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Sample records for multidetector row ct

  1. Multidetector-row CT: economics and workflow

    International Nuclear Information System (INIS)

    Pottala, K.M.; Kalra, M.K.; Saini, S.; Ouellette, K.; Sahani, D.; Thrall, J.H.

    2005-01-01

    With rapid evolution of multidetector-row CT (MDCT) technology and applications, several factors such ad technology upgrade and turf battles for sharing cost and profitability affect MDCT workflow and economics. MDCT workflow optimization can enhance productivity and reduce unit costs as well as increase profitability, in spite of decrease in reimbursement rates. Strategies for workflow management include standardization, automation, and constant assessment of various steps involved in MDCT operations. In this review article, we describe issues related to MDCT economics and workflow. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  4. Pitfalls in multidetector row CT colonography

    International Nuclear Information System (INIS)

    Stoyneva, V.

    2009-01-01

    Full text:MDCT colonography is a reliable method for detection and identification of type of the colon lesions. At every step of the examination an error could be made and that would be lead to an incorrect diagnosis. Problems and pitfalls can be overcome with various useful techniques. The relatively clean and dry colon after careful preparation, allows avoiding problems of residual fluid and faeces. The knowledge about the structure and thickness characteristics of lesions of the colon and artefacts can to be useful in distinction of the polypoidal lesions from normal findings. The aim of this lecture is to describe common and less common pitfalls in CT colonography and to clarify features and CT criteria to distinction of organic formations from pseudo lesions. Inadequate preparation of the patient, weaknesses into the protocol, gaps and errors in interpretation are responsible for false positive and false negative results. The training which reduces the residual solids and liquid, marking, protocols elaboration and CAD allows achieving higher sensitivity and specificity. The 2D and 3D application techniques and solid knowledge about CT characteristic of the colon organic findings and pseudo lesions will reduce the rate of false positive results

  5. Multidetector row CT for imaging the paediatric tracheobronchial tree

    International Nuclear Information System (INIS)

    Papaioannou, Georgia; Young, Carolyn; Owens, Catherine M.

    2007-01-01

    The introduction of multidetector row computed tomography (MDCT) scanners has altered the approach to imaging the paediatric thorax. In an environment where the rapid acquisition of CT data allows general hospitals to image children instead of referring them to specialist paediatric centres, it is vital that general radiologists have access to protocols appropriate for paediatric applications. Thus a dramatic reduction in the delivered radiation dose is ensured with optimal contrast bolus delivery and timing, and inappropriate repetition of the scans is avoided. This article focuses on the main principles of volumetric CT imaging that apply generically to all MDCT scanners. We describe the reconstruction techniques for imaging the paediatric thorax and the low-dose protocols used in our institution on a 16-slice detector CT scanner. Examples of the commonest clinical applications are also given. (orig.)

  6. Traumatic thoracic injury: the role of Multidetector-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyung Joo; Kang, Doo Kyung; Kim, Tae Hee [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2006-05-15

    The introduction of Multidetector-row CT (MDCT) has revolutionized the diagnostic strategy of multitrauma patients. The rapid acquisition of a large scanning volume with a thin slice collimation allows for motion-free images of high spatial resolution, and this enables the application of the multiplanar reformat (MPR) and 3D volume-rendering (VR) images. The MPR images more accurately demonstrate aortic rupture or dissection, diaphragmatic injuries and fracture of vertebrae, sternum and costal cartilages. Diagnosing vascular injuries can be aided by using the MIP images. Rib fracture, trachea and bronchial laceration are more easily detected by the 3D images, while airway and vascular injuries can be detected from performing virtual endoscopy. We introduce our current CT imaging protocol and we present our clinical experience with using MDCT in the assessment of patients with blunt thoracic trauma.

  7. Recent technologic advances in multi-detector row cardiac CT.

    Science.gov (United States)

    Halliburton, Sandra Simon

    2009-11-01

    Recent technical advances in multi-detector row CT have resulted in lower radiation dose, improved temporal and spatial resolution, decreased scan time, and improved tissue differentiation. Lower radiation doses have resulted from the use of pre-patient z collimators, the availability of thin-slice axial data acquisition, the increased efficiency of ECG-based tube current modulation, and the implementation of iterative reconstruction algorithms. Faster gantry rotation and the simultaneous use of two x-ray sources have led to improvements in temporal resolution, and gains in spatial resolution have been achieved through application of the flying x-ray focal-spot technique in the z-direction. Shorter scan times have resulted from the design of detector arrays with increasing numbers of detector rows and through the simultaneous use of two x-ray sources to allow higher helical pitch. Some improvement in tissue differentiation has been achieved with dual energy CT. This article discusses these recent technical advances in detail.

  8. Breast multidetector-row CT with histopathologic correlation

    International Nuclear Information System (INIS)

    Takeuchi, Makiko; Yamashita, Akiyoshi; Ohgi, Kazuyuki; Kobori, Kenichi; Furukawa, Takashi

    2004-01-01

    The purpose of this study was to evaluate the correlation between multidetector-row CT (MDCT) and histopathologic findings using the same MDCT image as the histopathologic cross-section. MDCT with contrast enhancement was performed in 10 patients with breast cancers (8 invasive ductal carcinomas, one invasive lobular carcinoma, and one non-invasive ductal carcinoma). We tried to reconstruct multiplanar reconstructions (MPR) in the same plane as the histopathologic cross-section, and we evaluated the histopathologic findings of the false-positive lesions. In all cases, we obtained the same MDCT image as the histopathologic cross-section. There were 10 main lesions and 18 other lesions. In the other lesions, we found no false-negative lesions and 11 false-positive lesions. False-positive lesions included periductal fibrosis, cystic change, duct papillomatosis, sclerosing adenosis, fibroadenoma, and others. Using MDCT of the breast, it is possible to obtain good correlation between CT images and histopathologic findings. MDCT is thought to be useful in the evaluation CT findings on the basis of histopathologic evidence. (author)

  9. Data explosion: the challenge of multidetector-row CT

    International Nuclear Information System (INIS)

    Rubin, Geoffrey D.

    2000-01-01

    The development of multi detector-row CT has brought many exciting advancements to clinical CT scanning. While multi detector-row CT offers unparalleled speed of acquisition, spatial resolution, and anatomic coverage, a challenge presented by these advantages is the substantial increase on the number of reconstructed cross-sections that are rapidly created and in need of analysis. This manuscript discusses currently available alternative visualization techniques for the assessment of volumetric data acquired with multi detector-row CT. Although the current capabilities of 3-D workstations offer many possibilities for alternative analysis of MCDT data, substantial improvements both in automated processing, processing speed and user interface will be necessary to realize the vision of replacing the primary analysis of transverse reconstruction's with alternative analyses. The direction that some of these future developments might take are discussed

  10. Data explosion: the challenge of multidetector-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, Geoffrey D. E-mail: grubin@standford.edu

    2000-11-01

    The development of multi detector-row CT has brought many exciting advancements to clinical CT scanning. While multi detector-row CT offers unparalleled speed of acquisition, spatial resolution, and anatomic coverage, a challenge presented by these advantages is the substantial increase on the number of reconstructed cross-sections that are rapidly created and in need of analysis. This manuscript discusses currently available alternative visualization techniques for the assessment of volumetric data acquired with multi detector-row CT. Although the current capabilities of 3-D workstations offer many possibilities for alternative analysis of MCDT data, substantial improvements both in automated processing, processing speed and user interface will be necessary to realize the vision of replacing the primary analysis of transverse reconstruction's with alternative analyses. The direction that some of these future developments might take are discussed.

  11. The detectability of the origin of the inferior phrenic artery by paging method on multidetector-row CT angiography

    International Nuclear Information System (INIS)

    Terayama, Koshi

    2005-01-01

    We evaluated the ability to detect the origin of the inferior phrenic artery (IPA) by paging method on multidetector-row computed tomography (CT) angiography. In 104 patients who underwent multidetector-row CT, detectability of the origin of the IPA was assessed. In addition, in 30 patients in whom arteriographic study was performed, the IPA findings on multidetector-row CT were compared with those on arteriography. In 100 patients (96%) the origin of the right IPA was demonstrated with multidetector-row CT and in 93 patients (89%) the origin of the left IPA was demonstrated. CT angiographic findings concurred with arteriographic findings in all 30 patients (100%) who underwent arteriographic study. In conclusion, paging method on multidetector-row CT angiography provides valuable anatomical information regarding IPA. (author)

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

    International Nuclear Information System (INIS)

    Ishifuro, Minoru; Akiyama, Yuji; Kushima, Toshio; Horiguchi, Jun; Nakashige, Aya; Tamura, Akihisa; Marukawa, Kazushi; Fukuda, Hiroshi; Ono, Chiaki; Ito, Katsuhide

    2002-01-01

    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.)

  13. Relationship between noise, dose, and pitch in cardiac multi-detector row CT.

    Science.gov (United States)

    Primak, Andrew N; McCollough, Cynthia H; Bruesewitz, Michael R; Zhang, Jie; Fletcher, Joel G

    2006-01-01

    In spiral computed tomography (CT), dose is always inversely proportional to pitch. However, the relationship between noise and pitch (and hence noise and dose) depends on the scanner type (single vs multi-detector row) and reconstruction mode (cardiac vs noncardiac). In single detector row spiral CT, noise is independent of pitch. Conversely, in noncardiac multi-detector row CT, noise depends on pitch because the spiral interpolation algorithm makes use of redundant data from different detector rows to decrease noise for pitch values less than 1 (and increase noise for pitch values > 1). However, in cardiac spiral CT, redundant data cannot be used because such data averaging would degrade the temporal resolution. Therefore, the behavior of noise versus pitch returns to the single detector row paradigm, with noise being independent of pitch. Consequently, since faster rotation times require lower pitch values in cardiac multi-detector row CT, dose is increased without a commensurate decrease in noise. Thus, the use of faster rotation times will improve temporal resolution, not alter noise, and increase dose. For a particular application, the higher dose resulting from faster rotation speeds should be justified by the clinical benefits of the improved temporal resolution. RSNA, 2006

  14. Current status of multi-detector row helical CT in imaging of adult ...

    African Journals Online (AJOL)

    Current status of multi-detector row helical CT in imaging of adult acquired pancreatic diseases and assessing surgical neoplastic resectability. ... The presence of inflammation, masses, and vascular invasion was evaluated and interpreted images were obtained during each phase. Results were compared with surgery, ...

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

    International Nuclear Information System (INIS)

    Taylor, S.A.; Halligan, S.; Moore, L.; Saunders, B.P.; Gallagher, M.; Phillips, R.K.S.; Bartram, C.I.

    2004-01-01

    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

  16. Current development of cardiac imaging with multidetector-row CT

    International Nuclear Information System (INIS)

    Becker, Christoph R.; Ohnesorge, Bernd M.; Schoepf, U. Joseph; Reiser, Maximilian F.

    2000-01-01

    Multidector-row CT (MDCT) with retrospective ECG gating allows scanning the entire heart with 1.25 mm slice thickness and 250 ms effective exposure time within 35 s investigation time. The resulting images allow for an accurate high-resolution assessment of morphological detail of both the coronary arteries and the cardiac chambers. Performing a contrast-enhanced MDCT angiography (MD-CTA) in addition to a non-enhanced scan for the detection and quantification of coronary calcifications may be indicated in patients with atypical chest pain and in young patients with high cardiovascular risk. This group of patients may show non-calcified plaques as the first sign of their coronary artery disease. As the proximal part of the coronary arteries is well displayed by MD-CTA it also helps to delineate the course in anomalous coronary vessels. Additional information is drawn from the preoperative use of MD-CTA do determine the distance of the left internal mammarian artery to the left anterior descending coronary artery prior to minimal invasive bypass grafting. Additional indications for MD-CTA are the non-invasive follow up after venous bypass grafting, PTCA, and coronary stent interventions. MD-CTA allows following the course of the coronary vessels to the level of third generation coronary segmental arteries. A definite diagnosis to rule out coronary artery disease can be reliably made in vessels with a diameter of 1.5 mm or greater. With MDCT a number of different atherosclerotic changes can be observed in diseased coronary arteries. Non-stenotic lesions may show tiny calcifications surrounded by large areas of irregularly distributed soft tissue. Calcifications in this type of atherosclerotic coronary artery wall changes appear as 'the tip of iceberg'. Heavy calcifications usually tend to be non-stenotic because of vessel remodelling resulting in a widening of the coronary vessel lumen. Therefore, heavy calcifications appear to act like an 'internal stent' for a

  17. 64-Row multidetector CT virtual hysterosalpingography. Findings in 2500 patients

    International Nuclear Information System (INIS)

    Carrascosa, Patricia; Capunay, Carlos; Baronio, Mariano; Vallejos, Javier; Papier, Sergio; Carrascosa, Jorge

    2011-01-01

    Objective. To depict typical features of virtual hysterosalpingography (VHSG) in infertile patients. Material and methods: 2500 VHSG performed using a 64-row MOCT were evaluated. Results: Cervical abnormalities visualized corresponded to parietal irregularities (21%); thickened folds (9%); polyps (11%); diverticula (5%); cervical strictures (8%), and synechiae (1.5%). At the level of uterine cavity, polyps (44%); submucous myomas (8%); intramural and subserosal fibroids (11%); synechiae (10%); malformations (10%); adenomyosis (4%), and cesarean section scar (3%). Unilateral hydrosalpinx (7%) and bilateral hydrosalpinx (2%). Tubal obstruction was reported in 6% of cases. The average radiation dose was 0.94 mSv. Eighty-four percent of the patients reported mild pain or no postoperative discomfort. Conclusions: The virtual hysterosalpingography allowed a proper assessment of the internal genital organs, providing useful diagnostic information on infertility and other gynecological disorders. It constitutes a virtually painless, low-dose radiation technique, besides being well tolerated by patients

  18. Traumatic thoracic injury: the role of Multidetector-row CT

    International Nuclear Information System (INIS)

    Lim, Se Kyong; Shin, Kyung Sook; Kim, Ha Young; Sung, Jae Kyu; Jung, Hyun Yong; Noh, Seong Moo; Song, Kyu Sang; Cho, June Sik

    2006-01-01

    Hyperplastic polyps are common gastric lesions that are characterized by nonneoplastic epithelial hyperplasia. However, to our knowledge, there are no reports of a hyperplastic polyp arising from an endoscopic mucosectomy site of early gastric cancer. We describe the CT findings with a histopathology correlation in a case of a hyperplastic polyp arising from a mucosectomy site that mimicked polypoid gastric cancer

  19. Traumatic thoracic injury: the role of Multidetector-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Se Kyong; Shin, Kyung Sook; Kim, Ha Young; Sung, Jae Kyu; Jung, Hyun Yong; Noh, Seong Moo; Song, Kyu Sang; Cho, June Sik [Chungnam National University School of Medicine, Daejeon (Korea, Republic of)

    2006-05-15

    Hyperplastic polyps are common gastric lesions that are characterized by nonneoplastic epithelial hyperplasia. However, to our knowledge, there are no reports of a hyperplastic polyp arising from an endoscopic mucosectomy site of early gastric cancer. We describe the CT findings with a histopathology correlation in a case of a hyperplastic polyp arising from a mucosectomy site that mimicked polypoid gastric cancer.

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

    International Nuclear Information System (INIS)

    Kim, Sang Won; Shin, Hyeong Cheol; Kim, Hyung Hwan; Kim, Young Tong; Kim, Il Young; Kang, Kil Ho

    2010-01-01

    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

  1. Evaluation of aortogenic embolic stroke using multi-detector row CT (MDCT)

    International Nuclear Information System (INIS)

    Mizuno, Masanori; Ooura, Kazumasa; Yamaguchi, Mao; Katsura, Noriyuki; Terayama, Yasuo

    2010-01-01

    Transesophageal cardioechography is one of the useful tools for detecting aortic arteriosclerosis causing aortogenic cerebral embolism. However, it is difficult to perform this method to all of the patients because of the technical difficulties due to patient's condition, especially the severity of atherosclerosis. To avoid the unexpected and adverse events, we are routinely applying multi-detector row CT (MDCT) to those patients. Among 10 cerebral embolic patients with unidentified embolic origin, MDCT revealed arteriosclerotic changes in aorta inducing mobile thrombus in 3 cases. The above data indicates that MDCT is safe and useful tool for diagnosis of aortogenic embolic stroke. (author)

  2. 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.

  3. Multidetector-row CT angiography of hepatic artery: comparison with conventional angiography

    International Nuclear Information System (INIS)

    Kim, Jin Woong; Jeong, Yong Yeon; Yoon, Woong; Kim, Jae Kyu; Park, Jin Gyoon; Seo, Jeong Jin; Kang, Heoung Keun

    2003-01-01

    To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MD-CT) for delineating the arterial anatomy of the liver. Hepatic arterial three-dimensional CT angiography was performed using MDCT (lightspeed Qx/I; GE medical systems, milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regrading a patient's hepatic arterial anatomy

  4. 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.

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

    International Nuclear Information System (INIS)

    Lee, Jung Bin; Kim, Dong Hun; Oh, Jae Hee; Seo, Hye Sun; Suk, Eun Ha

    2012-01-01

    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.

  6. Multidetector-row helical CT: analysis of time management and workflow

    Energy Technology Data Exchange (ETDEWEB)

    Roos, Justus E.; Desbiolles, Lotus M.; Willmann, Juergen K.; Weishaupt, Dominik; Marincek, Borut; Hilfiker, Paul R. [Institute of Diagnostic Radiology, University Hospital Zurich (Switzerland)

    2002-03-01

    The purpose of this study was to evaluate time management and workflow for multidetector-row helical CT (MDCT). Time for patient and data handling of at total of 580 patients were evaluated at two different time periods (December 1999, August 2000), each for the following baseline measurements: (a) change of clothes/instruction; (b) patient placement on the CT table/i.v. catheter; (c) CT planning and programming; (d) CT data acquisition; (e) CT data reconstruction; (f) CT data storage/printing. All imaging was performed on a Somatom Volume Zoom (Siemens, Erlangen, Germany). Time measurements summarized for different CT protocols revealed the following: (a) 5:01 min ({+-}2.06 min); (b) 4:36 min ({+-}2.43 min); (c) 4:11 min ({+-}2.55 min); (d) 0:43 min ({+-}0.15 min); (e) 6:59 min ({+-}2.39 min); (f) 09:51 min ({+-}3.51 min). Planning and programming was most time-consuming for CT angiography, whereas chest and abdominal CT needed only 3:26 and 3:30 min, respectively. Reconstruction time was highest for HRCT (9:22 min) and CTA (9:03 min). Data storage/printing was most time-consuming for HRCT (13:02 min), followed by combined neck-chest-abdomen examinations (12:19 min). Comparing the two time periods, during which a software update was performed, a mean time reduction of 4:31 min per patient (15%, p<0.001) was achieved. Whereas CT data acquisition time is no longer a problem with MDCT, patient management, data reconstruction, and data storage are the most time-consuming parts. Well-trained technicians, state-of-the-art workstations, and fast networking are the most important factors to improve workflow. (orig.)

  7. Usefulness of multiplanar reformatted images of multi-detector row helical CT in assessment of biliary stent patency

    International Nuclear Information System (INIS)

    Kim, Soo Jin; Kim, Suk; Kim, Chang Won; Lee, Jun Woo; Lee, Tae Hong; Choo, Ki Seok; Koo, Young Baek; Moon, Tae Yong; Lee, Suk Hong

    2004-01-01

    To evaluate the usefulness of multi-detector row helical CT (MDCT), multiplanar reformatted images for the noninvasive assessment of biliary stent patency, and for the planning for management in patients with a sele-expandable metallic stent due to malignant biliary obstruction. Among 90 consecutive patients, from August 1999 to July 2003, 26 cases in 23 patients with malignant biliary obstruction who underwent self-expandable metaIlic stent insertion in the biliary system and percutaneous transhepatic biliary drainage within 7 days after CT were enrolled in this study. On CT images, the complete and functional obstruction of the stent and the precise level of obstruction were evaluated. The presence of an enhancing intraluminal mass or wall thickening around stent was determined, and the causes of obstruction were evaluated. These findings were then compared with percutaneous transhepatic cholangiography. Multi-detector row helical CT correctly demonstrated the patency of a stent in 24 cases (92.3%). It was adequate in helping to depict the precise level of stent occlusion in 23 cases (88.5%). Multi-detector row helical CT also revealed the extent of tumor that represented as an enhancing intraluminal mass or wall thickening around the stent in 23 cases, and this was represented as complete obstruction on percutaneous transhepatic cholangiography. In the case of functional obstruction, MDCT predicted the possible cause of the obstruction. Multiplanar reformatted images of multi-detector row helical CT is a useful imaging modality for the noninvasive assessment of stent patency and the precise level of obstruction when stent obstruction is suspected in the patients with self-expandable metallic stent due to malignant biliary obstruction. It can also predict the possible cause of the obstruction and allows adequate planning for the medical management of such cases

  8. Usefulness of multiplanar reformatted images of multi-detector row helical CT in assessment of biliary stent patency

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Jin; Kim, Suk; Kim, Chang Won; Lee, Jun Woo; Lee, Tae Hong; Choo, Ki Seok; Koo, Young Baek; Moon, Tae Yong; Lee, Suk Hong [Pusan National Univ. Hospital, Busan (Korea, Republic of)

    2004-08-01

    To evaluate the usefulness of multi-detector row helical CT (MDCT), multiplanar reformatted images for the noninvasive assessment of biliary stent patency, and for the planning for management in patients with a sele-expandable metallic stent due to malignant biliary obstruction. Among 90 consecutive patients, from August 1999 to July 2003, 26 cases in 23 patients with malignant biliary obstruction who underwent self-expandable metaIlic stent insertion in the biliary system and percutaneous transhepatic biliary drainage within 7 days after CT were enrolled in this study. On CT images, the complete and functional obstruction of the stent and the precise level of obstruction were evaluated. The presence of an enhancing intraluminal mass or wall thickening around stent was determined, and the causes of obstruction were evaluated. These findings were then compared with percutaneous transhepatic cholangiography. Multi-detector row helical CT correctly demonstrated the patency of a stent in 24 cases (92.3%). It was adequate in helping to depict the precise level of stent occlusion in 23 cases (88.5%). Multi-detector row helical CT also revealed the extent of tumor that represented as an enhancing intraluminal mass or wall thickening around the stent in 23 cases, and this was represented as complete obstruction on percutaneous transhepatic cholangiography. In the case of functional obstruction, MDCT predicted the possible cause of the obstruction. Multiplanar reformatted images of multi-detector row helical CT is a useful imaging modality for the noninvasive assessment of stent patency and the precise level of obstruction when stent obstruction is suspected in the patients with self-expandable metallic stent due to malignant biliary obstruction. It can also predict the possible cause of the obstruction and allows adequate planning for the medical management of such cases.

  9. The quality of reconstructed 3D images in multidetector-row helical CT: experimental study involving scan parameters

    International Nuclear Information System (INIS)

    Shin, Ji Hoon; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul; Lim, Tae Hwan; Kang, Weechang

    2002-01-01

    To determine which multidetector-row helical CT scanning technique provides the best-quality reconstructed 3D images, and to assess differences in image quality according to the levels of the scanning parameters used. Four objects with different surfaces and contours were scanned using multidetector-row helical CT at three detector-row collimations (1.25, 2.50, 5.00 mm), two pitches (3.0, 6.0), and three different degrees of overlap between the reconstructed slices (0%, 25%, 50%). Reconstructed 3D images of the resulting 72 sets of data were produced using volumetric rendering. The 72 images were graded on a scale from 1 (worst) to 5 (best) for each of four rating criteria, giving a mean score for each criterion and an overall mean score. Statistical analysis was used to assess differences in image quality according to scanning parameter levels. The mean score for each rating criterion, and the overall mean score, varied significantly according to the scanning parameter levels used. With regard to detector-row collimation and pitch, all levels of scanning parameters gave rise to significant differences, while in the degree of overlap of reconstructed slices, there were significant differences between overlap of 0% and of 50% in all levels of scanning parameters, and between overlap of 25% and of 50% in overall accuracy and overall mean score. Among the 18 scanning sequences, the highest score (4.94) was achieved with 1.25 mm detector-row collimation, 3.0 pitch, and 50% overlap between reconstructed slices. Comparison of the quality of reconstructed 3D images obtained using multidetector-row helical CT and various scanning techniques indicated that the 1.25 mm, 3.0, 50% scanning sequence was best. Quality improved as detector-row collimation decreased; as pitch was reduced from 6.0 to 3.0; and as overlap between reconstructed slices increased

  10. Multidetector row CT of the brain and carotid artery: a correlative analysis

    International Nuclear Information System (INIS)

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

    2009-01-01

    Aim: To evaluate the association between types of carotid plaque, the presence of prior ischaemic events detectable with CT, and patient's symptoms. Materials and methods: Between January 2004 and May 2006, 112 patients were evaluated using multidetector row computed tomography angiography (MDCTA) of the carotid arteries and computed tomography (CT) of the brain. Carotid arteries were categorized by evaluating the degree of stenosis according to North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, the type of plaque, and the presence of plaque ulceration. The brain was assessed via CT for the presence, type, and position of lesions. Chi-square tests, Student's t test, and simple logistic regression analysis were performed and the Cohen kappa test was applied for interobserver variability measurement. Results: The Chi-square test indicated a statistically significant association between the presence of fatty plaques (p = 0.005) and CT-detectable lesions in the brain (p = 0.004). Moreover, the number of patients with CT-detectable brain lesions was greater in patients with >70% stenosis than in those with 70% stenosis and symptoms (p = 0.041), and an inverse association between calcified plaque and symptoms (p = 0.009). Conclusion: MDCTA allows adequate evaluation of the type of plaque. The results of the present study indicate that there is an association between cerebral lesions, symptoms, and fatty plaque in the carotid artery. The degree of stenosis also correlated with cerebral lesions and symptoms. According to the obtained data, the type of carotid plaque should be included among primary parameters in the classification of patients' risk class.

  11. Novel ultrahigh resolution data acquisition and image reconstruction for multi-detector row CT

    International Nuclear Information System (INIS)

    Flohr, T. G.; Stierstorfer, K.; Suess, C.; Schmidt, B.; Primak, A. N.; McCollough, C. H.

    2007-01-01

    We present and evaluate a special ultrahigh resolution mode providing considerably enhanced spatial resolution both in the scan plane and in the z-axis direction for a routine medical multi-detector row computed tomography (CT) system. Data acquisition is performed by using a flying focal spot both in the scan plane and in the z-axis direction in combination with tantalum grids that are inserted in front of the multi-row detector to reduce the aperture of the detector elements both in-plane and in the z-axis direction. The dose utilization of the system for standard applications is not affected, since the grids are moved into place only when needed and are removed for standard scanning. By means of this technique, image slices with a nominal section width of 0.4 mm (measured full width at half maximum=0.45 mm) can be reconstructed in spiral mode on a CT system with a detector configuration of 32x0.6 mm. The measured 2% value of the in-plane modulation transfer function (MTF) is 20.4 lp/cm, the measured 2% value of the longitudinal (z axis) MTF is 21.5 lp/cm. In a resolution phantom with metal line pair test patterns, spatial resolution of 20 lp/cm can be demonstrated both in the scan plane and along the z axis. This corresponds to an object size of 0.25 mm that can be resolved. The new mode is intended for ultrahigh resolution bone imaging, in particular for wrists, joints, and inner ear studies, where a higher level of image noise due to the reduced aperture is an acceptable trade-off for the clinical benefit brought about by the improved spatial resolution

  12. Effectiveness of thin-slice axial images of multidetector row CT for visualization of bronchial artery before bronchial arterial embolization

    International Nuclear Information System (INIS)

    Shida, Yoshitaka; Hasuo, Kanehiro; Aibe, Hitoshi; Kubo, Yuko; Terashima, Kotaro; Kinjo, Maya; Kamano, H.; Yoshida, Atsuko

    2008-01-01

    We assessed the ability of visualization of bronchial artery (BA) by using thin-slice axial images of 4-detector multidetector row CT in 65 patients with hemoptysis. In all patients, the origins of BA were well identified with observation of consecutive axial images with 1 mm thickness by paging method and bronchial arterial embolization (BAE) was performed successfully. Thin-slice axial images were considered to be useful to recognize BA and to perform BAE in patients with hemoptysis. (author)

  13. Chronic intestinal pseudo-obstruction in adult patients: multidetector row helical CT features

    International Nuclear Information System (INIS)

    Merlin, Aurelie; Soyer, Philippe; Boudiaf, Mourad; Hamzi, Lounis; Rymer, Roland

    2008-01-01

    Chronic intestinal pseudo-obstruction (CIPO) is a rare condition due to severe gastrointestinal motility disorder. Adult patients with CIPO experience symptoms of mechanical obstruction, but reliable clinical signs that may help distinguish between actual mechanical obstruction and CIPO are lacking. Additionally, abdominal plain films that commonly show bowel dilatation with air-fluid levels do not reach acceptable degrees of specificity to exclude actual obstruction. Therefore, most adult patients with CIPO usually undergo multiple and often fruitless surgery, often leading to repeated bowel resections before diagnosis is made. In these patients who present with abdominal signs mimicking symptoms that would warrant surgical exploration, multidetector-row helical CT (MDCT) is helpful to resolve this diagnostic dilemma. MDCT shows a diffusely distended bowel and helps to rule out a mechanical cause of obstruction, thus suggesting CIPO and obviating the need for unnecessary laparotomy. In adult patients with CIPO, MDCT may show pneumatosis intestinalis, pneumoperitoneum or intussusception. However, these conditions generally do not require surgery in patients with CIPO. This pictorial essay presents the more and less common MDCT features of CIPO in adult patients, to make the reader more familiar with this disease. (orig.)

