. Comparison of 64-row and 16-row multidetector CT in the perfusion CT evaluation of acute ischemic stroke patients receiving intravenous thrombolytic therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sillanpaa, Niko; Dastidar, Prasun; Soimakallio, Seppo [Tampere University Hospital, Medical Imaging Centre, PL 2000, Tampere (Finland); Rusanen, Harri [Oulu University Hospital, Department of Neurology, Oulu (Finland); Saarinen, Jukka T. [Tampere University Hospital, Department of Neurology, Tampere (Finland)

    2012-09-15

    Perfusion computed tomography (PCT) is increasingly performed in multimodal CT evaluation of acute ischemic stroke. We compared the technical quality of perfusion studies performed with a 16-row and a 64-row scanner and analyzed the differences between the scanners in their ability to detect perfusion defects. We analyzed retrospectively the clinical and imaging data of 140 consecutive acute (<3 h) stroke patients who underwent multimodal CT evaluation and received intravenous rtPA. Alberta Stroke Program Early CT Score (ASPECTS) was assigned to PCT maps. Clinical and imaging parameters were compared between the two scanners. There were more motion artifacts in the 16-row studies (p = 0.04), and the analysis software was able to completely correct significantly fewer of these (p < 0.001). Both ASPECTS levels were optimally covered in only 29% of the 16-row studies, whereas in the 64-row studies, both levels were invariably optimally visualized (p < 0.001). This significantly decreased the sensitivity of the 16-row scanner to detect perfusion defects in the upper ASPECTS level (p = 0.02). The 64-row scanner was able to detect more perfusion defects that were located entirely outside the ASPECTS regions (p = 0.03). There was no significant difference in the 3-month functional outcome. The 16-row scanner suffered from limited anatomic coverage that decreased the sensitivity to detect perfusion defects in the cranial parts of the middle cerebral artery region. The 16-row studies had poorer technical quality that was in part attributable to higher sampling frequency and smaller slice thickness making the imaging more sensitive to small-scale movement of the patient. (orig.)

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-10-15

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

  15. Multi-detector CT perfusion

    Directory of Open Access Journals (Sweden)

    Ashraf M. Enite

    2016-09-01

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

  16. Images in medicine: Diagnosis and pre-surgical triage of transanal rectal injury using multidetector CT with water-soluble contrast enema

    Directory of Open Access Journals (Sweden)

    Massimo Tonolini

    2013-01-01

    Full Text Available Transanal rectal injuries caused by foreign body insertion, sexual abuse, or iatrogenic procedures represent a very uncommon surgical emergency. Morbidity may be further increased by patient′s embarrassment and delayed presentation. Since management decisions largely depend on anatomic and severity assessment, multidetector Computed tomography with rectally administered water-soluble iodinated contrast medium is highly valuable to accurately depict traumatic rectal injuries, and to distinguish between intraperitoneal vs extraperitoneal injuries that require different surgical approaches.

  17. Children's (Pediatric) CT (Computed Tomography)

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    Full Text Available ... scanner. top of page How does the procedure work? In many ways, CT scanning is like other ... scanners to obtain multiple slices in a single rotation. These scanners, called "multislice CT" or "multidetector CT," ...

  18. Abdominal and Pelvic CT

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  19. Computed Tomography (CT) -- Head

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  20. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  1. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Magnetic Resonance Imaging ( ...

  2. Computed Tomography (CT) -- Head

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in ...

  3. Abdominal and Pelvic CT

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Ultrasound - Abdomen X- ...

  4. Cardiac CT Scan

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-02-01

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

  7. 64排螺旋CT灌注成像对前列腺癌的诊断价值研究%Study on Diagnostic Value of 64 - multidetector Spiral CT Perfusion Imaging in Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    殷少龙; 许庆森; 赵春龙; 武迎军; 冯庆韬

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-15

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    María Lourdes Mallo

    2010-12-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-01-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

  15. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called "multislice CT" or "multidetector CT," ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  16. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... top of page What are the benefits vs. risks? Benefits Using a multidetector CT unit to examine ... CT scans should have no immediate side effects. Risks The risk of serious allergic reaction to contrast ...

  17. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called "multislice CT" or "multidetector CT," ... special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in ...

  18. 256-slice CT angiographic evaluation of coronary artery bypass grafts: effect of heart rate, heart rate variability and Z-axis location on image quality.

    Directory of Open Access Journals (Sweden)

    Bettina M Gramer

    Full Text Available PURPOSE: The objective of this study is to assess the effect of heart rate, heart rate variability and z-axis location on coronary artery bypass graft (CABG image quality using a 256-slice computed tomography (CT scanner. METHODS: A total of 78 patients with 254 CABG (762 graft segments were recruited to undergo CABG assessment with 256-slice CT and prospective ECG-gating. Two observers rated graft segments for image quality on a 5-point scale. Quantitative measurements were also made. Logistic and cumulative link mixed models were used to assess the predictors of graft image quality. RESULTS: Graft image quality was judged as diagnostic (scores 5 (excellent, 4 (good and 3 (moderate in 96.6% of the 762 segments. Interobserver agreement was excellent (kappa ≥0.90. Graft image quality was not affected by heart rate level. However, high heart rate variability was associated with an important and significant image quality deterioration (odds ratio 4.31; p  =  0.036. Distal graft segments had significantly lower image quality scores than proximal segments (p ≤ 0.02. Significantly higher noise was noted at the origin of the mammary grafts (p  =  0.001, owing to streak artifacts from the shoulders. CONCLUSION: CABG imaging with 270-msec rotation 256-slice CT and prospective ECG-gating showed an adequate image quality in 96.6% of graft segments, and an excellent interobserver agreement. Graft image quality was not influenced by heart rate level. Image quality scores were however significantly decreased in patients with high heart rate variability, as well as in distal graft segments, which are closer to the heart.

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

    Directory of Open Access Journals (Sweden)

    Tanasković Slobodan

    2015-01-01

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

  20. Identification of predictive CT angiographic factors in the development of high-risk type 2 endoleaks after endovascular aneurysm repair in patients with infrarenal aortic aneurysms.

    Science.gov (United States)

    Löwenthal, D; Herzog, L; Rogits, B; Bulla, K; Weston, S; Meyer, F; Halloul, Z; Pech, M; Ricke, J; Dudeck, O

    2015-01-01

    An extensive analysis of the value of computed tomography (CT) parameters as potential predictors of the clinical outcome of type 2 endoleaks after endovascular aortic aneurysm repair (EVAR). Initial CT scans of 130 patients with abdominal aortic aneurysms (AAAs) were retrospectively reviewed. On the basis of postoperative CT scans and angiographies, patients were stratified into a low-risk group (LRG; without or transient type 2 endoleak; n = 80) and a high-risk group (HRG, persistent type 2 endoleak or need for reintervention; n = 50). Statistical analysis comprised a univariate and multivariate analysis. Anatomical, thrombus-specific, as well as aortic side branch parameters were assessed on the initial CT scan. Of all anatomical parameters, the diameter of the immediate infrarenal aorta was significantly different in the univariate analysis (LRG 22.4 ± 3.8 mm; HRG 23.6 ± 2.5 mm; p = 0.03). The investigation of the thrombus-specific parameters showed a trend towards statistical significance for the relative thrombus load (LRG 31.7 ± 18.0%; HRG 25.3 ± 17.5%; p = 0.09). Assessment of aortic side branches revealed only for the univariate analysis significant differences in the patency of the inferior mesenteric artery (LRG 71.3%; HRG 92.0%; p = 0.003) and their diameter (LRG 3.3 ± 0.7 mm; HRG 3.8 ± 0.9 mm; p = 0.004). In contrast, the number of lumbar arteries (LAs; LRG 2.7 ± 1.4; HRG 3.6 ± 1.2; univariate: p = 0.01; multivariate: p = 0.006) as well as their diameter (LRG 2.1 ± 0.4 mm; HRG 2.4 ± 0.4 mm; univariate: p < 0.001; multivariate: p = 0.006) were highly significantly associated with the development of type 2 endoleaks of the HRG. The most important predictive factors for the development of high-risk type 2 endoleaks were mainly the number and the diameter of the LAs which perfused the AAA. • This study is a very detailed and comprehensive analysis of the

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-15

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

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

    Science.gov (United States)

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

    2014-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

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

    OpenAIRE

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kloska, Stephan P.; Fischer, Tobias; Fischbach, Roman; Heindel, Walter [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Nabavi, Darius G.; Dittrich, Ralf; Ringelstein, E.B. [University of Muenster, Department of Neurology, Muenster (Germany); Ditt, Hendrik; Klotz, Ernst [Siemens AG, Medical Solutions, Forchheim (Germany)

    2007-09-15

    Computed tomography (CT) is still the primary imaging modality following acute stroke. To evaluate a prototype of software for the calculation of color-coded whole-brain perfused blood volume (PBV) images from CT angiography (CTA) and nonenhanced CT (NECT) scans, we studied 14 patients with suspected acute ischemia of the anterior cerebral circulation. PBV calculations were performed retrospectively. The detection rate of ischemic changes in the PBV images was compared with NECT. The volume of ischemic changes in PBV was correlated with the infarct volume on follow-up examination taking potential vessel recanalization into account. PBV demonstrated ischemic changes in 12/12 patients with proven infarction and was superior to NECT (8/12) in the detection of early ischemia. Moreover, PBV demonstrated the best correlation coefficient with the follow-up infarct volume (Pearson's R = 0.957; P = 0.003) for patients with proven recanalization of initially occluded cerebral arteries. In summary, PBV appears to be more accurate in the detection of early infarction compared to NECT and mainly visualizes the irreversibly damaged ischemic tissue. (orig.)

  7. Value of multi-detector CT angiography in Takayasu arteritis%多排螺旋CT对多发性大动脉炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    陈海雄; 胡秋根; 李景雷

    2014-01-01

    目的 探讨多排螺旋CT(MDCT)在多发性大动脉炎中的诊断价值。方法 回顾性分析32 例经临床确诊为大动脉炎患者的MDCT 资料及实验室检查,图像后处理方法包括多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现(VR),实验室检查主要包括红细胞沉降率(ESR)和C 反应蛋白(CRP)。结果 按照Lupi-Herrea 分类法,Ⅰ型10 例,Ⅱ型9 例,Ⅲ型8 例,Ⅳ型5 例;共累及血管134 支,狭窄- 阻塞型112 支;扩张型8 支;混合型14 支。受累血管管壁最大厚度范围为1.3~8.6 mm(平均3.65±1.58),活动期管壁最大厚度约2.7~8.6 mm(平均5.24±1.59),明显大于非活动期1.3~6.0 mm (平均2.93±0.92)(P<0.05)。增强扫描活动期管壁强化8 例(80.0%),非活动期管壁轻度强化2 例(9.0%),非活动期管壁钙化 7 例(31.8%)。结论 MDCT 能准确判断多发性大动脉炎的分型、分期及病变范围,可作为其首选检查方法。%ObjectiveTo investigate the clinical value of multi-detector computed tomography(MDCT)in the diagnosis of Takayasu's arteritis.Methods MDCT, erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels of 32 patients with Takayasu’s arteritis were analyzed retrospectively. Image processing included multi-planar reformation(MPR), maximum intensity projection (MIP), and volume rendering reconstruction(VR).Results The patients were classified Lupi-Herrea type I(10), type II(9), type III(8) and type IV(5). Of 134 abnormal vessels, 112 were stenotic or occlusive, 8 were dilated and 14 were mixed. The vessel wall thickness was 1.3-8.6 mm(average 3.65±1.58 mm)with significantly(P<0.05)thicker walls in the active phase(2.7-8.6 mm)than that in the resting phase(1.3-6.0 mm). There was heterogeneous contrast enhancement of the vessel walls in the active phase(80.0%), mild enhancement(9.0%)and calcification (31.8%)in the resting

  8. Usefulness of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI): Assessment of morphology and diameter of the superior mesenteric artery (SMA) on multi-planar reconstructed (MPR) images

    Energy Technology Data Exchange (ETDEWEB)

    Woodhams, Reiko, E-mail: reikow@hotmail.co.j [Department of Radiology, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Kanagawa 228-8555 (Japan); Nishimaki, Hiroshi, E-mail: emgrad@yhb.att.ne.j [Department of Radiology, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Kanagawa 228-8555 (Japan); Emergency Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Kanagawa, 228-8555 (Japan); Fujii, Kaoru, E-mail: kaorufujii@yahoo.co.j [Department of Radiology, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Kanagawa 228-8555 (Japan); Kakita, Satoko, E-mail: skakita@kitasato-u.ac.j [Department of Radiology, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Kanagawa 228-8555 (Japan); Hayakawa, Kazushige, E-mail: hayakazu@med.kitasato-u.ac.j [Department of Radiology, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Kanagawa 228-8555 (Japan)

    2010-10-15

    Objective: The purpose of this study was to assess the efficacy of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI) by analyzing morphology and diameter of superior mesenteric artery (SMA). We assessed whether MDCT was as useful as angiography for the diagnosis of NOMI. Materials and methods: Four patients who were diagnosed with NOMI were retrospectively analyzed. All patients had 8-row MDCT followed by laparotomy. Two of them underwent angiography after MDCT. The morphology and diameter of SMA of these cases was analyzed on multi-planar reconstructed (MPR) images. The mean diameter of SMA of NOMI cases was compared to that of 13 control cases. Results: MPR images of all NOMI cases showed irregular narrowing of the SMA, spasm of the arcades of SMA, and poor demonstration of intramural vessels. MPR images of two patients who had angiography were concordant with their angiograms. The mean diameter of SMA of NOMI patients was 3.4 {+-} 1.1 mm, which was statistically smaller than that of 13 control patients, 6.0 {+-} 1.5 mm (P < 0.05, Wilcoxon rank sum tests). Conclusion: Angiography has been recognized essential for the diagnosis of NOMI. This study shows the possibility of MDCT to be an equivalently useful modality compared to angiography for the diagnosis of NOMI by interpreting morphologic appearance and diameter of SMA. Introduction of MDCT in the decision tree of NOMI treatment may bring the benefit of prompt diagnosis and subsequent early and efficient initiation of therapy, which may improve the mortality.

  9. Evaluation of acute pulmonary embolism by sixty-four slice multidetector CT angiography: Correlation between obstruction index, right ventricular dysfunction and clinical presentation

    Directory of Open Access Journals (Sweden)

    Noha M. Attia

    2015-03-01

    Results: Dyspnea and RVD (RVD-ratio >1 were significantly more common in patients with central pulmonary emboli. The mean OI (35% ± 19% was significantly higher in patients with dyspnea, tachycardia and obesity. A positive correlation was found between the OI and both the CT pulmonary artery diameter (r = 0.66, p  43% identified more than 90% of patients with RVD (area under the curve on ROC analysis: 0.825; p  43% proved to be an independent predictor of RVD.

  10. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much like other x-ray examinations. Different ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much like other x-ray examinations. Different ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  12. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much like other x-ray examinations. Different ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

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

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  14. Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: impact on surgical procedure

    Energy Technology Data Exchange (ETDEWEB)

    Frericks, Bernd B.J. [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); University of Berlin, Department of Radiology, Berlin (Germany); Charite - University Medicine Berlin, Department of Radiology and Nuclear Medicine, Berlin (Germany); Kirchhoff, Timm D.; Shin, Hoen-Oh; Stamm, Georg; Merkesdal, Sonja; Abe, Takehiko; Galanski, Michael [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Schenk, Andrea; Peitgen, Heinz-Otto [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); MeVis - Center for Medical Diagnostic Systems and Visualization, Bremen (Germany); Klempnauer, Juergen [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Nashan, Bjoern [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Dalhousie University, Multi Organ Transplant Program, Halifax, Nova Scotia (Canada)

    2006-12-15

    The purpose was to assess the volumes of the different hepatic territories and especially the drainage of the right paramedian sector in adult living donor liver transplantation (ALDLT). CT was performed in 40 potential donors of whom 28 underwent partial living donation. Data sets of all potential donors were postprocessed using dedicated software for segmentation, volumetric analysis and visualization of liver territories. During an initial period, volumes and shapes of liver parts were calculated based on the individual portal venous perfusion areas. After partial hepatic congestion occurring in three grafts, drainage territories with special regard to MHV tributaries from the right paramedian sector, and the IRHV were calculated additionally. Results were visualized three-dimensionally and compared to the intraoperative findings. Calculated graft volumes based on hepatic venous drainage and graft weights correlated significantly (r=0.86,P<0.001). Mean virtual graft volume was 930 ml and drained as follows: RHV: 680 ml, IRHV: 170 ml (n=11); segment 5 MHV tributaries: 100 ml (n=16); segment 8 MHV tributaries: 110 ml (n=20). When present, the mean aberrant venous drainage fraction of the right liver lobe was 28%. The evaluated protocol allowed a reliable calculation of the hepatic venous draining areas and led to a change in the hepatic venous reconstruction strategy at our institution. (orig.)

  15. Imaging features of solid pseudopapillary tumor of the pancreas on multi-detector row computed tomography

    Institute of Scientific and Technical Information of China (English)

    Deng-Bin Wang; Qing-Bing Wang; Wei-Min Chai; Ke-Min Chen; Xia-Xing Deng

    2009-01-01

    AIM:To retrospectively analyze the imaging features of solid-pseudopapillary tumors (SPTs) of the pancreas on multi-detector row computed tomography (MDCT) and define the imaging findings suggestive of malignant potential.METHODS: A total of 24 consecutive cases with surgically and pathologically confirmed SPTs of the pancreas underwent preoperative abdominal MDCT studies in our hospital. All axial CT images, CT angiographic images, and coronally and sagittally reformed images were obtained. The images were retrospectively reviewed at interactive picture archiving and communication system workstations. RESULTS: Of the 24 cases of SPTs, 11 cases (45.8%) occurred in the pancreatic head and seven (29.1%) in the tail. Eighteen were pathologically diagnosed as benign and six as malignant. MDCT diagnosis of SPTs was well correlated with the surgical and pathological results (Kappa = 0.6, P < 0.05). The size of SPTs ranged from 3 to 15 cm (mean, 5.8 cm). When the size of the tumor was greater than 6 cm (including 6cm), the possibilities of vascular (8 vs 1) and capsular invasion (9 vs 0) increased significantly ( P < 0.05). Two pathologically benign cases with vascular invasion and disrupted capsule on MDCT presented with local recurrence and hepatic metastases during follow-up about 1 year after the resection of the primary tumors.CONCLUSION: Vascular and capsular invasion with superimposed spread into the adjacent pancreatic parenchyma and nearby structures in SPTs of the pancreas can be accurately revealed by MDCTpreoperatively. These imaging findings are predictive of the malignant potential associated with the aggressive behavior of the tumor, even in the pathologically benign cases.

  16. Angiographic findings of ischemic stroke in children.

    Science.gov (United States)

    Shirane, R; Sato, S; Yoshimoto, T

    1992-12-01

    A cooperative study was undertaken in the Tohoku district of Japan to investigate the relatively rare phenomenon of cerebral infarction in children. The purpose of the present paper is to describe the cerebral angiographic findings in 48 children whose ischemic lesions were confirmed by CT scan. The majority of lesions were considered to be idiopathic. The areas of cerebral infarction appearing in the CT scans were located in the territory of the middle cerebral artery including the basal ganglia. Angiographical abnormalities were observed in 40 patients (83%). The majority occurred in the supraclinoid portion of the internal carotid artery and in the cisternal portion of the middle and anterior cerebral arteries. Multiple lesions, such as in the C1, A1, and M1 or the C1, M1, and M2 segments were observed in 22 cases. These lesions generally appeared in continuation; no bilateral intracranial lesions were observed. Repeated angiography was performed in 22 cases, and in 55% of these some recovery of the lesions was seen.

  17. CT of tracheal agenesis

    Energy Technology Data Exchange (ETDEWEB)

    Strouse, Peter J.; Hernandez, Ramiro J. [C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Newman, Beverley [Children' s Hospital of Pittsburgh, PA (United States). Department of Pediatric Radiology; Afshani, Ehsan [Children' s Hospital of Buffalo, NY (United States). Departments of Radiology and Pediatrics; Bommaraju, Mahesh [Women' s and Children' s Hospital of Buffalo, Division of Neonatology, University Pediatrics Associates, Buffalo, NY (United States)

    2006-09-15

    Tracheal agenesis is a rare and usually lethal anomaly. In the past, opaque contrast medium was injected via the esophagus to demonstrate the anatomy. To demonstrate the utility of helical and multidetector CT in delineating the aberrant anatomy in newborns with tracheal agenesis. Four newborns with tracheal agenesis were identified from three institutions. Imaging studies and medical records were reviewed. Each child was imaged with chest radiography. One child was imaged on a single-detector helical CT scanner and the other three on multidetector scanners. Helical and multidetector CT with 2D and 3D reconstructions clearly delineated the aberrant tracheobronchial and esophageal anatomy in each infant. Minimum intensity projection reformatted CT images were particularly helpful. One infant each had type I and type II tracheal agenesis. Two infants had type III tracheal agenesis. All four infants died. CT is a useful tool for delineating the aberrant anatomy of newborns with tracheal agenesis and thus helps in making rational clinical decisions. (orig.)

  18. 多排螺旋CT 诊断小网膜囊病变的价值%Diagnostic value of multi-detector CT for abnormalities in lesser omental bursa

    Institute of Scientific and Technical Information of China (English)

    成峰; 吴凯宏; 李孝虎

    2011-01-01

    目的 探讨小网膜囊正常解剖及病变的多排螺旋CT(MDCT)表现,评价小网膜囊病变的CT 诊断价值.方法 对24 例小网膜囊病变进行上腹部CT 平扫及三期增强扫描检查,均经手术病理证实.结果 小网膜囊病变中:原发肿瘤6 例(神经鞘瘤2 例,平滑肌瘤1 例,血管瘤1 例,脂肪肉瘤1 例,淋巴瘤1 例),CT 表现为小网膜囊内边界清晰肿块.邻近脏器的良、恶性肿瘤8 例(胰头癌4 例,肝左叶肝细胞癌2 例,胃间质瘤2 例),CT 表现为小网膜囊肿块与邻近相应肿瘤边界不清.转移性肿瘤2 例.结核1 例,CT 表现多个病灶融合,内见钙化.积液(腹水漏出液、炎性渗出液、脓液、血液、胆汁、淋巴液)6 例;假性囊肿1 例;CT 均表现为小网膜囊内液性密度灶.结论 多排螺旋CT对小网膜囊病变具有重要的诊断价值.%Objective To investigate the normal CT anatomy and diagnostic value of CT for abnormalities of lesser omental bursa. Methods Twenty-four patients with 6 primary neoplasms (2 neurinomas, 1 leiomyoma, 1 cavernous hemangioma, 1 liposarcoma, 1 lymphoma), 8 local spread from adjacent benign or malignant neoplasms (4 carcinomas of head of pancreas, 2 left hepatic tumors, 2 gastrointestinal stromal tumors of the stomach), 2 metastatic tumors, 1 tuberculosis, 6 fluid collections (transudate ascites, inflammatory infiltrate, pus, blood, bile, lymph), lpseudocyst were enrolled in the study. All of the lesions were confirmed by operation and pathology. The pre- and post-contrast abdominal CT scans were reviewed. Results The borders of the 6 primary neoplasms were well-defined on CT whereas the 8 benign or malignant neoplasms originating from adjacent structures were contiguous with the primary tumors. CT showed multiple aggregated lesions on 2 patients with metastases and 1 patient with tuberculosis. The 6 fluid collections and lpseudocyst displayed fluid density within lesser omental bursa on CT. Conclusion CT is valuable in

  19. Value of multi-detector spiral CT angiography in the assessment of coronary artery elasticity%多层螺旋CT血管成像在冠状动脉弹性研究中的价值

    Institute of Scientific and Technical Information of China (English)

    许开元; 肖丹丹; 何祥发; 贾艳莲; 高芳琴; 张雪林

    2015-01-01

    Objective To study the efficacy of multi-detector spiral CT angiography (CTA) for evaluating coronary artery elasticity. Methods CTA was performed on 133 patients from August 2010 to April 2013..Diameter changes of 412 segment of coronary arteries in the systolic and diastolic phases were measured by CTA and digital subtraction angiography (DSA)..Coronary artery elastic parameters and elasticity index (ERI) were analyzed and correlated with DSA results. Results The ERI was positively correlated with remodeling on DSA (P0) in 46 coronary artery segments,.no significant remodeling (ERI=0) in 32 segments,.and negative remodeling (ERI<0) in 71 segments. Conclusion Multi-slice CTA can reflect the elasticity of coronary vessel walls. Compared with the results of DSA , coronary artery elasticity index correlates with the remodeling of coronary artery plaques and allows assessment of plaque instability.%目的:评价多层螺旋CT血管成像在冠状动脉弹性重塑中的价值。方法选取2010年8月~2013年4月本院行冠状动脉 CT 血管成像检查及冠脉 DSA 检查患者资料共133例,通过测量冠状动脉412节段在收缩期、舒张期的动脉管径变化,并与DSA对照,分析冠状动脉斑块处血管弹性,计算冠状动脉弹性重塑指数,并分析冠状动脉弹性重塑指数与DSA结果的相关性。结果冠状动脉弹性重塑指数(ERI)与DSA结果呈正相关,(P<0.05, r=0.402)。斑块处冠状动脉弹性正性重塑(ERI>0)46节段,无明显重塑者(ERI=0)32节段,负性重塑者(ERI<0)71节段。结论多层螺旋 CT 血管成像可较好反映正常冠状动脉血管壁弹性。与冠状动脉DSA结果相比,斑块处冠状动脉弹性重塑指数可反映斑块处冠状动脉弹性重塑情况,评价斑块稳定性。

  20. Optimization of acquisition and contrast injection protocol for C-arm CT imaging in transcatheter aortic valve implantation: initial experience in a swine model.

    Science.gov (United States)

    Numburi, Uma D; Kapadia, Samir R; Schoenhagen, Paul; Tuzcu, E Murat; von Roden, Martin; Halliburton, Sandra S

    2013-02-01

    To determine the optimal C-arm computed tomography (CT) protocol for transcatheter aortic valve implantation (TAVI) in swine. In 6 swine, C-arm CT was performed using 5-s ungated acquisition during sinus rhythm with aortic root (Method 1) or peripheral (Method 2) injection, and during rapid ventricular pacing with root injection (Method 3). Additionally, 24-s ECG-gated acquisitions were performed during sinus rhythm with root (Method 4) or peripheral (Method 5) injection. Aortic root enhancement, presence of artifacts and contrast volumes were compared for all methods. Aortic root measurements were also compared between C-arm CT and multidetector-row computed tomography (MDCT). The best C-arm CT image set was identified and used to predict optimal angiographic projection angles during TAVI; predictions were compared to those from MDCT. Methods 1, 3, 4, and 5 yielded sufficient root enhancement with mild or moderate artifacts and aortic annulus, sinotubular junction, and mid-ascending aorta diameters similar to MDCT. Ungated C-arm CT (Methods 1, 3) required less contrast than ECG-gated C-arm CT (Methods 4, 5). Method 3 was optimal yielding images with high attenuation, few artifacts (2.0), and root measurements similar to MDCT using minimal contrast (36 mL). Predicted angiographic projections from Method 3 were similar to MDCT. Ungated C-arm CT during rapid pacing with aortic root injection required minimal contrast, yielded high attenuation and few artifacts, and aortic root measurements and predicted angiographic planes similar to those from MDCT.

  1. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... the best way to see if treatment is working or if a finding is stable or changed over time. top of page What are the benefits vs. risks? Benefits Using a multidetector CT unit ...

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

    NARCIS (Netherlands)

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

    2012-01-01

    Objectives Patients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT. Methods ECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of p

  3. Multidetector CT and DSA research of beagle′s celiac artery anatomy%比格犬腹腔动脉解剖的多层螺旋 CT和 DSA 研究

    Institute of Scientific and Technical Information of China (English)

    迪里木拉提·巴吾冬; 巴哈提·哈立亚; 别克木拉提·马合木提; 赵建卿

    2013-01-01

    Objective To assess the anatomical features of beagle′s celiac artery by multidetector CT angi-ography (MDCTA) and digital subtraction angiography (DSA) .Methods 15 adult beagles were examined by multidetector CT (MDCT ) .Celiac artery was catheterized via a superficial branch access of femoral ar-tery and performed selective angiography .Results MDCT and angiography were performed successfully in all animals ,with a success rate of 100% (15/15) .Beagle′s celiac artery anatomy is very similar to the hu-man′s .Similarities between the beagle′s and human celiac artery anatomy revealed by MSCT and DSA in-clude:(1) The celiac artery arises from the aorta at the same level ;(2) After arising from the anterior wall of the aorta ,the celiac artery runs forwardly and gives branches ;(3) Although Left gastric artery ari-ses from the proximal splenic artery in beagle ,it is still a branch of the celiac artery ,therefore ,three branches of celiac artery ,the hepatic artery ,splenic artery and left gastric artery were the same with hu-man′s .The differences are :(1) Left gastric artery arise from the proximal splenic artery ;(2) Gastroduo-denal artery arise at the liver hilar .The proper hepatic artery is very short or absent .In 3 dogs ,right he-patic artery rises before the gastroduodenal artery (20% ) .Conclusion The study confirms anatomical similarity between the beagle′s celiac artery and the human celiac artery .It has broad application prospects in animal interventional studies of the liver ,spleen ,pancreas ,stomach and other organs .%目的:采用多层螺旋CT血管造影(MDCTA)和数字减影血管造影(DSA)评价比格犬腹腔动脉及其主要分支的解剖学特点。方法成年比格犬15只,分别进行多层螺旋C T (M DC T )检查和在直视下行经股动脉浅表分支选择性腹腔动脉插管及DSA造影术,观察腹腔干其主要分支的起源和走行并测量直径和长度。结果15只比格犬15条股动脉

  4. Diagnostic value of appendicolith in appendicitis with multi-detector CT%阑尾石多排螺旋CT征象诊断阑尾炎的价值

    Institute of Scientific and Technical Information of China (English)

    戚乐; 向军益; 戴平丰; 丁建平

    2012-01-01

    Objective To investigate the diagnostic value of appendicolith in appendicitis with multi-detector CT. Methods MDCT findings of 87 cases of appendicitis and 55 cases of non-appendicitis confirmed by surgery and clinical follow-up were retrospectively analysed. The relationship between appendicolith and appendicitis was statistically analysed. Results The appendicolith sign in MDCT was positive in 43 cases(33 cases of appendicitis and 10 cases of non-appendicitis). The appendicolith sign was not of significant difference on CT images in differential diagnosis for appendicitis and non-appendicitis, including pathologically classified (P>0. 05). The accuracy was 54. 9% , the sensitivity was 37. 9% , and the specificity was 81. 8% in diagnosing appendicititis with appendicolith sign. Obstructive appendicolith sign in 12 cases (short diameter>5 mm, located in the appendix proximal) was more seen in appendicitis group,but could identify pathologically classified(P>0. 05). The extraluminal appendicolith sign in 5 cases was seen only in gangrenous appendicitis (P<0. 05). Conclusion Obstructive appendicolith sign is helpful in diagnosis of appendicitis, and extraluminal appendicolith sign has high specificity in diagnosis of gangrenous appendicitis.%目的 探讨阑尾石MDCT征象诊断阑尾炎的价值.方法 回顾分析经手术和临床随访证实的87例阑尾炎和55例非阑尾炎患者的MDCT影像表现.统计分析阑尾石征象与阑尾炎的关系.结果 阑尾石征象阳性43例(阑尾炎患者33例,非阑尾炎患者10例),诊断阑尾炎的准确性、敏感性和特异性分别为54.9%、37.9%和81.8%,在阑尾炎组和非阑尾炎组中出现的概率无显著差异性,亦不能鉴别阑尾炎的病理分型(P>0.05).12例梗阻性阑尾石征象(短径≥5 mm,位于阑尾近端)多见于阑尾炎组,但不能鉴别阑尾炎病理分型(P>0.05).5例腔外阑尾石征象仅见于坏疽性阑尾炎(P<0.05).结论 梗阻性阑尾石征象有助于

  5. Multidetector CT of hepatic artery pathologies.

    Science.gov (United States)

    Karaosmanoglu, D; Erol, B; Karcaaltincaba, M

    2012-01-01

    The hepatic artery can be involved by a variety of pathology and diseases.Today MDCT enables high quality imaging of the hepatic artery using axial, MIP and volume rendered images. We illustrate MDCT findings of anatomical variations, aneurysm, dilatation, dissection, arteriovenous fistula, thrombosis and stenosis. Aneurysms can be saccular, fusiform and multiple and may develop due to atherosclerosis, vasculitis, trauma and biopsy. Dilatation of hepatic artery can be seen in portal hypertension, Osler-Weber-Rendu disease and hemangiomatosis. Hepatic artery can be occluded after trauma and transplantation. Dissection develops due to atherosclerosis, Marfan and Ehler Danlos syndromes and during pregnancy. Arteriovenous fistula can be congenital and acquired. We conclude that various hepatic artery pathologies can be confidently diagnosed by MDCT.

  6. 多排螺旋CT在气管、支气管异物临床诊断中的价值%Diagnostic Value of Multidetector Spiral CT for Foreign Bodies in Trachea and Bronchus of Children

    Institute of Scientific and Technical Information of China (English)

    赵银霞; 王晓东; 陆彪; 郭宏庆

    2011-01-01

    Objective To explore the diagnostic value of multidetector spiral CT (MDCT) for foreign bodies in trachea and bronchus of children. Methods The clinical and MDCT manifestations of 97 children with highly suspected tracheobronchial foreign body were analyzed retrospectively. MDCT scan and bronchoscopy were performed in all the patients, and the post - processing reconstruction included multiple planar reconstruction ( MPR ), CT virtual bronchoscopy (CTVB), shaded surface display (SSD) and minimum intensity projection (MinlP).Results The clinical symptoms of tracheobronchial foreign bodies in children were generally atypical, and the common symptoms were various degrees of wheezing, coughing and recurrent lung infection. Of all the 97 cases, the foreign bodies were mainly opaque plant ones,and mostly were located in the bronchus lobaris and below the segmental bronchus,the left or right main bronchus. In 89 eases, foreign bodies were found directly by MDCT reconstruction, and the complications such as obstructive pneumonia, emphysema, atelectasis and mediastinal emphysema caused by foreign bodies were also shown. In 4 cases, MDCT only showed emphysema on one side and patchy pulmonary inflammation, while the foreign bodies which were not found by MDCT were removed by bronchoscopy. In another 4 cases, foreign bodies in the bronchial lumen showed on MDCT disappeared under bronchoscopy, among which two turned to be thick sputum. After anti - inflammatory treatment, lung inflammation and clinical symptoms disappeared in these patients. Bronchoscopy was performed under the guidance of CT imaging results, and the foreign bodies were removed successfully in 93 cases. The accuracy of MDCT in the diagnosis of tracheobronchial foreign body in children was 95.9%. Conclusions MDCT has great value in the diagnosis of tracheobronchial foreign body in children, but the clinical history and physical signs of the patients should also be considered.%目的 探讨多排螺旋CT(MDCT)

  7. Angiographic studies of atrioventricular discordance.

    Science.gov (United States)

    Attie, F; Soni, J; Ovseyevitz, J; Muñoz-Castellanos, L; Testelli, M R; Buendia, A

    1980-08-01

    The results and value of conventional and axial angiocardiography were studied in 26 cases of atrioventricular discordance (AVD). The angiographic anatomy of this malformation was analyzed to determine the precise characteristics of atrioventricular and ventriculoarterial connections. The left and right ventricles in atrial situs solitus and levocardia show angiographic features that differ from those seen in atrial situs solitus and dextrocardia. The same differences are found in atrial situs inversus. Regardless of the type of ventriculoarterial connections, the ventricles maintain the same angiographic characteristics. The ventricular septum in AVD in situs solitus and levocardia and situs inversus and dextrocardia has a peculiar orientation. The use of axial angiocardiography facilitates detection and localization of the ventricular septal defect. In cases of malposition of the heart, the conventional frontal view allows visualization of the ventricular septum in all of its length. The axial projection is useful in diagnosing left ventricular outflow tract obstruction.

  8. Venous thromboembolic disease. CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, L. R. [Medical College of Wisconsin, Pulmonary Medicine and Intensive Care, Dept. of Diagnostic Radiology, Milwaukee, WI (United States)

    2001-12-01

    Helical and multidetector CT has proven to be a valuable imaging modality for both pulmonary embolism and deep venous thrombosis. This paper will review the sensitivity and specificity of CT and discuss diagnostic algorithms utilizing CT and more established imaging technologies.

  9. Angiographic warning of hemorrhagic transformation after stent retriever thrombectomy procedure

    OpenAIRE

    Vollman, Andrew T; Bruno, Charles A; Dumeer, Shifali; Malone, Hani; Meyers, Philip M

    2013-01-01

    This study reports cerebral angiographic findings observed after stent retriever thrombectomy that is suggestive of a higher risk of hemorrhagic transformation (HT). A woman aged 65–75 presented with a right middle cerebral artery syndrome confirmed by non-contrast CT brain scan. Endovascular revascularization using the Solitaire device was placed across the thromboembolic occlusion and thromboembolectomy was performed. Angiography showed complete recanalization of the left internal carotid a...

  10. 自发性腹腔干夹层的 MSCT 血管成像表现%Imaging manifestations of spontaneous celiac artery trunk dissection with multi-detector CT angiography

    Institute of Scientific and Technical Information of China (English)

    宁辉; 张龙江

    2015-01-01

    Objective:To summarize the multi-detector CT angiography (MDCTA)manifestations of spontaneous ce-liac artery trunk dissection.Methods:The clinical and MDCTA manifestations of 14 patients with spontaneous celiac artery trunk dissection were retrospectively analyzed.Results:Of the 14 patients,10 patients (71.4%,10/14)had spontaneous ce-liac artery trunk dissection,4 patients (28.6%,4/14)had both celiac artery trunk and superior mesenteric artery dissec-tion.Intimal plaque,orifice of dissection,true and false lumen were displayed in all involved 14 celiac artery trunk and 4 su-perior mesenteric artery dissections.Three dissected arteries were associated with thrombosis,2 dissected arteries with mu-ral calcification,2 dissected arteries with adjacent hematoma,and 1 with splenic infarct.Of the 14 celiac artery trunk dissec-tion,6 associated with aneurymal protrusion,and all 4 superior mesenteric artery dissection had aneurysmal protrusion asso-ciated.Two patients had celiac artery Digital Subtraction Angiography performed,the manifestations were similar to that of MSCT angiography.Intra-stent thrombosis was found in one patient underwent stent implantation.Conclusion:MDCT angi-ography can detect the pathology of celiac artery trunk dissection sensitively,which might used as the first choice modality for the diagnosis and follow up of this disease entity.%目的:总结自发性腹腔干夹层的 MSCT 血管成像表现。方法:回顾性分析14例自发性腹腔干夹层患者的临床及 MSCT 血管成像表现。结果:14例患者中自发性腹腔干夹层10例(71.4%,10/14),腹腔干和肠系膜上动脉夹层4例(28.6%,4/14)。14条腹腔干血管和4条肠系膜上动脉夹层均显示了内膜片、破口及真假腔,3条血管夹层合并血栓,2条夹层血管合并钙化,2例患者合并周围血肿,1例合并脾梗死。14条腹腔干夹层中6条血管夹层伴有动脉瘤样突起,4条肠系膜上动脉夹层

  11. Hemobilia in a child due to right hepatic artery pseudoaneurysm: Multidetector-row computed tomography demonstration

    Directory of Open Access Journals (Sweden)

    Nisar A Wani

    2011-01-01

    Full Text Available We present a case of a 12-year-old boy who developed upper gastrointestinal bleeding in the form of hematemesis and melena 1 month after blunt trauma to liver. Computed tomography (CT angiography with multidetector-row CT demonstrated pseudoaneurysm of right hepatic artery related to old liver laceration to be the cause of the bleeding. Pseudoaneurysm was resected using the roadmap provided by CT angiography findings.