  14. Venous variants and anomalies on routine abdominal multi-detector row CT

    International Nuclear Information System (INIS)

    Koc, Zafer; Ulusan, Serife; Oguzkurt, Levent; Tokmak, Naime

    2007-01-01

    Objective: This study aims to determine the types and prevalence rates of anatomic variations of the hepatic veins, portal vein, inferior vena cava and renal veins, and to establish statistical correlations between various anomalies and frequency differences between male and female using multi-detector row computed tomography (CT). Materials and methods: One thousand one hundred and twenty patients (588 men, 532 women) were evaluated with routine abdominal CT. Frequencies of different variants were noted and compared, and correlations between three categories of variation were tested. Results: In total, 1261 abdominal vein variants and anomalies were identified in 756 (67.5%) of 1120 patients. Six hundred and forty-two hepatic vein variants were detected in 468 (41.8%) patients. One or more inferior right hepatic veins were identified in 356 (31.8%) individuals, and tributary hepatic veins were detected in 147 (13.1%) patients. Portal vein variations and anomalies were observed in 307 (27.4%) cases. The most frequent of these was trifurcation (139 patients, 12.4%). A total of 311 inferior vena cava and renal vein variants were identified in 258 (23%) cases. Six patients (0.5%) exhibited inferior vena cava anomalies, 62 (5.5%) had circumaortic renal veins, 53 (4.7%) had retroaortic renal veins, and 210 (18.8%) had multiple renal veins. Conclusion: The prevalence of abdominal vein variations is high, and routine abdominal CT demonstrates these abnormalities very well. The data suggest that hepatic vein variants and multiple right renal veins are more frequent in women than in men, and that hepatic vein variation is correlated with portal vein variation

  15. Venous variants and anomalies on routine abdominal multi-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Koc, Zafer [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey)]. E-mail: koczafer@gmail.com; Ulusan, Serife [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey); Oguzkurt, Levent [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey); Tokmak, Naime [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey)

    2007-02-15

    Objective: This study aims to determine the types and prevalence rates of anatomic variations of the hepatic veins, portal vein, inferior vena cava and renal veins, and to establish statistical correlations between various anomalies and frequency differences between male and female using multi-detector row computed tomography (CT). Materials and methods: One thousand one hundred and twenty patients (588 men, 532 women) were evaluated with routine abdominal CT. Frequencies of different variants were noted and compared, and correlations between three categories of variation were tested. Results: In total, 1261 abdominal vein variants and anomalies were identified in 756 (67.5%) of 1120 patients. Six hundred and forty-two hepatic vein variants were detected in 468 (41.8%) patients. One or more inferior right hepatic veins were identified in 356 (31.8%) individuals, and tributary hepatic veins were detected in 147 (13.1%) patients. Portal vein variations and anomalies were observed in 307 (27.4%) cases. The most frequent of these was trifurcation (139 patients, 12.4%). A total of 311 inferior vena cava and renal vein variants were identified in 258 (23%) cases. Six patients (0.5%) exhibited inferior vena cava anomalies, 62 (5.5%) had circumaortic renal veins, 53 (4.7%) had retroaortic renal veins, and 210 (18.8%) had multiple renal veins. Conclusion: The prevalence of abdominal vein variations is high, and routine abdominal CT demonstrates these abnormalities very well. The data suggest that hepatic vein variants and multiple right renal veins are more frequent in women than in men, and that hepatic vein variation is correlated with portal vein variation.

  16. Multidetector-row CT finding of gastric cystic lymphangioma: A case report

    International Nuclear Information System (INIS)

    Kang, Tae Wook; Lee, Soon Jin; Song, Hye Jong

    2008-01-01

    Cystic lymphangioma is a rare benign submucosal tumor of the stomach thought to originate from sequestered lymphatic tissue that fails to communicate with the normal lymphatic system. The most commonly used method of evaluation for cystic lymphangioma of the stomach is an endoscopic ultrasonography. We report the multidetector-row computed tomography findings of a cystic lymphangioma of the stomach in a 46-year-old man along with a literature review

  17. Tuberculous Addison's disease: Morphological and quantitative evaluation with multidetector-row CT

    International Nuclear Information System (INIS)

    Ma Ensen; Yang Zhigang; Li Yuan; Guo Yingkun; Deng Yuping; Zhang Xiaochun

    2007-01-01

    Objective: To determine the characteristics of tuberculous Addison's disease on the axial and multiplanar reformatted (MPR) images of the multidetector-row computed tomography (MDCT). Materials and methods: The unenhanced and contrast-enhanced MDCT features in 19 patients with tuberculous Addison's disease were retrospectively assessed for the location, contour, size, calcification, attenuation, and enhancement patterns. The correlation between the duration of Addison's disease and the percentage of calcification presence was evaluated. Results: The adrenal glands were infected bilaterally in all of the 19 cases (100%, 38 glands). Enlargement of the glands appeared in 18 cases (94.7%, 36 glands) and the remaining one case (5.3%, two glands) showed atrophy bilaterally. Of the 36 enlarged adrenals, 13 (36.1%) had preserved contours, and the other 23 (63.9%) were mass-like. The size of the adrenals ranged from 0.6 to 4.8cm (mean 1.92+/-0.96cm). Calcification was revealed in 16 adrenals (16/38, 42.1%), increasing in incidence with disease progression. Fourteen of the 36 (38.9%) enlarged adrenals showed peripheral enhancement while the remaining 22 (61.1%) demonstrated heterogeneous enhancement. The ΔCT value, the attenuation measurement of mass-like lesions, was less in the central area (7+/-4HU) than that in the peripheral area (32+/-14HU) (P<0.01) between the unenhanced and contrast-enhanced scan. Conclusion: MDCT can reveal the characteristic morphology and CT attenuation in the tuberculous Addison's disease. Combined with its clinical presentations and biochemical findings, we can diagnose and stage adrenal tuberculosis with high specificity and accuracy on MDCT

  18. Multi-detector row CT in the assessment of axillary lymph node metastasis in breast cancer

    International Nuclear Information System (INIS)

    Murakami, Shogo

    2003-01-01

    The purpose of this study is to evaluate the diagnostic capability instead of clinical efficacy of multi-detector row CT (MDCT) in the assessment of axillary lymph node metastasis in breast cancer. MDCT was performed in 63 patients with breast cancer, and multiplanar reformation (MPR) and volume rendering (VR) images were reconstructed for the evaluation of bilateral axillary lymph nodes. Two hundred sixty eight lymph nodes were depicted with MDCT, and correlation with pathological findings was performed. The short axis length of lymph node was measured on MPR image, and the shape of the nodes was analyzed with the pathological results statistically. The diagnostic criteria on size and shape of lymph node metastasis were discussed Dynamic study with contrast media was also performed, and the CT value ratios (CTVR) of the lymph nodes and breast tumors were calculated. No relevance of axillary lymph node metastasis was noted to the pathological types of breast cancer. The average short axis length of the ipsilateral axillary nodes was 8.9 mm±3.8 (SD) while that of the contralateral nodes was 4.9 mm±1.1 (SD) showing significant difference. More than 6.5 mm in short length of the lymph node was thought to be an effective criterion for positive metastasis, and its sensitivity was 96%. Soybean-shape lymph node was statistically common in metastasis, while non-metastatic nodes were commonly demonstrated as letter ''c'' shape or ring-like shape. Statistical relevance was obtained between the CTVR of axillary lymph nodes and that of breast tumors, suggesting clinical usefulness of dynamic study using contrast media in the evaluation of lymph node metastasis. With MPR and VR images using MDCT, more accurate morphological evaluation of axillary lymph nodes was possible. When soybean-shape node with more than 6.5 mm in short axis is depicted in the axillar region on MDCT metastasis should be the consideration. Comparison with the contralateral side as a control in coronal

  19. Diagnostic value of multidetector row CT in rectal cancer staging: comparison of multiplanar and axial images with histopathology

    International Nuclear Information System (INIS)

    Sinha, R.; Verma, R.; Rajesh, A.; Richards, C.J.

    2006-01-01

    Aim: Although magnetic resonance (MR) imaging is widely used for rectal cancer staging, many centres in the UK perform computed tomography (CT) for staging rectal cancer at present. Furthermore in a small proportion of cases contraindications to MR imaging may lead to staging using CT. The purpose of this study was to evaluate the accuracy of current generation multidetector row CT (MDCT) in local staging of rectal cancer. In particular the accuracy of multiplanar (MPR) versus axial images in the staging of rectal cancer was assessed. Material and methods: Sixty-nine consecutive patients were identified who had undergone staging of rectal cancer on CT. The imaging data were reviewed as axial images and then as MPR images (coronal and sagittal) perpendicular and parallel to the tumour axis. CT staging on axial and MPR images was then compared to histopathological staging. Results: MPR images detected more T4 and T3 stage tumours than axial images alone. The overall accuracy of T-staging on MPR images was 87.1% versus 73.0% for axial images alone. The overall accuracy of N staging on MPR versus axial images was 84.8% versus 70.7%. There was a statistically significant difference in the staging of T3 tumours between MPR and axial images (p < 0.001). Conclusion: Multidetector row CT has high accuracy for local staging of rectal cancer. Addition of MPR images to standard axial images provides higher accuracy rates for T and N staging of rectal cancer than axial images alone

  20. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT. Correlation with histopathological findings

    International Nuclear Information System (INIS)

    Watadani, Takeyuki; Akahane, Masaaki; Ohtomo, Kuni; Yoshikawa, Takeharu

    2008-01-01

    Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma. Thirteen of 30 consecutive patients with hilar cholangiocarcinoma who underwent surgery, excluding 17 patients who underwent biliary drainage or preoperative portal embolization, were retrospectively evaluated. Using MDCT systems of 4 detector rows or 16 detector rows, plain and dynamic contrast-enhanced images of three phases were obtained. Extent of tumor spread and lymph node metastasis were assessed with MDCT and compared with histopathological findings. The Bismuth-Corlette classification of hilar cholangiocarcinoma with MDCT were type I, 1 patient; type IIIa, 3 patients; type IIIb, 4 patients; and type IV, 5 patients; those with histopathological findings were type I, 1 patient; type IIIa, 2 patients; type IIIb, 4 patients; and type IV, 6 patients. One patient diagnosed as type IIIa with MDCT was pathologically diagnosed as type IV. Accuracy of MDCT in tumoral spread was 92.3%, although that of lymph node metastasis was 54%. MDCT is likely to play an important role in evaluation of focal lesion spread especially in intrapancreatic tumor invasion, although a greater number of cohort cases are necessary to clearly define its role. (author)

  1. Usefulness of multidetector-row computed tomography (MD-CT) for diagnosis and evaluation of cardiovascular anomalies in infants

    International Nuclear Information System (INIS)

    Kani, Hiroyuki; Narabayashi, Isamu; Tanikake, Masato; Matsuki, Mitsuru; Uesugi, Yasuo

    2005-01-01

    We examined the effectiveness of multidetector-row CT (MD-CT) in the diagnosis and evaluation of cardiovascular anomalies in infants. MD-CT was performed 34 times on 21 patients with cardiovascular anomalies. We performed three evaluations: 1) The assessment of the specificity of MD-CT in detecting the morphological features of cardiovascular anomalies. 2) The diameters of aortae with coronary artery (CoA), and the diameters of pulmonary artery, measured by using MD-CT were compared with those by angiography. 3) The amount of exposure to radiation was measured. 1) MD-CT can detect CoA, pulmonary arteriovenous anomalies among extracardiac anomalies in all the patients. The diagnostic accuracy for intracardiac anomalies was poor as only six of the 15 anomalies could be accurately diagnosed. 2) The diameters of aortae and pulmonary artery obtained using MD-CT showed a good correlation with those obtained using arteriography (r=0.97, 0.95). 3) The average dose-length product was 269.2 mGy·cm. And the average effective dose was 5.1 mSv. MD-CT is not suitable for the evaluation of intracardiac anomalies, but is extremely effective in the evaluation of extracardiac major vascular anomalies. On the basis of the amount of information and noninvasive nature, MD-CT should be used first before angiography. (author)

  2. 16-slice multi-detector row CT coronary angiography: image quality and optimization of the image reconstruction window

    International Nuclear Information System (INIS)

    Kim, Yoo Kyung; Shim, Sung Shine; Lim, Soo Mee; Hwang, Ji Young; Kim, Yoon Kyung

    2005-01-01

    The purpose of this experiment is to investigate the image quality of CT coronary angiography using a 16-slice multi-detector row CT and to determine the optimal image reconstruction window. CT coronary angiography was obtained in 36 nonsymptomatic volunteers using a 16-slice multi-detector row CT (SOMATOM Sensation, Siemens Medical System). The mean heart rates were 70 beats per minute (bpm) or less in 18 persons and more than 70 bpm in 18 persons. Eleven data sets were obtained for each patient (reconstructed at 30%-80% of the cardiac cycle with an increment of 5%). Image quality of the eight coronary segments [left main coronary artery (LM), proximal and middle segments of left anterior descending artery (p-LAD, m-LAN) and left circumflex coronary artery (p-LCx, m-LCx) and proximal, middle and distal segments of right coronary artery (p-RCA, m-RCA, d-RCA)] was assessed. The optimal reconstruction windows in the cardiac cycle for the best image quality were 60-70% for the segments of the LM, LAD, and LC arteries in two groups (bpm 70) and 55-65% (bpm 70) for the segments of the RCA. On the best dataset for each coronary segment, the following diagnostic image quality was achieved in the two groups: LM: 100%, 83%; p-LAD: 100%, 88% m-LAD: 100%, 72%; p-LCx: 100%, 72%; m-LCx: 100%, 72%; p-RCA: 94%, 72%; m-RCA: 61%, 50%; d-RCA: 100%, 80%. The 16 slice multi-detector row CT scan provided visualization of the coronary arteries with high resolution. Especially in the group with a mean heart rate of 70 bpm or less, all the coronary segments except the RCA showed diagnostic image quality. Optimal image quality was achieved with a 60-70% trigger delay for all coronary arterial segments, but the best images of RCA were achieved in the earlier cardiac phase in the patients with a mean heart rate of more than 70 bpm

  3. Clinical usefulness of multidetector-row CT to evaluate coronary artery calcium score in type 2 diabetes

    International Nuclear Information System (INIS)

    Nishioka, Makiko; Sakuma, Toru; Sano, Hironari; Utsunomiya, Kazunori; Agata, Toshihiko; Shimizu, Keisuke; Tajima, Naoko

    2004-01-01

    According to recent studies, multidetector-row CT (MDCT) with a retrospective electrocardiogram (ECG)-gating reconstruction algorithm shows a high correlation with coronary artery calcium score determined using electron-beam CT. Diabetes leads to many macrovascular complications, including coronary artery disease. The aim of this study was to evaluate risk factors for cardiac macroangiopathy in type 2 diabetes using MDCT. An observational cross-sectional study was performed in 90 patients with diabetes mellitus. Coronary calcium data was acquired by MDCT (SOMATOM Volume Zoom, Siemens AG, Medical Solutions, Germany). Physical examinations, laboratory data, glycemic control, and control of other risk factors were analyzed. The coronary artery calcium score increased with age. Multivariant analysis revealed that the coronary calcium score was closely correlated with electrocardiogram evaluation and control of hypertension. Coronary artery calcium score as determined by MDCT can be used as a screening radiological examination for cardiac macroangiopathy in diabetes patients with electrocardiogram abnormality and hypertension. (author)

  4. 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.)

  5. Detection, visualization and evaluation of anomalous coronary anatomy on 16-slice multidetector-row CT

    International Nuclear Information System (INIS)

    Ooijen, Peter M.A. van; Dorgelo, Joost; Oudkerk, Matthijs; Zijlstra, Felix

    2004-01-01

    Early identification and evaluation of relatively frequent anomalous coronary anatomy is quite relevant because of the occurrence of sudden cardiac death or related symptoms of myocardial ischemia. Selective coronary angiography (CAG) is invasive, expensive and cannot always provide the required information adequately. Recently, non-invasive imaging techniques such as magnetic resonance imaging and multidetector-row computed tomography (MDCT) have been shown to provide a good anatomical view of the coronary artery tree. This study aims to demonstrate the value of 16-MDCT for evaluation of anomalous coronary anatomy. In 13 patients scanned using 16-MDCT, six different coronary anomalies were diagnosed [two absent left main, one single vessel left coronary artery (LCA), three LCA originating from the right (two with interarterial course), six right coronary artery originating from the left, one double left anterior descending (LAD)]. Mean diagnostic quality, recorded by two observers using a 5-point scale (1= non-diagnostic to 5= excellent diagnostic quality), resulted in a mean score of 3.73 (SD 1.19) without any non-diagnostic result. MDCT offers an accurate diagnostic modality to visualize the origin and course of anomalous coronary arteries by a three-dimensional display of anatomy. Shortcomings in CAG can be overcome by the use of contrast-enhanced MDCT. (orig.)

  6. Abdominal multi-detector row CT: Effectiveness of determining contrast medium dose on basis of body surface area

    International Nuclear Information System (INIS)

    Onishi, Hiromitsu; Murakami, Takamichi; Kim, Tonsok; Hori, Masatoshi; Osuga, Keigo; Tatsumi, Mitsuaki; Higashihara, Hiroki; Maeda, Noboru; Tsuboyama, Takahiro; Nakamoto, Atsushi; Tomoda, Kaname; Tomiyama, Noriyuki

    2011-01-01

    Purpose: To investigate the validity of determining the contrast medium dose based on body surface area (BSA) for the abdominal contrast-enhanced multi-detector row CT comparing with determining based on body weight (BW). Materials and methods: Institutional review committee approval was obtained. In this retrospective study, 191 patients those underwent abdominal contrast-enhanced multi-detector row CT were enrolled. All patients received 96 mL of 320 mg I/mL contrast medium at the rate of 3.2 mL. The iodine dose required to enhance 1 HU of the aorta at the arterial phase and that of liver parenchyma at portal venous phase per BSA were calculated (EU BSA ) and evaluated the relationship with BSA. Those per BW were also calculated (EU BW ) and evaluated. Estimated enhancement values (EEVs) of the aorta and liver parenchyma with two protocols for dose decision based on BSA and BW were calculated and patient-to-patient variability was compared between two protocols using the Levene test. Results: The mean of EU BSA and EU BW were 0.0621 g I/m 2 /HU and 0.00178 g I/kg/HU for the aorta, and 0.342 g I/m 2 /HU and 0.00978 g I/kg/HU for the liver parenchyma, respectively. In the aortic enhancement, EU BSA was almost constant regardless of BSA, and the mean absolute deviation of the EEV with the BSA protocol was significantly lower than that with the BW protocol (P < .001), although there was no significant difference between two protocols in the hepatic parenchymal enhancement (P = .92). Conclusion: For the aortic enhancement, determining the contrast medium dose based on BSA was considered to improve patient-to-patient enhancement variability.

  7. Clinical assessment of hypopharyngeal and laryngeal disorders by three-dimensional multidetector-row CT. Feasibility of imaging during phonation

    International Nuclear Information System (INIS)

    Tan, Xiaotian

    2002-01-01

    The hypopharynx and larynx can adapt their structures to physiological functions. To clarify the relation between morphologic changes and the development of pharyngeal and laryngeal disorders, images of the hypopharynx and larynx were obtained by multidetector-row CT (MD-CT) during phonation and quiet breathing. The clinical usefulness of such imaging study was assessed by comparing the images taken in the two phases. The study included 23 subjects, 20 patients with a hypopharyngeal or laryngeal disorder and 3 healthy volunteers. MD-CT scanning of the hypopharynx and larynx was not influenced by breathing and body movement. The volume rendering (VR) method was useful in that three-dimensional imaging could visualize the internal structure of the hypopharynx and larynx. Thus, the volume rendering method can be regarded as a virtual three-dimensional method. The normal anatomic structure of the hypopharynx and larynx were depicted in full and three-dimensionally. The extent of hypopharyngeal and laryngeal cancer was shown clearly. Edema due to paralysis of recurrent nerve was demonstrated in full and three-dimensionally, providing for functional diagnosis. In the case of mucosal edema caused by trauma, the extent of the edema and its effect on the airway were clearly observed. These results suggest that MD-CT with three-dimensional imaging during phonation is useful in the diagnosis of hypopharyngeal and laryngeal disorders. (author)

  8. Multi-detector row CT colonography: effect of collimation, pitch, and orientation on polyp detection in a human colectomy specimen.

    Science.gov (United States)

    Taylor, Stuart A; Halligan, Steve; Bartram, Clive I; Morgan, Paul R; Talbot, Ian C; Fry, Nicola; Saunders, Brian P; Khosraviani, Kirosh; Atkin, Wendy

    2003-10-01

    To investigate the effects of orientation, collimation, pitch, and tube current setting on polyp detection at multi-detector row computed tomographic (CT) colonography and to determine the optimal combination of scanning parameters for screening. A colectomy specimen containing 117 polyps of different sizes was insufflated and imaged with a multi-detector row CT scanner at various collimation (1.25 and 2.5 mm), pitch (3 and 6), and tube current (50, 100, and 150 mA) settings. Two-dimensional multiplanar reformatted images and three-dimensional endoluminal surface renderings from the 12 resultant data sets were examined by one observer for the presence and conspicuity of polyps. The results were analyzed with Poisson regression and logistic regression to determine the effects of scanning parameters and of specimen orientation on polyp detection. The percentage of polyps that were detected significantly increased when collimation (P =.008) and table feed (P =.03) were decreased. Increased tube current resulted in improved detection only of polyps with a diameter of less than 5 mm. Polyps of less than 5 mm were optimally depicted with a collimation of 1.25 mm, a pitch of 3, and a tube current setting of 150 mA; polyps with a diameter greater than 5 mm were adequately depicted with 1.25-mm collimation and with either pitch setting and any of the three tube current settings. Small polyps in the transverse segment (positioned at a 90 degrees angle to the z axis of scanning) were significantly less visible than those in parallel or oblique orientations (P detector row CT is highly dependent on collimation, pitch, and, to a lesser extent, tube current. Collimation of 1.25 mm, combined with pitch of 6 and tube current of 50 mA, provides for reliable detection of polyps 5 mm or larger while limiting the effective radiation dose. Polyps smaller than 5 mm, however, may be poorly depicted with use of these settings in the transverse colon. Copyright RSNA, 2003

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

    International Nuclear Information System (INIS)

    Byun, Sung Su; Kim, Youn Jeong; Chun, Yong Sun; Kim, Won Hong; Kim, Jeong Ho; Park, Chul Hi

    2008-01-01

    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

  10. 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.

  11. Three-dimensional reconstructions of the orbital floor by volume-rendering of multidetector-row CT data

    International Nuclear Information System (INIS)

    Yoshikawa, Tetsuya; Miyajima, Akira; Fujita, Yuko; Yamada, Kazuo

    2011-01-01

    The advent of 3D-CT has made the evaluation of complicated facial fractures much easier than before. However, its use in injuries involving the orbital floor has been limited by the difficulty of visualizing the thin bony structures given artifacts caused by the partial volume effect. Nevertheless, high-technology machines such as multidetector-row CT (MDCT) and new-generation software have improved the quality of 3D imaging, and this paper describes a procedure for obtaining better visualization of the orbital floor using a MDCT scanner. Forty trauma cases were subject to MDCT: 13 with injury to the orbital floor, and 27 without. All scans were performed in the standard manner, at slice thicknesses of 0.5 mm. 3D-CT images were created overlooking the orbital floor including soft tissue to minimize the pseudo-foramen artifacts produced through volume rendering. Bone deficits, fracture lines, and grafted bone were visible in the 3D images, and visualization was supported by the ready creation of stereoscopic images from MDCT volume data. Measurement of the pseudo-foramen revealed approximately half the artifacts to be less than 5 mm in diameter, suggesting practicality of this method without subjecting the patient to undue increases in radiation exposure in the treatment of cases involving injury to the orbital floor. (author)

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

    OpenAIRE

    Daniela Stoisa; Fabrizzio E. Galiano; Andrés Quaranta; Roberto L. Villavicencio

    2009-01-01

    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 cab...

  13. 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

  14. Tracheal compression due to an elongated aortic arch in patients with congenital heart disease: evaluation using multidetector-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Noriko; Hayabuchi, Yasunobu; Inoue, Miki; Sakata, Miho; Nabo, Manal Mohamed Helmy; Nakagawa, Ryuji; Saijo, Takahiko; Kagami, Shoji [University of Tokushima, Department of Pediatrics, Tokushima (Japan)

    2009-10-15

    The airway can become obstructed as a result of compression by an elongated aortic arch. In this study we evaluated tracheal compression using multidetector-row CT in patients with congenital heart disease and an elongated aortic arch. The trachea was measured at the level of the aortic arch in 205 children and young adults and then the severity of tracheal compression was determined by measuring the tracheal diameter ratio (short axis diameter/long axis diameter). Patients were divided as follows: group I (normal aortic arch; n=166), group II (transversely running aortic arch; n=22), and group III (elongated aortic arch; n=17). From the viewpoint of the relationship of the great arteries, group II had D-malposition, and group III had L-malposition. Age, height, weight and body surface area were significantly correlated with the short and long axis diameter in group I. There was a negative correlation between tracheal diameter ratio and the physical size parameters. The tracheal diameter ratio in group III was 0.50{+-}0.13, which was significantly lower than in groups I and II (P<0.01 and 0.05, respectively). Even apparently asymptomatic patients with an elongated aortic arch can have tracheal compression. An elongated aortic arch may be a useful predictor of tracheal compression. (orig.)

  15. Evaluation of various image reconstruction parameters in lower extremity stents using multidetector-row CT angiography: initial findings

    International Nuclear Information System (INIS)

    Heuschmid, Martin; Wiesinger, Benjamin; Tepe, Gunnar; Luz, Oliver; Kopp, Andreas F.; Claussen, Claus D.; Duda, Stephan H.

    2007-01-01

    Image quality, visible lumen and patency of lower limb stents was assessed by multidetector-row computed tomography (MDCT) angiography using various reconstruction parameters and the results compared with conventional angiography. Fourteen patients (25 stents) were evaluated. From MDCT datasets, axial and coronal oblique reformations were reconstructed using differing reconstruction parameters (slice thickness, kernel, views). Artifacts and image quality were assessed using a five-degree scale (1=excellent, 5=poor). Visible stent diameter was measured. Stenosis severity was compared with calibrated catheter angiography. The image quality of medium and sharp image kernels were good/fair (1.9-2.4), while smooth kernel provided only acceptable/poor image quality (3.9-4.4). Coronal oblique images were rated superior to assess in-stent lumen rather than axial. Using medium and sharp kernels, the visible stent lumen was significantly greater than using smooth kernel (P<0.001). thirteen out of fourteen patients (24/25 stents) were correctly classified as patent. In one patient, in-stent stenosis (≥50%) was falsely diagnosed using CT angiography (CTA) with smooth kernel and was, therefore, rated as false positive. Coronal oblique views, as well as medium and sharp kernels, have shown the best results regarding image quality to assess stent patency in the lower limb. Therefore, MDCT could be a valuable non-invasive modality for stent imaging in the peripheral vasculature. (orig.)

  16. Multidetector-row CT of right hemidiaphragmatic rupture caused by blunt trauma: a review of 12 cases

    International Nuclear Information System (INIS)

    Rees, O.; Mirvis, S.E.; Shanmuganathan, K.

    2005-01-01

    AIM: To determine the usefulness of multidetector-row CT (MDCT) with multiplanar reformatted (MPR) images in the sagittal and coronal plane in diagnosing acute right hemidiaphragmatic rupture. MATERIALS AND METHODS: Twelve patients were identified who received chest and abdominal MDCT after major blunt trauma diagnosed with right diaphragmatic injury. Sagittal and coronal reformations were performed in all cases. The images were retrospectively reviewed by two experienced radiologists for signs of right diaphragm injury, such as direct diaphragm discontinuity, the 'collar sign', the 'dependent viscera sign', and intra-thoracic location of herniated abdominal contents. RESULTS: Of the 12 cases of right hemidiaphragm rupture, diaphragm discontinuity was seen in seven (58%) cases, the collar sign in five (42%), the dependent viscera sign in four (33%), and transdiaphragmatic herniation of the right colon and fat in another. Two variants of the collar sign were apparent on high-quality sagittal and coronal reformations. The first, termed the 'hump sign', describes a rounded portion of liver herniating through the diaphragm forming a hump-shaped mass, and the second, termed the 'band sign,' is a linear lucency across the liver along the torn edges of the hemidiaphragm. The hump sign occurred in 10 (83%) patients and the band sign in four (33%). CONCLUSION: MDCT is very useful in the diagnosis of right hemidiaphragm injury caused by blunt trauma when sagittal and coronal reformatted images are obtained, and should allow more frequent preoperative diagnosis

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-15

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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

    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. (orig.)

  19. Detection of intracranial aneurysms using three-dimensional multidetector-row CT angiography: Is bone subtraction necessary?

    International Nuclear Information System (INIS)

    Hwang, Seung Bae; Kwak, Hyo Sung; Han, Young Min; Chung, Gyung Ho

    2011-01-01

    Purpose: The aim of this study was to evaluate the usefulness of three-dimensional CT angiography (3D CTA) with bone subtraction in a comparison with 3D CTA without bone subtraction for the detection of intracranial aneurysms. Materials and methods: Among 337 consecutive patients who had intracranial aneurysms detected on 3D CTA, 170 patients who underwent digital subtraction angiography (DSA) were included in the study. CTA was performed with a 16-slice multidetector-row CT (MDCT) scanner. We created the 3D reconstruction images with and without bone subtraction by using the volume rendering technique. Three neuroradiologists in a blinded fashion interpreted both 3D CTA images with and without bone subtraction. The diagnostic accuracy of both techniques was evaluated using the alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive value were also evaluated. Results: A total of 200 aneurysms (size: 2-23 mm) were detected in 170 patients. The area under the receiver operating characteristic curve (Az) for 3D CTA with bone subtraction (mean, Az = 0.933) was significantly higher than that for 3D CTA without bone subtraction (mean, Az = 0.879) for all observers (P < 0.05). The sensitivity of 3D CTA with bone subtraction for three observers was 90.0, 92.0 and 92.5%, respectively, while the sensitivity of 3D CTA without bone subtraction was 83.5, 83.5 and 87.5%, respectively. No significant difference in positive predictive value was observed between the two modalities. Conclusions: 3D CTA with bone subtraction showed significantly higher diagnostic accuracy for the detection of intracranial aneurysms as compared to 3D CTA without bone subtraction.

  20. Evaluation of peripheral artery stent with 64-slice multi-detector row CT angiography: Prospective comparison with digital subtraction angiography

    International Nuclear Information System (INIS)

    Li Xiaoming; Li Yuhua; Tian Jianming; Xiao Yi; Lu Jianping; Jing Zaiping; Sheng Jing; Edwin, Angela; Wu Fanghong

    2010-01-01

    Purpose: To assess the accuracy of 64-slice multi-detector row computed tomography (MDCT) angiography in the evaluation of peripheral artery in-stent or peristent restenosis, with conventional digital subtraction angiography (DSA) as the reference standard. Materials and methods: Forty-one patients (30 men, 11 women; mean age, 69.8 ± 9.2 years) with symptomatic peripheral arterial occlusive disease after peripheral artery stenting (81 stented lesions) underwent both conventional DSA and 64-slice MDCT angiography. Each stent was classified as evaluable or unevaluable, and every stent was divided into three segments (proximal stent, stent body, and distal stent), resulting in 243 segments. For evaluation, stenosis was graded as follows: 1, none or slight stenosis (<25%); 2, mild stenosis (25-49%); 3, moderate stenosis (50-74%); 4, severe stenosis or total occlusion (≥75%). Two readers evaluated all CT angiograms with regard to narrowing of in-stent or peristent restenosis by consensus. Results were compared with findings of the DSA. Results: Of 81 stents, 62 (76.5%) were determined to be assessable. The metal artifact of the gold marker and motion artifact increased uninterpretability of the images of stents. Overall, 24 of 28 in-stent restenosis and 38 of 53 persistent restenosis were correctly detected by MDCT (85.7% and 71.7% sensitivity). In evaluable stents, 21 of 22 in-stent restenoses and 27 of 28 persistent restenosis were correctly detected (95.4% and 96.4% sensitivity). Additionally, as the grade of stenosis increases, the mean level of CT values in the stent lumina decreases linearly accordingly. Conclusion: 64-Slice MDCT has a high accuracy for the detection of significant in-stent or peristent restenosis of assessable stents in patients with peripheral artery stent implantation and therefore can be considered as a valuable noninvasive technique for stent surveillance.

  1. Computer-assisted lung nodule volumetry from multi-detector row CT: Influence of image reconstruction parameters

    International Nuclear Information System (INIS)

    Honda, Osamu; Sumikawa, Hiromitsu; Johkoh, Takeshi; Tomiyama, Noriyuki; Mihara, Naoki; Inoue, Atsuo; Tsubamoto, Mitsuko; Natsag, Javzandulam; Hamada, Seiki; Nakamura, Hironobu

    2007-01-01

    Purpose: To investigate differences in volumetric measurement of pulmonary nodules caused by changing the reconstruction parameters for multi-detector row CT. Materials and methods: Thirty-nine pulmonary nodules less than 2 cm in diameter were examined by multi-slice CT. All nodules were solid, and located in the peripheral part of the lungs. The resultant 48 parameters images were reconstructed by changing slice thickness (1.25, 2.5, 3.75, or 5 mm), field of view (FOV: 10, 20, or 30 cm), algorithm (high-spatial frequency algorithm or low-spatial frequency algorithm) and reconstruction interval (reconstruction with 50% overlapping of the reconstructed slices or non-overlapping reconstruction). Volumetric measurements were calculated using commercially available software. The differences between nodule volumes were analyzed by the Kruskal-Wallis test and the Wilcoxon Signed-Ranks test. Results: The diameter of the nodules was 8.7 ± 2.7 mm on average, ranging from 4.3 to 16.4 mm. Pulmonary nodule volume did not change significantly with changes in slice thickness or FOV (p > 0.05), but was significantly larger with the high-spatial frequency algorithm than the low-spatial frequency algorithm (p < 0.05), except for one reconstruction parameter. The volumes determined by non-overlapping reconstruction were significantly larger than those of overlapping reconstruction (p < 0.05), except for a 1.25 mm thickness with 10 cm FOV with the high-spatial frequency algorithm, and 5 mm thickness. The maximum difference in measured volume was 16% on average between the 1.25 mm slice thickness/10 cm FOV/high-spatial frequency algorithm parameters and overlapping reconstruction. Conclusion: Volumetric measurements of pulmonary nodules differ with changes in the reconstruction parameters, with a tendency toward larger volumes in high-spatial frequency algorithm and non-overlapping reconstruction compared to the low-spatial frequency algorithm and overlapping reconstruction

  2. Hereditary haemorrhagic telangiectasia: study of hepatic vascular alterations with multi-detector row helical CT and reconstruction programs

    International Nuclear Information System (INIS)

    Memeo, Maurizio; Stabile Ianora, Amato Antonio; Scaldapane, Arnaldo; Rotondo, Antonio; Angelelli, Giuseppe; Suppressa, Patrizia; Cirulli, Anna; Sabba', Carlo

    2005-01-01

    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 [it

  3. Evaluation of thoracic abnormalities on 64-row multi-detector row CT: Comparison between axial images versus coronal reformations

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Mizuki [Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215 (United States)]. E-mail: mnishino@bidmc.harvard.edu; Kubo, Takeshi [Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215 (United States); Kataoka, Milliam L. [Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215 (United States); Gautam, Shiva [Department of General Clinical Research Center and Biometrics, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215 (United States); Raptopoulos, Vassilios [Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215 (United States); Hatabu, Hiroto [Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215 (United States)

    2006-07-15

    Purpose: To evaluate the capability of coronal reformations of chest on 64-row MDCT in demonstrating thoracic abnormalities in comparison with axial images. Materials and methods: Thirty-eight consecutive patients who underwent pulmonary CTA on 64-row MDCT were retrospectively studied with institutional review board (IRB) approval. Contiguous 2 mm axial and coronal images were reviewed independently with a 1-week interval, by consensus reading of two board-certified radiologists. Overall image quality was graded using a five-point scale. Abnormalities in mediastinum, hilum, pulmonary vessels, aorta, heart, esophagus, pleura, chest wall, and lung parenchyma were scored: 1 = definitely absent, 2 = probably absent, 3 = equivocal, 4 probably present, 5 = definitely present. Scores on axial and coronal images were compared using weighted {kappa} analysis. Results: Overall image quality was not different with statistical relevance between axial and coronal images (mean/median scores; 3.7/4; 3.6/4, respectively, P = 0.286, Wilcoxon signed-rank test). Significant agreement was observed between axial and coronal scores (mean weighted {kappa}, 0.661; range, 0.362-1). Agreement was almost perfect for pneumothorax, lung and pleural mass, effusion and consolidation (weighted {kappa} = 0.833-1); substantial for pulmonary embolism, trachea, mediastinal lymphadenopathy and non-skeletal chest wall lesion, heart, esophagus, and emphysema (weighted {kappa}, 0.618-0.799); moderate for atelectasis, mediastinum, hilar nodes, aorta, other lung lesions, skeletal chest wall lesions, linear scarring, nodules >1 cm, pulmonary artery abnormalities and pleural thickening (weighted {kappa}, 0.405-0.592); and fair for nodules <1 cm (weighted {kappa} = 0.362). Conclusion: Coronal reformations on 64-row MDCT had substantial agreement with axial images for evaluation of the majority of thoracic abnormalities.

  4. Evaluation of thoracic abnormalities on 64-row multi-detector row CT: Comparison between axial images versus coronal reformations

    International Nuclear Information System (INIS)

    Nishino, Mizuki; Kubo, Takeshi; Kataoka, Milliam L.; Gautam, Shiva; Raptopoulos, Vassilios; Hatabu, Hiroto

    2006-01-01

    Purpose: To evaluate the capability of coronal reformations of chest on 64-row MDCT in demonstrating thoracic abnormalities in comparison with axial images. Materials and methods: Thirty-eight consecutive patients who underwent pulmonary CTA on 64-row MDCT were retrospectively studied with institutional review board (IRB) approval. Contiguous 2 mm axial and coronal images were reviewed independently with a 1-week interval, by consensus reading of two board-certified radiologists. Overall image quality was graded using a five-point scale. Abnormalities in mediastinum, hilum, pulmonary vessels, aorta, heart, esophagus, pleura, chest wall, and lung parenchyma were scored: 1 = definitely absent, 2 = probably absent, 3 = equivocal, 4 probably present, 5 = definitely present. Scores on axial and coronal images were compared using weighted κ analysis. Results: Overall image quality was not different with statistical relevance between axial and coronal images (mean/median scores; 3.7/4; 3.6/4, respectively, P = 0.286, Wilcoxon signed-rank test). Significant agreement was observed between axial and coronal scores (mean weighted κ, 0.661; range, 0.362-1). Agreement was almost perfect for pneumothorax, lung and pleural mass, effusion and consolidation (weighted κ = 0.833-1); substantial for pulmonary embolism, trachea, mediastinal lymphadenopathy and non-skeletal chest wall lesion, heart, esophagus, and emphysema (weighted κ, 0.618-0.799); moderate for atelectasis, mediastinum, hilar nodes, aorta, other lung lesions, skeletal chest wall lesions, linear scarring, nodules >1 cm, pulmonary artery abnormalities and pleural thickening (weighted κ, 0.405-0.592); and fair for nodules <1 cm (weighted κ = 0.362). Conclusion: Coronal reformations on 64-row MDCT had substantial agreement with axial images for evaluation of the majority of thoracic abnormalities

  5. Multidetector row CT angiography of living related renal donors: Is there a need for venous phase imaging?

    International Nuclear Information System (INIS)

    Namasivayam, Saravanan; Kalra, Mannudeep K.; Waldrop, Sandra M.; Mittal, Pardeep K.; Small, William C.

    2006-01-01

    Objective: To prospectively evaluate whether renal venous anatomy can be detected from arterial phase images of multidetector row CT (MDCT) of renal donors. Material and methods: Institutional review board approved our study protocol with waiver of consent. Forty-eight consecutive renal donors (age range, 21-56 years; M:F, 20:28) referred for MDCT evaluation were included. Two sub-specialty radiologists performed an independent and separate evaluation of renal venous anatomy in arterial and venous phase images. Opacification of renal venous structures was scored on a five-point scale (1-not seen; 3-minimal opacification; 5-excellent opacification). Arterial and venous phase opacification scores were compared by Wilcoxon signed rank test. Results: Both readers detected all renal venous anomalies in arterial as well as venous phase images. Each reader detected accessory right renal veins (n = 14), retroaortic left renal vein (n = 2), circumaortic left renal vein (n = 1), and left renal hilar arteriovenous malformation (n = 1) in arterial phase images. Retroaortic left renal venous branch was difficult to differentiate from lumbar vein (reader-1, n = 1; reader-2, n = 2) in both arterial and venous phase images. Sensitivity of detection of renal veins, left adrenal, gonadal and lumbar veins in arterial phase images was 100, 83-88, 100, and 85-90%, respectively. As expected, venous phase images showed significantly greater opacification of renal veins, left gonadal, adrenal and lumbar veins (p < .05). However, this did not substantially limit the evaluation of renal venous anatomy in arterial phase images. Both readers had substantial interobserver agreement (kappa coefficient, 0.7; p < 0.05). Conclusions: Arterial phase MDCT images alone can be used to detect renal venous anomalies, and to identify small left renal venous branches namely, the left gonadal, adrenal and lumbar veins in renal donors. Venous phase MDCT acquisition is not necessary for evaluation of renal

  6. Multidetector row CT angiography of living related renal donors: Is there a need for venous phase imaging?

    Energy Technology Data Exchange (ETDEWEB)

    Namasivayam, Saravanan [Department of Radiology, Division of Abdominal Imaging, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322 (United States); Kalra, Mannudeep K. [Department of Radiology, Division of Abdominal Imaging, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322 (United States); Waldrop, Sandra M. [Department of Radiology, Division of Abdominal Imaging, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322 (United States); Mittal, Pardeep K. [Department of Radiology, Division of Abdominal Imaging, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322 (United States); Small, William C. [Department of Radiology, Division of Abdominal Imaging, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322 (United States)]. E-mail: wsmall@emory.edu

    2006-09-15

    Objective: To prospectively evaluate whether renal venous anatomy can be detected from arterial phase images of multidetector row CT (MDCT) of renal donors. Material and methods: Institutional review board approved our study protocol with waiver of consent. Forty-eight consecutive renal donors (age range, 21-56 years; M:F, 20:28) referred for MDCT evaluation were included. Two sub-specialty radiologists performed an independent and separate evaluation of renal venous anatomy in arterial and venous phase images. Opacification of renal venous structures was scored on a five-point scale (1-not seen; 3-minimal opacification; 5-excellent opacification). Arterial and venous phase opacification scores were compared by Wilcoxon signed rank test. Results: Both readers detected all renal venous anomalies in arterial as well as venous phase images. Each reader detected accessory right renal veins (n = 14), retroaortic left renal vein (n = 2), circumaortic left renal vein (n = 1), and left renal hilar arteriovenous malformation (n = 1) in arterial phase images. Retroaortic left renal venous branch was difficult to differentiate from lumbar vein (reader-1, n = 1; reader-2, n = 2) in both arterial and venous phase images. Sensitivity of detection of renal veins, left adrenal, gonadal and lumbar veins in arterial phase images was 100, 83-88, 100, and 85-90%, respectively. As expected, venous phase images showed significantly greater opacification of renal veins, left gonadal, adrenal and lumbar veins (p < .05). However, this did not substantially limit the evaluation of renal venous anatomy in arterial phase images. Both readers had substantial interobserver agreement (kappa coefficient, 0.7; p < 0.05). Conclusions: Arterial phase MDCT images alone can be used to detect renal venous anomalies, and to identify small left renal venous branches namely, the left gonadal, adrenal and lumbar veins in renal donors. Venous phase MDCT acquisition is not necessary for evaluation of renal

  7. Evaluation of multiple trauma victims with 16-row multidetector CT (MDCT): a time analysis

    International Nuclear Information System (INIS)

    Heyer, C.M.; Nicolas, V.

    2005-01-01

    Purpose: Description and time analysis of a 16-row MDCT protocol in the evaluation of multiple trauma patients considering transport, time of scanning, patient positioning, image reconstruction, and image interpretation. Materials and methods: Between May and December 2004, 60 multiple trauma patients underwent 16-row MDCT (Sensation, Siemens, Erlangen, Germany). The protocol included serial scanning of the head, spiral scanning of the cervical spine and contrast-enhanced spiral scanning of the thorax/abdomen with multiplanar reformations (MPR) of the thoracic/lumbar spine and the pelvis. All time intervals including transport, patient positioning, scanning, duration of MPR, total time in the examination room, and time to first and final image interpretation were prospectively evaluated. Furthermore, patient characteristics, trauma profiles, and mortality rates were recorded. Results: 46 male and 14 female patients (mean age 43.6 years) were enrolled in the study. Time analysis of 16-row MDCT revealed the following results (mean time standard deviation): Emergency room treatment and transport 19.2±6.7 min, patient positioning 16.5±6.5 min, scan duration 8.0±3.3 min, total time in examination room 24.5±7.2 min, image reconstruction including MPR 32.0±16.4 min, and time of first (16.4±4.7 min) and final image interpretation (82.5±30.4 min). Trauma profiles revealed thoracic injuries in 35/60 patients (58.3%), head injuries in 23/60 patients (38.3%), abdominal injuries in 15/60 patients (25.0%), injuries of the cervical (9/60 patients, 15.0%), thoracic (12/60 patients, 20.0%), and lumbar spine (19/60 patients, 31.7%), pelvic injuries in 13/60 patients (21.7%), and injuries of extremities in 39/60 patients (65.0%). The mortality rate was 21.7%. (orig.)

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

    International Nuclear Information System (INIS)

    Salem, Randa; Remy-Jardin, Martine; Delhaye, Damien; Khalil, Chadi; Teisseire, Antoine; Remy, Jacques; Delannoy-Deken, Valerie; Duhamel, Alain

    2006-01-01

    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 β-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-diastolic ventricular volumes. The mean (±SD) DLP

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

    African Journals Online (AJOL)

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

  10. The effects of misinterpretation of an artefact on multidetector row CT scans in children

    Energy Technology Data Exchange (ETDEWEB)

    Du Plessis, Anne-Marie; Theron, Salomine; Andronikou, Savvas [University of Stellenbosch, Radiology Department, Tygerberg Hospital, Cape Town (South Africa)

    2009-02-15

    Artefacts reflect problems with radiographic technique rather than true pathology. These may be misinterpreted as pathology with serious consequences. An artefact caused such problems in one paediatric imaging department. To determine the incidence, and consequences of misinterpretation, of a CT artefact in a paediatric imaging department. A retrospective review of images and reports of paediatric CT scans over a set period with a known artefact was performed. Reports were correlated with reviewers' evaluation of the presence of artefact and reviewed for correct identification of artefact, misinterpretation as pathology, and action taken as a result. A total of 74 CT scans had been performed over the study period and an artefact detected by reviewers on 32 (43%). Six (18.75%) of these were misinterpreted as pathology, of which three (9.4%) were reported as tuberculous granulomas, two (6.2%) as haemorrhages and one (3.1%) as an unknown hyperdensity. Two patients (6.2%) had subsequent MRI studies performed, and treatment for tuberculosis was continued in one patient (3.1%). No initial report identified the artefact. One-fifth of the scans with the artefact were misinterpreted as pathology and half of these misinterpretations led to further action. Artefacts result in false diagnoses and unnecessary investigations; vigilance is needed. (orig.)

  11. Detection of intracranial aneurysms using multi-detector row CT 3D-angiography: comparison with operative findings

    Energy Technology Data Exchange (ETDEWEB)

    Han, You Mie; Lim, Soo Mee; Seo, Eui Kyo; Kim, Yoo Kyung [Mokdong Hospital, Ewha Womans University, Seoul (Korea, Republic of)

    2006-04-15

    To assess the efficacy of three-dimensional CT angiography (3D-CTA) using multi-detector row computed tomography (MDCT) in the evaluation of intracranial aneurysms in patients with non-traumatic acute subarachnoid hemorrhage and to describe those aneurysms which were not found 3D-CTA. 3D-CTA was done in 40 patients with non-traumatic subarachnoid hemorrhage by using a 16-slice MDCT; conventional digital subtraction angiography (DSA) was done in 36 of those patients within 12 hours. The CT and DSA images were reviewed by two radiologists and the site, size and neck of the aneurysms were evaluated. The results from these two modalities were then compared with the operative findings. We calculated the detection rates by 3D-CTA and DSA and evaluated the size differences of aneurysms diagnosed with 3D-DTA and those found at surgery. We also analyzed the locations and sizes of aneurysms missed by 3D-CTA and attempted to explain these false negatives. A total of 55 aneurysms were surgically confirmed in 40 patients. 48 of these were detected pre-operatively by 3D-CTA. Thus, the detection rate by 3D-CTA was 87%. The size difference of aneurysms as calculated by 3-D CTA and found operatively was as follows: less than 1 mm in 17 cases, within 1-2 mm in 15 cases, and more than 2 mm in 16 cases. Seven aneurysms were not detected by 3D-CTA. The major cause of these missed aneurysms was their small size. The undetected aneurysms were less than 2 mm in size, except for 2 instances of PCoA aneurysms. One case was not detected due to difficult image evaluation. A possible explanation of the one remaining missed aneurysms was the filling of the aneurismal sac by thrombosis. Though there were some limitations in the detection of aneurysms, 3D-CTA using 16-channel MDCT may provide sufficient pre-operative information for the management of patients with intracranial aneurysms in cases of emergency operations or DSA-failure.

  12. Detection of intracranial aneurysms using multi-detector row CT 3D-angiography: comparison with operative findings

    International Nuclear Information System (INIS)

    Han, You Mie; Lim, Soo Mee; Seo, Eui Kyo; Kim, Yoo Kyung

    2006-01-01

    To assess the efficacy of three-dimensional CT angiography (3D-CTA) using multi-detector row computed tomography (MDCT) in the evaluation of intracranial aneurysms in patients with non-traumatic acute subarachnoid hemorrhage and to describe those aneurysms which were not found 3D-CTA. 3D-CTA was done in 40 patients with non-traumatic subarachnoid hemorrhage by using a 16-slice MDCT; conventional digital subtraction angiography (DSA) was done in 36 of those patients within 12 hours. The CT and DSA images were reviewed by two radiologists and the site, size and neck of the aneurysms were evaluated. The results from these two modalities were then compared with the operative findings. We calculated the detection rates by 3D-CTA and DSA and evaluated the size differences of aneurysms diagnosed with 3D-DTA and those found at surgery. We also analyzed the locations and sizes of aneurysms missed by 3D-CTA and attempted to explain these false negatives. A total of 55 aneurysms were surgically confirmed in 40 patients. 48 of these were detected pre-operatively by 3D-CTA. Thus, the detection rate by 3D-CTA was 87%. The size difference of aneurysms as calculated by 3-D CTA and found operatively was as follows: less than 1 mm in 17 cases, within 1-2 mm in 15 cases, and more than 2 mm in 16 cases. Seven aneurysms were not detected by 3D-CTA. The major cause of these missed aneurysms was their small size. The undetected aneurysms were less than 2 mm in size, except for 2 instances of PCoA aneurysms. One case was not detected due to difficult image evaluation. A possible explanation of the one remaining missed aneurysms was the filling of the aneurismal sac by thrombosis. Though there were some limitations in the detection of aneurysms, 3D-CTA using 16-channel MDCT may provide sufficient pre-operative information for the management of patients with intracranial aneurysms in cases of emergency operations or DSA-failure

  13. Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT.

    Science.gov (United States)

    Cho, S H; Sung, Y M; Kim, M S

    2012-10-01

    The objective of this study was to review the prevalence and radiological features of rib fractures missed on initial chest CT evaluation, and to examine the diagnostic value of additional coronal images in a large series of trauma patients. 130 patients who presented to an emergency room for blunt chest trauma underwent multidetector row CT of the thorax within the first hour during their stay, and had follow-up CT or bone scans as diagnostic gold standards. Images were evaluated on two separate occasions: once with axial images and once with both axial and coronal images. The detection rates of missed rib fractures were compared between readings using a non-parametric method of clustered data. In the cases of missed rib fractures, the shapes, locations and associated fractures were evaluated. 58 rib fractures were missed with axial images only and 52 were missed with both axial and coronal images (p=0.088). The most common shape of missed rib fractures was buckled (56.9%), and the anterior arc (55.2%) was most commonly involved. 21 (36.2%) missed rib fractures had combined fractures on the same ribs, and 38 (65.5%) were accompanied by fracture on neighbouring ribs. Missed rib fractures are not uncommon, and radiologists should be familiar with buckle fractures, which are frequently missed. Additional coronal imagescan be helpful in the diagnosis of rib fractures that are not seen on axial images.

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

    International Nuclear Information System (INIS)

    Goetschi, Stefan; Umbehr, Martin; Ullrich, Stephan; Glenck, Michael; Suter, Stefan; Weishaupt, Dominik

    2012-01-01

    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.

  15. Detection of the anatomic structure and pathology in animal lung specimens: comparison of micro CT and multi-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Kun Young [National Cancer Center, Goyang (Korea, Republic of); Lee, Hyun Ju; Lee, Chang Hyun; Son, Kyu Ri; Goo, Jin Mo; Im, Jung Gi [Seoul National University Hospital and the Institute of Radiation Medicine, Seoul (Korea, Republic of); Seo, Joon Beom [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2006-05-15

    We wanted to compare the capability of micro CT and the clinically available thin-slice multi-detector row CT (MDCT) for demonstrating fine anatomic structures and pathological lesions in formalin-fixed lung specimens. The porcine lung with shark liver oil-induced lipoid pneumonia and the canine lung with pulmonary paragonimiasis were fixed by ventilating them with formalin vapor, and they were then sliced into one-centimeter thick sections. Micro CT (section thickness, 18 micrometer) and MDCT (section thickness, 0.75 mm) images were acquired in four of the lung slices of the lipoid pneumonia specimen and in five of the lung slices of the paragonimiasis specimen. On 62 pairs of micro CT and MDCT images, 169 pairs of rectangular ROIs were manually drawn in the corresponding locations. Two chest radiologists recorded the detectability of three kinds of anatomic structures (lobular core structure, interlobular septum and small bronchiolar lumen) and two kinds of pathological lesions (ground-glass opacity and consolidation) with using a five-point scale. The statistical comparison was performed by using the Wilcoxon signed rank test. Interobserver agreement was evaluated with kappa statistics. For all observers, all the kinds of anatomic structures and pathological lesions were detected better on the micro CT images than on the MDCT images ({rho} < 0.01). Agreement was fair between two observers ({kappa} = 0.38, {rho} < 0.001). The fine anatomic structures and pathological lesions of the lung were more accurately demonstrated on micro CT than on thin-slice MDCT in the inflated and fixed lung specimens.