  12. Abdominal manifestations of polyarteritis nodosa demonstrated with CT

    Energy Technology Data Exchange (ETDEWEB)

    Adaletli, Ibrahim; Ozpeynirci, Yigit; Kurugoglu, Sebuh [Istanbul University, Department of Radiology, Cerrahpasa Medical School, Istanbul (Turkey); Sever, Lale; Arisoy, Nil [Istanbul University, Department of Pediatric Nephrology, Istanbul (Turkey)

    2010-05-15

    We report a rare case of polyarteritis nodosa (PAN) presenting in childhood. The child had multiple visceral aneurysms and later developed ascending colitis and jejunitis. The diagnosis was established with multidetector CT and CT angiography. (orig.)

  13. Usefulness of multidetector spiral computed tomography according to age and gender for diagnosis of acute pulmonary embolism.

    Science.gov (United States)

    Stein, Paul D; Beemath, Afzal; Quinn, Deborah A; Olson, Ronald E; Goodman, Lawrence R; Gottschalk, Alexander; Hales, Charles A; Hull, Russell D; Leeper, Kenneth V; Sostman, H Dirk; Weg, John G; Woodard, Pamela K

    2007-05-01

    Data from the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) were evaluated to test the hypothesis that the performance of multidetector computed tomographic (CT) pulmonary angiography and CT venography is independent of a patient's age and gender. In 773 patients with adequate CT pulmonary angiography and 737 patients with adequate CT pulmonary angiography and CT venography, the sensitivity and specificity for pulmonary embolism for groups of patients aged 18 to 59, 60 to 79, and 80 to 99 years did not differ to a statistically significant extent, nor were there significant differences according to gender. Overall, however, the specificity of CT pulmonary angiography was somewhat greater in women, but in men and women, it was > or =93%. In conclusion, the results indicate that multidetector CT pulmonary angiography and CT pulmonary angiography and CT venography may be used with various diagnostic strategies in adults of all ages and both genders.

  14. Persistent hypoglossal artery and its variants diagnosed by CT and MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Kozawa, Eito; Nishi, Naoko; Mizukoshi, Waka; Inoue, Kaiji; Nakajima, Reiko; Takahashi, Masahiro [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2013-01-15

    Persistent hypoglossal artery (PHA) is the second most common anastomosis between the carotid and vertebrobasilar systems and demonstrates some variations. We evaluated the prevalence of PHA on computed tomography (CT) angiography. We also evaluated characteristic features of PHA and its variants on magnetic resonance (MR) angiography. We retrospectively reviewed our database of 2,074 CT angiographic images obtained using either of two 64-slice multidetector CT scanners. We also reviewed our database of 7,646 MR angiographic images obtained using either of two 1.5-T or one 3.0-T imager. We could not determine the exact number of patients whose MR angiography included the hypoglossal canal. Most patients had or were suspected of having cerebrovascular diseases. We found six usual PHAs arising from the cervical internal carotid artery on CT angiography among 2,074 patients. On MR angiography, we also found six additional usual PHAs (total 12, right/left = 6/6, male/female = 3/9), three right PHAs originating from the external carotid artery (ECA), and two posterior inferior cerebellar arteries (PICAs) arising from the ECA without connection to the vertebral artery. The prevalence of usual PHA diagnosed by CT angiography was 0.29 %, slightly higher than that reported for angiography and may be due to selection bias in the examined patients. We propose naming usual PHA ''type 1 PHA''; PHA originating from the ECA, of which we found three, ''type 2 PHA''; and PICA arising from the ECA, of which we found two, ''type 2 PHA variant''. (orig.)

  15. WE-DE-207A-02: Advances in Cone Beam CT Anatomical and Functional Imaging in Angio-Suite to Enable One-Stop-Shop Stroke Imaging Workflow.

    Science.gov (United States)

    Chen, G

    2016-06-01

    1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT.

  16. Angiographic warning of hemorrhagic transformation after stent retriever thrombectomy procedure.

    Science.gov (United States)

    Vollman, Andrew T; Bruno, Charles A; Dumeer, Shifali; Malone, Hani; Meyers, Philip M

    2014-01-01

    This study reports cerebral angiographic findings observed after stent retriever thrombectomy that is suggestive of a higher risk of hemorrhagic transformation (HT). A woman aged 65-75 presented with a right middle cerebral artery syndrome confirmed by non-contrast CT brain scan. Endovascular revascularization using the Solitaire device was placed across the thromboembolic occlusion and thromboembolectomy was performed. Angiography showed complete recanalization of the left internal carotid artery, anterior and middle cerebral artery branches. Twelve hours following the procedure the patient had a hemorrhagic conversion of the ischemic infarct with significant mass effect causing herniation. Despite surgical intervention (hemicraniectomy) the patient died. The angiographic features following revascularization of the vessels distal to the occlusion showed subtle dilations which were visualized at the branch points of the vessels. This may be a warning sign of increased risk of HT.

  17. 腕骨脱位的X线平片及40层螺旋CT诊断比较%Diagnostic comparison of X-ray plain film and 40-multidetector CT in dislocation of carpal bones

    Institute of Scientific and Technical Information of China (English)

    于宝江; 曹立福; 骈文婷; 郭健; 宋伟兴; 白振武

    2012-01-01

    Objective To study the imaging manifestations and detecting rates of dislocation of carpal bones on X- ray plain film and 40-multidetector CT (MDCT), to improve the diagnostic accuracy and to reduce the missed diagnosis and misdiagnosis. Materials and Methods The X -ray plain films, MDCT, volume rendering (VR) and multiplanar reconstruction (MPR) of 21 patients with dislocation of carpal bones were retrospectively studied. 19 cases were male and two were female, mean age 31±7 years old (19-45 years). Dislocation was in left side in 14 cases, in right in seven cases. Result Eight cases of lunate dislocation, 13 cases of perilunar dislocation, three cases of simple perilunar dislocation , four cases of perilunar dislocation per navicular bone, One case of perilunar dislocation per navicular and triangular bones, three cases of perilunar dislocation per triangular bones, two cases of perilunar dislocation per styloid process of radius. Among the cases with fracture of other carpal bones, the diagnosis of fractures of radial styloid process and navicular bones were correctly detected on X-ray plain film. But in three cases with fracture of triangular bone, the fractures were indetectable or the original place of the bone fragments were unable to determine on X-ray plain film, but could be correctly detected with MDCT and reconstruct technology. Conclusion Diagnosis of dislocation of carpal bones can be correctly made with X-ray plain film in the most cases. But for the cases with fracture of carpal bones, especially with tiny fracture, X-ray plain film produces high rate of missed diagnosis. MDCT, VR and MPR can accurately show dislocations and fractures in three-dimension having high clinical value.%目的 探讨腕骨脱位X线平片及多层螺旋CT的影像学表现,并对两者的检出情况进行比较,以提高对腕骨脱位的诊断水平,减少漏诊误诊.资料与方法对2006年8月-2009年11月共21例腕骨脱位病人的X线平片、多层螺旋CT薄

  18. Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography.

    Science.gov (United States)

    Soukup, Jason W; Drees, Randi; Koenig, Lisa J; Snyder, Christopher J; Hetzel, Scott; Miles, Chanda R; Schwarz, Tobias

    2015-01-01

    The objective of this blinded study was to validate the use of cone beam computed tomography (C) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methylmethacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxillary segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT.

  19. Tomografía Computada Multidetector en el diagnóstico de la pseudocoartación de aorta: Reporte de dos casos y revisión de la literatura Multidetector CT in diagnosis of aortic pseudocoarctation: Two reported cases and revised literature

    Directory of Open Access Journals (Sweden)

    Martín Mela

    2011-06-01

    Full Text Available La pseudocoartación aórtica es una rara anomalía que consiste en una elongación tortuosa con acodadura de la arteria aorta que involucra la región distal del cayado y la porción descendente proximal, típicamente relacionada al sitio de inserción del ligamento arterioso. No suelen existir manifestaciones clínicas asociadas, por lo que el diagnóstico habitualmente es incidental mediante estudios de imágenes. Entre ellos, se destacan la angio Tomografía Computada Multidetector (angio TCMD y la Resonancia Magnética (RM. Se diferencia de la verdadera coartación aórtica por su morfología y por la ausencia de obstrucción hemodinámicamente significativa. En el presente artículo revisamos los aspectos imagenológicos utilizando TCMD en dos pacientes a los cuales se les diagnosticó la pseudocoartación, sin ser ésta la patología sospechada al momento de indicar el estudio. La TCMD permite realizar un diagnóstico apropiado mostrando las características diferenciales con otras anomalías aórticas.The aortic pseudocoarctation is a rare anomaly characterized by a tortuous elongation with kink aorta which compromises the distal portion of the aortic arch and the proximal descending portion, typically related to the insertion site of arterious ligament. Usually, there are no associated symptoms so the diagnosis is generally incidental with imaging such as Multidetector Computed Tomography (MDCT or Magnetic Resonance Imaging (MRI. It differs from the true aortic coarctaction in their morphology and in the absence of hemodynamically significant obstruction. In this paper we review the imagenologic features using MDCT in two patients who were diagnosed with pseudocoartaction, which was not suspected before performing the study. MDCT allows a proper diagnosis showing differential characteristics with other aortic anomalies.

  20. Evaluation of retrospectively ECG-gated 4-row multidetector CT in patients planned for minimal invasive coronary artery bypass grafting; Die EKG-getriggerte 4-Zeilen-Spiral-CT des Herzens in der praeoperativen Bildgebung vor minimalinvasiver koronarer Bypass-Operation

    Energy Technology Data Exchange (ETDEWEB)

    Begemann, P.G.C.; Ittrich, H.; Koops, A.; Adam, G.; Weber, C. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Radiologisches Zentrum, Universitaetsklinikum, Hamburg (Germany); Arnold, M.; Detter, C.; Boehm, D.H.; Reichenspurner, H. [Universitaetsklinikum Hamburg-Eppendorf, Herzzentrum, Herz und Gefaesschirurgie, Hamburg (Germany)

    2005-08-01

    Purpose: Minimal invasive direct coronary artery bypass grafting (MIDCAB) or off-pump coronary artery bypass grafting (OPCAB) on the beating heart with full or mini-sternotomy are becoming more common in coronary bypass surgery of the left anterior descending (LAD). In the decision, which surgical approach (MIDCAB, OPCAB or conventional surgery with cardiopulmonary bypass) will be best used, knowledge of the anatomical field is of major importance. The aim of the study was to evaluate retrospective ECG-gated 4-row multidetector CT (MDCT) in patients planned for MIDCAB as additional imaging to coronary angiography. Material and methods: The study included 25 consecutive patients. MSCT was performed as unenhanced (collimation 4 x 2.5 mm) and contrast-enhanced examination (140-170 ml, 300 mg Iodine/ml, collimation 4 x 1 mm). The evaluation included presence of LAD calcifications, distance of LAD and left internal mammarian artery (LIMA), coursek of LAD and LIMA, the presence or absence of bridging through myocardium or epicardial fat and the presence of pleural fibrosis. The MDCT results were correlated with intra-operative findings. Results: All MDCTs could be assessed with reference to the demands. In 20/25 operations, MDCT had direct influence as to the selection of the surgical approach (11 MIDCAB, 7 OPCAB with mini-sternotomy and 5 with full sternotomy, 2 conventional surgeries). The distance of LAD and LIMA varied from 0.9 to 4.5 cm in MDCT. As to calcifications, 3/25 correlated patients had calcifications and 10 patients had no calcifications in the middle LAD. Seven patients had intraoperative fibrosis of the vessel wall without calcification of the middle LAD, which could not be detected with MDCT. Another 5 patients had single calcified plaques in the middle LAD, 4 of these had a fibrosis of the vessel and 1 had a normal vessel at surgery. In these cases, the anastomosis was done between the calcified plaques. No myocardial bridging was detected by MDCT and

  1. Hepatocellular carcinoma: prediction of blood supply from an intercostal artery with multidetector row computed tomography.

    Science.gov (United States)

    Kim, Min-Uk; Kim, Hyo-Cheol; Chung, Jin Wook; An, Sangbu; Seong, Nak Jong; Jae, Hwan Jun; Park, Jae Hyung

    2011-10-01

    To evaluate the ability of multidetector row computed tomography (CT) to detect blood supply from the intercostal artery in patients with hepatocellular carcinoma (HCC). Between January 2003 and December 2007, angiography of the intercostal artery was performed in 93 patients (76 men and 17 women, mean age 58 years) with HCC who had also undergone multidetector row CT. CT scans and digital subtraction angiograms of these patients were retrospectively reviewed by two investigators in consensus to evaluate tumor feeding vessels. Multiple logistic regression analysis was used to identify factors that predict the presence of an HCC blood supply from an intercostal artery. Tumor staining fed by an intercostal artery was noted in 65 patients (70%; 112 tumor feeding vessels) by intercostal angiography. Readers interpreted that tumor feeding vessels were evident by CT in 35 (54%) of these 65 patients with tumor staining supplied by an intercostal artery by angiography. Multiple logistic regression analysis showed that a visible tumor feeding vessel by CT (P = .003) and hepatic artery attenuation by angiography (P = .014) were significantly related to the presence of a blood supply from an intercostal artery. Visualization of a tumor feeding vessel from the intercostal artery by multidetector row CT is an important sign of parasitic supply to an HCC. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  2. Advanced Gastric Cancer: Differentiation of Borrmann Type IV versus Borrmann Type III by Two-Phased Dynamic Multi-Detector Row CT with Use of the Water Filling Method

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Jung; Yu, Jeong Sik; Lee, Sang Min; Kim, Joo Hee; Chung, Jae Joon; Kim, Ki Whang [Dept. of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kang, Hae Youn [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2013-02-15

    To characterize Borrmann type IV from Borrmann type III advanced gastric cancer (AGC) by two-phased multi-detector row computed tomography (MDCT) using the water filling method. A total of 143 patients (pathologically confirmed Borrmann type III and IV - 100 and 43 patients), who underwent preoperative MDCT, were enrolled. Two radiologists, retrospectively and independently, determined tumor enhancement pattern using a 5-grade scale without clinical information. A weighted kappa test was applied for interobserver variability. The score of tumor enhancement pattern correlated with Borrmann type as determined by Spearman's correlation coefficient. The accuracy of differentiation of Borrmann type using MDCT was determined by receiver operating characteristic curves. Interobserver agreement (weighted kappa = 0.683) was substantial. The tumor enhancement pattern score showed a significant correlation with Borrmann type (reviewer 1, r = 0.591, p < 0.001; reviewer 2, r = 0.616, p < 0.001). The accuracy for differentiation of Borrmann type on MDCT was 0.86 (p < 0.001) in both reviewers. The sensitivity and specificity of the diagnosis of Borrmann type IV were 79% and 82% in reviewer 1, and 88% and 78% in reviewer 2, respectively. Dual-phased MDCT using the water filling method can differentiate between Borrmann type IV and III AGC with high accuracy.

  3. Percutaneous vertebroplasty with a high-quality rotational angiographic unit.

    Science.gov (United States)

    Pedicelli, Alessandro; Rollo, Massimo; Piano, Mariangela; Re, Thomas J; Cipriani, Maria C; Colosimo, Cesare; Bonomo, Lorenzo

    2009-02-01

    We evaluated the reliability of a rotational angiographic unit (RA) with flat-panel detector as a single technique to guide percutaneous vertebroplasty (PVP) and for post-procedure assessment by 2D and 3D reformatted images. Fifty-five consecutive patients (104 vertebral bodies) were treated under RA fluoroscopy. Rotational acquisitions with 2D and 3D reconstruction were obtained in all patients for immediate post-procedure assessment. In complex cases, this technique was also used to evaluate the needle position during the procedure. All patients underwent CT scan after the procedure. RA and CT findings were compared. In all cases, a safe trans-pedicular access and an accurate control of the bone-cement injection were successfully performed with high-quality fluoroscopy, even at the thoracic levels and in case of vertebra plana. 2D and 3D rotational reconstructions permitted CT-like images that clearly showed needle position and were similar to CT findings in depicting intrasomatic implant-distribution. RA detected 40 cement leakages compared to 42 demonstrated by CT and showed overall 95% sensitivity and 100% specificity compared to CT for final post-procedure assessment. Our preliminary results suggest that high-quality RA is reliable and safe as a single technique for PVP guidance, control and post-procedure assessment. It permits fast and cost-effective procedures avoiding multi-modality imaging.

  4. Percutaneous vertebroplasty with a high-quality rotational angiographic unit

    Energy Technology Data Exchange (ETDEWEB)

    Pedicelli, Alessandro [Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome (Italy)], E-mail: apedicelli@rm.unicatt.it; Rollo, Massimo [Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome (Italy)], E-mail: mrollo@rm.unicatt.it; Piano, Mariangela [Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome (Italy)], E-mail: mariangela.piano@gmail.com; Re, Thomas J. [Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome (Italy)], E-mail: tomjre@gmail.com; Cipriani, Maria C. [Department of Gerontology, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome (Italy)], E-mail: alexped@yahoo.com; Colosimo, Cesare [Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome (Italy)], E-mail: colosimo@rm.unicatt.it; Bonomo, Lorenzo [Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome (Italy)], E-mail: lbonomo@rm.unicatt.it

    2009-02-15

    We evaluated the reliability of a rotational angiographic unit (RA) with flat-panel detector as a single technique to guide percutaneous vertebroplasty (PVP) and for post-procedure assessment by 2D and 3D reformatted images. Fifty-five consecutive patients (104 vertebral bodies) were treated under RA fluoroscopy. Rotational acquisitions with 2D and 3D reconstruction were obtained in all patients for immediate post-procedure assessment. In complex cases, this technique was also used to evaluate the needle position during the procedure. All patients underwent CT scan after the procedure. RA and CT findings were compared. In all cases, a safe trans-pedicular access and an accurate control of the bone-cement injection were successfully performed with high-quality fluoroscopy, even at the thoracic levels and in case of vertebra plana. 2D and 3D rotational reconstructions permitted CT-like images that clearly showed needle position and were similar to CT findings in depicting intrasomatic implant-distribution. RA detected 40 cement leakages compared to 42 demonstrated by CT and showed overall 95% sensitivity and 100% specificity compared to CT for final post-procedure assessment. Our preliminary results suggest that high-quality RA is reliable and safe as a single technique for PVP guidance, control and post-procedure assessment. It permits fast and cost-effective procedures avoiding multi-modality imaging.

  5. Comparison of in vivo cone-beam and multidetector computed tomographic scans by three-dimensional merging software.

    Science.gov (United States)

    Rostetter, Claudio; Metzler, Philipp; Schenkel, Jan S; Seifert, Burkhardt; Luebbers, Heinz-Theo

    2015-12-01

    In dentomaxillofacial radiology, cone-beam computed tomography (CT) is used to give fast and high-resolution 3-dimensional images of bone with a low dose of radiation. However, its use for quantitative measurement of bone density based on absolute values (Hounsfield units, HU) as in multidetector CT is still controversial. We know of no in vivo study of 3-dimensional merging software that will reliably match identical bone areas of cone-beam and multidetector CT datasets. We studied 19 multidetector, and 19 cone-beam, CT scans of the skull. The two datasets were fused, corresponding points were identified for measurement, and we compared mean density. We used linear regression to analyse the relation between the two different scanning methods, and studied a total of 4180 measurements. The mean time interval between scans was 5.2 (4.7) months. Mean R(2) over all measurements was 0.63 (range 0.22 - 0.79) with a mean internal consistency (Cronbach's α) of 0.86 (range 0.61 - 0.93). The strongest linearity, seen at the left mastoid, was R(2)=0.79 with high internal consistency (Cronbach's α 0.89), and the weakest was at the left zygomatic bone with R(2)=0.22 and Cronbach's α=0.61. Measurements of bone density based on cone-beam and multidetector CT scans generated in vivo showed high and reproducible internal consistency but poor linearity.

  6. MR angiography and determination of the flow reserve after minimal invasive direct coronary artery bypass (MIDCAB) surgery of the left internal mammary arteria in comparison to the multidetector-row CT; MR-Angiographie und Flussreservenbestimmung nach minimalinvasiver direkter Koronararterien-Bypass(MIDCAB)-Operation der linken Arteria mammaria interna im Vergleich zur Mehrzeilen-CT

    Energy Technology Data Exchange (ETDEWEB)

    Stauder, N.I.; Fenchel, M.; Kuettner, A.; Kramer, U.; Claussen, C.D.; Miller, S. [Abt. Radiologische Diagnostik, Universitaetsklinik Tuebingen (Germany); Stauder, H.; Scheule, A.M. [Abt. Thorax-, Herz- und Gefaesschirurgie, Universitaetsklinik Tuebingen (Germany)

    2005-08-01

    Purpose: To evaluate graft patency, flow and flow reserve in patients with minimal invasive direct coronary artery bypass (MIDCAB) of internal mammary artery (IMA) grafts using a combined MR protocol with phase-contrast technique and MR angiography. Material and methods: At a 1.5T Magnetom Sonata (SIEMENS), 19 symptomatic (angina CCS I-III, intermittent thoracic discomfort, scar disorders) patients (59.9{+-}7.9 years old) with 19 left internal mammary artery (LIMA) grafts implanted in minimal invasive technique were examined 6.9{+-}1.5 years post surgery. Contrast enhanced MR angiography (TR 2.5 ms, TE 1 ms, flip angle 20 , spatial resolution 1.4 x 0.9 x 1.0 mm{sup 3}, breath hold technique, no ECG-triggering, 25 ml Gd-DTPA) was performed to assess bypass patency. Phase-contrast flow measurements with retrospective gating (TR 41 msec, TE 3.2 msec, flip angle 30 , spatial resolution 1.1 x 1.1 x 5 mm{sup 3}, temporal resolution 42 msec, venc 90 cm/sec) were applied in the IMA grafts at rest and after stress induction with dipyridamole (0.56 mg/kg/BW). For comparison, graft patency was evaluated by multidetector-row computed tomography (16-row CT). In 9 patients a selective catheter angiography was performed. Results: MIDCAB grafts were occluded in 4/19 patients. In 4 patients the anastomosis to LAD was highly stenotic (>70%) at MDCT (2 experienced investigators in consensus reading). In MRA 9 grafts could be delineated completely including the distal anastomosis to LAD (47%). In 9 patients the distal part could not be evaluated. In patients with patent grafts (MDCT), a significant improvement of graft flow (at rest 75.4{+-}33.3 ml/min; after stress 202.7{+-}49.6; P<0.002) and flow reserve (patent grafts 3.0{+-}1.1; stenotic grafts 1.5{+-}0.2, P<0.02; occluded grafts 0.9{+-}0.2, P<0.01) after stress induction was detected. Diastolic-to-systolic peak velocity ratios (D/S-PVR) at baseline were not significant between patent and stenotic grafts. Mean flow at baseline and

  7. Distant metastases and synchronous second primary tumors in patients with newly diagnosed oropharyngeal and hypopharyngeal carcinomas: evaluation of {sup 18}F-FDG PET and extended-field multi-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Shu-Hang; Ko, Sheung-Fat; Chin, Shu-Chyn [Chang Gung University, Department of Molecular Imaging Center and Diagnostic Radiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan (China); Chan, Sheng-Chieh; Yen, Tzu-Chen [Chang Gung University, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan (China); Liao, Chun-Ta; Huang, Shiang-Fu [Chang Gung University, Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Taoyuan (China); Chang, Joseph Tung-Chieh; Lin, Chin-Yu. [Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China); Wang, Hung-Ming [Chang Gung University, Department of Medical Oncology, Chang Gung Memorial Hospital, Taoyuan (China)

    2008-11-15

    Patients with oropharyngeal or hypopharyngeal squamous cell carcinoma (SCC) have a high risk of having distant metastases or second primary tumors. We prospectively evaluate the clinical usefulness of {sup 18}F-fluoro-2-deoxyglucose positron emission tomography ({sup 18}F-FDG PET), extended-field multi-detector computed tomography (MDCT), and their side-by-side visual correlation for the detection of distant malignancies in these two tumors at presentation. A total of 160 patients with SCC of the oropharynx (n = 74) or hypopharynx (n=86) underwent {sup 18}F-FDG PET and extended-field MDCT to detect distant metastases or second primary tumors. Suspected lesions were investigated by means of biopsy, clinical, or imaging follow-up. Twenty-six (16.3%) of our 160 patients were found to have distant malignancy. Diagnostic yields of {sup 18}F-FDG PET and MDCT were 12.5% and 8.1%, respectively. The sensitivity of {sup 18}F-FDG PET for detection of distant malignancies was 1.5-fold higher than that of MDCT (76.9% vs. 50.0%, P=0.039), while its specificity was slightly lower (94.0% vs. 97.8%, P=0.125). Side-by-side visual correlation of MDCT and {sup 18}F-FDG PET improved the sensitivity and specificity up to 80.8% and 98.5%, respectively, leading to alteration of treatment in 13.1% of patients. A significant difference in survival rates between its positive and negative results was observed. {sup 18}F-FDG PET and extended-field MDCT had acceptable diagnostic yields for detection of distant malignancies in untreated oropharyngeal and hypopharyngeal SCC. {sup 18}F-FDG PET was 1.5-fold more sensitive than MDCT, but had more false-positive findings. Their visual correlation improved the diagnostic accuracy, treatment planning, and prognosis prediction. (orig.)

  8. Advances and perspectives in lung cancer imaging using multidetector row computed tomography.

    Science.gov (United States)

    Coche, Emmanuel

    2012-10-01

    The introduction of multidetector row computed tomography (CT) into clinical practice has revolutionized many aspects of the clinical work-up. Lung cancer imaging has benefited from various breakthroughs in computing technology, with advances in the field of lung cancer detection, tissue characterization, lung cancer staging and response to therapy. Our paper discusses the problems of radiation, image visualization and CT examination comparison. It also reviews the most significant advances in lung cancer imaging and highlights the emerging clinical applications that use state of the art CT technology in the field of lung cancer diagnosis and follow-up.

  9. CT urography

    Energy Technology Data Exchange (ETDEWEB)

    Korobkin, M. [Dept. of Radiology, Univ. of Michigan, Ann Arbor, MI (United States)

    2005-11-15

    With the advent of multidetector row CT scanners, evaluation of the urothelium of the entire urinary tract with high-resolution thin sections during a single breath-hold has become a reality. Multidetector CT urography (MDCTU) is a single examination that allows evaluation of potential urinary tract calculi, renal parenchymal masses, and both benign and malignant urothelial lesions. Initial results with this new technique are encouraging. Current investigations of MDCTU focus on methods to improve opacification and distension of the upper urinary tract - the collecting systems, pelvis, and ureters. The role of abdominal compression, infusion of saline and/or furosemide, and optimal time delay of excretory phase imaging is being explored. Upper tract urothelial malignancies, including small lesions less the 5 mmin diameter, can be detected with high sensitivity. Methods to reduce radiation exposure are being explored, including split-bolus contrast injection techniques that combine nephrographic and excretory phases into a single phase. It is likely that in the near future, radiological evaluation of significant unexplained hematuria or of known or prior urothelial malignancy will consist of a single examination - MDCTU. (orig.)

  10. Comparison between multi-detector row CT angiography and Doppler ultrasound on detecting carotid artery wall thickness%多层螺旋CT与Doppler超声对颈动脉壁层厚度的对比性研究

    Institute of Scientific and Technical Information of China (English)

    赵刚; 查云飞; 王弘; 洪玮; 邱晓明; 王珍; 肖友梅

    2013-01-01

    Objective To explore the relationship and consistency between multi-detector row computed tomography angiography (MDCTA) and color Doppler ultrasound (CD-US) in measuring carotid artery wall thickness (CAWT) and intima-media thickness (IMT). Methods CAWT and IMT of 38 subjects were measured using MDCTA and CD-US, respectively. Linear correlation analysis was performed to analyze the correlation between the results from CAWT and IMT,and Bland-Altman statistics was employed to analyze the consistency between them. Results The IMT value measured by CD-US was (0.85+0.16) mm, and the CAWT value measured by MDCTA was (0.87.± 0.18) mm (P > 0.05), and there was a high degree of correlation between them (correlation coefficient was 0.958,P< 0.01). An excellent consistency between CAWT and IMT was found by Bland-Altman plot, with a bias of 0.026 mm and the limit of consistency from -0.023 to 0.075. Conclusions There were significant correlation and consistency between MDCTA and CD-US in detecting CAWT and IMT. As a more objective and comprehensive new method, MDCTA can replace CD-US in the evaluation of early carotid atherosclerosis.%目的:探讨多层螺旋CT血管造影(MDCTA)和彩色多普勒超声(CD-US)在检测颈总动脉壁厚度(CAWT)和颈总动脉内膜-中层厚度(IMT)中的相关性和一致性.方法:应用MDCTA和CD-US分别对38例受试者颈总动脉的CAWT和IMT进行检测,用Pearson直线相关分析比较CAWT和IMT的相关性,用Bland-Altman分析比较两者的一致性.结果:MDCTA测量的颈总动脉CAWT为(0.87±0.18)mm,CD-US测量的颈总动脉IMT为(0.85±0.16)mm,两者比较无统计学差异,有高度相关性,相关系数为0.958,P<0.01,Bland-Altman分析两者间存在良好一致性,偏倚为0.026 mm,一致性界限为-0.023 ~ 0.075.结论:MDCTA和CD-US在检测颈总动脉CAWT和IMT时存在良好的相关性和一致性,MDCTA可以替代CD-US,作为一种评价颈动脉早期粥样硬化的更加客观全面的新方法.

  11. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... over time. Follow-up examinations are sometimes the best way to see if treatment is working or if a finding is stable or changed over time. top of page What are the benefits vs. risks? Benefits Using a multidetector CT unit to ...

  12. The normal internal carotid artery: a computed tomography angiographic study

    Energy Technology Data Exchange (ETDEWEB)

    Koskinen, Suvi Maaria; Valanne, Leena; Silvennoinen, Heli [Helsinki University Central Hospital and University of Helsinki, Department of Radiology, HUS Medical Imaging Center, Helsinki (Finland); Soinne, Lauri [Helsinki University Central Hospital, Department of Neurology, Helsinki (Finland)

    2014-09-15

    Systematic computed tomography angiographic (CTA) studies investigating variation in internal carotid artery (ICA) luminal diameters (LDs) are scarce. Knowledge of the normal intra-individual LD variability would provide a cut-off value for detection of more subtle collapses. In addition, low intra-individual variability would allow using contralateral LD as a reference for estimation of stenosis degree in cases where ipsilateral measurement is hampered. Therefore, our aim was to investigate intra-individual LD variation of normal ICA. We retrospectively collected multidetector high-speed CTAs of 104 patients younger than 40 years who were considered not to have carotid pathology. We carried out independent measurements of the common carotid artery (CCA) and ICA LDs bilaterally from axial source images by two observers, analysing side-to-side LD differences from averaged double measurements with a paired t test. We discovered no significant side-to-side LD differences. In the female group, the mean differences (mm) with 95 % confidence intervals were 0.08 (0.00, 0.17) for CCA and 0.03 (-0.04, 0.11) for ICA, with ICA LD standard deviation of 0.4 mm. In the male group, these were: 0.06 (-0.04, 0.17), 0.02 (-0.07, 0.11) and 0.4 mm, respectively. We detected no ICA agenesis. The intrinsic intra-individual variation of the LD of normal ICA is minimal. This uniformity may serve as the basis for detection of subtle grades of side-to-side variation caused by pathology. (orig.)

  13. The Value of Multi-detector row CT in Gastroenteropathy and Application of Contrast Agents%MDCT在胃肠道检查中的价值及对比剂的应用

    Institute of Scientific and Technical Information of China (English)

    鲁桂青; 陈克敏; 刘林祥

    2007-01-01

    胃肠道疾患在过去以传统的检查方法 (主要为消化道钡剂透视及纤维内窥镜)为主,随着多层螺旋CT(multi-detector row CT,MDCT)的快速发展以及各种不同腔内对比剂的研究与应用,CT对胃肠道的检查价值显著提高。

  14. Dose versus image quality in multidetector CT scanning: a methodology for acquisition protocols optimization;Dose versus qualite image en TDM multidetecteur: une methodologie pour l'optimisation des protocoles d'acquisition

    Energy Technology Data Exchange (ETDEWEB)

    Bonniaud, G.; Tran Dinh, V.; Texier, N.; Touati, R.; Simon, J.; Roger, P.

    2009-10-15

    Objective: to determine the influence of acquisition and reconstruction parameters on the dose and the image quality in multi detectors CT scanning to optimize the protocols. As conclusion: The optimization allowed to reduce, in average, the weighted computed tomography dose index-vol (wC.T.D.I.vol) of 20% through the pitch increase, the use of the broadest collimation and/or the use of a retrospectively reconstruction (zoom factor and/or increase matrix size) without deteriorating the noise and/or resolution performances more than 10%. (N.C.)

  15. Surgical Management of Juvenile Nasopharyngeal Angiofibroma Without Angiographic Embolization

    Directory of Open Access Journals (Sweden)

    Raja Ahmad

    2008-10-01

    Full Text Available Juvenile nasopharyngeal angiofibroma (JNA is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrence, and local tissue destruction. The surgical approaches are either standard open method which include external or intraoral incisions, or the recent advanced approach, i.e. via using the endonasal endoscope. It is widely accepted that the use of preoperative angiographic embolization reduces the occurrence of intraoperative bleeding and facilitates tumour removal. However, angiographic embolization is not available at all centres. The purpose of this article is to present our experience with five patients diagnosed with JNA who were resected without embolization, using various surgical approaches. Two tumours were removed via endonasal endoscopic surgery. None of the tumours were embolized prior to surgery. We highlight the preoperative evaluation of tumour extent, using both computed tomography (CT and magnetic resonance angiography, and the importance of temporary clamping of the external carotid artery intraoperatively. Our results suggest that the latter procedure is a safe and effective means of facilitating surgery and reducing intraoperative bleeding.

  16. Experimental study about the effect of different scan parameters and post-processing methods of multi-detector CT on metallic artifacts%多排螺旋 CT 不同扫描参数及图像后处理方式对金属伪影的影响

    Institute of Scientific and Technical Information of China (English)

    储斌; 邹月芬; 王传兵

    2015-01-01

    目的:探讨多排螺旋 CT(MDCT)扫描参数及图像后处理方式对金属植入物伪影的影响,以期获得最佳方案减少金属伪影。方法制作钛合金钢板水模,将其置入 MDCT 下通过调节不同参数进行扫描(包括管电压、管电流、螺距、焦点),然后测定所得图像伪影面积大小并评价其相关性;对常规扫描参数下获得的15例椎体内固定术后患者图像进行后处理,分别使用常规方式和优化方式重建,包括多平面重建(MPR)、调节窗宽窗位及容积再现技术(VRT),然后评价图像质量。结果不同管电压、螺距、焦点下,伪影面积差异有统计学意义,随着管电压升高,伪影面积逐渐减小;随着螺距减小,伪影面积逐渐减小;使用小焦点扫描较大焦点伪影面积小;不同管电流下,伪影面积差异无统计学意义。图像后处理时骨窗重建选择软组织算法(Kernel B40f)、观察时选择窗位600 HU、窗宽2000 HU 及 VRT 三维重建可减少金属伪影。结论选择适当的 MDCT 扫描参数及图像后处理方式可以减少金属伪影,提高图像质量,有助于影像诊断。%Objective To explore the effect of multi-detector computed tomography (MDCT)scan parameters and imaging post-processing methods on metallic artifacts,so as to achieve the perfection in reduction of artifacts caused by metallic implants.Methods Water phantom with titanium alloy steel plate was scanned under MDCT with alternating scan parameters including tube voltage, tube current,pitch and focal spot.The areas of image artifacts were measured and correlated with the scan parameters.Another 1 5 postoperative patients with vertebral implantation scaned with the conventional scan parameters were also included in the study.Ima-ging post-processing including multi-planar reconstruction (MPR),window width and level adjustment,and volume rendering tech-nique (VRT)was performed by using optimized and

  17. Multidetector computed tomographic and magnetic resonance enterography in children: state of the art.

    Science.gov (United States)

    Hammer, Matthew R; Podberesky, Daniel J; Dillman, Jonathan R

    2013-07-01

    Advanced multidetector computed tomographic and magnetic resonance imaging techniques (CT and MR enterography, respectively), designed to provide detailed images of the bowel and mesentery, can be successfully performed in children of all ages, frequently without sedation. Cross-sectional enterography allows for noninvasive diagnosis, detection of various disease-related complications and extraintestinal manifestations, and monitoring of bowel-wall inflammation in pediatric inflammatory bowel disease (IBD). This article provides a contemporary review of CT and MR enterography in the pediatric population, including up-to-date techniques and clinical applications. A range of bowel abnormalities is illustrated, with an emphasis on IBD and its many abdominopelvic manifestations.

  18. 多层螺旋CT血管成像在脾动脉瘤中的应用价值%Application value of multidetector CT angiography in splenic artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    孙建梅

    2016-01-01

    目的:研究CT血管成像(CTA)检出的脾动脉瘤的特征。方法2013年1月至2015年11月共32例患者被诊断为脾动脉瘤,回顾性分析检出脾动脉瘤的分布及CT表现。结果32例患者共发现35个脾动脉瘤,30例为单发脾动脉瘤(94%,30/32),位于脾动脉近脾门处28例(93%,28/30),中段2例(7%,2/30);2例(6%,2/32)为多发动脉瘤,其中1例2个动脉瘤,位于脾动脉近段和中段;1例3个动脉瘤,分别位于脾动脉近段、中段和远端近脾门处。35个脾动脉瘤中,囊性动脉瘤占97%,平均最大径为16±6 mm;13个动脉瘤合并瘤壁钙化(37%,13/35),5个合并瘤内血栓形成(14%,5/35)。结论脾动脉瘤最常位于脾动脉近脾门处,多表现为单发囊型瘤样扩张,可伴有壁钙化和血栓形成。 CTA可作为脾动脉瘤术前诊断和随访检查的重要手段。%Objective To investigate the distribution and features of splenic artery aneurysms detected in CT angiography. Methods Splenic artery aneurysms were diagnosed in 32 patients from Jan. 2013 to Nov. 2015. Distri-bution and CT findings were retrospectively analyzed. Results Thirty five aneurysms were detected in 32 patients, solitary aneurysm was found in 30 patients (94%, 30/32). Twenty eight aneurysms were located in distal segment (93%, 28/30), middle segment in 2 patients (7%, 2/30). Two patients (6%, 2/32) had multiple aneurysms. One patient had two aneurysms located in the proximal and middle segment of splenic artery. One patient had three aneurysms lo-cated in the proximal, middle and distal segment of splenic artery. Of 35 splenic aneurysms, cystic aneurysms ac-counted for 97%with the mean diameter of 16±6 mm. Thirteen aneurysms (37%,13/35) had mural calcification and 5 aneurysms (14%, 5/35) with thrombosis formation. Conclusion Splenic aneurysms mostly localized in the distal seg-ment of splenic artery, most of which are solitary and

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

    Science.gov (United States)

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

    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. PMID:27403020

  20. 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.