  16. Detection of the anatomic structure and pathology in animal lung specimens: comparison of micro CT and multi-detector row CT

    International Nuclear Information System (INIS)

    Lim, Kun Young; Lee, Hyun Ju; Lee, Chang Hyun; Son, Kyu Ri; Goo, Jin Mo; Im, Jung Gi; Seo, Joon Beom

    2006-01-01

    We wanted to compare the capability of micro CT and the clinically available thin-slice multi-detector row CT (MDCT) for demonstrating fine anatomic structures and pathological lesions in formalin-fixed lung specimens. The porcine lung with shark liver oil-induced lipoid pneumonia and the canine lung with pulmonary paragonimiasis were fixed by ventilating them with formalin vapor, and they were then sliced into one-centimeter thick sections. Micro CT (section thickness, 18 micrometer) and MDCT (section thickness, 0.75 mm) images were acquired in four of the lung slices of the lipoid pneumonia specimen and in five of the lung slices of the paragonimiasis specimen. On 62 pairs of micro CT and MDCT images, 169 pairs of rectangular ROIs were manually drawn in the corresponding locations. Two chest radiologists recorded the detectability of three kinds of anatomic structures (lobular core structure, interlobular septum and small bronchiolar lumen) and two kinds of pathological lesions (ground-glass opacity and consolidation) with using a five-point scale. The statistical comparison was performed by using the Wilcoxon signed rank test. Interobserver agreement was evaluated with kappa statistics. For all observers, all the kinds of anatomic structures and pathological lesions were detected better on the micro CT images than on the MDCT images (ρ < 0.01). Agreement was fair between two observers (κ = 0.38, ρ < 0.001). The fine anatomic structures and pathological lesions of the lung were more accurately demonstrated on micro CT than on thin-slice MDCT in the inflated and fixed lung specimens

  17. Effect of computer-aided detection as a second reader in multidetector-row CT colonography

    International Nuclear Information System (INIS)

    Mang, Thomas; Peloschek, Philipp; Plank, Christina; Maier, Andrea; Weber, Michael; Herold, Christian; Schima, Wolfgang; Graser, Anno; Bogoni, Luca

    2007-01-01

    Our purpose was to assess the effect of computer-aided detection (CAD) on lesion detection as a second reader in computed tomographic colonography, and to compare the influence of CAD on the performance of readers with different levels of expertise. Fifty-two CT colonography patient data-sets (37 patients: 55 endoscopically confirmed polyps ≥0.5 cm, seven cancers; 15 patients: no abnormalities) were retrospectively reviewed by four radiologists (two expert, two nonexpert). After primary data evaluation, a second reading augmented with findings of CAD (polyp-enhanced view, Siemens) was performed. Sensitivities and reading time were calculated for each reader without CAD and supported by CAD findings. The sensitivity of expert readers was 91% each, and of nonexpert readers, 76% and 75%, respectively, for polyp detection. CAD increased the sensitivity of expert readers to 96% (P = 0.25) and 93% (P = 1), and that of nonexpert readers to 91% (P = 0.008) and 95% (P = 0.001), respectively. All four readers diagnosed 100% of cancers, but CAD alone only 43%. CAD increased reading time by 2.1 min (mean). CAD as a second reader significantly improves sensitivity for polyp detection in a high disease prevalence population for nonexpert readers. CAD causes a modest increase in reading time. CAD is of limited value in the detection of cancer. (orig.)

  18. Thin-section multiplanar reformats from multidetector-row CT data: Utility for assessment of regional tumor extent in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Higashino, Takanori; Ohno, Yoshiharu; Takenaka, Daisuke; Watanabe, Hirokazu; Nogami, Munenobu; Ohbayashi, Chiho; Yoshimura, Masahiro; Satouchi, Miyako; Nishimura, Yoshihiro; Fujii, Masahiko; Sugimura, Kazuro

    2005-01-01

    Purpose: To determine the clinical utility of thin-section multiplanar reformats (MPRs) from multidetector-row CT (MDCT) data sets for assessing the extent of regional tumors in non-small cell lung cancer (NSCLC) patients. Materials and methods: Sixty consecutive NSCLC patients, who were considered candidates for surgical treatment, underwent contrast-enhanced MDCT examinations, surgical resection and pathological examinations. All MDCT examinations were performed with a 4-detector row computed tomography (CT). From each raw CT data set, 5 mm section thickness CT images (routine CT), 1.25 mm section thickness CT images (thin-section CT) and 1.25 mm section thickness sagittal (thin-section sagittal MPR) and coronal images (thin-section coronal MPR) were reconstructed. A 4-point visual score was used to assess mediastinal, interlobar and chest wall invasions on each image set. For assessment of utility in routine clinical practice, mean reading times for each image set were compared by means of Fisher's protected least significant difference (PLSD) test. A receiver operator characteristic (ROC) analysis was performed to determine the diagnostic capability of each of the image data sets. Finally, sensitivity, specificity and accuracy of the reconstructed images were compared by McNemar test. Results: Mean reading times for thin-section sagittal and coronal MPRs were significantly shorter than those for routine CT and thin-section CT (p < 0.05). Areas under the curve (Azs) showing interlobar invasion on thin-section sagittal and coronal MPRs were significantly larger than that on routine CT (p = 0.03), and the Az on thin-section sagittal MPR was also significantly larger than that on routine CT (p = 0.02). Accuracy of chest wall invasion by thin-section sagittal MPR was significantly higher than that by routine CT (p = 0.04). Conclusion: Thin-section multiplanar reformats from multidetector-row CT data sets are useful for assessing the extent of regional tumors in non

  19. Image quality of high-resolution CT with 16-channel multidetector-row CT. Comparison between helical scan and conventional step-shoot scan

    International Nuclear Information System (INIS)

    Sumikawa, Hiromitsu; Johkoh, Takeshi; Koyama, Mitsuhiro

    2005-01-01

    The aim of this study was to evaluate the image quality of high-resolution CT (HRCT) reconstructed from volumetric data with 16-channel multidetector-row CT (MDCT). Eleven autopsy lungs that were diagnosed histopathologically were scanned by 16-channel MDCT with the step-and-shoot scan mode and three helical scan modes. Each helical mode had each size of focal spot, pitch, and time of gantry rotation. HRCT images were reconstructed from the volumetric data with each helical mode and axial sequence data. Two observers evaluated the image quality and noted the most appropriate diagnosis for each imaging. Visualization of abnormal structures with one helical mode was equal to those with axial mode, whereas those with the other two helical modes were inferior to those with axial mode (Wilcoxon signed rank test; p<0.0001). There was no significant difference in diagnostic efficacy between modes. The image quality of HRCT with appropriate helical mode is equal to that with axial mode and diagnostic efficacy is equal among all modes. These results may indicate that sufficient HRCT images can be obtained by only one helical scan without the addition of conventional axial scans. (author)

  20. Comparison of a dental cone beam CT with a multi-detector row CT on effective doses and physical image quality

    International Nuclear Information System (INIS)

    Yoshida, Yutaka; Tokumori, Kenji; Okamura, Kazutoshi; Yoshiura, Kazunori

    2011-01-01

    The purpose of this study was to compare a dental cone beam computed tomography (dental CBCT) and a multi-detector row CT (MDCT) using effective doses and physical image quality. A dental mode (D-mode) and an implant mode (I-mode) were employed for calculating effective doses. Field of view (FOV) size of the MDCT was 150 mm. Three types of images were obtained using 3 different reconstruction functions: FC1 (for abdomen images), FC30 (for internal ear and bone images) and FC81 (for high resolution images). Effective doses obtained with the D-mode and with the I-mode were about 20% and 50% of those obtained with the MDCT, respectively. Resolution properties obtained with the D-mode and I-mode were superior to that of the MDCT in a high frequency range. Noise properties of the D-mode and the I-mode were better than those with FC81. It was found that the dental CBCT has better potential as compared with MDCT in both dental and implant modes. (author)

  1. Multi-detector row helical CT of the liver. Quantitative assessment of iodine concentration of intravenous contrast material on multiphasic CT. A prospective randomized study

    International Nuclear Information System (INIS)

    Tsurusaki, Masakatsu; Sugimoto, Koji; Fujii, Masahiko; Sugimura, Kazuro

    2004-01-01

    The purpose of this study was to assess the quantitative effects of contrast material concentration on hepatic parenchymal and vascular enhancement in multiphasic computed tomography (CT), using multi-detector row helical CT. We designed a prospective randomized study to test two different concentrations of contrast material on five phasic scans of the liver. One hundred patients were randomly assigned to two groups: an iodine concentration of 300 mg/mL in group A and 370 mg/mL in group B. All patients received a fixed volume of 100 mL at a 4 mL/sec injection rate. Enhancement values for the hepatic parenchyma and aorta at three levels (upper, middle, and lower level of the liver), and values for portal and hepatic veins were statistically compared between the two groups. Hepatic parenchymal enhancement values at all levels of the liver in portal phase (PP) and equilibrium phase (EP) were significantly higher in group B than in group A (p<0.01). Aortic enhancement values at two levels of the liver (middle and lower) in early hepatic arterial phase (EAP) were significantly higher in group B than in group A (p<0.05), however, there was no significant difference between groups A and B in aortic enhancement during the delayed hepatic arterial phase (DAP). Portal and hepatic venous enhancement values in PP and EP were significantly higher in group B than in group A (p<0.01). On multiphasic dynamic CT, the use of a higher iodine concentration of contrast material results in higher hepatic parenchymal enhancement and aortic enhancement, as well as higher portal and hepatic venous enhancement. (author)

  2. Contribution of multi-detector row CT (MDCT) to decision making in the management of patients with small bowel obstruction or ileus

    International Nuclear Information System (INIS)

    Osada, Hisato; Watanabe, Wataru; Okada, Taketomo

    2007-01-01

    We retrospectively evaluated the contribution of multi-detector row CT (MDCT) to patient management decisions in 62 patients with small bowel obstruction or ileus. The sensitivity and specificity of MDCT diagnosis of small bowel obstruction with strangulation or closed loop were 78.9% (15/19) and 93.0% (40/43), respectively. In 19 patients with small bowel obstruction with strangulation or closed loop, the median interval between CT examination and the commencement of surgery was significantly longer in misdiagnosed patients than in those correctly diagnosed (43.3 vs. 4.5 hours, p<0.05). Only two patients displayed severe physical signs that required urgent surgical treatment. Our results suggest that MDCT plays a key role in the management of patients with small bowel obstruction. (author)

  3. Upper abdominal gadoxetic acid-enhanced and diffusion-weighted MRI for the detection of gastric cancer: Comparison with two-dimensional multidetector row CT

    International Nuclear Information System (INIS)

    Jang, K.M.; Kim, S.H.; Lee, S.J.; Lee, M.W.; Choi, D.; Kim, K.M.

    2014-01-01

    Aim: To evaluate the diagnostic performance of abdominal magnetic resonance imaging (MRI) for the detection of gastric cancer in comparison with that of two-dimensional (2D) multidetector row computed tomography (CT). Materials and methods: The study included 189 patients with 170 surgically confirmed gastric cancers and 19 patients without gastric cancer, all of whom underwent gadoxetic acid-enhanced MRI with diffusion-weighted (DW) imaging, and multidetector contrast-enhanced abdominal CT imaging. Two observers independently analysed three sets of images (CT set, conventional MRI set, and combined conventional and DW MRI set). A five-point scale for likelihood of gastric cancer was used. Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were evaluated. Quantitative [apparent diffusion coefficient (ADC) analyses with Mann–Whitney U-test were conducted for gastric cancers and the nearby normal gastric wall. Results: The diagnostic accuracy and sensitivity for detection of gastric cancer were significantly higher on combined conventional and DW MRI set (77.8–78.3%; 75.3–75.9%) than the CT imaging set (67.7–71.4%; 64.1–68.2%) or the conventional MRI set (72–73%; 68.8–70%; p < 0.01). In particular, for gastric cancers with pT2 and pT3, the combined conventional and DW MRI set (91.6–92.6%) yielded significantly higher sensitivity for detection of gastric cancer than did the CT imaging set (76.8–81.1%) by both observers (p < 0.01). The mean ADC of gastric cancer lesions (1 ± 0.23 × 10 −3 mm 2 /s) differed significantly from that of normal gastric wall (1.77 ± 0.25 × 10 −3  mm 2 /s; p < 0.01). Conclusion: Abdominal MRI with DW imaging was more sensitive for the detection of gastric cancer than 2D-multidetector row CT or conventional MRI alone. - Highlights: • The sensitivity for detection of gastric cancer is high on abdominal MR imaging. • DW imaging is helpful for

  4. Fusion of the midplane with the left intersectional plane: a liver anatomical variation revisited with multidetector-row CT

    International Nuclear Information System (INIS)

    Lucidarme, Olivier; Taboury, Jacques; Savier, Eric; Hannoun, Laurent; Cadi, Mehdi; Grenier, Philippe A.

    2006-01-01

    This article updates the description of an anatomical variation of the liver, in which the gallbladder is adjacent to the ligamentum teres, that was described until now as ''right-sided ligamentum teres and right umbilical portion of the portal vein''. A study of eight patients showing this anatomical variation has led to a new archetypal anatomical description of the hepatic and portal veins, using multidetector-row computed tomography (MDCT) with three-dimensional (3D) volume-rendering (VR) reconstructions. While 2D axial imaging gave the same information, MDCT imaging with VR reconstructions provided a clear 3D visualization of this anatomical variation. Typical features can be described as follows: (1) juxtaposition of the ligamentum teres and the gallbladder; (2) typical portal vein branching with a right posterior branch, a left posterior branch and a main medial branch that terminates in the ligamentum teres; (3) two main hepatic veins and a hypotrophied medial hepatic vein. We think, based on the direct comparison of anatomical findings and knowledge of chronological embryological development, that this abnormality results from the defective development of the central part of the liver and not from the persistence of the right rather than the left umbilical vein. Because of the presence of only one medial plane, containing both the gallbladder and the ligamentum teres, we propose renaming it ''fusion of hepatic planes''. (orig.)

  5. 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

    International Nuclear Information System (INIS)

    Lee, Tain; Tsai, I.C.; Chen, Min-Chi; Fu, Yun-Ching; Jan, Sheng-Lin; Wang, Chung-Chi; Chang, Yen

    2006-01-01

    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.)

  6. Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique

    International Nuclear Information System (INIS)

    Tsai, I.C.; Lee, Tain; Chen, Min-Chi; Fu, Yun-Ching; Jan, Sheng-Lin; Wang, Chung-Chi; Chang, Yen

    2007-01-01

    Multidetector CT (MDCT) seems to be a promising tool for detection of neonatal coronary arteries, but whether the ECG-gated or non-ECG-gated technique should be used has not been established. To compare the detection rate and image quality of neonatal coronary arteries on MDCT using ECG-gated and non-ECG-gated techniques. Twelve neonates with complex congenital heart disease were included. The CT scan was acquired using an ECG-gated technique, and the most quiescent phase of the RR interval was selected to represent the ECG-gated images. The raw data were then reconstructed without the ECG signal to obtain non-ECG-gated images. The detection rate and image quality of nine coronary artery segments in the two sets of images were then compared. A two-tailed paired t test was used with P values <0.05 considered as statistically significant. In all coronary segments the ECG-gated technique had a better detection rate and produced images of better quality. The difference between the two techniques ranged from 25% in the left main coronary artery to 100% in the distal right coronary artery. For neonates referred for MDCT, if evaluation of coronary artery anatomy is important for the clinical management or surgical planning, the ECG-gated technique should be used because it can reliably detect the coronary arteries. (orig.)

  7. Detection of intestinal bleeding with multi-detector row CT in an experimental setup. How many acquisitions are necessary?

    International Nuclear Information System (INIS)

    Dobritz, Martin; Engels, Heinz-Peter; Bauer, Jan; Rummeny, Ernst J.; Schneider, Armin

    2009-01-01

    The purpose of the study was to evaluate multi-detector computed tomography (MDCT) acquired in different acquisitions (unenhanced, and arterial and portal venous phase following intravenous contrast medium) for detection of intestinal bleeding using an experimental bowel model. The model consisted of an injector tube with a perforation placed in a 7-m-long small bowel of a pig. The bowel was filled with water/contrast medium solution of 30-40 HU and was incorporated in a phantom model. Intestinal bleeding in different locations and bleeding velocities varying from zero to 0.75 ml/min (0.05 ml/min increments) were simulated. Twenty-six datasets in simulated unenhanced, arterial and portal venous contrast phase using increasing bleeding velocities and ten negative controls were measured using 64-row MDCT. Two radiologists blinded to the experimental settings evaluated the datasets in a random order. The likelihood of intestinal bleeding was assessed using a 5-point scale with subsequent ROC analysis. The overall sensitivity for detecting bleeding was 0.44 for an arterial acquisition alone, 0.68 for a portal venous acquisition, 0.68 for the combination unenhanced/arterial, 0.72 for unenhanced/portal venous and 0.80 for arterial/portal. Bleeding velocities of above 0.25 ml/min were detected with a sensitivity of 0.59 for arterial, 0.88 for portal venous, 0.85 for unenhanced/arterial, 0.94 for unenhanced/portal venous and 0.97 for arterial/portal venous contrast phase protocols, respectively. The specificity was 1.00. MDCT provides the highest sensitivity and specificity in the detection of intestinal bleeding using arterial and portal venous acquisition in comparison to mono-phase protocols. (orig.)

  8. Assessment of vertebral artery stents using 16-slice multi-detector row CT angiography in vivo evaluation: Comparison of a medium-smooth kernel and a sharp kernel

    International Nuclear Information System (INIS)

    Yoo, Won Jong; Lim, Yeon Soo; Ahn, Kook Jin; Choi, Byung Gil; Kim, Ji Young; Kim, Sung Hoon

    2009-01-01

    Objectives: To assess the lumen visibility of extracranial vertebral artery stents examined with 16-slice multi-detector row computed tomography (MDCT) angiography in vivo using a medium-smooth kernel (B30s) and a sharp kernel (B60s), and to compare these with digital subtraction angiography (DSA) after stent placement. Methods: Twenty stents from 20 patients (14 men, 6 women; mean age, 62.7 ± 10.1 years) who underwent CT angiography (CTA) with 16-slice MDCT were retrospectively analyzed. In CT angiograms using a B30s and a B60s, the lumen diameters and CT attenuations of the stented vessels were measured three times by three observers, and artificial luminal narrowing (ALN) was calculated. To assess measurement reliability on CT angiograms, the intraclass correlation coefficient (ICC) was used. DSA served as the reference standard for the in-stent luminal measurements on CT angiography. The median interval between CT angiography and DSA was 1 day (range 1-10). Results: For interobserver reliability, intraclass correlation coefficients for the lumen diameters on CT angiograms with a B30s and a B60s were 0.90 and 0.96, respectively. The lumen diameters on CT angiograms using a B30s were consistently smaller than that on CT angiograms using a B60s (p < 0.01). The mean ALN was 37 ± 7% on CT angiograms using a B30s and 25 ± 9% on CT angiograms using a B60s. The mean CT attenuation in in-stent lumen was 347 ± 55 HU on CT angiograms using a B30s and 295 ± 46 HU on CT angiograms using a B60s. The ALN and CT attenuation within the stented vessels between CT angiograms using a B30s and a B60s was significant (p < 0.01). Conclusions: 16-slice MDCT using a sharp kernel allows good visualization of the stented vessels and is useful in the assessment of vertebral artery stent patency after stent placement.

  9. 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.)

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

    International Nuclear Information System (INIS)

    Xie, Xueqian; Zhao, Yingru; Ooijen, Peter M.A. van; Vliegenthart, Rozemarijn; Snijder, Roland A.; Greuter, Marcel J.W.; Jong, Pim A. de; Oudkerk, Matthijs; Bock, Geertruida H. de

    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 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 5 mm in diameter. Semi-automated volumetry yielded more accurate nodule volumes than manual measurements. (orig.)

  11. Right heart on multidetector CT

    Science.gov (United States)

    Gopalan, D

    2011-01-01

    Right ventricular function plays an integral role in the pathogenesis and outcome of many cardiovascular diseases. Imaging the right ventricle has long been a challenge because of its complex geometry. In recent years there has been a tremendous expansion in multidetector row CT (MDCT) and its cardiac applications. By judicious modification of contrast medium protocol, it is possible to achieve good opacification of the right-sided cardiac chambers, thereby paving the way for exploring the overshadowed right heart. This article will describe the key features of right heart anatomy, review MDCT acquisition techniques, elaborate the various morphological and functional information that can be obtained, and illustrate some important clinical conditions associated with an abnormal right heart. PMID:22723537

  12. Quantification of myocardial blood flow using dynamic 320-row multi-detector CT as compared with 15O-H2O PET

    International Nuclear Information System (INIS)

    Kikuchi, Yasuka; Oyama-Manabe, Noriko; Kudo, Kohsuke; Naya, Masanao; Manabe, Osamu; Tomiyama, Yuuki; Tamaki, Nagara; Sasaki, Tsukasa; Katoh, Chietsugu; Shirato, Hiroki

    2014-01-01

    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 15 O-H 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 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.)

  13. Mediastinal and hilar lymphadenopathy: cross-referenced anatomy on axial and coronal images displayed by using multi-detector row CT

    International Nuclear Information System (INIS)

    Lee, Ju Hyun; Lee, Kyung Soo; Kim, Tae Sung; Yi, Chin A; Cho, Jae Min; Lee, Min Hee

    2003-01-01

    The accurate evaluation of mediastinal and pulmonary hilar lymphadenopathy, especially in patients with lung cancer, is important for determining treatment options and evaluating the response to therapy. To indicate nodal location in detail, mediastinal and hilar lymph nodes have been assigned to one of 14 nodal stations. Mediastinal nodes of greater than 10 mm short-axis diameter are regarded as abnormal, irrespective of their nodal station, while hilar nodes are considered abnormal if their diameter is greater than 10 mm in any axis or they are convex compared to surrounding lung. By providing multiplanar images, multi-detector row CT allows detailed evaluation of thoracic anatomic structures more easily than in the past, when axial images only were available. At cross-referenced imaging, a lymph node depicted at axial imaging in one anatomical location can be visualized simultaneously and automatically at coronal imaging at the exactly corresponding anatomical location. Cross-referenced coincidental axial and coronal images help assess both the size and morphology of mediastinal and hilar lymph nodes

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

    International Nuclear Information System (INIS)

    Schertler, T.; Wildermuth, S.; Willmann, J.K.; Crook, D.W.; Marincek, B.; Boehm, T.

    2004-01-01

    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 [de

  15. Quantification of myocardial blood flow using dynamic 320-row multi-detector CT as compared with ¹⁵O-H₂O PET.

    Science.gov (United States)

    Kikuchi, Yasuka; Oyama-Manabe, Noriko; Naya, Masanao; Manabe, Osamu; Tomiyama, Yuuki; Sasaki, Tsukasa; Katoh, Chietsugu; Kudo, Kohsuke; Tamaki, Nagara; Shirato, Hiroki

    2014-07-01

    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 (15)O-H₂O 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 dynamic CTP and PET (r = 0.67, P = 0.0126). CFRCT 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. • MBF and CFR can be calculated using dynamic CTP with 320-row MDCT. • MBF and CFR showed good correlation between dynamic CTP and PET. • Lower CFR was well demonstrated in CAD patients by dynamic CTP.

  16. Radiological emergency room management with emphasis on multidetector-row

    Energy Technology Data Exchange (ETDEWEB)

    Philipp, M.O.; Kubin, K.; Hoermann, M.; Metz, V.M. E-mail: viktor.metz@univie.ac.at

    2003-10-01

    Trauma is the fifth leading cause of death after disease of the cardiovascular system, malignomas and disease of the respiratory and digestive system. The management of severely injured patients, including radiological imaging, is a matter of ongoing development. In particular, as for the imaging modalities, multidetector-row CT represents a substantial refinement in the diagnostic work-up of multitrauma patients. Sufficient therapy within the first hour after trauma increases the patient's chances for survival significantly. Thus, therapeutic procedures and diagnostic evaluation have to be concomitant events, performed by a multidisciplinary team, namely trauma surgeon, anesthesiologist and, last but not least, radiologist. The increased performance of multidetector-row CT leads to increased spatial resolution, which is a prerequisite for sophisticated two- and three-dimensional postprocessing. The increased volume coverage speed allows for comprehensive whole-body CT at still high levels of spatial resolution, resulting in significant spare of time which influences patient's survival. Using this technique conventional imaging such as plane film or angiography may be omitted.

  17. Multi-detector row CT of the kidney: Optimizing scan delays for bolus tracking techniques of arterial, corticomedullary, and nephrographic phases

    Energy Technology Data Exchange (ETDEWEB)

    Goshima, Satoshi [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Kanematsu, Masayuki [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Department of Radiology Services, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Nishibori, Hironori; Kondo, Hiroshi; Tsuge, Yusuke [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Yokoyama, Ryujiro; Miyoshi, Toshiharu [Department of Radiology Services, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Onozuka, Minoru [Department of Physiology and Neuroscience, Kanagawa Dental College, Yokosuka, Kanagawa (Japan); Shiratori, Yoshimune [Department of Medical Informatics, Gifu University School of Medicine, Gifu (Japan); Moriyama, Noriyuki [Department of Diagnostic Radiology, National Cancer Center Hospital, Tsukiji, Chuo-Ku, Tokyo (Japan); Bae, Kyongtae T. [Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States)

    2007-09-15

    Purpose: To determine optimal scan delays for renal arterial-, corticomedullary-, and nephrographic-phase imaging with multi-detector row computed tomography (MDCT) of the kidney using a bolus-tracking technique. Methods and materials: One hundred and twenty-eight patients underwent three-phase CT scan of the kidney with eight-row MDCT after receiving 2 mL/kg of 300 mg I/mL contrast medium at 4 mL/s. Patients were prospectively randomized into three groups with different scan delays for the three scan phases (arterial, corticomedullary, and nephrographic) after bolus-tracking triggered at 50 HU of aortic contrast enhancement: group 1 (5, 20, 45 s); group 2 (10, 25, 50 s); and group 3 (15, 30, 55 s). Mean CT values (HU) of the abdominal aorta, renal artery, renal vein, renal cortex, and renal medulla were measured; increases in CT values pre- to post-contrast were assessed as contrast enhancement. Renal artery-to-vein and renal cortex-to-medulla contrast differences were also assessed. Qualitative analysis was also performed. Results: Mean renal artery enhancement was 240-288 HU at 5-15 s after the trigger and peaked at 10 s (P < .001). Mean renal cortical enhancement was 195-217 HU at 10-30 s and peaked at 25 s (P < .01). Contrast enhancement in the renal medulla increased gradually and reached mean 145 HU at 55 s. Cortex-to-medulla contrast difference was high (110-140 HU) at 5-30 s and decreased below 30 HU at 45 s after the trigger. Renal artery-to-vein contrast difference was high (121-125 HU) at 5-10 s. Qualitative results correlated well with quantitative results. Conclusion: For the injection protocol used in this study, optimal scan delays after the bolus-tracking trigger were 5-10 s for renal arterial, 15-25 s for corticomedullary, and 50-55 s for nephrographic phases.