  1. 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)

  2. Value of contrast-enhanced CT in detecting arterial injury with pelvic fracture

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Keigo; Iwase, Toshiki; Ohshima, Takeshi; Tsuboi, Masaki; Sugiura, Sakae; Hara, Suguru [Okazaki City Hospital, Aichi (Japan)

    2000-04-01

    Computed tomography (CT) was used for detecting ongoing pelvic hemorrhage in patients with pelvic fracture, and for deciding an indication or transcatheter arterial embolization. The authors compared plane CT with contrast-enhanced CT to examine the value of contrast-enhanced CT in detecting arterial injury with pelvic fracture. The diagnosis of arterial injury was made by angiography. CT-determined hematoma was detected in 10 parts according to bleeding sites. Each hematoma was counted and compared with angiographic arterial injury. Contrast-enhanced CT was more useful than plane CT, but the hemorrhage sites determined by contrast-enhanced CT were not identical with those of angiographic arterial injuries. (author)

  3. Accuracy of whole-body low-dose multidetector CT (WBLDCT) versus skeletal survey in the detection of myelomatous lesions, and correlation of disease distribution with whole-body MRI (WBMRI)

    Energy Technology Data Exchange (ETDEWEB)

    Gleeson, T.G. [Mater Misericordiae University Hospital, Department of Radiology and Diagnostic Imaging, Dublin 7 (Ireland)]|[St Paul' s Hospital, Radiology Department, Vancouver, BC (Canada); Moriarty, J.; Shortt, C.P.; O' Connell, M.; Eustace, S.J. [Mater Misericordiae University Hospital, Department of Radiology and Diagnostic Imaging, Dublin 7 (Ireland); Gleeson, J.P. [University of Limerick, Department of Applied Mathemathics and Statistics, Limerick (Ireland); Fitzpatrick, P. [University College Dublin, UCD School of Public Health and Population Science, Dublin 2 (Ireland); Byrne, B. [Mater Misericordiae University Hospital, Department of Medical Physics, Dublin 7 (Ireland); McHugh, J.; O' Gorman, P. [Mater Misericordiae University Hospital, Department of Haematology, Dublin 7 (Ireland)

    2009-03-15

    The aim of the study is to assess the feasibility of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of multiple myeloma and compare to skeletal survey (SS), using bone marrow biopsy and whole-body magnetic resonance imaging (WBMRI; where available) as gold standard. Patients referred over an 18-month period for investigation of suspected multiple myeloma or restaging of myeloma were randomized to undergo one of two WBLDCT protocols using high kVp, low mAs technique (140 kVp, 14 mAs; or 140 kVp, 25 mAs). Recent WBMRI scans were reviewed in 23 cases. Each imaging modality was assessed by two radiologists in consensus and scored from 0-3 (0= normal, 1=1-4 lesions, 2=5-20 lesions, 3{>=}20 lesions/diffuse disease) in ten anatomical areas. Overall stage of disease, image quality score, and the degree of confidence of diagnosis were recorded. Diagnostic accuracy of skeletal survey and WBLDCT were determined using a gold standard of bone marrow biopsy and distribution of disease was compared to WBMRI. Thirty-nine patients were evaluated. WBLDCT identified more osteolytic lesions than skeletal survey with a greater degree of diagnostic confidence and led to restaging in 18 instances (16 upstaged, two downstaged). In those with recent WBMRI, distribution of disease on WBLDCT showed superior correlation with WBMRI when compared with SS. Overall reader impression of stage on WBLDCT showed significant correlation with WBMRI ({kappa}=0.454, p<0.05). WBLDCT provided complementary information to WBMRI in nine patients with normal marrow signal following treatment response, but which were shown to have diffuse residual cortical abnormalities on CT. WBLDCT at effective doses lower than previously reported, is superior to SS at detecting osteolytic lesions and at determining overall stage of multiple myeloma, and provides complementary information to WBMRI. (orig.)

  4. Clinical usefulness of CT in the diagnosis of severe pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Gotoh, Shinsuke; Tajima, Hiroyuki [Nippon Medical School, Tokyo (Japan)

    1998-11-01

    The purpose of this paper is to clarify the clinical significance of CT in the diagnosis of severe pelvic fractures. Fifty-six consecutive patients with severe pelvic ring fractures were the subjects of this study. The assessments were as follows: comparison of the diagnostic value of plain X-P and CT for the detection of pelvic fractures, comparison hemodynamic findings before TAE therapy, comparison between abnormal angiographic findings and fracture sites on CT, and comparison between abnormal angiographic findings and volume of retroperitoneal hematomas on CT. CT was more useful for the detection of severe pelvic ring fractures, especially for sacral fracture and iliosacral joint dislocations, than plain X-P. Sacral fracture group was more severe than iliac fracture group on CT. There was a discrepancy between the angiographic findings and fracture sites in 20 of the 56 patients. Angiographic abnormalities without fracture were seen especially in the lateral sacral artery and iliolumbar artery. There was a discrepancy between the angiographic findings and retroperitoneal hematomas in 38 of the 56 patients. Retroperitoneal hematomas, especially around the ilium, were seen on CT in 40 areas in the absence of any abnormal angiographic findings. Conversely, angiographic extravasation without hematoma on CT was seen in 20 areas, especially in lateral sacral artery. CT is useful for detection and intervention in severe pelvic ring fractures. (author)

  5. The value of multidetector row CT in evaluating left renal vein anatomy in living renal transplantation donors%多层螺旋CT在活体肾移植术前左肾静脉解剖评估中的价值

    Institute of Scientific and Technical Information of China (English)

    陶舒敏; 张喆; 吉秋; 孔祥; 张龙江

    2016-01-01

    Objective To discuss the left renal vein anatomy at multi-detector row CT and the implications for living renal transplantation.Methods The left renal vein anatomy and the branches in79 living renal transplantation donors who underwent contrast-enhanced CT angiography were analyzed retrospectively in this study. Maximum intensity projection, curve planar reformation and volume renderings were used for displaying the left renal vein anatomy. Anomalies of left renal vein and branches were recorded and classified.Results Left renal veins were all visualized on late arterial and venous phase CT images in all subjects. There were one case of circumaortic renal vein(n=1) and one case of left inferior vena cava(n=1).0 or1 adrenal vein,0 to2 lumbar veins and0 to 2 gonadal veins were found in each donor.Conclusion Among the left renal vein branches, the number of lumbar vein varied more frequently,multiple gonadal veins were detected in some subjects. Left renal vein branches should be handled carefully to avoid massive haemorrhage in left nephrectomy.%目的:探讨左肾静脉解剖变异及其属支在多层螺旋CT中的表现及其对活体肾移植的意义。方法回顾性分析79例行多层螺旋CT增强的肾移植供者左肾静脉的解剖结构及汇入左肾静脉的属支情况。采用最大密度投影、曲面重组和容积再现后处理技术,总结左肾静脉解剖变异及属支情况并分类讨论。结果多层螺旋CT动脉晚期和静脉期图像均显示左肾静脉主干,发现环主动脉左肾静脉解剖变异1例,左侧下腔静脉1例。每例供者发现肾上腺静脉0~1根,腰静脉0~2根,生殖静脉0~2根。结论左肾静脉属支中,腰静脉数目变异较多,生殖静脉肾有时会出现多根。在左肾切除术中要仔细处理静脉属支,避免大出血的发生。

  6. Instrumentation for multi-detector arrays

    Indian Academy of Sciences (India)

    R K Bhowmik

    2001-07-01

    The new generation of detector arrays require complex instrumentation and data acquisition system to ensure increased reliability of operation, high degree of integration, software control and faster data handling capability. The main features of some of the existing multi-detector arrays like MSU 4 array, Gammasphere and Eurogam are summarized. The instrumentation for the proposed INGA array in India is discussed.

  7. CHIMERA Multidetector at Laboratori Nazionali del Sud

    Energy Technology Data Exchange (ETDEWEB)

    Aiello, S.; Anzalone, A.; Baldo, M.; Barna, R.; Campisi, M.g.; Cardella, G.; Cavallaro, Sl., Amico, V.D.; De Filippo, E.; DePasquale, D.; Femino, S.; Geraci, E.; Giustolisi, F.; Guazzoni, P.; Iacono-Manno, C.M.; Italiano, A.; Lanzalone, G.; Lanzano, G.; LoNigro, S.; Lombardo, U.; Manfredi, G.; Pagano, A.; Papa, M.; Pirrone, S.; Politi, G.; Porto, F.; Sambataro, S.; Sperduto, M.L.; Sutera, C.M.; Zetta, L.

    2000-12-31

    The installation of CHIMERA multidetector, designed in order to study central collisions in heavy ion reactions at intermediate energy, is going on at LNS and the first experiment with the forward part (688 telescopes) is running since May 1999. The aim of this contribution is to present the status of the project.

  8. Development of Digitex premier digital angiographic systems

    Energy Technology Data Exchange (ETDEWEB)

    Miura, Yoshiaki; Miura, Yusuke; Goto, Keiichi; Imanishi, Tetsuo; Miyamoto, Wataru [Shimadzu Corp., Medical Systems Division, Kyoto (Japan)

    2003-06-01

    The technique of interventional radiology has come to be widely utilized in the field of angiography. This has brought forth a strong demand that digital angiographic systems provide high efficiency in patient examinations and high level of interventional support. This report refers to our newly developed Digitex Premier Series digital angiographic systems, designed to meet the above demands. The new systems utilize a high-speed, wide-range C-arm system, a high-resolution image intensifier, a fluid-lubricant X-ray tube, and a digital image processing system, in order to ensure high patient examination efficiency. Their IVR (interventional radiology)-Master bed-side image controller further enhances the efficiency of patient examinations, and also, their CAT (comfortable angio terminal) and FMC (file management console) improve the patient examination throughput and diagnostic workflow of the systems. (author)

  9. Angiographic diagnosis and treatment of gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Sung, Kyu Bo; Koo, Kyung Hoi; Bae, Tae Young; Chung, Eun Chul; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-02-15

    Diagnostic angiographic evaluations were done in 33 patients with gastrointestinal bleeding for recent 5 years at Department of Radiology, Seoul National University Hospital. On 11 patients of them, therapeutic interventional procedures were made and the results were analysed. 1. In a total of 33 cases, there were 18 cases of upper GI bleeding and 15 cases of lower GI bleeding. The most frequent causes were peptic ulcer in the former and intestinal typhoid fever in the latter. 2. Bleeding sites were localized angiographically in 28 cases, so the detection rate was 85%. Four of the five angiographically negative cases were lower GI bleeding cases. 3. The most frequent bleeding site was left gastric artery (7/33). The next was ileocecal branch of superior mesenteric artery (6/33). 4. Among the 11 interventional procedures, Gelfoam embolization was done in 7 cases and Vasopressin infusion was tried in 4 cases. They were successful in 4 and 3 cases, suggesting 57% and 47% success rates respectively.

  10. Double Chooz Improved Multi-Detector Measurements

    CERN Document Server

    CERN. Geneva

    2016-01-01

    The Double Chooz experiment (DC) is a reactor neutrino oscillation experiment running at Chooz nuclear power plant (2 reactors) in France. In 2011, DC first reported indication of non-zero θ13 with the far detector (FD) located at the maximum of oscillation effects (i.e. disappearance), thus challenging the CHOOZ non-observation limit. A robust observation of θ13 followed in 2012 by the Daya Bay experiments with multiple detector configurations. Since 2015 DC runs in a multi-detector configuration making thus the impact of several otherwise dominating systematics reduce strongly. DC’s unique almost "iso-flux" site, allows the near detector (ND) to become a direct accurate non-oscillation reference to the FD. Our first multi-detector results at MORIOND-2016 showed an intriguing deviation of θ13 with respect to the world average. We will address this issue in this seminar. The combined "reactor-θ13" measurement is expected to ...

  11. Normal values for renal parenchymal volume and kidney length as measured by non-enhanced multidetector spiral computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Fei; Wu, Xiao Hou (Dept. of Urology, The First Affiliated Hospital of Chongqing Medical Univ., Chongqing (China)), email: wuxiaohou@yahoo.com; Yang, Mei (Inst. of Neuroscience, Chongqing Medical Univ., Chongqing (China)); Luo, Chun Li (Dept. of Laboratory Medicine, Chongqing Medical Univ., Chongqing (China)); Pang, Hua (Dept. of Radiology, The First Affiliated Hospital of Chongqing Medical Univ., Chongqing (China))

    2011-07-15

    Background: Renal parenchymal volume (RPV) is considered an important index for clinical decisions. However, normal values have not been established, which hinders the clinical application of RPV. Purpose: To test the accuracy and reproducibility of RPV and to investigate the normal values of RPV and kidney length as measured by non-enhanced multidetector computed tomography (CT). Material and Methods: An animal model study was performed to test the accuracy and repeatability of RPV measured by CT. RPV of porcine kidneys was measured by water displacement (actual values) and non-enhanced multidetector CT. Individual RPV and kidney length were measured by non-enhanced CT in patients with no clinical history of renal disease (n 722). Patient height, age, weight, body surface area (BSA), and body mass index (BMI) were assessed before each patient's CT examination was performed. Results: RPV obtained by the CT method was within 2% of the RPV determined by the water displacement method. The normal values of RPV (M +- 1.96 standard deviation [SD]) were 145.72 +- 54.37 mL for men and 132.46 +- 41.94 mL for women. The normal values of kidney length (M +- 1.96 SD) were 10.27 +- 1.98 cm for men and 9.93 +- 1.58 cm for women. RPV did not significantly correlate with BSA or weight in women, but correlated significantly with height and age in both men and women. Of the assessed factors age, weight, height, BSA, and BMI, age, and height were the independent factors that best reflected RPV, in both men and women. Conclusion: The present animal study results showed that non-enhanced multidetector CT findings accurately reflect the RPV. The subsequent study performed in humans showed that the RPV of the presently sampled Chinese population was lower than the commonly quoted reference values obtained from Western populations

  12. Extrapleural Inner Thoracic Wall Lesions: Multidetector CT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Soo; Kim, Young Tong; Jou, Sung Shik [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of)

    2010-06-15

    The extrapleural space is external to the parietal pleura in the thorax. The structures within and adjacent to this region include the fat pad, endothoracic fascia, intercostal muscles, connective tissue, nerves, vessels, and ribs. Further, the space is divided into the inner and outer thoracic wall by the innermost intercostal muscle. Extrapleural lesions in the inner thoracic wall are classified as air-containing lesions, fat-containing lesions, and soft tissue-containing lesions according on their main component. Air-containing lesions include extrapleural air from direct chest trauma and extrapleural extension from pneumomediastinum. Prominent extrapleural fat is seen in decreased lung volume conditions, and can also be seen in normal individuals. Soft tissue-containing lesions include extrapleural extensions from a pleural or chest wall infection as well as tumors and extrapleural hematoma. We classify extrapleural lesions in the inner thoracic wall and illustrate their imaging findings

  13. 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.)

  14. 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.

  15. 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.

  16. 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

  17. Identification of predictive CT angiographic factors in the development of high-risk type 2 endoleaks after endovascular aneurysm repair in patients with infrarenal aortic aneurysms; Identifikation praediktiver CT-angiographischer Faktoren fuer die Entstehung eines Hochrisiko Typ-2 Endoleaks nach endovaskulaerem Aortenrepair bei Patienten mit infrarenalen Bauchaortenaneurysmen

    Energy Technology Data Exchange (ETDEWEB)

    Loewenthal, D.; Herzog, L.; Rogits, B.; Bulla, K.; Pech, M.; Ricke, J.; Dudeck, O. [Magdeburg Univ. (Germany). Radiology and Nuclear Medicine; Weston, S. [Magdeburg Univ. (Germany). Biometry and Medical Informatics; Meyer, F.; Halloul, Z. [Magdeburg Univ. (Germany). General, Visceral and Vascular Surgery

    2015-01-15

    An extensive analysis of the value of computed tomography (CT) parameters as potential predictors of the clinical outcome of type 2 endoleaks after endovascular aortic aneurysm repair (EVAR). Initial CT scans of 130 patients with abdominal aortic aneurysms (AAAs) were retrospectively reviewed. On the basis of postoperative CT scans and angiographies, patients were stratified into a low-risk group (LRG; without or transient type 2 endoleak; n = 80) and a high-risk group (HRG, persistent type 2 endoleak or need for reintervention; n = 50). Statistical analysis comprised a univariate and multivariate analysis. Anatomical, thrombus-specific, as well as aortic side branch parameters were assessed on the initial CT scan. Of all anatomical parameters, the diameter of the immediate infrarenal aorta was significantly different in the univariate analysis (LRG 22.4 ± 3.8 mm; HRG 23.6 ± 2.5 mm; p = 0.03). The investigation of the thrombus-specific parameters showed a trend towards statistical significance for the relative thrombus load (LRG 31.7 ± 18.0 %; HRG 25.3 ± 17.5 %; p = 0.09). Assessment of aortic side branches revealed only for the univariate analysis significant differences in the patency of the inferior mesenteric artery (LRG 71.3 %; HRG 92.0 %; p = 0.003) and their diameter (LRG 3.3 ± 0.7 mm; HRG 3.8 ± 0.9 mm; p = 0.004). In contrast, the number of lumbar arteries (LAs; LRG 2.7 ± 1.4; HRG 3.6 ± 1.2; univariate: p = 0.01; multivariate: p = 0.006) as well as their diameter (LRG 2.1 ± 0.4 mm; HRG 2.4 ± 0.4 mm; univariate: p < 0.001; multivariate: p = 0.006) were highly significantly associated with the development of type 2 endoleaks of the HRG. The most important predictive factors for the development of high-risk type 2 endoleaks were mainly the number and the diameter of the LAs which perfused the AAA.

  18. Accessory left gastric artery: angiographic anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Soo; Lim, Hyung Guhn; Kim, Hong Soo; Jeon, Doo Sung [Presbyterian Medical Center, Chunju (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Song, Soon Young [Myongji Hospital, College of Medicine, Kwandong University, Seoul (Korea, Republic of)

    2000-09-01

    To evaluate the angiographic anatomy of the accessory left gastric artery (accLGA). We evaluated the angiographic findings of the accLGA in 50 patients (Angiostar; Siemens, Erlangen, Germany). Performing celiac and selective angiography in 50 and 34 patients, respectively. By means of celiac angiography, (1) site of origin, (2) anatomical course, (3) diameter, (4) degree of tortuosity, and (5) distal tapering were evaluated, while selective angiography was used to determine (1) arterial branching, (2) area of blood supply, and (3) patterns of gastric wall stain. Celiac angiography showed that the accLGA arose from the left hepatic artery (LHA) in 45 cases (90%) and from the proper hepatic artery in five (10%). If the accLGA arose from the LHA, its origin entirely depended on the branching pattern of the latter. It always arose from the lateral branch of the LHA furthest to the left and uppermost, and proximal to its umbilical point. The most common anatomical course of the accLGA, seen in 27 cases (54%), was between the S2 and S3 segmental branch. The diameter and degree of tortuosity of the accLGA were similar to those of adjacent intrahepatic branches in 21 (42%) and 33 cases (66%), respectively. The degree of tapering was less than that of adjacent intrahepatic vessel in 28 (56%). Selective angiography demonstrated esophageal branching of the acc LGA in 27 cases (79%), inferior phrenic arterial branching in three (9%), a mediastinal branch in one (3%), and hypervascularity of the lung in one (3%). In 15 cases (44%), bifurcation of the accLGA was recognized. The vascular territory of the accLGA was the gastric fundus together with the distal esophagus in 21 cases (62%), mainly the gastric fundus in six (18%), and mainly the distal esophagus in four (12%). The pattern of gastric mucosal stain was curvilinear wall in 31 cases (91%) and nodular in three (9%). A knowledge of the angiographic anatomy of the accLGA facilitates accurate recognition of this artery on

  19. Contrast-enhanced multidetector computerized tomography for odontogenic cysts and cystic-appearing tumors of the jaws: is it useful?

    Science.gov (United States)

    Kakimoto, Naoya; Chindasombatjaroen, Jira; Tomita, Seiki; Shimamoto, Hiroaki; Uchiyama, Yuka; Hasegawa, Yoko; Kishino, Mitsunobu; Murakami, Shumei; Furukawa, Souhei

    2013-01-01

    The purpose of this study was to investigate the usefulness of computerized tomography (CT), particularly contrast-enhanced CT, in differentiation of jaw cysts and cystic-appearing tumors. We retrospectively analyzed contrast-enhanced CT images of 90 patients with odontogenic jaw cysts or cystic-appearing tumors. The lesion size and CT values were measured and the short axis to long axis (S/L) ratio, contrast enhancement (CE) ratio, and standard deviation ratio were calculated. The lesion size and the S/L ratio of keratocystic odontogenic tumors were significantly different from those of radicular cysts and follicular cysts. There were no significant differences in the CE ratio among the lesions. Multidetector CT provided diagnostic information about the size of odontogenic cysts and cystic-appearing tumors of the jaws that was related to the lesion type, but showed no relation between CE ratio and the type of these lesions. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Min; Shin, Sang Soo; Park, Jin Gyoon [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Jeong, Yong Yeon [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

    2015-06-15

    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.

  1. Spiral CT during pharmacoangiography with angiotensin II in patients with pancreatic disease. Technique and diagnostic efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, C.; Mihara, N.; Hosomi, N.; Inoue, E.; Fujita, M. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Diagnostic Radiology; Ohigashi, H.; Ishikawa, O. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Surgery; Nakaizumi, A. [Osaka Medical Center for Cancer and Cardiovascular Deseases (Japan). Dept. of Internal Medicine; Ishiguro, S. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Pathology

    1998-03-01

    Purpose: To compare the diagnostic efficacy of pancreatic pharmacoangiographic CT using angiotensin II with conventional angiographic CT. Material and Methods: Eighteen patients with space-occupying pancreatic disease were examined in this study. Pharmacoangiographic CT was performed with a 1-3-{mu}/6-ml solution of angiotensin II injected through a catheter into the celiac artery during spiral CT. Results: In 17 of the 18 (94%) patients, the area of pancreatic parenchymal enhancement was the same or larger at pharmacoangiographic CT than at conventional angiographic CT. The attenuation value of the pancreatic parenchyma was significantly increased at pharmacoangiographic CT (p=0.0010). Although the attenuation value of tumors was also increased on images obtained after the injection of angiotensin II, the tumor-to-pancreas contrast was significantly greater at pharmacoangiographic CT (p=0.0479). The mean differences in attenuation between tumor and pancreas at angiographic CT with and without angiotensin II were respectively 182 HU and 115 HU. Conclusion: Pharmacoangiographic CT with angiotensin II proved superior to conventional angiographic CT in the diagnosis of pancreatic disease. We therefore recommend it as a supplementary technique at the angiographic examination of patients with suspected pancreatic tumor. (orig.).

  2. A case of fatal sigmoid volvulus visualized on postmortem radiography: The importance of image optimization with multidetector computed tomography.

    Science.gov (United States)

    Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Ishizuka, Yuya; Ikeda, Tomoya; Saito, Haruo; Funayama, Masato

    2016-03-01

    This report describes the case of a man who developed fatal sigmoid volvulus that was identified on postmortem radiography before forensic autopsy. Postmortem radiography is useful for visualizing the body prior to autopsy. We discuss postmortem multidetector computed tomography that was tailored for optimum image quality to allow reconstruction of the fatal findings in multiple axes and in three dimensions, helping to pinpoint the anatomical sites of interest. This involves techniques such as manipulation of the scanning beam pitch and overlapping CT section acquisition. These techniques are best performed by personnel with CT technology training.

  3. Angiographic analysis of congenital mitral stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-09-15

    Congenital mitral stenosis may be defined as a development abnormality of the mitral valve leaflets, commissures, interchordal spaces, papillary muscles, annulus or immediate supravalvular area producing obstruction to left ventricular filling. Authors had experience of nine case of congenital mitral stenosis confirmed by two dimensional echocardiography, angiocardiography and surgery in recent 5 years since 1979, and analyzed them with emphasis on the angiographic findings. The results are as follows: 1. Among 9 cases, 6 patients were male and 3 were female. Age distribution was from 4 month to 11 years. 2. The types of congenital mitral stenosis were 1 typical congenital mitral stenosis, 5 cases of parachute mitral valve and 3 cases of supramitral ring. 3. Angiographically typical congenital mitral stenosis showed narrowing of mitral valvular opening, parachute mitral valve displayed single large papillary muscle with narrowing valvular opening and supramitral ring disclosed semilunar shaped filling defect between left atrium and ventricle. 4. Associated cardiac and extracardiac anomalies of congenital mitral stenosis, as frequency wise, were ventricular septal defect, patent ductus arteriosus, coarctation of aorta, supra and subvalvular aortic stenosis, mitral regurgitation and double outlet right ventricle. 5. Cardiac angiography is essential to diagnose congenital mitral stenosis, but the need of two dimensional echocardiography cannot be ignored.

  4. Evaluation of angiographic delayed vasospasm due to ruptured aneurysm in comparison with cerebral circulation time measured by IA-DSA

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Yoshikazu; Shima, Takeshi; Nishida, Masahiro; Yamane, Kanji; Okita, Shinji; Hatayama, Takashi; Yoshida, Akira; Naoe, Yasutaka; Shiga, Naoko (Chugoku Rosai Hospital, Hiroshima (Japan))

    1994-05-01

    Delayed vasospasm due to ruptured aneurysm has been basically evaluated by angiographic changes in contrast to clinical features such as delayed ischemic neurological deficits (DIND). However, the discrepancies between angiographic and clinical findings have been pointed out. In this study, angiographic changes and cerebral circulation time in ruptured aneurysms were simultaneously investigated with IA-DSA. Thirty-two patients, who had ruptured aneurysms at the anterior circle of Willis and neck clippings at the acute stage, were investigated. Carotid angiogram was performed with IA-DSA on the 7-13th day after the attack. Angiographic changes were evaluated by Fischer's classification and circulation time was calculated in the following way. A time-density curve was obtained at the two ROI's: the C3-C4 portion and the rolandic vein. Circulation time was defined by the difference between the time showing peak optical density at the carotid and the venous portion. The control value of this circulation time obtained from 20 cases with non-rupture aneurysm and epilepsy was 3.4 sec (53 year old) on the average. X-ray CT scan examination was performed at the same time and clinical features were observed every day. Angiographically, 3 cases were free from vasospasm, 18 cases were found to present slight to moderate vasospasm, and 11 cases showed severe vasospasm. Circulation time in patients with no spasm was 3.6 seconds, in patients with slight to moderate vasospasm it was 4.3 seconds and in patients with severe vasospasm it was 6.8 seconds. Ten patients showing cerebral infarction on CT scans demonstrated significantly long circulation time, 7.0 seconds on the average. And all patients having severe vasospasm with circulation time more than 6 seconds presented DIND such as hemiparesis. (author).

  5. Multidetector computed tomography in acute lower gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    John Palma

    2010-11-01

    Full Text Available John Palma, Marius Mihaila, Frank PilleulDépartement de Radiologie Digestive et des Urgences, Hôpital Edouard Herriot, Hospices Civils de Lyon, CHU, Lyon, FranceBackground: The aim of this study is to evaluate multidetector computed tomography (MDCT in acute massive lower gastrointestinal bleeding, with endoscopy and surgery as reference examinations.Methods: A single-center retrospective study involving 34 patients with acute massive lower gastrointestinal bleeding was carried out. All patients were evaluated by MDCT scan then endoscopic or surgical examinations. Sensitivity, specificity, and positive and negative predictive values of MDCT scan were calculated using the extravasation of the contrast agent as the main criterion.Results: Extravasation of the contrast agent was found in 30 of 34 patients (88%. The bleeding site seen on CT was always the same as on endoscopic or surgical examinations (100%. Sensitivity of MDCT scan was 94%, specificity 100%, positive predictive value 100%, and negative predictive value 50% (P < 0.001. Twelve diverticulum bleedings were seen on MDCT scan compared with 13 (92% on endoscopic or surgical examinations. Angiodysplasia was overestimated by MDCT scan.Conclusion: MDCT scan appears to be an excellent tool to find and localize the bleeding site in cases of acute massive lower gastrointestinal disease.Keywords: MDCT, acute lower gastrointestinal bleeding, extravasation, contrast agent

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

  7. A multidetector scintillation camera with 254 channels

    DEFF Research Database (Denmark)

    Sveinsdottir, E; Larsen, B; Rommer, P

    1977-01-01

    A computer-based scintillation camera has been designed for both dynamic and static radionuclide studies. The detecting head has 254 independent sodium iodide crystals, each with a photomultiplier and amplifier. In dynamic measurements simultaneous events can be recorded, and 1 million total counts...... per second can be accommodated with less than 0.5% loss in any one channel. This corresponds to a calculated deadtime of 5 nsec. The multidetector camera is being used for 133Xe dynamic studies of regional cerebral blood flow in man and for 99mTc and 197 Hg static imaging of the brain....

  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. 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.

  10. 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.

  11. Vertebral Stenting and Vertebroplasty Guided by an Angiographic 3D Rotational Unit

    Directory of Open Access Journals (Sweden)

    Escobar-de la Garma Víctor Hugo

    2015-01-01

    Full Text Available Introduction. Use of interventional imaging systems in minimally invasion procedures such as kyphoplasty and vertebroplasty gives the advantage of high-resolution images, various zoom levels, different working angles, and intraprocedure image processing such as three-dimensional reconstructions to minimize complication rate. Due to the recent technological improvement of rotational angiographic units (RAU with flat-panel detectors, the useful interventional features of CT have been combined with high-quality fluoroscopy into one single machine. Intraprocedural 3D images offer an alternative way to guide needle insertion and the safe injection of cement to avoid leakages. Case Report. We present the case of a 72-year-old female patient with insidious lumbar pain. Computed tomography revealed a wedge-shaped osteoporotic compression fracture of T10 vertebrae, which was treated successfully with the installation of vertebral stenting system and vertebroplasty with methacrylate guided with a rotational interventional imaging system. Conclusion. Rotational angiographic technology may provide a suitable place for the realization of high-quality minimally invasive spinal procedures, such as kyphoplasty, vertebroplasty, and vertebral stenting. New software programs available nowadays offer the option to make three-dimensional reconstructions with no need of CT scans with the same degree of specificity.

  12. Angiographic features of rapidly involuting congenital hemangioma (RICH)

    Energy Technology Data Exchange (ETDEWEB)

    Konez, Orhan; Burrows, Patricia E. [Department of Radiology, Children' s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Mulliken, John B. [Division of Plastic Surgery, Children' s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Fishman, Steven J. [Department of Pediatric Surgery, Children' s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Kozakewich, Harry P.W. [Department of Pathology, Children' s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States)

    2003-01-01

    Rapidly involuting congenital hemangioma (RICH) is a recently recognized entity in which the vascular tumor is fully developed at birth and undergoes rapid involution. Angiographic findings in two infants with congenital hemangioma are reported and compared with a more common postnatal infantile hemangioma and a congenital infantile fibrosarcoma. Congenital hemangiomas differed from infantile hemangiomas angiographically by inhomogeneous parenchymal staining, large and irregular feeding arteries in disorganized patterns, arterial aneurysms, direct arteriovenous shunts, and intravascular thrombi. Both infants had clinical evidence of a high-output cardiac failure and intralesional bleeding. This congenital high-flow vascular tumor is difficult to distinguish angiographically from arteriovenous malformation and congenital infantile fibrosarcoma. (orig.)

  13. Endoscopic ultrasound guided thrombin injection of angiographically occult pancreatitis associated visceral artery pseudoaneurysms:Case series

    Institute of Scientific and Technical Information of China (English)

    Shivanand; Gamanagatti; Usha; Thingujam; Pramod; Garg; Surajkumar; Nongthombam; Nihar; Ranjan; Dash

    2015-01-01

    Pseudoaneurysm is a known complication of pancreatitis associated with significant mortality and morbidity. Imaging plays an important role in the diagnosis and management. Computed tomography(CT) helps localize the lesion and the severity of the background pancreatitis but digital subtraction angiography with coil embolization is recommended to avoid bleeding and inadvertent surgery. However, in cases where angiographic coil embolization is not feasible due to technical reasons, thrombin injection via CT or ultrasound guidance remains a viable option and often described in literature. In this series, effort has been made to highlight the role of endoscopic ultrasound guided thrombin instillation especially in patients with poorly visualized pseudoaneurysm on ultrasound thereby avoiding surgery and the associated mortality and morbidity.

  14. Coronary CT in Acute Cardiac Care

    NARCIS (Netherlands)

    A. Dedic (Admir)

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  16. Data acquisition for experiments with multi-detector arrays

    Indian Academy of Sciences (India)

    A Chatterjee; Sushil Kamerkar; A K Jethra; S Padmini; M P Diwakar; S S Pande; M D Ghodgaonkar

    2001-07-01

    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 developed recently which is in regular use in experiments at the Pelletron Laboratory, Mumbai. This includes the in-house development of a dedicated crate controller, PC interface card and software.

  17. Diagnostic accuracy of unenhanced, contrast-enhanced perfusion and angiographic MRI sequences for pulmonary embolism diagnosis: results of independent sequence readings

    Energy Technology Data Exchange (ETDEWEB)

    Revel, Marie Pierre [Hopital Europeen Georges Pompidou, APHP, Departments of Radiology, Paris (France); Universite Paris Descartes Sorbonne Paris Cite, Paris (France); Hotel-Dieu, Service de Radiologie, Paris (France); Sanchez, Olivier; Meyer, Guy [Hopital Europeen Georges Pompidou, APHP, Respiratory and intensive care and, Paris (France); Universite Paris Descartes Sorbonne Paris Cite, Paris (France); INSERM Unite 765, Paris (France); Lefort, Catherine; Couchon, Sophie; Hernigou, Anne; Frija, Guy [Hopital Europeen Georges Pompidou, APHP, Departments of Radiology, Paris (France); Niarra, Ralph [Hopital Europeen Georges Pompidou, APHP, Clinical Epidemiology, Paris (France); Universite Paris Descartes Sorbonne Paris Cite, Paris (France); Chatellier, Gilles [Hopital Europeen Georges Pompidou, APHP, Clinical Epidemiology, Paris (France); Universite Paris Descartes Sorbonne Paris Cite, Paris (France); INSERM CIC-EC E4, Paris (France)

    2013-09-15

    To independently evaluate unenhanced, contrast-enhanced perfusion and angiographic MR sequences for pulmonary embolism (PE) diagnosis. Prospective investigation, including 274 patients who underwent perfusion, unenhanced 2D steady-state-free-precession (SSFP) and contrast-enhanced 3D angiographic MR sequences on a 1.5-T unit, in addition to CTA (CT angiography). Two independent readers evaluated each sequence independently in random order. Sensitivity, specificity, predictive values and inter-reader agreement were calculated for each sequence, excluding sequences judged inconclusive. Sensitivity was also calculated according to PE location. Contrast-enhanced angiographic sequences showed the highest sensitivity (82.9 and 89.7 %, reader 1 and reader 2, respectively), specificity (98.5 and 100 %) and agreement (kappa value 0.77). Unenhanced angiographic sequences, although less sensitive overall (68.7 and 76.4 %), were sensitive for the detection of proximal PE (92.7 and 100 %) and showed high specificity (96.1 and 99.1 %) and good agreement (kappa value 0.62). Perfusion sequences showed lower sensitivity (75.0 and 79.3 %), specificity (84.8 and 89.7 %) and agreement (kappa value 0.51), and a negative predictive value of 84.8 % at best. Compared with contrast-enhanced angiographic sequences, unenhanced sequences demonstrate lower sensitivity, except for proximal PE, but high specificity and agreement. The negative predictive value of perfusion sequences was insufficient to safely rule out PE. (orig.)

  18. Clinical manifestations and cerebral angiographic findings of moyamoya disease

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To study the clinical features and angiographic findings of moyamoya disease (MMD) as well as their relationship. Methods A total of 22 MMD patients received routine digital substraction angiography (DSA). The clinical manifestations and angiographic findings were analyzed. Results Clinical manifestations varied and each patient often had multiple symptoms,including cerebral infarction in 9 patients with an average age of 23.6 (13-39 years) and cerebral hemorrhage in 7 patients with an average age...

  19. CT enterography: Principles, technique and utility in Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Huprich, James E. [Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 (United States)], E-mail: huprich@mayo.edu; Fletcher, J.G. [Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 (United States)], E-mail: fletcher.joel@mayo.edu

    2009-03-15

    CT enterography is a modification of conventional CT technique optimized for the evaluation of small bowel. This technique utilizes multidetector scanners with high spatial and temporal resolution; multiplanar reconstructions; and large volumes of enteric contrast to provide bowel distension. This article discusses the essential principles of the exam and its use in the evaluation of Crohn's disease of the small bowel.

  20. Fractured Ribs and the CT Funky Fat Sign of Diaphragmatic Rupture

    Directory of Open Access Journals (Sweden)

    Iclal Ocak

    2016-01-01

    Full Text Available Traumatic diaphragmatic rupture remains a diagnostic challenge for both radiologists and surgeons. In recent years, multidetector CT has markedly improved the diagnosis of diaphragmatic injury in polytrauma patients. Herein, we describe two cases of subacute presentation of traumatic diaphragmatic rupture from a penetrating rib fracture and subsequent intrathoracic herniation of omental fat, representing the CT “funky fat” sign.

  1. Small cell carcinoma of the urinary bladder: Virtual CT cystoscopic findings

    Directory of Open Access Journals (Sweden)

    Tsili A

    2009-01-01

    Full Text Available A 74-year-old man underwent multidetector CT virtual cystoscopy due to macroscopic hematuria. A large, irregularly-surfaced, solid bladder mass was detected, infiltrating the perivesical fat, the seminal vesicles and the prostate. CT examination of the chest and abdomen showed no distant metastases. Radical cystectomy was performed and pathology reported pure small cell carcinoma of the urinary bladder.

  2. Obscure gastrointestinal bleeding: preoperative CT-guided percutaneous needle localization of the bleeding small bowel segment.

    Science.gov (United States)

    Heiss, Peter; Feuerbach, Stefan; Iesalnieks, Igors; Rockmann, Felix; Wrede, Christian E; Zorger, Niels; Schlitt, Hans J; Schölmerich, Jürgen; Hamer, Okka W

    2009-04-01

    A 57-year-old woman presented with obscure gastrointestinal bleeding. Double balloon enteroscopy, angiography, and surgery including intraoperative enteroscopy failed to identify the bleeding site. Multidetector computed tomography (CT) depicted active bleeding of a small bowel segment. The bleeding segment was localized by CT-guided percutaneous needle insertion and subsequently removed surgically.

  3. Pelvic and scrotal trauma: CT and triage of patients.

    Science.gov (United States)

    Ezra, Navid; Afari, Arash; Wong, Jimmie

    2009-07-01

    Traumatic dislocation of the testicles was first reported during crush injury but is now more commonly related to motor vehicle accidents. Approximately 55 cases had been reported by 2003. Virtually no papers discuss the role of CT in the rapid diagnosis of penoscrotal trauma, although most polytrauma or "pelvic trauma" patients are rapidly evaluated by CT in the emergency room setting. As more patients with pelvic trauma are triaged and evaluated using CT scanners with greater multidetector capability, more patients will be seen with testicular injury. It is important for the emergency physicians, radiologists, and traumatologists not to overlook unsuspected cases of penoscrotal injury which are typically initially evaluated by history, physical exam, and ultrasound. We describe a recent case of initial diagnosis of bilateral testicular dislocation from blunt trauma using modern multidetector CT imaging technique.

  4. Prevalence of ear disease in dogs undergoing multidetector thin-slice computed tomography of the head.

    Science.gov (United States)

    Foster, Allison; Morandi, Federica; May, Elizabeth

    2015-01-01

    Previous reports describing the prevalence of ear diseases in dogs have primarily been based on dogs presenting with clinical signs of disease. The prevalence of subclinical ear disease remains unknown. The purpose of this cross-sectional retrospective study was to describe the prevalence of lesions consistent with middle and external ear disease in dogs presented for multidetector computed tomography (CT) of the head and/or cranial cervical spine at our hospital during the period of July 2011 and August 2013. For each included dog, data recorded were signalment, CT findings, diagnosis, and treatment. A total of 199 dogs met inclusion criteria. Nineteen dogs (9.5%) were referred for evaluation of suspected ear disease and 27 dogs (13.5%) had histories or physical examination findings consistent with otitis externa. A total of 163 dogs (81.9%) had CT lesions consistent with external ear disease (i.e. ear canal mineralization, external canal thickening, and/or narrowing of the external canal). Thirty-nine dogs (19.5%) had CT lesions consistent with middle ear disease (i.e. soft tissue attenuating/fluid material in the tympanic bullae, bulla wall thickening or lysis, and/or periosteal proliferation of the temporal bone). Findings from this study indicated that the prevalence of external and middle ear disease in dogs could be higher than that previously reported.