  18. 64-Slice multidetector row CT angiography of the abdomen: comparison of low versus high concentration iodinated contrast media in a porcine model

    Science.gov (United States)

    Holalkere, N-S; Matthes, K; Kalva, S P; Brugge, W R; Sahani, D V

    2011-01-01

    Objective In this study we aimed to assess the image quality and degree of vascular enhancement using low-concentration contrast media (LCCM) (300 mg I ml–1) and high-concentration contrast media (HCCM) (370 mg I ml–1) on 64-slice multidetector row CT (MDCT) abdominal CT angiography (CTA). In addition, we aimed to study the feasibility of using HCCM with a reduced total iodine dose. Methods CTA of the abdomen on a 64-slice MDCT was performed on 15 anaesthetised pigs. Study pigs were divided into three groups of five each based on the iodine concentration and dose received: Group A (LCCM; 300 mg I ml–1), Group B (HCCM; 370 mg I ml–1) and Group C HCCM with 20% less iodine dose. The total iodine injected was kept constant (600 mg kg–1) in Groups A and B. Qualitative and quantitative analyses were performed to study and compare each group for image quality, visibility of the branch order of the superior mesenteric artery (SMA), artefacts, degree of enhancement in the aorta and main stem arteries and uniformity of enhancement in the aorta. Groups were compared using the analysis of variance test. Results The image quality of 64-slice MDCT angiography was excellent with a mean score of 4.63 and confident visualisation of the third to fifth order branches of the SMA in all groups. Group B demonstrated superior vascular enhancement, as compared with Groups A and C (p≤0.05). Uniform aortic enhancement was achieved with the use of LCCM and HCCM with 20% less iodine dose. Conclusion 64-slice MDCT angiography of the abdomen was of excellent quality. HCCM improves contrast enhancement and overall CTA image quality and allows the iodine dose to be reduced. PMID:21081582

  19. Comparison radiation dose of Z-axis automatic tube current modulation technique with fixed tube current multi-detector row CT scanning of lower extremity venography

    International Nuclear Information System (INIS)

    Yoo, Beong Gyu; Kweon, Dae Cheol; Lee, Jong Seok; Jang, Keun Jo; Jeon, Sang Hwan; Kim, Yong Soo

    2007-01-01

    Z-axis automatic tube current modulation technique automatically adjusts tube current based on size of body region scanned. The purpose of the current study was to compare noise, and radiation dose of Multi-Detector row CT (MDCT) of lower extremity performed with Z-axis modulation technique of automatic tube current modulation with manual selection fixed tube current. Fifty consecutive underwent MDCT venography of lower extremity with use of a MDCT scanner fixed tube current and Z-axis automatic tube current modulation technique (10, 11 and 12 HU noise index, 70∼450 mA). Scanning parameters included 120 kVp, 0.5 second gantry rotation time, 1.35:1 beam pitch, and 1 mm reconstructed section thickness. For each subject, images obtained with Z-axis modulation were compared with previous images obtained with fixed tube current (200, 250, 300 mA) and with other parameters identical. Images were compared for noise at five levels: iliac, femoral, popliteal, tibial, and peroneal vein of lower extremity. Tube current and gantry rotation time used for acquisitions at these levels were recorded. All CT examinations of study and control groups were diagnostically acceptable, though objective noise was significantly more with Z-axis automatic tube current modulation. Compared with fixed tube current, Z-axis modulation resulted in reduction of CTDIvol (range, -6.5%∼-35.6%) and DLP (range,-0.2%∼-20.2%). Compared with manually selected fixed tube current, Z-axis automatic tube current modulation resulted in reduced radiation dose at MDCT of lower extremity venography

  20. 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.

  1. Acute pulmonary embolism: prediction of cor pulmonale and short-term patient survival from assessment of cardiac dimensions in routine multidetector-row CT

    International Nuclear Information System (INIS)

    Engeike, C.; Rummeny, E.; Marten, K.

    2006-01-01

    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 D , LV 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 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 D /LV D ratio had a PPV of 0.85 for cor pulmonale. (orig.)

  2. Multi-detector row CT of the head and neck: comparison of different volumes of contrast material with and without a saline chaser

    International Nuclear Information System (INIS)

    Yoon, Dae Young; You, Su Yeon; Choi, Chul Soon; Chang, Suk Ki; Yun, Eun Joo; Seo, Young Lan; Park, Sang Joon; Lee, Yu-Jin; Moon, Jeung Hee; Rho, Young-Soo; Kim, Jin-Hwan

    2006-01-01

    The aim of this study was to determine the effect of different volumes of contrast material with and without a saline chaser on tissue enhancement in multidetector row CT (MDCT) of the head and neck. In a blind prospective fashion, 120 patients were randomized into the following four groups: group 1, 80 ml contrast material administered at a flow rate of 2.0 ml/s; group 2, 80 ml followed by 40 ml saline at 2.0 ml/s; group 3, 60 ml at 1.5 ml/s; and group 4, 60 ml followed by 30 ml saline at 1.5 ml/s. The attenuation values of the carotid artery, internal jugular vein, and muscle were measured at an interval of 1.5 s in each patient. The degree of perivenous artifacts was subjectively assessed. Mean attenuation values in the carotid artery and internal jugular vein were significantly higher in groups 1 and 2 than in groups 3 and 4. The width of the diagnostic window (both carotid and jugular enhancement >150 HU) were significantly longer in groups 1 and 2 than in groups 3 and 4. The addition of a saline chaser did not result in improved vascular enhancement or a wider diagnostic window, but reduced perivenous artifacts, compared with using contrast material alone. Reduction of contrast material from 80 to 60 ml results in insufficient enhancement of neck vessels. In addition, the benefit of a saline chaser technique is not obvious except for its ability to reduce perivenous artifacts. (orig.)

  3. 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.

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

    International Nuclear Information System (INIS)

    Taylor, S.A.; Halligan, S.; Burling, D.; Bassett, P.; Bartram, C.I.

    2005-01-01

    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

  5. 320-Multidetector row whole-head dynamic subtracted CT angiography and whole-brain CT perfusion before and after carotid artery stenting: Technical note

    International Nuclear Information System (INIS)

    San Millan Ruiz, Diego; Murphy, Kieran; Gailloud, Philippe

    2010-01-01

    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.

  6. 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

  7. Impaired left ventricular function has a detrimental effect on image quality in multi-detector row CT coronary angiography

    International Nuclear Information System (INIS)

    Manghat, N.E.; Morgan-Hughes, G.J.; Shaw, S.R.; Marshall, A.J.; Roobottom, C.A.

    2008-01-01

    Aim: To determine whether there is a relationship between left ventricular (LV) haemodynamic parameters, circulation times, and arterial contrast opacification that might affect the image quality of computed tomography (CT) coronary angiography. Methods: Thirty-six patients were included in the study: 18 with cardiomyopathy (CM) and LV dilatation of suspected ischaemic aetiology [age 57.9 ± 13.7 years, range 30-77 years; 14 male, four female; body mass index (BMI) = 27.7 ± 4.5, range 25.5-31.8] and 18 controls (age 62.3 ± 9.4 years, range 47-89 years; 10 male, eight female; BMI 27.8 ± 6.6; range 19.2-33.6). Coronary artery image quality was assessed using a three-point visual scale; contrast medium circulation times, aortic root contrast attenuation, and LV functional parameters were studied. Results: Visually reduced contrast opacification impaired image quality more often in the CM group than the control group (27.4 versus 5.1%). A total of 55.6% CM patients had a contrast transit time ranging from 30-75 s; the number of 'unassessable' segments increased with increasing transit time conforming to a fitted quadratic model (R 2 = 0.74). The relationship between LV ejection fraction and contrast attenuation may also conform to a quadratic model (R 2 = 0.71). Conclusion: LV haemodynamics influence coronary artery opacification using cardiac CT, and users imaging this subgroup must do so with the knowledge of this potential pitfall. The results indicate the need for further studies examining CT protocols in this clinical subgroup

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

    International Nuclear Information System (INIS)

    Yi, Bo Ram; Sun, Joo Sung; Yang, Hyoung Mo; Kang, Doo Kyoung

    2015-01-01

    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.

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

    International Nuclear Information System (INIS)

    Elijovich, Lucas; Kazmi, Khuram; Gauvrit, Jean Y.; Law, Meng

    2006-01-01

    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.)

  10. 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.)

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

    International Nuclear Information System (INIS)

    Krumm, P.; Schraml, C.; Bretschneider, C.; Seeger, A.; Klumpp, B.; Kramer, U.; Claussen, C.D.; Miller, S.

    2011-01-01

    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.)

  12. Diagnostic assessment of painless microhematuria: prospective study comparing image quality, assessibility and diagnostic certainty of multidetector-row CT and intravenous pyelography within a single examination

    International Nuclear Information System (INIS)

    Boehm, T.; John, H.; Ruedi, C.; Marincek, B.; Wildermuth, S.; Michael, M.

    2005-01-01

    Purpose: The purpose of this study is to prospectively compare intravenous pyelography (IVP) and combined unenhanced and excretory phase multidetector-row CT (MDCT) with respect to image quality, diagnostic certainty and diagnostic concordance with the final clinical diagnosis in patients with painless microhematuria. Materials and Methods: Unenhanced MDCT, IVP and excretory phase MDCT were performed in 59 consecutive patients (21 women, 38 men, mean age 56±19 years, range 23-83 years) with painless microhematuria of unknown origin during a single examination with a single contrast media application (100 ml, non-ionic iodinate contrast media). Images were assessed by two experienced urogenital radiologists in consensus for image quality, diagnostic certainty of stone detection, obstruction, parenchymal lesions and morphological distinctive features. Imaging diagnoses of MDCT and IVP were compared with the final clinical diagnoses. In case of failure to detect an relevant pathology, the final clinical diagnosis was established after a mean follow-up period of 18±6 months (10 months to 2 years). Costs and radiation exposure of IVP and MDCT were compared. Results: MDCT scan performed better than IVP in terms of image quality for all regarded variables. Image quality of MDCT was rated in all parameters as very good or good; the image quality of IVP differed in a wide range. MDCT and IVP reached a sensitivity of 100% and 50% for stone detection (n=14, p=0.008), respectively. Two bladder stones were not detected by IVU but correctly seen with MDCT. MDCT and IVP were unsatisfactory for detecting transitional cell carcinomas (n=4, 2 of 4 detected with MDCT, 0 of 4 detected with IVU). One false positive transitional cell carcinoma was detected with IVP, none with MDCT. Additional relevant pathological changes (one teratoma, one abdominal aortic aneurysma and one abscess) were detected using MDCT but missed with IVP. In 38 of 59 patients (64%) imaging and clinical follow

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

    Science.gov (United States)

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

  14. Multidetector CT of the colon

    International Nuclear Information System (INIS)

    Luboldt, W.; Hoepffner, N.; Holzer, K.

    2003-01-01

    Multidetector technology, enabling faster imaging, higher spatial resolution and reduction in radiation dose, increases the role of CT in colonic diagnostic. The higher spatial resolution in the z-direction also changes the way to analyze the images. Instead of reading axial sections, now the colon can be systematically assessed in 3D by scrolling through multiplanar reconstructions or in CT colonography by virtual endoscopy. With ongoing improvements in computer-aided diagnosis CT colonography becomes an alternative to fiberoptic colonocopy for screening (http://www.multiorganscreening.org). In this article we propose a CT examination protocol for the colon, describe the typical imaging findings of different colonic diseases, and summarize the current status of CT colonography. (orig.)

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-15

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

  17. Visualization of the Adamkiewicz artery in patients with acute Stanford A dissections. A prospective 64-row multi-detector CT study

    International Nuclear Information System (INIS)

    Kovacs, Attila; Willinek, W.A.; Schild, H.; Urbach, H.; Schiller, W.; Gerhards, H.M.; Welz, A.; Flacke, S.

    2009-01-01

    Purpose: to evaluate the detectability of the Adamkiewicz artery (AA) in patients with acute Stanford type A aortic dissections with multi-detector computed tomography (MDCT). Materials and Methods: 51 patients with Stanford type A dissection underwent contrast-enhanced 64-row MDCT of the entire aorta (collimation 64 x 0.625 mm; rotation time 0.4sec; 120kV; 300 mAs). The visualization of the AA, its origin, and whether it originated from the true or false lumen were analyzed using source and multiplanar reformation images. Results: a single anterior radicular artery that formed a hairpin turn constituting the anterior spinal artery was visualized in 36 (70%) patients. Thirty (83%) of these arteries originated from the left side, and 35 (97%) originated between the level T7 and L2. Twenty-three (64%) arteries originated from the true and 13 (36%) from the false lumen. Two AAs in the same patient were not observed. Conclusion: MDCT depicts the AA in a high percentage of patients with acute Stanford type A aortic dissection. (orig.)

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

    International Nuclear Information System (INIS)

    Chu, W.C.W.; Lam, W.W.M.; Mok, G.C.F.; Yam, M.; Sung, R.Y.T.

    2006-01-01

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

  19. Evaluation of multiple trauma victims with 16-row multidetector CT (MDCT): a time analysis; Anwendung der 16-Zeilen-Mehrdetektor-CT in der Initialdiagnostik beim Polytrauma: Eine Zeitanalyse

    Energy Technology Data Exchange (ETDEWEB)

    Heyer, C.M.; Nicolas, V. [Bochum Univ. (Germany). Inst. fuer Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin; Rduch, G.J. [Bochum Univ. (Germany). Klinik fuer Chirurgie; Wick, M.; Muhr, G. [Bochum Univ. (Germany). Medizinische Klinik III, Pneumologie, Allergologie und Schlafmedizin; Bauer, T.T. [Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Univ. Bochum (Germany)

    2005-12-15

    Purpose: Description and time analysis of a 16-row MDCT protocol in the evaluation of multiple trauma patients considering transport, time of scanning, patient positioning, image reconstruction, and image interpretation. Materials and methods: Between May and December 2004, 60 multiple trauma patients underwent 16-row MDCT (Sensation, Siemens, Erlangen, Germany). The protocol included serial scanning of the head, spiral scanning of the cervical spine and contrast-enhanced spiral scanning of the thorax/abdomen with multiplanar reformations (MPR) of the thoracic/lumbar spine and the pelvis. All time intervals including transport, patient positioning, scanning, duration of MPR, total time in the examination room, and time to first and final image interpretation were prospectively evaluated. Furthermore, patient characteristics, trauma profiles, and mortality rates were recorded. Results: 46 male and 14 female patients (mean age 43.6 years) were enrolled in the study. Time analysis of 16-row MDCT revealed the following results (mean time standard deviation): Emergency room treatment and transport 19.2{+-}6.7 min, patient positioning 16.5{+-}6.5 min, scan duration 8.0{+-}3.3 min, total time in examination room 24.5{+-}7.2 min, image reconstruction including MPR 32.0{+-}16.4 min, and time of first (16.4{+-}4.7 min) and final image interpretation (82.5{+-}30.4 min). Trauma profiles revealed thoracic injuries in 35/60 patients (58.3%), head injuries in 23/60 patients (38.3%), abdominal injuries in 15/60 patients (25.0%), injuries of the cervical (9/60 patients, 15.0%), thoracic (12/60 patients, 20.0%), and lumbar spine (19/60 patients, 31.7%), pelvic injuries in 13/60 patients (21.7%), and injuries of extremities in 39/60 patients (65.0%). The mortality rate was 21.7%. (orig.)

  20. Imaging of Acute Mesenteric Ischemia Using Multidetector CT and CT Angiography in a Porcine Model

    OpenAIRE

    Rosow, David E.; Sahani, Dushyant; Strobel, Oliver; Kalva, Sanjeeva; Mino-Kenudson, Mari; Holalkere, Nagaraj S.; Alsfasser, Guido; Saini, Sanjay; Lee, Susanna I.; Mueller, Peter R.; Castillo, Carlos Fernández-del; Warshaw, Andrew L.; Thayer, Sarah P.

    2005-01-01

    Acute mesenteric ischemia, a frequently lethal disease, requires prompt diagnosis and intervention for favorable clinical outcomes. This goal remains elusive due, in part, to lack of a noninvasive and accurate imaging study. Traditional angiography is the diagnostic gold standard but is invasive and costly. Computed tomography (CT) is readily available and noninvasive but has shown variable success in diagnosing this disease. The faster scanning time of multidetector row CT (M.D.CT) greatly f...

  1. Analysis of main influence factors on coronary artery image quality with 64-multidetector row helical CT using a pulsating cardiac phantom

    International Nuclear Information System (INIS)

    Liu Bin; Zhao Hong; Wu Xingwang; Zhang Jiawen; Yu Yongqiang; Liao Jingmin

    2006-01-01

    Objective: To explore the main influence factors (heart rate, rotation speed, and reconstruction algorithm) on the image quality of coronary artery with 40 mm VCT (64-detector row helical CT) using a pulsating cardiac phantom. Methods: An adjustable pulsating cardiac phantom (GE) containing predetermined simulated coronary arteries was scanned using a 40 mm VCT (GE LightSpeed CT) with cardiac pulsating rates of 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, and 115 beats per minute (bpm). The variable rotation speeds technique of 0.35 s, 0.40 s, and 0.45 s were used, respectively. The raw data were reconstructed using both one-sector and multi-sector reconstruction algorithm at optimal window of the R-R interval. The image quality score (IQS) was evaluated by two radiologists according to the same evaluation standard of reformated image. The correlation between heart rate (HR), roation speed, reconstruction algorithm, and IQS were analyzed. The IQS as independent variable and the HR, rotation speed, reconstruction algorithm as dependent variables were analyzed by multiple linear regression analysis. Results: The heart rate and the reconstruction algorithm had significant influence on IQS. The rotation speed (0.35s, 0.40 s, and 0.45 s) didn't have significant influence on IQS. There was linear regression relationship between heart rate, reconstruction algorithm and IQS (P<0.01). The equation of multiple regression was IQS=5.154-0.046 x (HR) + 0.500 x (reconstruction algorithm). The multi-sector reconstruction algorithm improved the image quality than one-sector did. Conclusion: The main influence factors on the image quality of coronary artery can be evaluated with 40 mm VCT using a pulsating cardiac phantom. It plays an important role in clinical research and application. (authors)

  2. 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

    International Nuclear Information System (INIS)

    Woodhams, Reiko; Nishimaki, Hiroshi; Fujii, Kaoru; Kakita, Satoko; Hayakawa, Kazushige

    2010-01-01

    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.

  3. 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.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  5. 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.

    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

  6. The Incidence and Anatomy of Accessory Pudendal Arteries as Depicted on Multidetector-Row CT Angiography: Clinical Implications of Preoperative Evaluation for Laparoscopic and Robot-Assisted Radical Prostatectomy

    International Nuclear Information System (INIS)

    Park, Beom Jin; Sung, Deuk Jae; Kim, Min Ju; Cho, Sung Bum; Kim, Yun Hwan; Chung, Kyoo Byung; Kang, Seok Ho; Cheon, Jun

    2009-01-01

    To help preserve accessory pudendal arteries (APAs) and to ensure optimal postoperative sexual function after a laparoscopic or robot-assisted radical prostatectomy, we have evaluated the incidence of APAs as detected on multidetector-row CT (MDCT) angiography and have provided a detailed anatomical description. The distribution of APAs was evaluated in 121 consecutive male patients between February 2006 and July 2007 who underwent 64- channel MDCT angiography of the lower extremities. We defined an APA as any artery located within the periprostatic region running parallel to the dorsal vascular complex. We also subclassified APAs into lateral and apical APAs. Two radiologists retrospectively evaluated the origin, course and number of APAs; the final APA subclassification based on MDCT angiography source data was determined by consensus. We identified 44 APAs in 36 of 121 patients (30%). Two distinct varieties of APAs were identified. Thirty-three APAs (75%) coursed near the anterolateral region of the prostatic apex, termed apical APAs. The remaining 11 APAs (25%) coursed along the lateral aspect of the prostate, termed lateral APAs. All APAs originated from the internal obturator artery and iliac artery or a branch of the iliac artery such as the inferior vesical artery. The majority of apical APAs arose from the internal obturator artery (84%). Seven patients (19%) had multiple APAs. APAs are more frequently detected by the use of MDCT angiography than as suggested by previous surgical studies. The identification of APAs on MDCT angiography may provide useful information for the surgical preservation of APAs during a laparoscopic or robot-assisted radical prostatectomy

  7. Clinico-statistical study of preoperative examination for the dental implant using multi-detector row computed tomography

    International Nuclear Information System (INIS)

    Sekiya, Keiko; Mori, Shintaro; Sekiya, Kotaro

    2008-01-01

    In April 2006, a new affiliated hospital opened at Nihon University School of Dentistry at Matsudo, and the latest model was introduced into the department of radiology. CT examinations for preoperative dental implant going on 64 multi-detector row CT, the number of cases has increased. CT examination is useful for preoperative dental implant, and many studies of concerning clinical studies using CT images have been reported. The purpose of this study was to the clinico-statistical studies of preoperative CT examinations for dental implant at our radiology department using 64 multi-detector row CT. The subjects consisted of 5174 regions in 1312 cases of preoperative CT examinations, between April 2006 and December 2007. CT machine used was the Aquilion TM 64 (Toshiba Medical Systems, Japan), and the workstation used was the ZIOSTATION (ZIOSOFT, Japan). All of CT examinations were performed the position of implant placement and disease examined from CT findings. The following results were obtained: The 1312 cases consisted of 426 males and 886 females. Patient age ranged from 16 yrs to 86 yrs old, the average age were 55.5 yrs old. Six hundred and seventy four cases were ordered at another private dental office not our hospital, and 638 cases were ordered at our hospital. The numbers of implant placement were on the average of 3.9, and the rate got higher with age. The lesions which detected by preoperative CT examination were maxillary sinusitis, periodontitis, ectopic calcification, and mucous retention cyst. (author)

  8. Imaging of acute mesenteric ischemia using multidetector CT and CT angiography in a porcine model.

    Science.gov (United States)

    Rosow, David E; Sahani, Dushyant; Strobel, Oliver; Kalva, Sanjeeva; Mino-Kenudson, Mari; Holalkere, Nagaraj S; Alsfasser, Guido; Saini, Sanjay; Lee, Susanna I; Mueller, Peter R; Fernández-del Castillo, Carlos; Warshaw, Andrew L; Thayer, Sarah P

    2005-12-01

    Acute mesenteric ischemia, a frequently lethal disease, requires prompt diagnosis and intervention for favorable clinical outcomes. This goal remains elusive due, in part, to lack of a noninvasive and accurate imaging study. Traditional angiography is the diagnostic gold standard but is invasive and costly. Computed tomography (CT) is readily available and noninvasive but has shown variable success in diagnosing this disease. The faster scanning time of multidetector row CT (M.D.CT) greatly facilitates the use of CT angiography (CTA) in the clinical setting. We sought to determine whether M.D.CT-CTA could accurately demonstrate vascular anatomy and capture the earliest stages of mesenteric ischemia in a porcine model. Pigs underwent embolization of branches of the superior mesenteric artery, then imaging by M.D.CT-CTA with three-dimensional reconstruction protocols. After scanning, diseased bowel segments were surgically resected and pathologically examined. Multidetector row CT and CT angiography reliably defined normal and occluded mesenteric vessels in the pig. It detected early changes of ischemia including poor arterial enhancement and venous dilatation, which were seen in all ischemic animals. The radiographic findings--compared with pathologic diagnoses-- predicted ischemia, with a positive predictive value of 92%. These results indicate that M.D.CT-CTA holds great promise for the early detection necessary for successful treatment of acute mesenteric ischemia.

  9. Diffusion-weighted MR imaging vs. multi-detector row CT: Direct comparison of capability for assessment of management needs for anterior mediastinal solitary tumors

    International Nuclear Information System (INIS)

    Seki, Shinichiro; Koyama, Hisanobu; Ohno, Yoshiharu; Nishio, Mizuho; Takenaka, Daisuke; Maniwa, Yoshimasa; Itoh, Tomoo; Nishimura, Yoshihiro; Sugimura, Kazuro

    2014-01-01

    Purpose: To evaluate and compare the capability of diffusion-weighted MR imaging (DWI) and CT for assessment of management needs for anterior mediastinal solitary tumors. Materials and methods: Thirty-five patients with pathologically confirmed anterior mediastinal tumors were enrolled. The tumors were divided into two groups according to need for management: tumors not needing further intervention or treatment (group A; thymoma type A, AB and B1) and tumors needing further intervention and treatment (group B; other thymoma types and malignancies). The apparent diffusion coefficient (ADC) of each tumor was measured, and probabilities of malignancy and need for further intervention and treatment were visually assessed on CT. The differences in ADCs between group A and B and between malignancies and thymomas in group B were evaluated with the Mann–Whitney's U-test. Feasible threshold values for differentiation of group B from group A and distinguishing malignancies from thymomas assessed as group B were determined by the ROC-based positive test, and McNemar's test was used for comparing diagnostic capabilities of DWI with those of CT. Results: ADCs for the two groups were significantly different (p < 0.001). Application of the threshold value for differentiation of group B from A showed no significant difference (p > 0.05). Application of the feasible threshold value for distinguishing malignant from thymomas assessed as group B showed that specificity (76.9%) and accuracy (85.2%) of DWI were significantly better than those of visual score (p < 0.05). Conclusion: DWI has useful potential for the assessment of management needs for anterior mediastinum solitary tumors as well as CT

  10. Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: impact on surgical procedure

    International Nuclear Information System (INIS)

    Frericks, Bernd B.J.; Kirchhoff, Timm D.; Shin, Hoen-Oh; Stamm, Georg; Merkesdal, Sonja; Abe, Takehiko; Galanski, Michael; Schenk, Andrea; Peitgen, Heinz-Otto; Klempnauer, Juergen; Nashan, Bjoern

    2006-01-01

    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.)

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

    International Nuclear Information System (INIS)

    Yasui, Takahiro; Tanabe, Nobuhiro; Terada, Jiro

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    International Nuclear Information System (INIS)

    Imagawa, Hiroshi; Kawachi, Kanji; Takano, Shinji

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-03-15

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  17. 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

  18. Evaluation of radiation dose in 64-row whole-body CT of multiple injured patients compared to 4-row CT

    International Nuclear Information System (INIS)

    Harrieder, A.; Geyer, L.L.; Koerner, M.; Deak, Z.; Wirth, S.; Reiser, M.; Linsenmaier, U.

    2012-01-01

    Purpose: To evaluate radiation exposure in whole-body CT (WBCT) of multiple injured patients comparing 4-row multidetector computed tomography (MDCT) to 64-row MDCT. Materials and Methods: 200 WBCT studies were retrospectively evaluated: 92 4-row MDCT scans and 108 64-row MDCT scans. Each CT protocol was optimized for the particular CT system. The scan length, CT dose index (CTDI), and dose length product (DLP) were recorded and analyzed for radiation exposure. The mean effective dose was estimated based on conversion factors. Student's t-test was used for statistical analysis. Results: The mean CTDI vol values (mGy) of the thorax and abdomen were significantly reduced with 64-row MDCT (10.2 ± 2.5 vs. 11.4 ± 1.4, p < 0.001; 14.2 ± 3.7 vs. 16.1 ± 1.7, p < 0.001). The DLP values (mGy x cm) of the head and thorax were significantly increased with 64-row MDCT (1305.9 ± 201.1 vs. 849.8 ± 90.9, p < 0,001; 504.4 ± 134.4 vs. 471.5 ± 74.1, p = 0.030). The scan lengths (mm) were significantly increased with 64-row MDCT: head 223.6 ± 35.8 vs. 155.5 ± 12.3 (p < 0.001), thorax 427.4 ± 44.5 vs. 388.3 ± 57.5 (p < 0.001), abdomen 520.3 ± 50.2 vs. 490.8 ± 51.6 (p < 0.001). The estimated mean effective doses (mSv) were 22.4 ± 2.6 (4-row MDCT) and 24.1 ± 4.6 (64-row MDCT; p = 0.001), resulting in a percentage increase of 8 %. Conclusion: The radiation dose per slice of the thorax and abdomen can be significantly decreased by using 64-row MDCT. Due to the technical advances of modern 64-row MDCT systems, the scan field can be adapted to the clinical demands and, if necessary, enlarged without time loss. As a result, the estimated mean effective dose might be increased in WBCT. (orig.)

  19. Multidetector CT evaluation of potential right lobe living donors for ...

    African Journals Online (AJOL)

    Mohamed Saied Abdelgawad

    Multidetector CT evaluation of potential right lobe living donors for liver transplantation. Mohamed Saied Abdelgawad *, Osama L. El-Abd. National Liver Institute, El-Menoufiya University, Shebein El-Koom, Alexandria, Egypt. Received 4 June 2011; accepted 18 June 2011. KEYWORDS. Liver transplantation;. Multidetector ...

  20. Study on children patient dose in single-detector and multi-detector row helical computed tomography

    International Nuclear Information System (INIS)

    Lu Heqing; Zhu Guoying; Zhuo Weihai; Liu Haikuan; Guo Changyi

    2008-01-01

    Objective: To study and evaluate the radiation dose of children patient in single-detector and multi-detector row helical CT scan. Methods: The head and body CT dose index of 21 CT scanners were tested. Then the values of CTDI w , CTDI vol and DLP were calculated combining with the parameters of routine head and chest scan for children of 0-1 year old group, 5 years old group, 10 years old group and adults. The effective doses of children of every age group and adults in routine head and chest scan were subsequently estimated from effective dose per DLP by age and the calculated values of DLP. Results: CTDI per mAs is greater in the head than that in the body. In head routine scan, the effective doses of 0-1 year old group,5 years old group and 10 year old group were 2.2, 1.3 and 1.1 mSv, respectively. In chest routine scan, the effective doses of 0-1 year old group,5 years old group and 10 years old group were 5.3, 3.1 and 3.4 mSv, respectively. Effective doses to children per mAs are equally 1.8 times higher than corresponding values for adults. The CTDI vol , DLP and effective dose to children in head routine scan for MDCT were greater those that for single-detector CT and dual- detector CT. The CTDI vol , DLP and effective dose to children in chest routine scan for MDCT and dual-detector row CT were smaller than that for single-detector row CT. Conclusions: Children me more radiation risk in CT examination as compared with adults. So we should strictly abide by justification of children CT examination, and optimize the parameters of CT scan rationally in order to reduce the radiation dose to children patient as much as possible. (authors)

  1. 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.

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

    Science.gov (United States)

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

    2013-07-01

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

  3. Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography.

    Science.gov (United States)

    Dreizin, David; Boscak, Alexis R; Anstadt, Michael J; Tirada, Nikki; Chiu, William C; Munera, Felipe; Bodanapally, Uttam K; Hornick, Michael; Stein, Deborah M

    2016-12-01

    Purpose To determine the diagnostic performance of multidetector computed tomography (CT) with trajectography for penetrating colorectal injuries. Materials and Methods This institutional review board-approved and HIPAA-compliant study was a 6-year blinded retrospective review by two independent readers of 182 consecutive patients who preoperatively underwent 40- or 64-row multidetector CT for penetrating torso trauma below the diaphragm and had surgically confirmed findings. Colorectal perforation was present in 42 patients. Trajectory analysis with postprocessing software was used for all studies. Additional signs evaluated were rectal contrast agent leak, collections of extruded fecal material, mural defect, wall thickening, abnormal enhancement, free fluid or stranding, and free air. The quality of the colorectal contrast agent administration was recorded. Sensitivity, specificity, predictive values, areas under the receiver operating characteristic curves (AUCs), and Cohen κ were determined. Results In patients with rectal contrast agent administration (n = 151), AUCs were 0.90-0.91, which indicated excellent accuracy. Trajectory was sensitive (88%-91%). For single wounds (n = 104), sensitivity of trajectory was 96% for both readers, but was only 80% for multiple wounds (n = 47). Contrast agent leak was highly specific (96%-98%), but insensitive (42%-46%). Improved diagnostic performance was observed in patients with poor colonic distension or opacification. Accuracy remained high (AUC, 0.86-0.99) in the group without rectal contrast agent administration (n = 31). Conclusion Trajectory had excellent sensitivity, while rectal contrast agent leak was specific but insensitive. Sensitivity of trajectory was lower for multiple wounds. Accuracy remained high in patients without rectal contrast agent administration. © RSNA, 2016.

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

    Science.gov (United States)

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

    2016-01-01

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

  5. Multidetector CT portal venography in evaluation of portosystemic collateral vessels

    International Nuclear Information System (INIS)

    Agarwal, A.; Jain, M.

    2008-01-01

    This essay shows the usefulness of multidetector CT angiography for evaluation of the splenoportal venous system, which is essential in the management of patients with portal hypertension and its complications, such as portal vein thrombosis. By providing scanning with reconstruction of thin axial source images and reformatting into thicker multiplanar reformats, multidetector CT can help to determine the extent and location of portosystemic collateral vessels in patients with portal hypertension and is probably the optimal imaging technique in this setting.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  9. 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

  10. Multidetector CT angiography in Takayasu arteritis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. Multi-detector CT (MDCT in bowel and mesenteric injury

    Directory of Open Access Journals (Sweden)

    Vajjalla Ravikumar

    2013-04-01

    Full Text Available Objectives: To evaluate multi-detector CT (MDCT findings in bowel and mesenteric injury due to blunt abdominal trauma.Method: Retrospective evaluation of MDCT scan reports of patients admitted in Hamad Medical Corporation, Doha, Qatar with bowel and mesenteric injury during the period of January 2005 to April 2008.Results: MDCT, without using oral contrast, clearly demonstrated various specific and less specific findings of bowel and mesenteric injury.Conclusion: Multi-detector CT is an excellent diagnostic modality in bowel and mesenteric injury. Routine administration of oral contrast agent is not mandatory for initial evaluation of these patients.

  12. Congenital anomalies of coronary arteries: Diagnosis with 64 slice multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Tariq, Rukhsana, E-mail: drrukhsanatariq@hotmail.com [Consultant Radiologists, Advanced Radiology Clinic, Behind Hamdard University Hospital, Off M.A. Jinnah Road, Karachi (Pakistan); Kureshi, Shahzad Babar [Consultant Radiologists, Advanced Radiology Clinic, Behind Hamdard University Hospital, Off M.A. Jinnah Road, Karachi (Pakistan); Siddiqui, Usman T. [Medical College, Aga Khan University, Karachi (Pakistan); Ahmed, Rashid [Consultant Radiologists, Advanced Radiology Clinic, Behind Hamdard University Hospital, Off M.A. Jinnah Road, Karachi (Pakistan)

    2012-08-15

    Objective: Congenital coronary artery anomalies are generally incidental, uncommon and asymptomatic. Some can cause severe potentially life threatening symptoms. The common mode of studying the coronary arteries is Conventional Coronary Angiogram. ECG-gated-multidetector CT is a non invasive modality. The objective of our study was to identify rare congenital coronary artery anomalies and discuss their clinical significance. Material and methods: A total number of 900 MDCT coronary angiograms were carried out at our institution between the period of April 2006 and October 2010. Patients with coronary artery anomaly constituted the subject of study. Results: The incidence of anomalous anatomical origin and course of the coronary arteries in our study was 1.55%. Hemodynamical significance was seen in five patients. 3 cases of single coronary artery originating from right coronary sinus were seen. 1 case of anomalous left coronary artery arising from main pulmonary artery was seen. 4 cases of anomalous RCA arising from left aortic cusp, 6 cases of absent LMCA with separate origin of LAD and LCX were seen. Conclusion: Multidetector row CT is a noninvasive modality in cardiac imaging. It provides superior resolution of coronary tree and its variant. No projectional vascular overlap is seen. Various postprocessing techniques outclass catheter angiography imaging. Definition of ostia and proximal course of the coronary arteries by Multidetector CT is better than catheter angiography.

  13. Congenital anomalies of coronary arteries: Diagnosis with 64 slice multidetector CT

    International Nuclear Information System (INIS)

    Tariq, Rukhsana; Kureshi, Shahzad Babar; Siddiqui, Usman T.; Ahmed, Rashid

    2012-01-01

    Objective: Congenital coronary artery anomalies are generally incidental, uncommon and asymptomatic. Some can cause severe potentially life threatening symptoms. The common mode of studying the coronary arteries is Conventional Coronary Angiogram. ECG-gated-multidetector CT is a non invasive modality. The objective of our study was to identify rare congenital coronary artery anomalies and discuss their clinical significance. Material and methods: A total number of 900 MDCT coronary angiograms were carried out at our institution between the period of April 2006 and October 2010. Patients with coronary artery anomaly constituted the subject of study. Results: The incidence of anomalous anatomical origin and course of the coronary arteries in our study was 1.55%. Hemodynamical significance was seen in five patients. 3 cases of single coronary artery originating from right coronary sinus were seen. 1 case of anomalous left coronary artery arising from main pulmonary artery was seen. 4 cases of anomalous RCA arising from left aortic cusp, 6 cases of absent LMCA with separate origin of LAD and LCX were seen. Conclusion: Multidetector row CT is a noninvasive modality in cardiac imaging. It provides superior resolution of coronary tree and its variant. No projectional vascular overlap is seen. Various postprocessing techniques outclass catheter angiography imaging. Definition of ostia and proximal course of the coronary arteries by Multidetector CT is better than catheter angiography.

  14. Multi-detector CT assessment of traumatic renal lesions

    African Journals Online (AJOL)

    Mohamed Samir Shaaban

    2015-07-10

    Jul 10, 2015 ... Aim of the work: To demonstrate different traumatic lesions of the kidneys using multi-detector. CT, and its use in ... sis and staging of renal trauma and guiding management. © 2015 The ... Emotion 6 (Siemens, Germany), and 16 detectors PHILIPS .... with active bleeding within the hematoma and was man-.

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

    International Nuclear Information System (INIS)

    Romano, Stefania; Romano, Luigia; Grassi, Roberto

    2007-01-01

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

  16. Evaluation of radiation dose in 64-row whole-body CT of multiple injured patients compared to 4-row CT; Evaluation der Strahlendosis bei Polytrauma-CT-Untersuchungen eines 64-Zeilen-CT im Vergleich zur 4-Zeilen-CT

    Energy Technology Data Exchange (ETDEWEB)

    Harrieder, A.; Geyer, L.L.; Koerner, M.; Deak, Z.; Wirth, S.; Reiser, M.; Linsenmaier, U. [Ludwig-Maximilians-Univ. Muenchen (Germany). Inst. fuer Klinische Radiologie

    2012-05-15

    Purpose: To evaluate radiation exposure in whole-body CT (WBCT) of multiple injured patients comparing 4-row multidetector computed tomography (MDCT) to 64-row MDCT. Materials and Methods: 200 WBCT studies were retrospectively evaluated: 92 4-row MDCT scans and 108 64-row MDCT scans. Each CT protocol was optimized for the particular CT system. The scan length, CT dose index (CTDI), and dose length product (DLP) were recorded and analyzed for radiation exposure. The mean effective dose was estimated based on conversion factors. Student's t-test was used for statistical analysis. Results: The mean CTDI{sub vol} values (mGy) of the thorax and abdomen were significantly reduced with 64-row MDCT (10.2 {+-} 2.5 vs. 11.4 {+-} 1.4, p < 0.001; 14.2 {+-} 3.7 vs. 16.1 {+-} 1.7, p < 0.001). The DLP values (mGy x cm) of the head and thorax were significantly increased with 64-row MDCT (1305.9 {+-} 201.1 vs. 849.8 {+-} 90.9, p < 0,001; 504.4 {+-} 134.4 vs. 471.5 {+-} 74.1, p = 0.030). The scan lengths (mm) were significantly increased with 64-row MDCT: head 223.6 {+-} 35.8 vs. 155.5 {+-} 12.3 (p < 0.001), thorax 427.4 {+-} 44.5 vs. 388.3 {+-} 57.5 (p < 0.001), abdomen 520.3 {+-} 50.2 vs. 490.8 {+-} 51.6 (p < 0.001). The estimated mean effective doses (mSv) were 22.4 {+-} 2.6 (4-row MDCT) and 24.1 {+-} 4.6 (64-row MDCT; p = 0.001), resulting in a percentage increase of 8 %. Conclusion: The radiation dose per slice of the thorax and abdomen can be significantly decreased by using 64-row MDCT. Due to the technical advances of modern 64-row MDCT systems, the scan field can be adapted to the clinical demands and, if necessary, enlarged without time loss. As a result, the estimated mean effective dose might be increased in WBCT. (orig.)

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  18. Multi-detector CT knee arthrography - initial experience

    International Nuclear Information System (INIS)

    Thomson, J.M.Z.; Fallon, M.; Breidahl, W.H.

    2002-01-01

    Full text: Traditional plain film arthrography can achieve reasonable accuracy and is an accepted method of investigation of patients with knee pain and possible meniscal tear. Multi-detector CT can potentially provide a more detailed and accurate examination due to its high-resolution crosssectional and multi-planar capabilities. The aim of this study was to assess the accuracy of our technique. All patients who underwent a multi-detector CT knee arthrogram in an initial 8 month period were identified. Initially the referring clinician was contacted. If the patient was referred to an orthopaedic surgeon the outcome of orthopaedic review was recorded using clinical, arthroscopic and / or MRI follow-up of the patient population. One hundred and twelve patients had a Multi-detector CT knee arthrogram performed within and 8 month period. Follow-up information was received in 69.7% of patients. Of these 68.9% had orthopaedic assessment - of which 69.2% underwent a knee arthroscopy.There was total agreement of findings in 67%, agreement of meniscal findings in 67% and chondral findings in 100%. Overall, orthopaedic opinion agreed with CT findings in 76.9%. At this stage, all meniscal tears not described in the initial CT arthrogram report have in retrospect been visible. Multi-detector CT knee arthrography is an accurate and elegant technique for investigation of knee pain, providing information in a format familiar to those reporting knee MRI. There is an initial learning curve. The technique is particularly useful in chondral assessment. It is accurate for meniscal pathology, although caution and recognition of potential pitfalls is required. Copyright (2002) Blackwell Science Pty Ltd

  19. Patent foramen ovale: detection with nongated multidetector CT.

    Science.gov (United States)

    Revel, Marie-Pierre; Faivre, Jean-Baptiste; Letourneau, Thierry; Henon, Hilde; Leys, Didier; Delannoy-Deken, Valérie; Remy-Jardin, Martine; Remy, Jacques

    2008-10-01

    To evaluate nongated multidetector computed tomography (CT) in the detection of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) in comparison with transesophageal echocardiography (TEE). The study was approved by the institutional review board, and informed consent was obtained from all patients. One hundred five patients (57 men, 48 women; mean age, 53 years) with a recent stroke underwent TEE and multidetector CT on the same day. After injection of a diluted iodinated contrast material, a series of 2.4-mm-thick transverse images centered on the fossa ovalis were acquired in conjunction with release of the Valsalva maneuver. Two independent radiologists considered PFO present if left atrial enhancement was detected visually before enhancement of the pulmonary veins or if an early peak of left atrial enhancement was found at time-attenuation curve analysis. PFO was detected with 98% specificity (95% confidence interval [CI]: 0.91, 0.99). Overall sensitivity was 55% (95% CI: 0.38, 0.70), ranging from 28% for shunts classified as grade 1 at TEE to 91% for those classified as grade 4 at TEE. Interreader agreement was good (kappa = 0.81). Visual assessment was better than time-attenuation curve analysis, which enabled detection of only 15 of the 40 cases of PFO. Multidetector CT depicted only 22% of cases of ASA. The mean effective radiation dose was 2.3 mSv. Nongated multidetector CT can be used to diagnose high-grade shunts through a PFO, with 91% sensitivity and 98% specificity. Thus, PFO detection, in addition to routine CT evaluation of the lungs, could be indicated in patients with unexplained hypoxemia. (c) RSNA, 2008.

  20. Dose reduction in multidetector CT of the urinary tract. Studies in a phantom model

    International Nuclear Information System (INIS)

    Coppenrath, E.; Meindl, T.; Herzog, P.; Khalil, R.; Mueller-Lisse, U.; Krenn, L.; Reiser, M.; Mueller-Lisse, U.G.

    2006-01-01

    A novel ureter phantom was developed for investigations of image quality and dose in CT urography. The ureter phantom consisted of a water box (14 cm x 32 cm x 42 cm) with five parallel plastic tubes (diameter 2.7 mm) filled with different concentrations of contrast media (1.88-30 mg iodine/ml). CT density of the tubes and noise of the surrounding water were determined using two multidetector scanners (Philips MX8000 with four rows, Siemens Sensation 16 with 16 rows) with varying tube current-time product (15-100 mAs per slice), voltage (90 kV, 100 kV, 120 kV), pitch (0.875-1.75), and slice thickness (1 mm, 2 mm, 3.2 mm). Contrast-to-noise ratio as a parameter of image quality was correlated with dose (CTDI) and was compared with image evaluation by two radiologists. The CT densities of different concentrations of contrast media and contrast-to-noise ratio were significantly higher when low voltages (90 kV versus 120 kV, 100 kV versus 120 kV) were applied. Smaller slice thickness (1 mm versus 2 mm) did not change CT density but decreased contrast-to-noise ratio due to increased noise. Contrast phantom studies showed favourable effects of low tube voltage on image quality in the low dose range. This may facilitate substantial dose reduction in CT urography. (orig.)

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

    International Nuclear Information System (INIS)

    Wiesner, Walter; Hauser, Andreas; Steinbrich, Wolfgang

    2004-01-01

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  3. Multidetector CT evaluation of the postoperative pancreas.

    Science.gov (United States)

    Yamauchi, Fernando I; Ortega, Cinthia D; Blasbalg, Roberto; Rocha, Manoel S; Jukemura, José; Cerri, Giovanni G

    2012-01-01

    Several pancreatic diseases may require surgical treatment, with most of these procedures classified as resection or drainage. Resection procedures, which are usually performed to remove pancreatic tumors, include pancreatoduodenectomy, central pancreatectomy, distal pancreatectomy, and total pancreatectomy. Drainage procedures are usually performed to treat chronic pancreatitis after the failure of medical therapy and include the Puestow and Frey procedures. The type of surgery depends not only on the patient's symptoms and the location of the disease, but also on the expertise of the surgeon. Radiologists should become familiar with these surgical procedures to better understand postoperative changes in anatomic findings. Multidetector computed tomography is the modality of choice for identifying normal findings after surgery, postoperative complications, and tumor recurrence in patients who have undergone pancreatic surgery. RSNA, 2012

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  5. ROLE OF MULTIDETECTOR CT IN EVALUATION OF NECK LESIONS

    Directory of Open Access Journals (Sweden)

    Reena Mathur

    2016-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-02-15

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  8. Distant metastases and synchronous second primary tumors in patients with newly diagnosed oropharyngeal and hypopharyngeal carcinomas: evaluation of 18F-FDG PET and extended-field multi-detector row CT

    International Nuclear Information System (INIS)

    Ng, Shu-Hang; Ko, Sheung-Fat; Chin, Shu-Chyn; Chan, Sheng-Chieh; Yen, Tzu-Chen; Liao, Chun-Ta; Huang, Shiang-Fu; Chang, Joseph Tung-Chieh; Lin, Chin-Yu.; Wang, Hung-Ming

    2008-01-01

    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 18 F-fluoro-2-deoxyglucose positron emission tomography ( 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 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 18 F-FDG PET and MDCT were 12.5% and 8.1%, respectively. The sensitivity of 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 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. 18 F-FDG PET and extended-field MDCT had acceptable diagnostic yields for detection of distant malignancies in untreated oropharyngeal and hypopharyngeal SCC. 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.)

  9. Multidetector CT in children: current concepts and dose reduction strategies

    Energy Technology Data Exchange (ETDEWEB)

    Nievelstein, Rutger A.J.; Dam, Ingrid M. van [University Medical Centre Utrecht, Department of Pediatric Radiology, Wilhelmina Children' s Hospital, E01.132, P.O. Box 85500, Utrecht (Netherlands); Molen, Aart J. van der [Leiden University Medical Centre, Department of Radiology, C-2S, Leiden (Netherlands)

    2010-08-15

    The recent technical development of multidetector CT (MDCT) has contributed to a substantial increase in its diagnostic applications and accuracy in children. A major drawback of MDCT is the use of ionising radiation with the risk of inducing secondary cancer. Therefore, justification and optimisation of paediatric MDCT is of great importance in order to minimise these risks (''as low as reasonably achievable'' principle). This review will focus on all technical and non-technical aspects relevant for paediatric MDCT optimisation and includes guidelines for radiation dose level-based CT protocols. (orig.)

  10. Multidetector CT in children: current concepts and dose reduction strategies

    International Nuclear Information System (INIS)

    Nievelstein, Rutger A.J.; Dam, Ingrid M. van; Molen, Aart J. van der

    2010-01-01

    The recent technical development of multidetector CT (MDCT) has contributed to a substantial increase in its diagnostic applications and accuracy in children. A major drawback of MDCT is the use of ionising radiation with the risk of inducing secondary cancer. Therefore, justification and optimisation of paediatric MDCT is of great importance in order to minimise these risks (''as low as reasonably achievable'' principle). This review will focus on all technical and non-technical aspects relevant for paediatric MDCT optimisation and includes guidelines for radiation dose level-based CT protocols. (orig.)

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

    International Nuclear Information System (INIS)

    Nakayama, Yoshiharu; Imuta, Masanori; Funama, Yoshinori; Kadota, Masataka; Utsunomiya, Daisuke; Shiraishi, Shinya; Hayashida, Yoshiko; Yamashita, Yasuyuki

    2002-01-01

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  13. Respiratory gated lung CT using 320-row area detector CT

    International Nuclear Information System (INIS)

    Sakamoto, Ryo; Noma, Satoshi; Higashino, Takanori

    2010-01-01

    Three hundred and twenty-row Area Detector CT (ADCT) has made it possible to scan whole lung field with prospective respiratory gated wide volume scan. We evaluated whether the respiratory gated wide volume scan enables to reduce motion induced artifacts in the lung area. Helical scan and respiratory gated wide volume scan were performed in 5 patients and 10 healthy volunteers under spontaneous breathing. Significant reduction of motion artifact and superior image quality were obtained in respiratory gated scan in comparison with helical scan. Respiratory gated wide volume scan is an unique method using ADCT, and is able to reduce motion artifacts in lung CT scans of patients unable to suspend respiration in clinical scenes. (author)

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

    Science.gov (United States)

    Kim, Jong Gyu

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-04-15

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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  17. Multidetector CT of blunt cervical spine trauma in adults.

    Science.gov (United States)

    Dreizin, David; Letzing, Michael; Sliker, Clint W; Chokshi, Falgun H; Bodanapally, Uttam; Mirvis, Stuart E; Quencer, Robert M; Munera, Felipe

    2014-01-01

    A number of new developments in cervical spine imaging have transpired since the introduction of 64-section computed tomographic (CT) scanners in 2004. An increasing body of evidence favors the use of multidetector CT as a stand-alone screening test for excluding cervical injuries in polytrauma patients with obtundation. A new grading scale that is based on CT and magnetic resonance (MR) imaging findings, the cervical spine Subaxial Injury Classification and Scoring (SLIC) system, is gaining acceptance among spine surgeons. Radiographic measurements described for the evaluation of craniocervical distraction injuries are now being reevaluated with the use of multidetector CT. Although most patients with blunt trauma are now treated nonsurgically, evolution in the understanding of spinal stability, as well as the development of new surgical techniques and hardware, has driven management strategies that are increasingly favorable toward surgical intervention. It is therefore essential that radiologists recognize findings that distinguish injuries with ligamentous instability or a high likelihood of nonfusion that require surgical stabilization from those that are classically stable and can be treated with a collar or halo vest alone. The purpose of this article is to review the spectrum of cervical spine injuries, from the craniocervical junction through the subaxial spine, and present the most widely used grading systems for each injury type. ©RSNA, 2014.

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

    International Nuclear Information System (INIS)

    Riegger, Carolin; Kroepil, Patric; Lanzman, Rotem S.; Miese, Falk R.; Antoch, Gerald; Scherer, Axel; Jungbluth, Pascal; Hakimi, Mohssen; Wild, Michael; Hakimi, Ahmad R.

    2012-01-01

    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.)

  19. 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.)

  20. [Comparison of radiation dose reduction of prospective ECG-gated one beat scan using 320 area detector CT coronary angiography and prospective ECG-gated helical scan with high helical pitch (FlashScan) using 64 multidetector-row CT coronary angiography].

    Science.gov (United States)

    Matsutani, Hideyuki; Sano, Tomonari; Kondo, Takeshi; Fujimoto, Shinichiro; Sekine, Takako; Arai, Takehiro; Morita, Hitomi; Takase, Shinichi

    2010-12-20

    A high radiation dose associated with 64 multidetector-row computed tomography (64-MDCT) is a major concern for physicians and patients alike. A new 320 row area detector computed tomography (ADCT) can obtain a view of the entire heart with one rotation (0.35 s) without requiring the helical method. As such, ADCT is expected to reduce the radiation dose. We studied image quality and radiation dose of ADCT compared to that of 64-MDCT in patients with a low heart rate (HR≤60). Three hundred eighty-five consecutive patients underwent 64-MDCT and 379 patients, ADCT. Patients with an arrhythmia were excluded. Prospective ECG-gated helical scan with high HP (FlashScan) in 64 was used for MDCT and prospective ECG-gated conventional one beat scan, for 320-ADCT. Image quality was visually evaluated by an image quality score. Radiation dose was estimated by DLP (mGy・cm) for 64-MDCT and DLP.e (mGy・cm) for 320-ADCT. Radiation dose of 320-ADCT (208±48 mGy・cm) was significantly (P<0.0001) lower than that of 64-MDCT (484±112 mGy・cm), and image quality score of 320-ADCT (3.0±0.2) was significantly (P=0.0011) higher than that of 64-MDCT (2.9±0.4). Scan time of 320-ADCT (1.4±0.1 s) was also significantly (P<0.0001) shorter than that of 64-MDCT (6.8±0.6 s). 320-ADCT can achieve not only a reduction in radiation dose but also a superior image quality and shortening of scan time compared to 64-MDCT.

  1. Multidetector spiral CT arthrography of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. Multidetector spiral CT arthrography of the shoulder

    International Nuclear Information System (INIS)

    Lecouvet, Frederic E.; Simoni, Paolo; Koutaissoff, Sophie; Vande Berg, Bruno C.; Malghem, Jacques; Dubuc, Jean-Emile

    2008-01-01

    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

  3. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT

    International Nuclear Information System (INIS)

    Smith, S.L.; Rajan, P.S.

    2004-01-01

    Pancreatic adenocarcinoma is the fourth most frequent cause of cancer-related death. The incidence is increasing and the overall survival has altered little in recent years. Moreover, patients usually present late with inoperable disease and curative resection by standard pancreatico-duodenectomy (Whipple's procedure) is associated with significant morbidity. It should only be attempted in that small group of patients lacking radiological evidence of advanced disease. Despite the recent advances in body magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS), computed tomography (CT) is the mainstay of staging in most centres and the recent development of multidetector CT machines (MDCT) has raised hope of an improvement in preoperative staging. This review focuses on the CT of pancreatic adenocarcinoma with particular emphasis on examination technique and on those criteria that determine resectability

  4. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Smith, S.L. E-mail: simon.smith@ipsh-tr.anglox.nhs.uk; Rajan, P.S

    2004-01-01

    Pancreatic adenocarcinoma is the fourth most frequent cause of cancer-related death. The incidence is increasing and the overall survival has altered little in recent years. Moreover, patients usually present late with inoperable disease and curative resection by standard pancreatico-duodenectomy (Whipple's procedure) is associated with significant morbidity. It should only be attempted in that small group of patients lacking radiological evidence of advanced disease. Despite the recent advances in body magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS), computed tomography (CT) is the mainstay of staging in most centres and the recent development of multidetector CT machines (MDCT) has raised hope of an improvement in preoperative staging. This review focuses on the CT of pancreatic adenocarcinoma with particular emphasis on examination technique and on those criteria that determine resectability.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-02-15

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

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

    International Nuclear Information System (INIS)

    Nedevska, M.; Stoinova, V.

    2006-01-01

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

  7. Statistical iterative reconstruction for streak artefact reduction when using multidetector CT to image the dento-alveolar structures.