  5. Analysis of angiographic trial data in women.

    Science.gov (United States)

    Havel, R J

    1994-01-01

    There are few angiographic trials of cholesterol lowering in women. Two trials have included a sufficient number of women for meaningful assessment of lesion change, as determined by quantitative coronary angiography. In the University of California, San Francisco Specialized Center of Research in Arteriosclerosis (UCSF SCOR) trial, 72 patients (57% women) with familial hypercholesterolaemia (90% of whom had no overt coronary heart disease) were randomised to receive either diet and intensive drug therapy (combinations of colestipol, nicotinic acid and lovastatin) or diet and modest doses of colestipol, according to baseline low density lipoprotein cholesterol level. Coronary angiograms were obtained at 2-year intervals. Change in percentage area of stenosis (the primary end-point) in women receiving intensive drug treatment was -2.06% compared with +1.07% for the controls (p = 0.05). For the intensively treated men, corresponding values were -0.88% compared with +0.41% for the controls (difference not significant). In a recently completed trial in Canada, 269 men and 62 women with established coronary heart disease were randomised to receive either diet alone, or diet and lovastatin (up to 80 mg daily). In men, the increase in percentage diameter of stenosis was reduced by 43% (p = 0.05), and in women by 40% (not significant). By contrast, new lesions appeared in 4% of women assigned to intensive drug treatment, compared with 45% of those randomised to diet (p < 0.001). In men, new lesions appeared in 18% and 29% of patients, respectively (p = 0.047). These data suggest that coronary artery lesions in women respond at least as well as those in men to cholesterol lowering.

  6. Multidetector computed tomography mesentericography for the diagnosis of obscure gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Heiss, P.; Hamer, O.W.; Mueller-Wille, R.; Rennert, J.; Feuerbach, S.; Zorger, N. [Regensburg Univ. (Germany). Inst. fuer Roentgendiagnostik; Wrede, C.E. [Helios-Klinikum Berlin-Buch (Germany). Interdisziplinaeres Notfallzentrum mit Rettungsstelle; Siebig, S.; Schoelmerich, J. [Regensburg Univ. (Germany). Medizinische Klinik und Poliklinik I

    2011-01-15

    Purpose: To evaluate the diagnostic yield of 16-row multidetector computed tomography (CT) mesentericography in patients with obscure gastrointestinal bleeding. Materials and Methods: The radiological information system database was used to retrospectively identify all patients in whom CT mesentericography (CTM) was performed for the diagnosis of obscure gastrointestinal bleeding between July 2002 and September 2006. A subsequent prospective study was conducted between October 2006 and September 2009 to evaluate CTM in patients with major obscure gastrointestinal bleeding. The retrospectively identified patients (six patients) as well as the prospectively evaluated patients (seven patients) constitute the study population. Following mesenteric DSA the catheter was left in the superior mesenteric artery, the patient was transferred to the CT suite and CTM was carried out by scanning the abdomen after contrast material injection via the catheter. Active bleeding was suspected if a focal area of high attenuation consistent with contrast material extravasation was found within the bowel lumen. Results: CTM detected the site of active bleeding in three of 13 patients (23 %). In the subpopulation of patients who were prospectively evaluated, CT mesentericography identified the site of active bleeding in one of seven patients (14 %). Depiction of active bleeding by CTM prompted surgical intervention in each case and surgery confirmed the findings of CT mesentericography. Conclusion: Due to the relatively low rate of positive findings and inherent drawbacks, we feel that CTM cannot be recommended in general. However, in selected patients who are continuously bleeding at a low rate and in whom iv-CT was negative, CT mesentericography might be helpful. (orig.)

  7. Cone beam CT for dental and maxillofacial imaging: dose matters

    OpenAIRE

    Pauwels, Ruben

    2015-01-01

    The widespread use of cone-beam CT (CBCT) in dentistry has led to increasing concern regarding justification and optimisation of CBCT exposures. When used as a substitute to multidetector CT (MDCT), CBCT can lead to significant dose reduction; however, low-dose protocols of current-generation MDCTs show that there is an overlap between CBCT and MDCT doses. More importantly, although the 3D information provided by CBCT can often lead to improved diagnosis and treatment compared with 2D radiogr...

  8. Spiral CT arthrography of the knee: technique and value in the assessment of internal derangement of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Vande B.C.; Lecouvet, F.E.; Maldague, B.; Malghem, J. [Department of Radiology, Cliniques Universitaires St. Luc, Universite Catholique de Louvain, Brussels (Belgium); Poilvache, P. [Department of Orthopedic Surgery, Cliniques Universitaires St. Luc, Universite Catholique de Louvain, Brussels (Belgium)

    2002-07-01

    Computed tomography imaging has achieved excellent multiplanar capability and submillimeter spatial resolution due to the development of the spiral acquisition mode and multidetector row technology. Multidetector spiral CT arthrography (CTA) yields valuable information for the assessment of internal derangement of the joints. This article focuses on the value of spiral CTA of the knee in the assessment of the meniscus, anterior cruciate ligament, and hyaline cartilage lesions. Advantages and disadvantages of spiral CTA with respect to MR imaging are presented. (orig.)

  9. Hyaline cartilage thickness in radiographically normal cadaveric hips: comparison of spiral CT arthrographic and macroscopic measurements.

    Science.gov (United States)

    Wyler, Annabelle; Bousson, Valérie; Bergot, Catherine; Polivka, Marc; Leveque, Eric; Vicaut, Eric; Laredo, Jean-Denis

    2007-02-01

    To assess spiral multidetector computed tomographic (CT) arthrography for the depiction of cartilage thickness in hips without cartilage loss, with evaluation of anatomic slices as the reference standard. Permission to perform imaging studies in cadaveric specimens of individuals who had willed their bodies to science was obtained from the institutional review board. Two independent observers measured the femoral and acetabular hyaline cartilage thickness of 12 radiographically normal cadaveric hips (from six women and five men; age range at death, 52-98 years; mean, 76.5 years) on spiral multidetector CT arthrographic reformations and on coronal anatomic slices. Regions of cartilage loss at gross or histologic examination were excluded. CT arthrographic and anatomic measurements in the coronal plane were compared by using Bland-Altman representation and a paired t test. Differences between mean cartilage thicknesses at the points of measurement were tested by means of analysis of variance. Interobserver and intraobserver reproducibilities were determined. At CT arthrography, mean cartilage thickness ranged from 0.32 to 2.53 mm on the femoral head and from 0.95 to 3.13 mm on the acetabulum. Observers underestimated cartilage thickness in the coronal plane by 0.30 mm +/- 0.52 (mean +/- standard error) at CT arthrography (P cartilage thicknesses at the different measurement points was significant for coronal spiral multidetector CT arthrography and anatomic measurement of the femoral head and acetabulum and for sagittal and transverse CT arthrography of the femoral head (P cartilage thickness from the periphery to the center of the joint ("gradients") were found by means of spiral multidetector CT arthrography and anatomic measurement. Spiral multidetector CT arthrography depicts cartilage thickness gradients in radiographically normal cadaveric hips. (c) RSNA, 2007.

  10. Multi-detector Computed Tomography Angiography of the Hepatic Artery in Liver Transplant Recipients

    Energy Technology Data Exchange (ETDEWEB)

    Boraschi, P.; Donati, F.; Cossu, M.C.; Gigoni, R.; Vignali, C.; Filipponi, F.; Bartolozzi, C.; Falaschi, F. [Pisa Univ. Hospital (Italy). 2nd Dept. of Radiology

    2005-08-01

    PURPOSE: To evaluate the ability of multi-detector row computed tomography angiography (CTA) in detecting hepatic artery complications in the follow-up of liver transplant patients, performing volume-rendering as reconstruction technique. MATERIAL AND METHODS: The anatomy of hepatic artery was studied in 27 liver transplant recipients with a four-row CT scanner using the following parameters: collimation, 1 mm; slice width, 1 mm; table feed, 6-8 mm/s; spiral reconstruction time, 0.5 s; reconstruction interval, 0.5 mm; mAs, 160; kVp, 120. Before the study, the patients received 1000 ml of water as oral contrast agent to produce negative contrast in the stomach and the small bowel. A non-ionic contrast medium was infused intravenously at a rate of 5 ml/s with a bolus tracking system. Volume-rendering of hepatic artery was performed with the 3D Virtuoso software. RESULTS: The celiac trunk, the hepatic artery, and the right and left hepatic arteries were successfully displayed in high detail in all patients. Side branches, including small collaterals, and hepatic artery anastomosis could also be readily visualized. Volume-rendered CTA detected six hepatic artery stenoses, two hepatic artery thromboses, and two intrahepatic pseudoaneurysms. In two cases, CT detected hepatic artery stenosis with a diameter reduction of less than 50%, while digital subtraction angiography showed a normal artery. CONCLUSION: Volume-rendered multi-detector CTA is a promising non-invasive technique, since it allows images of high quality to be generated with excellent anatomical visualization of the hepatic artery and its complications in liver transplant recipients.

  11. Characteristics of paraesophageal varices: A study with 64-row multidetector computed tomograghy portal venography

    Institute of Scientific and Technical Information of China (English)

    Li-Qin Zhao; Wen He; Guang Chen

    2008-01-01

    AIM:To identify the charactedsUcs of morphology,location and collateral circulation involved in paraesophageal varices (para-EV) of portal hypertension patients with 64-row multidetector computed tomograghy (MDCT).METHODS:Fifty-two of 501 patients with portal hypertensive cirrhosis accompanied with esophageal varices were selected for 64-row MDCT examination after the observation of para-EV.The CT protocol included unenhanced,arterial and portal phases with a slice thickness of 0.625 mm and a scanning field of 2 cm above the bifurcation to the lower edge of kidney.The CT portal venography (CTPV) was reformatted on AW4.3 workstation.The characteristics of origination,location,morphology and collateral circulation in para-EV were observed.RESULTS:Among the 52 cases of para-EV,50 showed the originations from the posterior branch of left gastric vein,while the others from the anterior branch.Fifty cases demonstrated their locations close to the esophagealgastric junction,and the other two cases were extended to the inferior bifurcation of the trachea.The circuitous pattern was observed in 16 cases,while reticulated pattern was seen in 36 cases.Collateral circulation identified 4 cases of single periesophageal varices (peri-EV) communication,3 cases of single hemiazygous vein,one case of single inferior vena cava,41 cases of mixed type (collateral communications of at least 2 of above mentioned types) and 3 cases of undetermined communications.Among all the cases,43 patients showed the communications between para-EV and peri-EV,while hemiazygous vein (43 cases) and inferior vena cava (5 cases) were also involved.CONCLUSION:Sixty-four-row multidetector computed tomograghy portal venography could display the location,morphology,origin,and collateral types of paraEV,which provides important and referable information for clinical management and disease prognosis.

  12. Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art

    OpenAIRE

    Stradiotti, P.; Curti, A.; G. Castellazzi; Zerbi, A.

    2009-01-01

    The projectional nature of radiogram limits its amount of information about the instrumented spine. MRI and CT imaging can be more helpful, using cross-sectional view. However, the presence of metal-related artifacts at both conventional CT and MRI imaging can obscure relevant anatomy and disease. We reviewed the literature about overcoming artifacts from metallic orthopaedic implants at high-field strength MRI imaging and multi-detector CT. The evolution of multichannel CT has made available...

  13. 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.

  14. Biphasic contrast medium injection in cardiac CT: moderate versus high concentration contrast material at identical iodine flux and iodine dose.

    NARCIS (Netherlands)

    Rutten, A.; Meijs, M.F.; Vos, A.M.C.; Seidensticker, P.R.; Prokop, M.

    2010-01-01

    OBJECTIVE: To prospectively investigate the influence of contrast material concentration on enhancement in cardiac CT by using a biphasic single-injection protocol. METHODS: Sixty-four-row multidetector cardiac CT angiography was performed in 159 patients randomised to a moderate or high contrast me

  15. Angiographic outcomes in the PLATO Trial (Platelet Inhibition and Patient Outcomes)

    National Research Council Canada - National Science Library

    Kunadian, Vijay; James, Stefan K; Wojdyla, Daniel M; Zorkun, Cafer; Wu, Jinhui; Storey, Robert F; Steg, Ph Gabriel; Katus, Hugo; Emanuelsson, Hakan; Horrow, Jay; Maya, Juan; Wallentin, Lars; Harrington, Robert A; Gibson, C Michael

    2013-01-01

    The PLATO (Platelet Inhibition and Patient Outcomes) angiographic substudy sought to compare the efficacy of ticagrelor versus clopidogrel with respect to angiographic outcomes before and after PCI in the setting of acute coronary syndrome...

  16. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    P.N. Ruygrok (Peter); M.W.I. Webster (Mark); V. de Valk (Vincent); G.A. van Es (Gerrit Anne); J.A. Ormiston (John); M-A.M. Morel (Marie-Angèle); P.W.J.C. Serruys (Patrick)

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND

  17. Relative risk analysis of angiographic predictors of restenosis within the coronary Wallstent

    NARCIS (Netherlands)

    B.H. Strauss (Bradley); P.W.J.C. Serruys (Patrick); I.K. de Scheerder (Ivan); J.G.P. Tijssen (Jan); M.E. Bertrand (Michel); J. Puel (Jacques); B. Meier (Bernard); U. Kaufmann; J.C. Stauffer; A.F. Rickards (Anthony); U. Sigwart (Ulrich)

    1991-01-01

    textabstractBACKGROUND. Late angiographic narrowing has been observed following coronary implantation of the Wallstent. To identify the angiographic variables that predict restenosis within the stented segment, a retrospective study of data from the European Wallstent core laboratory was performed.

  18. SPECT/CT and pulmonary embolism

    DEFF Research Database (Denmark)

    Mortensen, Jann; Borgwardt, Henrik Gutte

    2014-01-01

    Acute pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/P) scintigraphy or pulmonary CT angiography (CTPA). In recent years both techniques have improved. Many nuclear medicine centres have adopted the single photon emission CT (SPECT) technique as opposed to the planar...... technique for diagnosing PE. SPECT has been shown to have fewer indeterminate results and a higher diagnostic value. The latest improvement is the combination of a low-dose CT scan with a V/P SPECT scan in a hybrid tomograph. In a study comparing CTPA, planar scintigraphy and SPECT alone, SPECT/CT had...... the best diagnostic accuracy for PE. In addition, recent developments in the CTPA technique have made it possible to image the pulmonary arteries of the lungs in one breath-hold. This development is based on the change from a single-detector to multidetector CT technology with an increase in volume...

  19. 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.

  20. Endovascular treatment of thoracic aortic diseases: Follow-up and complications with multi-detector computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Iezzi, Roberto [Department of Radiology, University ' G. D' Annunzio' , Chieti (Italy)], E-mail: r.iezzi@rad.unich.it; Cotroneo, Antonio Raffaele; Marano, Riccardo; Filippone, Antonella; Storto, Maria Luigia [Department of Radiology, University ' G. D' Annunzio' , Chieti (Italy)

    2008-03-15

    Endovascular procedures with placement of stent-graft has become an accepted alternative to traditional open surgery for treatment of descending thoracic aortic aneurysms, ulcers, post-traumatic rupture, or complications of type-B dissection, due to significant reduction in perioperative mortality, rate of complications and length of hospitalization. Moreover, increasing operator experience and continuous advances in stent-graft technology are making treatment of a wider range of cases possible with redefinition of guidelines for endovascular stent-graft. The feasibility of endovascular stent-graft is mainly dependent on anatomic factors which represent the important predictors of the success of this procedure as well as on strictly follow-up in order to obtain early detection and treatment of eventual complications. Multi-detector CT-angiography is a fast, safe, and minimally invasive imaging technique that represents the standard of reference in the follow-up of patients who have undergone endovascular stent-graft, as it is effective and specific in the detection of procedure-correlated complications. The purpose of this article is to give a brief review of those techniques most commonly used for endovascular treatment of thoracic aortic diseases together with a more detailed description of post-procedural complications and their appearance on multi-detector CT-angiography.

  1. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    OpenAIRE

    Ruygrok, Peter; Webster, Mark; de Valk, Vincent; Es, Gerrit Anne; Ormiston, John; Morel, Marie-Angèle; Serruys, Patrick

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND RESULTS: All patients with angiographic restenosis from the BENESTENT I, BENESTENT II pilot, BENESTENT II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, and ROSE studies were analyzed. Multivariat...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-12-15

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

  3. Economic evaluation of angiographic interventions including a whole-radiology in- and outpatient care; Wirtschaftliche Evaluation angiographischer Interventionen einschliesslich einer radiologischen stationaeren und ambulanten Patientenbetreuung

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.; Abel, K.; Krupski, G.; Lorenzen, J.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

    2006-01-01

    Purpose: To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. Materials and Methods: The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called ''ambulant operation'' (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Results: Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 Euro, the profits in our university hospital range between -872 Euro and +3411 Euro (mean: +1348 Euro). On the other hand, those angiographic interventions suitable for ''ambulant operation'' generate average profits of +372 Euro, if only direct costs are considered. The data of outpatient radiological interventions average between 381 Euro up to 1612 Euro lower than compared with profits obtained from in patient care. (orig.)

  4. Spontaneous coronary artery dissection: complete angiographic resolution without stenting

    Directory of Open Access Journals (Sweden)

    Alexandre Abizaid

    2007-09-01

    Full Text Available A case of spontaneous coronary artery dissection in a 49-year-oldwoman is presented. She did not present the classical cardiovascular riskfactors. Etiology and treatment are discussed. She underwent primarypercutaneous coronary intervention of the left anterior descendingartery with no stenting and had complete angiographic resolution.

  5. Reduction of aneurysm clip artifacts on CT angiograms: a technical note.

    Science.gov (United States)

    Brown, J H; Lustrin, E S; Lev, M H; Ogilvy, C S; Taveras, J M

    1999-04-01

    We describe a head tilt technique for use with CT angiography that reduces beam-hardening artifacts in patients with aneurysm clips. This simple maneuver directs the artifacts away from pertinent anatomy, thus increasing the chances for diagnostic accuracy. No significant changes in the CT angiographic protocol are required, and the maneuver can easily be combined with other artifact-minimizing strategies.

  6. 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.

  7. Interventional spinal procedures guided and controlled by a 3D rotational angiographic unit

    Energy Technology Data Exchange (ETDEWEB)

    Pedicelli, Alessandro; Verdolotti, Tommaso; Desiderio, Flora; D' Argento, Francesco; Colosimo, Cesare; Bonomo, Lorenzo [Catholic University of Rome, A. Gemelli Hospital, Department of Bioimaging and Radiological Sciences, Rome (Italy); Pompucci, Angelo [Catholic University of Rome, A. Gemelli Hospital, Department of Neurotraumatology, Rome (Italy)

    2011-12-15

    The aim of this paper is to demonstrate the usefulness of 2D multiplanar reformatting images (MPR) obtained from rotational acquisitions with cone-beam computed tomography technology during percutaneous extra-vascular spinal procedures performed in the angiography suite. We used a 3D rotational angiographic unit with a flat panel detector. MPR images were obtained from a rotational acquisition of 8 s (240 images at 30 fps), tube rotation of 180 and after post-processing of 5 s by a local work-station. Multislice CT (MSCT) is the best guidance system for spinal approaches permitting direct tomographic visualization of each spinal structure. Many operators, however, are trained with fluoroscopy, it is less expensive, allows real-time guidance, and in many centers the angiography suite is more frequently available for percutaneous procedures. We present our 6-year experience in fluoroscopy-guided spinal procedures, which were performed under different conditions using MPR images. We illustrate cases of vertebroplasty, epidural injections, selective foraminal nerve root block, facet block, percutaneous treatment of disc herniation and spine biopsy, all performed with the help of MPR images for guidance and control in the event of difficult or anatomically complex access. The integrated use of ''CT-like'' MPR images allows the execution of spinal procedures under fluoroscopy guidance alone in all cases of dorso-lumbar access, with evident limitation of risks and complications, and without need for recourse to MSCT guidance, thus eliminating CT-room time (often bearing high diagnostic charges), and avoiding organizational problems for procedures that need, for example, combined use of a C-arm in the CT room. (orig.)

  8. 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.)