    Science.gov (United States)

    Dong, J; Hayakawa, Y; Kober, C

    2014-01-01

    When metallic prosthetic appliances and dental fillings exist in the oral cavity, the appearance of metal-induced streak artefacts is not avoidable in CT images. The aim of this study was to develop a method for artefact reduction using the statistical reconstruction on multidetector row CT images. Adjacent CT images often depict similar anatomical structures. Therefore, reconstructed images with weak artefacts were attempted using projection data of an artefact-free image in a neighbouring thin slice. Images with moderate and strong artefacts were continuously processed in sequence by successive iterative restoration where the projection data was generated from the adjacent reconstructed slice. First, the basic maximum likelihood-expectation maximization algorithm was applied. Next, the ordered subset-expectation maximization algorithm was examined. Alternatively, a small region of interest setting was designated. Finally, the general purpose graphic processing unit machine was applied in both situations. The algorithms reduced the metal-induced streak artefacts on multidetector row CT images when the sequential processing method was applied. The ordered subset-expectation maximization and small region of interest reduced the processing duration without apparent detriments. A general-purpose graphic processing unit realized the high performance. A statistical reconstruction method was applied for the streak artefact reduction. The alternative algorithms applied were effective. Both software and hardware tools, such as ordered subset-expectation maximization, small region of interest and general-purpose graphic processing unit achieved fast artefact correction.

  8. Comparison of CT numbers between cone-beam CT and multi-detector CT

    International Nuclear Information System (INIS)

    Kim, Dong Soo; Han, Won Jeong; Kim, Eun Kyung

    2010-01-01

    To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, ρ(g/cm 3 ), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were ρ=0.001 H+1.07 with R2 value of 0.999 for Somatom Emotion, ρ=0.002 H+1.09 with R2 value of 0.991 for Alphard VEGA, ρ=0.001 H+1.43 with R2 value of 0.980 for i-CAT and ρ=0.001 H+1.30 with R2 value of 0.975 for Implagraphy. CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

  9. Comparison of CT numbers between cone-beam CT and multi-detector CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

    To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, {rho}(g/cm{sup 3}), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were {rho}=0.001 H+1.07 with R2 value of 0.999 for Somatom Emotion, {rho}=0.002 H+1.09 with R2 value of 0.991 for Alphard VEGA, {rho}=0.001 H+1.43 with R2 value of 0.980 for i-CAT and {rho}=0.001 H+1.30 with R2 value of 0.975 for Implagraphy. CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

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

    International Nuclear Information System (INIS)

    Okumoto, Tadayuki; Yamada, Takayuki; Sato, Akihiro

    2009-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

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

    International Nuclear Information System (INIS)

    Sekine, Takako; Kodama, Takahide; Kondo, Takeshi

    2010-01-01

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

  13. Multidetector CT findings of bowel Transection in blunt abdominal trauma

    International Nuclear Information System (INIS)

    Cho, Hyun Suk; Woo, Ji Young; Hong, Hye Suk; Park, Mee Hyun; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji Young; Ha, Hong Il

    2013-01-01

    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 blunt abdominal trauma. We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.

  14. Multidetector CT and MRI in diseases of the GI tract

    International Nuclear Information System (INIS)

    Bruel, J.M.; Gallix, B.

    2003-01-01

    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)

  15. Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography

    International Nuclear Information System (INIS)

    Hartmann, Ieneke J.C.; Remy-Jardin, Martine; Menchini, Laura; Teisseire, Antoine; Khalil, Chadi; Remy, Jacques

    2007-01-01

    The purpose of this study was to determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis. Over a 5-year period (2000-2005), 251 consecutive patients with hemoptysis underwent multidetector-row CT angiography of the thorax. From this population, 37 patients were excluded because of a suboptimal CTA examination (n = 19), the presence of extensive mediastinal disease (n = 15) or severe chest deformation (n = 3) precluding any precise analysis of the bronchial arteries at CTA. Our final study group included 214 patients who underwent a thin-collimated CT angiogram (contrast agent: 300 to 350 mg/ml) on a 4- (n = 56), 16- (n = 119) and 64- (n = 39) detector-row scanner. The site of origin and distribution of bronchial arteries were analyzed on transverse CT scans, maximum intensity projections and volume-rendered images. The site of the ostium of a bronchial artery was coded as orthotopic when the artery originated from the descending aorta between the levels of the fifth and sixth thoracic vertebrae; all other bronchial arteries were considered ectopic. From the studied population, 137 (64%) patients had only orthotopic bronchial arteries, whereas 77 patients (36%) had at least one bronchial artery of ectopic origin. A total of 147 ectopic arteries were depicted, originating as common bronchial trunks (n = 23; 19%) or isolated right or left bronchial arteries (n = 101; 81%). The most frequent sites of origin of the 124 ostiums were the concavity of the aortic arch (92/124; 74%), the subclavian artery (13/124; 10.5%) and the descending aorta (10/124; 8.5%). The isolated ectopic bronchial arteries supplied the ipsilateral lung in all but three cases. Bronchial artery embolization was indicated in 26 patients. On the basis of CTA information, (1

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-11-15

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

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

    Science.gov (United States)

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

    2010-03-01

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

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

    International Nuclear Information System (INIS)

    Komatsu, Sei; Imai, Atsuko; Kodama, Kazuhisa

    2011-01-01

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

  20. Preoperative staging of esophageal carcinoma with multidetector CT and virtual endoscopy

    International Nuclear Information System (INIS)

    Onbas, Omer; Eroglu, Atilla; Kantarci, Mecit; Polat, Pinar; Alper, Fatih; Karaoglanoglu, Nurettin; Okur, Adnan

    2006-01-01

    Purpose: The aim of this study was to assess the accuracy of multidetector computed tomography (MDCT), including virtual endoscopy (VE) for detection, precise localization, preoperative evaluation and staging of esophageal cancer (EC) by comparison with surgical and histopathological findings. Materials and methods: Between September 2003 and April 2005, 44 patients with histologically proven EC underwent MDCT and VE. Among 44 patients, the findings were confirmed in 24 at surgery. The accuracy of three-dimensional MDCT for detection, localization, and staging of EC was determined, and compared with surgical finding and histopathology. Results: The overall accuracy of three-dimensional multidetector row CT for detection of EC was 100% (24/24). MDCT staging was correct in 20 patients (83.3%). The T parameter was correctly assessed in 22 (91.7%) cases (understaged in 1 and overstaged in 1). The N parameter was correctly evaluated in 20 (83.4%) patients (understaged in 2 and overstaged in 2). The overall accuracy of VE for the morphologic classification of EC was 81.5%. Conclusions: Three-dimensional MDCT, along with VE is a promising method for preoperative evaluation and staging of EC. Although accuracy in N staging remains low in comparison to PET, it provides a larger amount of diagnostic and staging information

  1. Measurement of Trabecular Bone Parameters in Porcine Vertebral Bodies Using Multidetector CT: Evaluation of Reproducibility of 3-Dimensional CT Histomorphometry

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Sung Hwan; Goo, Jin Mo [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Moon Kyung Chul [Dept. of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Sang Bu [Dept. of radiology, National Cancer Center, Goyang (Korea, Republic of); Kim, Kwang Gi [Dept. of Biomedical Engineering, Division of Basic and Applied Sciences, National Cancer Center, Goyang (Korea, Republic of)

    2011-05-15

    To evaluate the reproducibility of 3-dimensional histomorphometry for the microarchitecture analysis of trabecular bone parameters using multidetector computed tomography (MDCT). Thirty-six specimens from porcine vertebral bodies were imaged five times with a 64- detector row MDCT system using the same scan protocols. Locations of the specimens were nearly identical through the scans. Three-dimensional structural parameters of trabecular bone were derived from the five data sets using image analyzing software. The features measured by the analysis programs were trabecular bone volume, trabecular bone volume/tissue volume, trabecular thickness, trabecular separation, trabecular number, trabecular bone pattern factor, structural model index. The structural trabecular parameters showed excellent reproducibility through repeated scanning. Intraclass correlation coefficients of all seven structural parameters were in the range of 0.998 to 1.000. Coefficients of variation of the six structural parameters, excluding structural model index, were not over 1.6%. The measurement of the trabecular structural parameters using multidetector CT and three-dimensional histomophometry analysis program was validated and showed excellent reproducibility. This method could be used as a noninvasive and easily available test in a clinical setting.

  2. Comparison of the multidetector-row computed tomography findings of IgG4-related sclerosing cholangitis and extrahepatic cholangiocarcinoma

    International Nuclear Information System (INIS)

    Yata, M.; Suzuki, K.; Furuhashi, N.; Kawakami, K.; Kawai, Y.; Naganawa, S.

    2016-01-01

    Aim: To compare the multidetector-row computed tomography (MDCT) findings of IgG4-related sclerosing cholangitis (IgG4-SC) and extrahepatic cholangiocarcinoma (EH-CCA). Materials and methods: Two radiologists who had no knowledge of the patients' clinical information retrospectively evaluated the CT findings of patients with IgG4-SC (n=33) and EH-CCA (n=39) on a consensus basis. Another radiologist measured the biliary lesions. IgG4-SC was diagnosed using the Japan Biliary Association criteria (2012) or the Mayo Clinic's HISORt criteria. EH-CCA was diagnosed based on surgical findings. Results: Compared with EH-CCA, IgG4-SC exhibited the following findings significantly more frequently: (a) wall thickening alone, (b) concentric wall thickening, (c) smooth inner margins, (d) homogeneous attenuation in the arterial phase, (e) a lesion involving the intrapancreatic bile duct, (f) smooth outer margins, (g) fully visible lumen, (h) a funnel-shaped proximal bile duct, (i) skip lesions, and (j) abnormal pancreatic findings. Conversely, (k) dual-layered attenuation in all phases was significantly more common in EH-CCA. The specificity values of parameters (e–k) were >80%. Regarding dimensions, (l) the biliary lesions were longer in IgG4-SC than in EH-CCA. (m) The diameters of the dilated proximal common bile duct and (n) the dilated proximal intrahepatic bile duct were smaller in IgG4-SC than in EH-CCA. Conclusion: A number of CT findings are useful for differentiating between IgG4-SC and EH-CCA. CT findings (e–k) are particularly useful for this purpose. - Highlights: • Some CT findings are useful for differentiating between IgG4-SC and EH-CCA. • Homogeneous attenuation in all phases was more common in IgG4-SC than in EH-CCA. • Abnormal pancreatic findings showed high sensitivity and specificity values. • Dual-layered attenuation in all phases was more common in EH-CCA than in IgG4-SC.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  4. 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.

  5. 320-detector row CT coronary angiography in patients with arrhythmia

    International Nuclear Information System (INIS)

    Lu Li; Zhang Zhaoqi; Xu Lei; Yang Lin

    2011-01-01

    Objective: To evaluate the feasibility of CT coronary angiography (CTCA) in patients with arrhythmia using 320-detector row CT. Methods: Thirty-one patients with persistent atrial fibrillation and 8 patients with premature ventricular contraction were enrolled in this study. All patients underwent 320- detector row CTCA. CT image quality was evaluated with 4-point grading scale by two radiologists. Inter- observer agreement was evaluated by Kappa statistics. The radiation dose was calculated. Results: In total 510 coronary segments, 496 (97.2%) segments met diagnostic standard. The mean effective dose was (12.7±4.8) mSv in this study. There was a good agreement in image quality scoring between the two reviewers (Kappa = 0.72). Conclusion: 320-detector row CTCA is feasible in patients with atrial fibrillation and premature ventricular contraction. Arrhythmia may not be considered as a contraindication to CTCA. (authors)

  6. Gastrointestinal tract wall visualization and distention during abdominal and pelvic multidetector CT with a neutral barium sulphate suspension: comparison with positive barium sulphate suspension and with water.

    Science.gov (United States)

    Oliva, M R; Erturk, S M; Ichikawa, T; Rocha, T; Ros, P R; Silverman, S G; Mortele, K J

    2012-01-01

    When examining patients with contrast-enhanced multidetector-row CT, we determined if the stomach and small bowel were visualized and distended better with a neutral barium sulphate suspension than with positive barium sulphate suspension or water. After obtaining approval from our institutional review board, 156 patients (women: 84; mean age: 54 yrs) with no history of gastrointestinal tract disease were randomized prospectively to receive orally either 900 ml of neutral (0.1% w/v) barium sulphate suspension (n = 53), 900 ml of positive (2.1% w/v) barium sulphate suspension (n = 53), or 900 ml of water (n = 50), prior to undergoing contrast-enhanced abdominal and pelvic multidetector-row CT. Two independent radiologists evaluated the stomach, and small bowel, for luminal distension and wall visualization, using a five point scale. Results were compared using Kruskal-Wallis and Mann-Whitney U tests. The walls of the stomach, and small bowel were visualized better in patients who were administered neutral barium sulphate suspension than those who were administered either positive barium sulphate suspension (p barium sulphate suspension, the stomach and small bowel were distended better compared to patients administered water (p barium sulphate suspension (p contrast-enhanced abdominal and pelvic multidetector-row CT, orally administered neutral barium sulphate suspension allows the gastrointestinal tract to be visualized and distended better than either positive barium sulphate suspension, or water.

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

    International Nuclear Information System (INIS)

    Hoey, Edward T.D.; Gopalan, Deepa; Agrawal, S.K.B.; Screaton, Nicholas J.

    2009-01-01

    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.)

  8. 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.)

  9. Cardiac Conduction System: Delineation of Anatomic Landmarks With Multidetector CT

    Directory of Open Access Journals (Sweden)

    Farhood Saremi

    2009-11-01

    Full Text Available Major components of the cardiac conduction system including the sinoatrial node (SAN, atrioventricular node (AVN, the His Bundle, and the right and left bundle branches are too small to be directly visualized by multidetector CT (MDCT given the limited spatial resolution of current scanners. However, the related anatomic landmarks and variants of this system a well as the areas with special interest to electrophysiologists can be reliably demonstrated by MDCT. Some of these structures and landmarks include the right SAN artery, right atrial cavotricuspid isthmus, Koch triangle, AVN artery, interatrial muscle bundles, and pulmonary veins. In addition, MDCT has an imperative role in demarcating potential arrhythmogenic structures. The aim of this review will be to assess the extent at which MDCT can outline the described anatomic landmarks and therefore provide crucial information used in clinical practice.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  14. Imaging of patent foramen ovale with 64-section multidetector CT.

    Science.gov (United States)

    Saremi, Farhood; Channual, Stephanie; Raney, Aidan; Gurudevan, Swaminatha V; Narula, Jagat; Fowler, Steven; Abolhoda, Amir; Milliken, Jeffrey C

    2008-11-01

    To investigate the feasibility of 64-section multidetector computed tomography (CT) by using CT angiography (a) to demonstrate anatomic detail of the interatrial septum pertinent to the patent foramen ovale (PFO), and (b) to visually detect left-to-right PFO shunts and compare these findings in patients who also underwent transesophageal echocardiography (TEE). In this institutional review board-approved HIPAA-compliant study, electrocardiographically gated coronary CT angiograms in 264 patients (159 men, 105 women; mean age, 60 years) were reviewed for PFO morphologic features. The length and diameter of the opening of the PFO tunnel, presence of atrial septal aneurysm (ASA), and PFO shunts were evaluated. A left-to-right shunt was assigned a grade according to length of contrast agent jet (grade 1, 1 cm to 2 cm; grade 3, >2 cm). In addition, 23 patients who underwent both modalities were compared (Student t test and linear regression analysis). A difference with P patent at the entry into the right atrium (PFO) in 62 patients (61.4% of patients with flap valve, 23.5% of total patients). A left-to-right shunt was detected in 44 (16.7% of total) patients (grade 1, 61.4%; grade 2, 34.1%; grade 3, 4.5%). No shunt was seen in patients without a flap valve. Mean length of PFO tunnel was 7.1 mm in 44 patients with a shunt and 12.1 mm in 57 patients with a flap valve without a shunt (P < .0001). In patients with a tunnel length of 6 mm or shorter, 92.6% of the shunts were seen. ASA was seen in 11 (4.2%) patients; of these patients, a shunt was seen in seven (63.6%). In 23 patients who underwent CT angiography and TEE, both modalities showed a PFO shunt in seven. Multidetector CT provides detailed anatomic information about size, morphologic features, and shunt grade of the PFO. Shorter tunnel length and septal aneurysms are frequently associated with left-to-right shunts in patients with PFO. (c) RSNA, 2008.

  15. Capability of abdominal 320-detector row CT for small vasculature assessment compared with that of 64-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Maeda, Tetsuo; Ohno, Yoshiharu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Radiology, Kobe University Hospital, Kobe (Japan); Yoshikawa, Takeshi [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Konishi, Minoru [Division of Radiology, Kobe University Hospital, Kobe (Japan); Kanda, Tomonori; Onishi, Yumiko; Matsumoto, Keiko; Koyama, Hisanobu; Takenaka, Daisuke; Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan)

    2011-11-15

    Objective: To compare the capability of 320-detector row CT (area-detector CT: ADCT) with step-and-shoot scan protocol for small abdominal vasculature assessment with that of 64-detector row CT with helical scan protocol. Materials and methods: Total of 60 patients underwent contrast-enhanced abdominal CT for preoperative assessment. Of all, 30 suspected to have lung cancer underwent ADCT using step-and-shoot scan protocol. The other 30 suspected to have renal cell carcinoma underwent 64-MDCT using helical scan protocol. Two experienced radiologists independently assessed inferior epigastric, hepatic subsegmental (in the segment 8), mesenteric marginal (Griffith point) and inferior phrenic arteries by using 5-point visual scoring systems. Kappa analysis was used for evaluation of interobserver agreement. To compare the visualization capability of the two systems, the Mann-Whitney U-test was used to compare the scores for each of the arteries. Results: Overall interobserver agreements for both systems were almost perfect ({kappa} > 0.80). Visualization scores for inferior epigastric and mesenteric arteries were significantly higher for ADCT than for 64-detector row CT (p < 0.05). No significant difference was found for hepatic subsegmental and inferior phrenic arteries. Conclusion: Small abdominal vasculature assessment by ADCT with step-and-shoot scan protocol is potentially equal to or better than that by 64-detector row CT with helical scan protocol.

  16. Capability of abdominal 320-detector row CT for small vasculature assessment compared with that of 64-detector row CT

    International Nuclear Information System (INIS)

    Kitajima, Kazuhiro; Maeda, Tetsuo; Ohno, Yoshiharu; Yoshikawa, Takeshi; Konishi, Minoru; Kanda, Tomonori; Onishi, Yumiko; Matsumoto, Keiko; Koyama, Hisanobu; Takenaka, Daisuke; Sugimura, Kazuro

    2011-01-01

    Objective: To compare the capability of 320-detector row CT (area-detector CT: ADCT) with step-and-shoot scan protocol for small abdominal vasculature assessment with that of 64-detector row CT with helical scan protocol. Materials and methods: Total of 60 patients underwent contrast-enhanced abdominal CT for preoperative assessment. Of all, 30 suspected to have lung cancer underwent ADCT using step-and-shoot scan protocol. The other 30 suspected to have renal cell carcinoma underwent 64-MDCT using helical scan protocol. Two experienced radiologists independently assessed inferior epigastric, hepatic subsegmental (in the segment 8), mesenteric marginal (Griffith point) and inferior phrenic arteries by using 5-point visual scoring systems. Kappa analysis was used for evaluation of interobserver agreement. To compare the visualization capability of the two systems, the Mann-Whitney U-test was used to compare the scores for each of the arteries. Results: Overall interobserver agreements for both systems were almost perfect (κ > 0.80). Visualization scores for inferior epigastric and mesenteric arteries were significantly higher for ADCT than for 64-detector row CT (p < 0.05). No significant difference was found for hepatic subsegmental and inferior phrenic arteries. Conclusion: Small abdominal vasculature assessment by ADCT with step-and-shoot scan protocol is potentially equal to or better than that by 64-detector row CT with helical scan protocol.

  17. Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Julie M.; Vavere, Andrea L.; Arbab-Zadeh, Armin; Bush, David E.; Lardo, Albert C.; Texter, John; Brinker, Jeffery; Lima, Joao A.C. [Johns Hopkins Hospital, Johns Hopkins University, Department of Medicine, Division of Cardiology, Baltimore, MD (United States); Dewey, Marc [Charite - Universitaetsmedizin Berlin, Medical School, Humboldt-Universitaet und Freie Universitaet zu Berlin, Department of Radiology, Berlin, PO Box 10098 (Germany); Rochitte, Carlos E.; Lemos, Pedro A. [University of Sao Paulo Medical School, Heart Institute (InCor), Sao Paulo (Brazil); Niinuma, Hiroyuki [Iwate Medical University, Department of Cardiology, Morioka (Japan); Paul, Narinder [Toronto General Hospital, Department of Medical Imaging, Toronto (Canada); Hoe, John [Medi-Rad Associates Ltd, CT Centre, Mt Elizabeth Hospital, Singapore (Singapore); Roos, Albert de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Yoshioka, Kunihiro [Iwate Medical University, Department of Radiology, Morioka (Japan); Cox, Christopher [Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD (United States); Clouse, Melvin E. [Harvard University, Department of Radiology, Beth Israel Deaconess, Boston, MA (United States)

    2009-04-15

    Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ''CORE-64'' trial (''Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors''). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows. (orig.)

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  19. 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.

  20. Prevalence of thoracolumbar vertebral fractures on multidetector CT

    International Nuclear Information System (INIS)

    Bartalena, Tommaso; Giannelli, Giovanni; Rinaldi, Maria Francesca; Rimondi, Eugenio; Rinaldi, Giovanni; Sverzellati, Nicola; Gavelli, Giampaolo

    2009-01-01

    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.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  2. Diagnosis of arterial sequestration using multidetector CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Yu Hong, E-mail: yuhong.2002@hotmail.com [Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, 200003 (China); Li Huimin, E-mail: lihuiminphd@163.com [Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, 200003 (China); Liu Shiyuan, E-mail: cjr.liushiyuan@vip.163.com [Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, 200003 (China); Xiao Xiangsheng, E-mail: cjr.xxsh@vip.163.com [Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, 200003 (China)

    2010-11-15

    Background: Arterial sequestration is a rare congenital disorder. The diagnostic evaluation of this condition using multidetector computerized tomography (MDCT) has not been described previously. The purpose of this study was to describe the characteristic features of this disorder and to assess the use of MDCT in visualizing the characteristic anatomic features. Methods: We retrospectively reviewed the records of seven patients with anomalous systemic blood supply to left lower lobe of the lung. All the patients had undergone MDCT angiography. To evaluate the lung parenchyma, bronchial branching pattern, and vascular anatomy, four series of images were systematically reconstructed as follows: contiguous transverse CT scans viewed at mediastinal and pulmonary window settings, oblique coronal and sagittal maximum intensity projections (MIP), multiplanar reconstruction (MPR), and three-dimensional volume-rendered images (VR) of airway and thoracic vascular structures. Results: All 7 cases had isolated and tortuous arterial anatomy from the descending thoracic aorta to the basal segment of the left lower lobe; however, variable distribution of branches was observed. Characteristic findings of anomalous systemic arterial (ASA) supply were distinct from those seen in other pulmonary sequestration syndromes and were well visualized by the use of noninvasive MDCT. Conclusion: Complex CT findings allow clear imaging of arterial sequestration and the ASA blood supply; MDCT angiography has demonstrated its value and accuracy in diagnosing this condition, obviating the use of digital subtraction angiography and magnetic resonance angiography for the diagnosis of arterial sequestration.

  3. Diagnosis of arterial sequestration using multidetector CT angiography

    International Nuclear Information System (INIS)

    Yu Hong; Li Huimin; Liu Shiyuan; Xiao Xiangsheng

    2010-01-01

    Background: Arterial sequestration is a rare congenital disorder. The diagnostic evaluation of this condition using multidetector computerized tomography (MDCT) has not been described previously. The purpose of this study was to describe the characteristic features of this disorder and to assess the use of MDCT in visualizing the characteristic anatomic features. Methods: We retrospectively reviewed the records of seven patients with anomalous systemic blood supply to left lower lobe of the lung. All the patients had undergone MDCT angiography. To evaluate the lung parenchyma, bronchial branching pattern, and vascular anatomy, four series of images were systematically reconstructed as follows: contiguous transverse CT scans viewed at mediastinal and pulmonary window settings, oblique coronal and sagittal maximum intensity projections (MIP), multiplanar reconstruction (MPR), and three-dimensional volume-rendered images (VR) of airway and thoracic vascular structures. Results: All 7 cases had isolated and tortuous arterial anatomy from the descending thoracic aorta to the basal segment of the left lower lobe; however, variable distribution of branches was observed. Characteristic findings of anomalous systemic arterial (ASA) supply were distinct from those seen in other pulmonary sequestration syndromes and were well visualized by the use of noninvasive MDCT. Conclusion: Complex CT findings allow clear imaging of arterial sequestration and the ASA blood supply; MDCT angiography has demonstrated its value and accuracy in diagnosing this condition, obviating the use of digital subtraction angiography and magnetic resonance angiography for the diagnosis of arterial sequestration.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-15

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

  5. Efficacy of double arterial phase dynamic magnetic resonance imaging with the sensitivity encoding technique versus dynamic multidetector-row helical computed tomography for detecting hypervascular hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kumano, Seishi; Okada, Masahiro; Murakami, Takamichi; Uemura, Masahiko; Haraikawa, Toyoaki; Hirata, Masaaki; Kikuchi, Keiichi; Mochizuki, Teruhito; Kim, Tonsok

    2009-01-01

    The aim of this study was to evaluate the efficacy of double arterial phase dynamic magnetic resonance imaging (MRI) with the sensitivity encoding technique (SENSE dynamic MRI) for detection of hypervascular hepatocellular carcinoma (HCC) in comparison with double arterial phase dynamic multidetector-row helical computed tomography (dynamic MDCT). A total of 28 patients with 66 hypervascular HCCs underwent both double arterial SENSE dynamic MRI and dynamic MDCT. The diagnosis of HCC was based on surgical resection (n=7), biopsy (n=10), or a combination of CT during arterial portography (CTAP), CT during hepatic arteriography (CTA), and/or the 6-month follow-up CT (n=49). Based on alternative-free response receiving operating characteristic (ROC) analysis, the diagnostic performance for detecting HCC was compared between double arterial phase SENSE dynamic MRI and double arterial phase dynamic MDCT. The mean sensitivity, positive predictive value, and mean A Z values for hypervascular HCCs were 72%, 80%, and 0.79, respectively, for SENSE dynamic MRI and 66%, 92%, and 0.78, respectively, for dynamic MDCT. The mean sensitivity for double arterial phase SENSE dynamic MRI was higher than that for double arterial phase dynamic MDCT, but the difference was not statistically significant. Double arterial phase SENSE dynamic MRI is as valuable as double arterial phase dynamic MDCT for detecting hypervascular HCCs. (author)

  6. Evaluation of prosthetic valve obstruction on electrocardiographically gated multidetector-row computed tomography--identification of subprosthetic pannus in the aortic position.

    Science.gov (United States)

    Ueda, Tomohiro; Teshima, Hideki; Fukunaga, Shuji; Aoyagi, Shigeaki; Tanaka, Hiroyuki

    2013-01-01

    This study was performed to evaluate the diagnostic role of electrocardiographically gated multidetector-row computed tomography (MDCT) for prosthetic valve obstruction (PVO) in the aortic position. Between 2002 and 2006, 9 patients were diagnosed with PVO of an aortic bileaflet mechanical valve based on echocardiographic and cineradiographic criteria. These 9 patients were examined using MDCT before replacement of the mechanical valve, and intraoperative findings were compared to morphologic periprosthetic abnormalities observed on MDCT. CT attenuation (Hounsfield units; HU) of the periprosthetic abnormalities was measured to investigate the underlying cause of the PVO. MDCT showed subprosthetic masses extending beyond the prosthetic ring into the orifice of the valve. At reoperation, presence of subprosthetic pannus was confirmed in all of the 9 patients, but no periprosthetic thrombus was found. The mean CT attenuation of the subprosthetic pannus was 170 HU, and it was significantly greater than that obtained from the interventricular septum (108 HU; Ppannus causing PVO and the mean CT attenuation of subprosthetic pannus is significantly higher than that of the interventricular septum on MDCT.

  7. 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.

  8. 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.

  9. First experiences with multidetector CT in traumatized children

    International Nuclear Information System (INIS)

    Hoermann, Marcus; Scharitzer, Martina; Philipp, M.; Metz, Viktor M.; Lomoschitz, F.