  9. Computed Tomography (CT) Perfusion in Abdominal Cancer

    DEFF Research Database (Denmark)

    Hansen, Martin Lundsgaard; Norling, Rikke; Lauridsen, Carsten

    2013-01-01

    Computed Tomography (CT) Perfusion is an evolving method to visualize perfusion in organs and tissue. With the introduction of multidetector CT scanners, it is now possible to cover up to 16 cm in one rotation, and thereby making it possible to scan entire organs such as the liver with a fixed...... table position. Advances in reconstruction algorithms make it possible to reduce the radiation dose for each examination to acceptable levels. Regarding abdominal imaging, CT perfusion is still considered a research tool, but several studies have proven it as a reliable non-invasive technique...... for assessment of vascularity. CT perfusion has also been used for tumor characterization, staging of disease, response evaluation of newer drugs targeted towards angiogenesis and as a method for early detection of recurrence after radiation and embolization. There are several software solutions available...

  10. 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.

  11. 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.

  12. CT enteroclysis in small bowel Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kohli, Marc D. [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Maglinte, Dean D.T. [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States)], E-mail: dmaglint@iupui.edu

    2009-03-15

    The diagnostic evaluation of small bowel Crohn's disease has changed dramatically over the last decade. The introduction of wireless capsule endoscopy, double balloon endoscopy and the introduction of newer therapeutic agents have changed the role of imaging in the small bowel. Additionally, advances in multidetector CT technology have further changed how radiologic investigations are utilized in the diagnosis and management of small bowel Crohn's disease. This article describes how we perform CT enteroclysis in the investigation of small bowel Crohn's disease and discusses the role of CT enteroclysis in the current management of small bowel Crohn's disease.

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

    Directory of Open Access Journals (Sweden)

    Mubarak F, Alam MS

    2011-04-01

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

  14. Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Athina; C; Tsili; Maria; I; Argyropoulou

    2015-01-01

    Renal cell carcinoma(RCC) accounts for approximately 90%-95% of kidney tumors. With the widespread use of cross-sectional imaging modalities, more than half of RCCs are detected incidentally, often diagnosed at an early stage. This may allow the planning of more conservative treatment strategies. Computed tomography(CT) is considered the examination of choice for thedetection and staging of RCC. Multidetector CT(MDCT) with the improvement of spatial resolution and the ability to obtain multiphase imaging, multiplanar and threedimensional reconstructions in any desired plane brought about further improvement in the evaluation of RCC. Differentiation of RCC from benign renal tumors based on MDCT features is improved. Tumor enhancement characteristics on MDCT have been found closely to correlate with the histologic subtype of RCC, the nuclear grade and the cytogenetic characteristics of clear cell RCC. Important information, including tumor size, localization, and organ involvement, presence and extent of venous thrombus, possible invasion of adjacent organs or lymph nodes, and presence of distant metastases are provided by MDCT examination. The preoperative evaluation of patients with RCC was improved by depicting the presence or absence of renal pseudocapsule and by assessing the possible neoplastic infiltration of the perirenal fat tissue and/or renal sinus fat compartment.

  15. Enteroclysis CT and PEG-CT in patients with previous small-bowel surgical resection for Crohn's disease: CT findings and correlation with endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Minordi, Laura Maria; Vecchioli, Amorino; Poloni, Giuliana; Bonomo, Lorenzo [Radiology Institute, UCSC, Department of Bio-Imaging and Radiological Sciences, Rome (Italy); Guidi, Luisa; De Vitis, Italo [Catholic University (UCSC), Gastrointestinal Department, Complesso Integrato Columbus, Rome (Italy)

    2009-10-15

    The aim of this study was to evaluate the accuracy of multidetector CT in patients with Crohn's disease (CD) relapse after ileocolic resection compared with endoscopy. Thirty-four patients were studied by endoscopy and multidetector CT, after oral administration of polyethylene glycol solution (n = 21) or after administration of methylcellulose via nasojejunal tube (n = 13). In CT examinations we evaluated the presence of mural thickening, target sign, perienteric stranding, comb sign, fibrofatty proliferation and complications. Endoscopic results were classified in accordance with Rutgeerts score (from 0 to 4). The statistical evaluations were carried out by using Fisher's exact text and {chi} {sup 2} testing (p < 0.05, statistically significant difference). Sensitivity, specificity and accuracy of the CT were 96.9%, 100% and 97%, respectively. We found a statistically significant correlation between an endoscopic score of 4 and the CT signs of target sign, perienteric stranding, comb sign and fibrofatty proliferation, and between scores 1 and 2 and mucosal hyperdensity without or with mural thickening, respectively (p < 0.05). Moreover, only CT identified the presence of jejunal and proximal ileum disease in two and three patients, respectively, and fistulas in three patients. CT is a reliable method in the diagnosis of CD relapse and shows agreement with the approved endoscopic Rutgeerts score. (orig.)

  16. Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage.

    Science.gov (United States)

    Chen, Zhi; Chen, Jingyu; Miao, Hongpin; Li, Fei; Feng, Hua; Zhu, Gang

    2013-05-01

    Hemorrhagic events associated with cerebral paragonimiasis are not rare, especially in children and adolescents; however, angiographic evidence of cerebrovascular involvement has not been reported. The authors describe angiographic abnormalities of the cerebral arteries seen in 2 children in whom cerebral paragonimiasis was associated with hemorrhagic stroke. The patients presented with acute intracerebral and subarachnoid hemorrhage. Angiography revealed a beaded appearance and long segmental narrowing of arteries, consistent with arteritis. In both patients, involved vessels were seen in the area of the hemorrhage. The vascular changes and the hemorrhage, together with new lesions that developed close to the hemorrhage and improved after praziquantel treatment, were attributed to paragonimiasis. Further study of the frequency and mechanism of hemorrhagic cerebrovascular complications associated with cerebral paragonimiasis is needed.

  17. Angiographic leakage of polypoidal choroidal vasculopathy on indocyanine angiography

    Institute of Scientific and Technical Information of China (English)

    ZUO Cheng-guo; WEN Feng; HUANG Shi-zhou; LUO Guang-wei; YAN Hong; WU Wei-ju; WU De-zheng

    2010-01-01

    Background There is no detailed report about the angiographic leakage of polypoidal choroidal vasculopathy (PCV)lesions on indocyanine green (ICG) angiography. This study aimed to investigate the angiographic leakage of polypoidal lesions in PCV on ICG angiography.Methods One hundred and forty-four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, fluorescein angiography, and ICG angiography were performed. Leakage of polypoidal lesions and clinical features were recorded according to the angiograms.Results In all 144 eyes, 110 eyes showed angiographic leakage (leakage group) on ICG angiography and three subtypes of leakage group were noted, which were polypoidal dilations leakage (47 eyes, 42.7%), branching vascular networks leakage (14 eyes, 12.7%) and leakage of both (49 eyes, 44.5%). The other 34 eyes showed regression of polypoidal lesions (regression group). In leakage group, the rates of pigment epithelial detachment (PED), best corrected visual acuity (BCVA) <0.1 and old subretinal hemorrhages were 56.4% (62 eyes), 19.1% (21 eyes), and 4.6% (5 eyes)respectively, compared with 8.8% (3 eyes), 50% (17 eyes) and 38.2% (13 eyes) of regression group (P <0.001). The history of regression group was significantly longer (P <0.001).Conclusions Angiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect that the former is active or in the early course while the later is resting or in the late phase of PCV.

  18. A practical approach to radiological evaluation of CT lung cancer screening examinations

    NARCIS (Netherlands)

    Xie, Xueqian; Heuvelmans, Marjolein A.; van Ooijen, Peter M. A.; Oudkerk, Matthijs; Vliegenthart, Rozemarijn

    2013-01-01

    Lung cancer is the most common cause of cancer-related death in the world. The Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON) was launched to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk patients will lead

  19. A practical approach to radiological evaluation of CT lung cancer screening examinations

    NARCIS (Netherlands)

    Xie, Xueqian; Heuvelmans, Marjolein A.; van Ooijen, Peter M. A.; Oudkerk, Matthijs; Vliegenthart, Rozemarijn

    2013-01-01

    Lung cancer is the most common cause of cancer-related death in the world. The Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON) was launched to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk patients will lead

  20. CT findings of primary squamous cell carcinoma of the stomach: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyoung Min; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min [Guro Hospital of Korea University, Seoul (Korea, Republic of)

    2008-07-15

    Primary squamous cell carcinoma is a rare tumor of the stomach with an incidence ranging from 0.04% to 0.4% of all diagnosed gastric cancers. We report a case of squamous cell carcinoma in the stomach associated with hypertrophic gastropathy and observed as a huge mass and wall thickening on the greater curvature site by a multidetector CT.

  1. Recurrent pyogenic cholangitis : angiographic findings and its significance

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Chan; Kim, Eui Jong; Oh, Joo Hyung; Yoon, Yup; Lim, Joo Won; Kim, Ihn Sub [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1997-07-01

    To analyse the angiographic findings of recurrent pyogenic cholangitis Hepatic arteriography and portography were performed preoperatively in 34 patients with intrahepatic stones and recurrent cholangitis. Twenty five of these underwent partial resection of the liver and in nine, the biliary tract was drained. Hepatic arteriogram and portogram findings correlated with liver atrophy and were analysed retrospectively by two radiologists;angiographic and pathologic findings also correlated. In the arterial phase, abnormal stained areas, were seen in 17 of 34 cases, periarterial staining in 14, mass-like staining in two and a mixed pattern in one. The hepatic artery showed spastic change in 11 of 34 cases and tortuous change in 17. Arteriovenous shunting was not seen. In the portal phase, abnormal findings of the portal veins were noted in 16 cases; decreased size and nonvisualization were seen in eleven patients, and decreased size only, in five. Fifteen cases showed liver atrophy;in 13 of these, portal vein abnormalities were also present. In recurrent pyogenic cholangitis, angiographic findings may be normal or findings of abnormal periarterial staining, mass-like staining, spastic and tortuous change of the hepatic artery, and abnormal portal vein can be present. The differential diagnosis of hepatitis, hepatic mass and cirrhosis should be considered.

  2. Tracheomalacia in adults with cystic fibrosis: determination of prevalence and severity with dynamic cine CT.

    LENUS (Irish Health Repository)

    McDermott, Shaunagh

    2012-02-01

    PURPOSE: To determine the prevalence and severity of tracheomalacia in adults with cystic fibrosis (CF) by using dynamic cine multidetector computed tomography (CT) and to correlate these findings with pulmonary function test (PFT) results and the severity of parenchymal lung disease. MATERIALS AND METHODS: In this institutional review board-approved HIPAA-compliant study, 40 patients with CF (22 men, 18 women; mean age, 28 years +\\/- 8 [standard deviation]; age range, 18-54 years) prospectively underwent PFTs, standard thin-section CT, and two dynamic cine multidetector CT acquisitions. Ten control subjects underwent dynamic cine multidetector CT. After standard thin-section CT was completed, dynamic cine multidetector CT was performed during a forced expiratory maneuver and during coughing. Dynamic cine multidetector CT images in nine patients were excluded. Maximal inspiratory, dynamic expiratory, and end-expiratory tracheal luminal areas were compared (Student t test) and correlated (Spearman rank) with PFT results and severity of parenchymal lung disease. RESULTS: Mean predicted forced expiratory volume in 1 second (FEV(1)) was 70.6% +\\/- 20.7, and mean Bhalla CT score was 41.8% +\\/- 13.6. In patients with CF, dynamic cine mean tracheal cross-sectional area reduction was 51.7% +\\/- 18.4 (range, 9%-89%) for forced expiratory maneuvers and 68.8% +\\/- 11.7 (range, 18%-88%) for coughing (P = .001). Tracheomalacia was demonstrated in 24 (69%) patients and no control subjects during forced expiratory maneuvers (P = .001) and in 10 (29%) patients and one (10%) control subject during coughing. For end-expiration images, mean tracheal luminal reduction was 16.1% +\\/- 14.0% (range, 0.0%-53.0%), with one patient demonstrating tracheal luminal reduction of more than 50%. There was no correlation between tracheal cross-sectional luminal reduction and either predicted FEV(1) or CT Bhalla score. CONCLUSION: Tracheomalacia depicted at dynamic cine multidetector CT is a

  3. SPECT/CT and pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, Jann [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); The Faroese National Hospital, Department of Medicine, Torshavn (Faroe Islands); Gutte, Henrik [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Herlev Hospital, Copenhagen University Hospital, Department of Radiology, Copenhagen (Denmark); University of Copenhagen, Cluster for Molecular Imaging, Faculty of Health Sciences, Copenhagen (Denmark)

    2014-05-15

    Acute pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/P) scintigraphy or pulmonary CT angiography (CTPA). In recent years both techniques have improved. Many nuclear medicine centres have adopted the single photon emission CT (SPECT) technique as opposed to the planar technique for diagnosing PE. SPECT has been shown to have fewer indeterminate results and a higher diagnostic value. The latest improvement is the combination of a low-dose CT scan with a V/P SPECT scan in a hybrid tomograph. In a study comparing CTPA, planar scintigraphy and SPECT alone, SPECT/CT had the best diagnostic accuracy for PE. In addition, recent developments in the CTPA technique have made it possible to image the pulmonary arteries of the lungs in one breath-hold. This development is based on the change from a single-detector to multidetector CT technology with an increase in volume coverage per rotation and faster rotation. Furthermore, the dual energy CT technique is a promising modality that can provide functional imaging in combination with anatomical information. Newer high-end CT scanners and SPECT systems are able to visualize smaller subsegmental emboli. However, consensus is lacking regarding the clinical impact and treatment. In the present review, SPECT and SPECT in combination with low-dose CT, CTPA and dual energy CT are discussed in the context of diagnosing PE. (orig.)

  4. Clinical and angiographic outcomes after intracoronary bare-metal stenting.

    Directory of Open Access Journals (Sweden)

    I-Chang Hsieh

    Full Text Available BACKGROUND: Data from a large patient population regarding very long-term outcomes after BMS implantation are inadequate. This study aimed to evaluate the very long-term (8-17 years clinical and long-term (3-5 years angiographic outcomes after intracoronary bare-metal stenting (BMS. METHODS AND RESULTS: From the Cardiovascular Atherosclerosis and Percutaneous TrAnsluminal INterventions (CAPTAIN registry, a total of 2391 patients with 2966 lesions treated with 3190 BMSs between November 1995 and May 2004 were evaluated. In total, 1898 patients with 2364 lesions, and 699 patients with 861 lesions underwent 6-month and 3- to 5- year angiographic follow-up, respectively. During a mean follow-up period of 149 ± 51 months, 18.6% of the patients died (including 10.8% due to cardiac death, 6.1% developed reinfarction, 16.2% had target lesion revascularization (including 81% of the patients within the first year, 14.5% underwent new lesion stenting (including 72% of the patients after 3 years, 2.4% underwent coronary bypass surgery, and 1.6% had definite stent thrombosis. The overall cardiovascular event-free survival rate was 58.5%. The 6-month angiographic study indicated a 20% restenosis rate. The minimal luminal diameter increased from 0.65 ± 0.44 mm to 3.02 ± 0.46 mm immediately after stenting, decreased to 2.06 ± 0.77 mm at the 6-month follow-up, and increased to 2.27 ± 0.68 mm at the 3- to 5-year follow-up. CONCLUSIONS: This study provides clinical and angiographic results from a large population of patients who underwent BMS implantations after a long-term follow-up period (149 ± 51 months. The progression of coronary atherosclerosis developed over time, and presented with new lesion required stent implantation. The follow-up angiographic findings reconfirmed the late and sustained improvement in luminal diameter between 6 months and 3-5 years.

  5. 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)

  6. Angiographic adverse events during percutaneous coronary intervention fail to predict creatine kinase-MB elevation.

    Science.gov (United States)

    Blankenship, James C; Islam, M Ashequl; Wood, G Craig; Iliadis, Elias A

    2004-09-01

    We attempted to determine if aggressive detection of angiographic adverse events during coronary intervention could predict subsequent creatine kinase (CK)-MB elevations. During coronary intervention, both fluoroscopy and cine angiography were used to detect angiographic adverse events. At least one angiographic adverse event occurred in 133/251 (53%) of procedures. CK-MB elevation occurred in 24% of procedures. Slow flow during the procedure (P=0.002) and chest discomfort at the end of the procedure (P=0.007) were the strongest predictors of CK-MB elevation. Among procedures with no angiographic adverse events, CK-MB elevation occurred in 15/121 (12%), accounting for 25% of CK-MB elevations. We conclude that CK-MB elevation occurs after angiographically uncomplicated coronary interventions even when angiographic adverse events are aggressively detected. Routine monitoring of cardiac enzymes is necessary to detect all patients who will experience myocardial injury after coronary intervention.

  7. Multidetector computed tomography arthrography of the knee: Diagnostic accuracy and indications

    Energy Technology Data Exchange (ETDEWEB)

    De Filippo, Massimo [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy)], E-mail: massimo.defilippo@unipr.it; Bertellini, Annalisa [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Pogliacomi, Francesco [Department of Surgery, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Sverzellati, Nicola [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Corradi, Domenico [Department of Anatomy, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Garlaschi, Giacomo [Department of Radiology, University of Genoa, Genoa Hospital, Via Balbi, 5-16126 Genova (Italy); Zompatori, Maurizio [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy)

    2009-05-15

    Purpose: To evaluate the diagnostic accuracy and indications of arthrography with multidetector computed tomography (arthro-MDCT) of the knee, in patients with absolute or relative contraindications to MRI and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. Materials and methods: After intra-articular injection of iodixanol and volumetric acquisition, 68 knees in patients of both sexes (30 females, 38 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 either because of absolute contraindications (subcutaneous electronic implants), surgical metal implants or claustrophobia. In 37 of 68 patients who had had previous knee 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 non-operated patients the comparison between arthro-MDCT and arthroscopy showed sensitivity and specificity ranging between 86% and 100%. In the 37 operated knees, arthro-MDCT had an accuracy of 95% compared with 53% of the MRI. Inter-observer agreement was almost perfect (K = 0.97) in the evaluation of all types lesions, both on MDCT and MRI. When arthro-MDCT was compared with MRI in post-operative patients by a McNemar test, a significant difference (p < 0.05) was found between these two techniques. Conclusions: Arthro-MDCT of the knee is a safe technique that provides accurate diagnosis in identifying chondral, fibrocartilaginous and intra-articular ligamentous lesions, in patients that cannot be evaluated by MRI, and in patients after surgical.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-01

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

  9. [Clinical presentation and coronary angiographic results in unstable angina pectoris].

    Science.gov (United States)

    Weber, T; Kirchgatterer, A; Auer, J; Wimmer, L; Lang, G; Mayr, H; Maurer, E; Punzengruber, C; Eber, B

    1999-01-01

    The syndrome "unstable angina" (UA) covers a broad spectrum of patients. In this study we tried to determine the relationship between the severity of UA and angiographic findings. We evaluated 1000 consecutive patients undergoing coronary angiography. Those with the clinical diagnosis "UA" were included in the study. In a retrospective analysis of their records we categorized them, using the Braunwald-classification for determination of the severity of the disease. 352 patients were include, 209 men and 143 women, the mean age was 65 years. 47% met Braunwald-Class I, 26% Class II and 27% Class III. Coronary single-vessel disease was present in 29%, two-vessel disease in 20%, three-vessel disease in 25%, normal coronaries in 13% and coronary atherosclerosis without critical narrowing in 13%. Left ventricular function was preserved in 72%, mild systolic dysfunction was found in 10%, moderate in 13% and severe in 5%. There was no overall correlation between clinical presentation (Braunwald-Classes) and angiographic findings. Women showed a similar distribution of Braunwald-Classes, but significantly more coronary arteries without critical obstruction. In patients with reduced systolic function the percentage of multi-vessel disease was significantly higher, the percentage without relevant coronary artery narrowing was significantly lower. 1) The lack of overall correlation between clinical presentation and angiographic findings supports the importance of coronary angiography in the evaluation of patients with UA. 2) The assessment of women with chest pain is more difficult than of men with regard to coronary heart disease. 3) UA in patients with impaired left ventricular function is a predictor of severe coronary artery dise