    2003-01-01

    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

  10. 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.

  11. Coronary Vasospastic Angina: Assessment by Multidetector CT Coronary Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Koung Mi; Choi, Sang Il; Chun, Eun Ju; Kim, Jeong A; Youn, Tae Jin; Choi, Dong Ju [Seoul National University Bundang Hospital, Sungnam (Korea, Republic of)

    2012-01-15

    We aimed to describe the imaging findings of multidetector CT coronary angiography (MDCTA) in cases of vasospastic angina (VA) and to determine the accuracy of MDCTA in the identification of VA as compared with invasive coronary angiography with an ergonovine provocation test (CAG with an EG test). Fifty-three patients with clinically suspected VA were enrolled in this study. Two radiologists analyzed the stenosis degree, presence or absence of plaque, plaque composition, and a remodeling index of the related-segment in CAG with an EG test, which were used as a gold standard. We evaluated the diagnostic performances of MDCTA by comparing the MDCTA findings with those of CAG with an EG test. Among the 25 patients with positive CAG with an EG test, all 12 patients with significant stenosis showed no definite plaque with the negative arterial remodeling. Of the six patients with insignificant stenosis, three (50%) had non-calcified plaque (NCP), two (33%) had mixed plaque, and one (17%) had calcified plaque. When the criteria for significant stenosis with negative remodeling but no definite evidence of plaque as a characteristic finding of MDCTA were used, results showed sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) of 48%, 100%, 100%, and 68%, respectively. Significant stenosis with negative remodeling, but no definite evidence of plaque, is the characteristic finding on MDCTA of VA. Cardiac MDCTA shows good diagnostic performance with high specificity and PPV as compared with CAG with an EG test.

  12. Importance of multidetector CT imaging in multiple trauma

    International Nuclear Information System (INIS)

    Linsenmaier, U.; Geyer, L.L.; Reiser, M.; Wirth, S.; Koerner, M.

    2014-01-01

    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.) [de

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

    Directory of Open Access Journals (Sweden)

    Hung-Jung Wang

    2007-10-01

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

  14. Multi-Detector CT Findings of Palpable Chest Wall Masses in Children: A Pictorial Essay

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Ho; Kim, Young Tong [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of); Hong, Hyun Sook [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2013-03-15

    A wide variety of diseases manifest as palpable chest wall masses in children. These include normal variation, congenital anomalies, trauma, infection, axillary lymphadenopathies, soft tissue tumors and bone tumors. Given that most of these diseases are associated with chest wall deformity, diagnosis is difficult by physical examination or ultrasonography alone. However, multi-detector CT with three dimensional reconstruction is useful in the characterization and differential diagnosis of palpable chest wall lesions. In this article, we review the spectrum of palpable chest wall diseases and illustrate their multi-detector CT presentation.

  15. How many CT detector rows are necessary to perform adequate three dimensional visualization?

    International Nuclear Information System (INIS)

    Fischer, Lars; Tetzlaff, Ralf; Schoebinger, Max; Radeleff, Boris; Bruckner, Thomas; Meinzer, H.P.; Buechler, M.W.; Schemmer, Peter

    2010-01-01

    Introduction: The technical development of computer tomography (CT) imaging has experienced great progress. As consequence, CT data to be used for 3D visualization is not only based on 4 row CTs and 16 row CTs but also on 64 row CTs, respectively. The main goal of this study was to examine whether the increased amount of CT detector rows is correlated with improved quality of the 3D images. Material and Methods: All CTs were acquired during routinely performed preoperative evaluation. Overall, there were 12 data sets based on 4 detector row CT, 12 data sets based on 16 detector row CT, and 10 data sets based on 64 detector row CT. Imaging data sets were transferred to the DKFZ Heidelberg using the CHILI teleradiology system. For the analysis all CT scans were examined in a blinded fashion, i.e. both the name of the patient as well as the name of the CT brand were erased. For analysis, the time for segmentation of liver, both portal and hepatic veins as well as the branching depth of portal veins and hepatic veins was recorded automatically. In addition, all results were validated in a blinded fashion based on given quality index. Results: Segmentation of the liver was performed in significantly shorter time (p < 0.01, Kruskal-Wallis test) in the 16 row CT (median 479 s) compared to 4 row CT (median 611 s), and 64 row CT (median 670 s), respectively. The branching depth of the portal vein did not differ significantly among the 3 different data sets (p = 0.37, Kruskal-Wallis test). However, the branching depth of the hepatic veins was significantly better (p = 0.028, Kruskal-Wallis test) in the 4 row CT and 16 row CT compared to 64 row CT. The grading of the quality index was not statistically different for portal veins and hepatic veins (p = 0.80, Kruskal-Wallis test). Even though the total quality index was better for the vessel tree based on 64 row CT data sets (mean scale 2.6) compared to 4 CT row data (mean scale 3.25) and 16 row CT data (mean scale 3.0), these

  16. Diagnostic Accuracy of the Volume Rendering Images of Multi-Detector CT for the Detection of Lumbar Transverse Process Fractures

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yun Hak; Chun, Tong Jin [Dept. of Radiology, Eulji University Hospital, Daejeon (Korea, Republic of)

    2012-01-15

    To compare the accuracy of three-dimensional computed tomographic (3D CT) volume rendering techniques with axial images of multi-detector row computed tomography to identify lumbar transverse process (LTP) fractures in trauma patients. We retrospectively evaluated 42 patients with back pain as a result of blunt trauma between January and June of 2010. Two radiologists examined the 3D CT volume rendering images independently. The confirmation of a LTP fracture was based on the consensus of the axial images by the two radiologists. The results of 3D CT volume rendering images were compared with the axial images and the diagnostic powers (sensitivity, specificity, and accuracy) were calculated. Seven of the 42 patients had twenty five lumbar transverse process fractures. The diagnostic power of the 3D CT volume rendering technique is as accurate as axial images. Reader 1, sensitivity 96%, specificity 100%, accuracy 99.9%; and Reader 2 sensitivity 100%, specificity 99.8%, accuracy 99.8%. The accordance of the two radiologists was 99.8%. 3D CT volume rendering images can alternate axial images to detect lumbar transverse process fractures with good image quality.

  17. Assessment of left ventricular myocardial function using 16-slice multidetector-row computed tomography: comparison with magnetic resonance imaging and echocardiography

    International Nuclear Information System (INIS)

    Heuschmid, Martin; Rothfuss, Julia K.; Fenchel, Michael; Stauder, Norbert; Kuettner, Axel; Miller, Stephan; Claussen, Claus D.; Kopp, Andreas F.; Schroeder, Stephen; Burgstahler, Christof; Franow, Andreas; Kuzo, Ronald S.

    2006-01-01

    To assess functional parameters using multidetector-row computed tomography (MDCT) and echocardiography and to compare the results with magnetic resonance imaging (MRI). End-diastolic-volume (EDV), end-systolic-volume (ESV), stroke-volume (SV), ejection-fraction (EF), and myocardial mass (MM) were calculated based on CT data sets from 52 patients. Echocardiography was performed in 24 of the 52 patients. The results from MDCT and echocardiography were compared with MRI. A strong correlation between MDCT and MRI (r=0.66-0.90) was found for all parameters. Echocardiography revealed a low or moderate correlation (0.05-0.59). Compared to MRI the average differences with MDCT were for EDV 15.1 ml, ESV 10.6 ml, SV 4.5 ml, EF 1.8%, and MM 8.2 g, for EDV determined by echocardiography 36.2 ml, ESV 6.8 ml, and EF 13.9%. Bland-Altman analysis revealed acceptable limits of agreement between MRI and MDCT. MDCT enables reliable quantification of left ventricular function. Echocardiography was found to have only a moderate agreement of functional parameters with MRI. (orig.)

  18. Quantitative assessment of lung volumes using multi-detector row computed tomography (MDCT) in patients with chronic obstructive pulmonary disease (COPD)

    International Nuclear Information System (INIS)

    Lee, Sang Min; Hur, Jin; Kim, Tae Hoon; Kim, Sang Jin; Kim, Hyung Jung

    2008-01-01

    To evaluate the clinical value of the multi-detector row computed tomography (MDCT) in the quantitative assessment of lung volumes and to assess the relationship between the MDCT results and disease severity as determined by a pulmonary function test (PFT) in Chronic Obstructive Pulmonary Disease (COPD) patients. We performed a PFT and MDCT on 39 COPD patients. Using the GOLD classifications, we divided the patients into three groups according to disease severity; stage I (mild, n = 10), stage II (moderate, n = 15), and stage III (severe, n = 14). Using the pulmo-CT software program, we measured the proportion of lung volumes with attenuation values below -910 and -950 HU. The mean FEV1 (% of predicted) and FEV1/FVC was 82.2 ± 2% and 66.2 ± 3% in stage I, 53.5 ± 11% and 52 ± 6% in stage II, and 32.3 ± 7% and 44.2% ± 13% in stage III, respectively. Differences in lung volume percentage at each of the thresholds (-910 and -950 HU) among the 3 stages were statistically significant (ρ < 0.01, ρ < 0.01) and correlated well with the FEV1 and FEV1/FVC (r = -0.803, r -0.766, r = -0.817, and r = -0.795, respectively). The volumetric measurement obtained by MDCT provides an accurate means of quantifying pulmonary emphysema

  19. Threshold-dependent variability of coronary artery calcification measurements - implications for contrast-enhanced multi-detector row-computed tomography

    International Nuclear Information System (INIS)

    Moselewski, Fabian; Ferencik, Maros; Achenbach, Stephan; Abbara, Suhny; Cury, Ricardo C.; Booth, Sarah L.; Jang, Ik-Kyung; Brady, Thomas J.; Hoffmann, Udo

    2006-01-01

    Introduction: The present study investigated the threshold-dependent variability of coronary artery calcification (CAC) measurements and the potential to quantify CAC in contrast-enhanced multi-detector row-computed tomography (MDCT). Methods: We compared the mean CT attenuation of CAC to luminal contrast enhancement of the coronary arteries in 30 patients (n = 30) undergoing standard coronary contrast-enhanced spiral MDCT. The modified Agatston score [AS], calcified plaque volume [CV], and mineral mass [MM]) at four different thresholds (130, 200, 300, and 400 HU) were measured in 50 patients who underwent non-contrast-enhanced MDCT. Results: Mean CT attenuation of CAC was similar to the attenuation of the contrast-enhanced coronary lumen (CAC 297.1 ± 68.7 HU versus 295 ± 65 HU (p < 0.0001), respectively). Above a threshold of 300 HU CAC measurements significantly varied to standard measurements obtained at a threshold of 130 HU (p < 0.0001). The threshold-dependent variation of MM measurements was significantly smaller than for AS and CV (130 HU versus 400 HU: 63, 75, and 81, respectively; p < 0.001). These differences resulted in a change of age and gender based percentile category for AS in 78% of subjects. Discussion: We demonstrated that CAC measurements are threshold dependent with MM measurements having significantly less variation than AS or CV. Due to the similarity of mean CT attenuation of CAC and the contrast-enhanced coronary lumen accurate quantification of CAC may be difficult in standard coronary contrast-enhanced spiral MDCT

  20. Threshold-dependent variability of coronary artery calcification measurements - implications for contrast-enhanced multi-detector row-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Moselewski, Fabian [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Ferencik, Maros [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Achenbach, Stephan [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Department of Internal Medicine II (Cardiology), University of Erlangen (Germany); Abbara, Suhny [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Cury, Ricardo C. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Booth, Sarah L. [Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St., Boston, MA 02114 (United States); Jang, Ik-Kyung [Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Brady, Thomas J. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hoffmann, Udo [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)]. E-mail: uhoffman@partners.org

    2006-03-15

    Introduction: The present study investigated the threshold-dependent variability of coronary artery calcification (CAC) measurements and the potential to quantify CAC in contrast-enhanced multi-detector row-computed tomography (MDCT). Methods: We compared the mean CT attenuation of CAC to luminal contrast enhancement of the coronary arteries in 30 patients (n = 30) undergoing standard coronary contrast-enhanced spiral MDCT. The modified Agatston score [AS], calcified plaque volume [CV], and mineral mass [MM] at four different thresholds (130, 200, 300, and 400 HU) were measured in 50 patients who underwent non-contrast-enhanced MDCT. Results: Mean CT attenuation of CAC was similar to the attenuation of the contrast-enhanced coronary lumen (CAC 297.1 {+-} 68.7 HU versus 295 {+-} 65 HU (p < 0.0001), respectively). Above a threshold of 300 HU CAC measurements significantly varied to standard measurements obtained at a threshold of 130 HU (p < 0.0001). The threshold-dependent variation of MM measurements was significantly smaller than for AS and CV (130 HU versus 400 HU: 63, 75, and 81, respectively; p < 0.001). These differences resulted in a change of age and gender based percentile category for AS in 78% of subjects. Discussion: We demonstrated that CAC measurements are threshold dependent with MM measurements having significantly less variation than AS or CV. Due to the similarity of mean CT attenuation of CAC and the contrast-enhanced coronary lumen accurate quantification of CAC may be difficult in standard coronary contrast-enhanced spiral MDCT.

  1. Evaluation of secondary spontaneous pneumothorax with multidetector CT

    International Nuclear Information System (INIS)

    Hilliard, N.J.; Marciniak, S.J.; Babar, J.L.; Balan, A.

    2013-01-01

    The purpose of this article is to review the underlying causes of secondary pneumothoraces as observed on multidetector computed tomography (MDCT). Using examples from our institutional experience, we shall illustrate important diagnostic features to indicate the underlying lung disease. Understanding the varied range of conditions is important for accurate diagnosis and facilitation of patient management

  2. Usefulness of preoperative chest multidetector CT for evaluation of breast cancer: comparison with breast MRI

    International Nuclear Information System (INIS)

    Chang, Yun Woo; Kim, Dong Hun; Lee, Min Hyuk

    2005-01-01

    To evaluate the efficacy of chest multidetector-row helical computed tomography (MDCT) in detecting breast cancer in preoperative metastasis work-ups and to assess the accuracy of MDCT compared with magnetic resonance imaging (MRI). MDCT were performed on 69 consecutive patients with 94 lesions of histologically proven breast cancer. Retrospectively, two radiologists performed a blind review of the MDCT images for margin, shape, mass enhancement pattern and the enhancing distribution of non-mass lesions with consensus. CT attenuation values were measured in the average HU on pre-enhancing and enhanced CT in gland, fat, muscle, and in masses with the largest region of interest (ROI). MDCT finding were analyzed and compared with breast MRI. Of the 91 breast lesions detected on MDCT, 64 were mass lesions and 24 were non-mass lesions on enhancement, 86 lesions were malignant and 5 were benign. Three pathologically proven malignant masses were not detected on MDCT. Positive predictive value, false positive rate and false negative rate were 94.5%, 5.3%, 3.2% respectively. The highly predictive features for malignancy were a spiculated or irregular margin, an irregular of round shape, and a heterogeneously or rim enhanced mass. Another highly predictive feature for malignancy was linear or segmentally distributed enhancing non-mass lesions. The CT values of masses in pre-enhanced scans were 38.6 ± 7.9 HU; these values increased to 110.9 ± 26.6 HU after contrast injection (90 sec). The attenuation values from enhancing CT of malignant lesions were significantly higher than those of non-enhancing lesions. The depiction of enhancing masses on MDCT compared with MR imaging were 88.6%. The extension of malignancy were equally well correlated MDCT with MR imaging. The diagnostic value of chest MDCT for preoperative staging is comparable with MR imaging for the detection and extension of lesions. Therefore, chest MDCT of breast cancer can add to the information obtained from

  3. Role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in diagnosis and management of pancreatic cancer; comparison with multidetector row computed tomography, magnetic resonance imaging and endoscopic ultrasonography.

    Science.gov (United States)

    Ergul, N; Gundogan, C; Tozlu, M; Toprak, H; Kadıoglu, H; Aydin, M; Cermik, T F

    2014-01-01

    We aimed to analyze the contribution of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging to the diagnosis and management of pancreatic cancer compared with multidetector row computed tomography (MDCT), magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS). We retrospectively scanned the data of 52 patients who were referred for FDG PET/CT imaging for evaluation of pancreatic lesions greater than 10mm. The diagnostic performances of 4 imaging methods and the impact of PET/CT on the management of pancreatic cancer were defined. Pancreatic adenocarcinoma was diagnosed in 33 of 52 patients (63%), 15 patients had benign diseases of pancreas (29%), and 4 patients were normal (8%). Sensitivity and NPV of EUS and PET/CT were equal (100%) and higher than MDCT and MRI. Specificity, PPV and NPV of PET/CT were significantly higher than MDCT. However, sensitivities of two imaging methods were not significantly different. There was no significant difference between PET/CT and MRI and EUS for these values. When the cut-off value of SUVmax was 3.2, the most effective sensitivity and specificity values were obtained. PET/CT contributed to the management of pancreatic cancer in 30% of patients. FDG PET/CT is a valuable imaging method for the diagnosis and management of pancreatic cancer, especially when applied along with EUS as first line diagnostic tools. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  4. Hypervascular hepatocellular carcinomas: detection with gadoxetate disodium-enhanced MR imaging and multiphasic multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Onishi, Hiromitsu; Kim, Tonsok; Hori, Masatoshi; Nakaya, Yasuhiro; Tsuboyama, Takahiro; Nakamoto, Atsushi; Tatsumi, Mitsuaki; Tomiyama, Noriyuki [Osaka University Graduate School of Medicine, Department of Radiology, Suita, Osaka (Japan); Imai, Yasuharu [Ikeda Municipal Hospital, Department of Gastroenterology, Ikeda, Osaka (Japan); Nagano, Hiroaki [Osaka University Graduate School of Medicine, Department of Surgery, Suita, Osaka (Japan); Kumano, Seishi; Okada, Masahiro; Murakami, Takamichi [Kinki University School of Medicine, Department of Radiology, Osakasayama, Osaka (Japan); Takamura, Manabu [Ikeda Municipal Hospital, Department of Radiology, Ikeda, Osaka (Japan); Wakasa, Kenichi [Osaka City University Graduate School of Medicine, Department of Diagnostic Pathology, Osaka, Osaka (Japan)

    2012-04-15

    To retrospectively compare the accuracy of detection of hypervascular hepatocellular carcinoma (HCC) by multiphasic multidetector CT and by gadoxetate disodium-enhanced MR imaging. After ethical approval, we analysed a total of 73 hypervascular HCC lesions from 31 patients suspected of having HCC, who underwent both gadoxetate disodium-enhanced MR imaging and multiphasic multidetector CT. Five blinded observers independently reviewed CT images, as well as dynamic MR images alone and combined with hepatobiliary phase MR images. Diagnostic accuracy (Az values), sensitivities and positive predictive values were compared by using the Scheffe post hoc test. The mean Az value for dynamic and hepatobiliary phase MR combined (0.81) or dynamic MR images alone (0.78) was significantly higher than that for CT images (0.67, P < 0.001, 0.005, respectively). The mean sensitivity of the combined MR images (0.67) was significantly higher than that of dynamic MR alone (0.52, P < 0.05) or CT images (0.44, P < 0.05). The mean positive predictive values were 0.96, 0.95 and 0.94, for CT, dynamic MR alone and combined MR images, respectively. Compared with multiphasic multidetector CT, gadoxetate disodium-enhanced MR imaging combining dynamic and hepatobiliary phase images results in significantly improved sensitivity and diagnostic accuracy for detection of hypervascular HCC. (orig.)

  5. Multidetector-row computed tomography imaging of prosthetic heart valves: clinical and experimental aspects

    NARCIS (Netherlands)

    Symersky, P.

    2012-01-01

    Tot voor kort had het afbeelden van hartklepprothesen (kunstkleppen) door middel van een CT-scan geen aanvullende waarde. Kunstkleppen zijn bewegende metalen objecten, en daardoor werden CT-beelden vervormd door artefacten en dubbelcontouren. De huidige CT-systemen kunnen echter vaak wel een

  6. Four-channel multidetector-row computed tomography in the evaluation of facial fractures - optimized parameters for acquisition and multiplanar reformation

    International Nuclear Information System (INIS)

    Omid, P. M.

    2002-08-01

    The first part of this thesis is designed to give the reader a comprehensive survey on the complex basic principles of computed tomography (CT), from the early beginning to the recent development of multidetector-row CT (MD-CT). Attention is focused on imaging of trauma in general and on imaging of facial fractures in particular. The second part of this thesis describes a clinical study performed to optimize acquisition protocols and multiplanar reformation (MPR) algorithms for the evaluation of facial fractures using MD-CT, which has not been yet described in literature. For this study, a cadaver head with artificial blunt facial trauma was examined using a 4-channel MD-CT scanner. The influence of acquisition parameters (collimation: 2x0.5 mm/4x1 mm/4x2.5 mm; tube current: 120 mAs/90 mAs/60 mAs), image reconstruction algorithms (standard vs. ultra-high resolution (UHR) modes; reconstructed slice thicknesses: 0.5 mm/1 mm/3 mm; increment: 0.3 mm/0.6 mm/1.5 mm), and reformation algorithms (slice thicknesses: 0.5 mm/1 mm/3 mm; overlap: 0.5 mm/1 mm/3 mm) on detectability of facial fractures in MPRs with MD-CT was analyzed. Effects of algorithms and parameters on image noise, artifacts and delineation of soft tissues were evaluated. The results of this study reliably demonstrate that fracture detection was significantly higher with thin MPRs (0.5/0.5 mm, 1/0.5 mm, 1/1 mm) (p = 0 .014) acquired with 2x0.5 mm collimation (p = 0 .046), in UHR mode (p .0005) with 120 mAs (p = 0 .025). Inter-observer variability showed very good agreement (κ > = 0 .942). Non-UHR mode, lower mAs and thick MPRs (3/0.5 mm, 3/1 mm, 3/0.5 mm) showed significantly decreased detectability. (author)

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  8. [Sigmoid endometriosis: a diagnostic dilemma on multidetector CT].

    Science.gov (United States)

    Telegrafo, Michele; Lorusso, Valentina; Rubini, Giuseppe; Rella, Leonarda; Pezzolla, Angela; Stabile Ianora, Amato Antonio; Moschetta, Marco

    2013-01-01

    Intestinal endometriosis represents a common condition that occurs particularly in women of reproductive age. The gastrointestinal tract is the third most common localization of endometriosis, after the ovaries and the peritoneum, and recto-sigmoid tract is involved in 70% of cases. Recto-sigmoid endometriosis has to be differentiated from other diseases of large bowel, especially in patients without a history of endometriosis. We report a case of sigmoid endometriosis which represented a diagnostic dilemma on multidetector computed tomography.

  9. 64-slice multidetector coronary CT angiography: in vitro evaluation of 68 different stents

    International Nuclear Information System (INIS)

    Maintz, David; Seifarth, Harald; Rink, Michael; Oezguen, Murat; Heindel, Walter; Fischbach, Roman; Raupach, Rainer; Flohr, Thomas; Sommer, Torsten

    2006-01-01

    The purpose of this study was to test a large sample of different coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in 64-slice multidetector-row computed tomography (MDCT) in vitro and to provide a catalogue of currently used coronary artery stents when imaged with state-of the-art MDCT. We examined 68 different coronary artery stents (57 stainless steel, four cobalt-chromium, one cobalt-alloy, two nitinol, four tantalum) in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70). Stents were imaged in axial orientation with standard parameters: 32x0.6 collimation, pitch 0.24, 680 mAs, 120 kV, rotation time 0.37 s. Four different image reconstructions were obtained with varying convolution kernels and section thicknesses: (1) soft, 0.6 mm, (2) soft, 0.75, (3) medium soft, 0.6, and (4) stent-optimized sharp, 0.6. To evaluate visualization characteristics of of the stent, the lumen diameter, intraluminal density and noise were measured. The high-resolution kernel offered significantly better average lumen visualization (57% ±10%) and more realistic lumen attenuation (222 HU ±66 HU) at the expense of increased noise (15.3 HU ±3.7 HU) compared with the soft and medium-soft CT angiography (CTA) protocol (p<0.001 for all). Stents with a lumen visibility of more than 66% were: Arthos pico, Driver, Flex, Nexus2, S7, Tenax complete, Vision (all 67%), Symbiot, Teneo (70%), and Radius (73%). Only ten stents showed a lumen visibility of less than 50%. Stent lumen visibility largely varies depending on the stent type. Even with the improved spatial resolution of 64-slice CT, a stent-optimized kernel remains beneficial for stent visualization when compared with the standard medium-soft CTA protocol. Using 64-slice CT and high-resolution kernel, the majority of stent products show a lumen visibility of more than 50% of the stent

  10. Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT: an anthropomorphic phantom study

    Science.gov (United States)

    Xie, X; Willemink, M J; Zhao, Y; de Jong, P A; van Ooijen, P M A; Oudkerk, M; Greuter, M J W

    2013-01-01

    Objective: To assess inter- and intrascanner variability in volumetry of solid pulmonary nodules in an anthropomorphic thoracic phantom using low-dose CT. Methods: Five spherical solid artificial nodules [diameters 3, 5, 8, 10 and 12 mm; CT density +100 Hounsfield units (HU)] were randomly placed inside an anthropomorphic thoracic phantom in different combinations. The phantom was examined on two 64-row multidetector CT (64-MDCT) systems (CT-A and CT-B) from different vendors with a low-dose protocol. Each CT examination was performed three times. The CT examinations were evaluated twice by independent blinded observers. Nodule volume was semi-automatically measured by dedicated software. Interscanner variability was evaluated by Bland–Altman analysis and expressed as 95% confidence interval (CI) of relative differences. Intrascanner variability was expressed as 95% CI of relative variation from the mean. Results: No significant difference in CT-derived volume was found between CT-A and CT-B, except for the 3-mm nodules (pvolumetry of artificial pulmonary nodules between 5 mm and 12 mm in diameter. Inter- and intrascanner variability decreases at a larger nodule size to a maximum of 4.9% for ≥8 mm nodules. Advances in knowledge: The commonly accepted cut-off of 25% to determine nodule growth has the potential to be reduced for ≥8 mm nodules. This offers the possibility of reducing the interval for repeated CT scans in lung cancer screenings. PMID:23884758

  11. 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.

  12. Limitations of airway dimension measurement on images obtained using multi-detector row computed tomography.

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Oguma

    Full Text Available OBJECTIVES: (a To assess the effects of computed tomography (CT scanners, scanning conditions, airway size, and phantom composition on airway dimension measurement and (b to investigate the limitations of accurate quantitative assessment of small airways using CT images. METHODS: An airway phantom, which was constructed using various types of material and with various tube sizes, was scanned using four CT scanner types under different conditions to calculate airway dimensions, luminal area (Ai, and the wall area percentage (WA%. To investigate the limitations of accurate airway dimension measurement, we then developed a second airway phantom with a thinner tube wall, and compared the clinical CT images of healthy subjects with the phantom images scanned using the same CT scanner. The study using clinical CT images was approved by the local ethics committee, and written informed consent was obtained from all subjects. Data were statistically analyzed using one-way ANOVA. RESULTS: Errors noted in airway dimension measurement were greater in the tube of small inner radius made of material with a high CT density and on images reconstructed by body algorithm (p<0.001, and there was some variation in error among CT scanners under different fields of view. Airway wall thickness had the maximum effect on the accuracy of measurements with all CT scanners under all scanning conditions, and the magnitude of errors for WA% and Ai varied depending on wall thickness when airways of <1.0-mm wall thickness were measured. CONCLUSIONS: The parameters of airway dimensions measured were affected by airway size, reconstruction algorithm, composition of the airway phantom, and CT scanner types. In dimension measurement of small airways with wall thickness of <1.0 mm, the accuracy of measurement according to quantitative CT parameters can decrease as the walls become thinner.

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

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2011-09-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  16. Pulmonary nodules: sensitivity of maximum intensity projection versus that of volume rendering of 3D multidetector CT data

    NARCIS (Netherlands)

    Peloschek, Philipp; Sailer, Johannes; Weber, Michael; Herold, Christian J.; Prokop, Mathias; Schaefer-Prokop, Cornelia

    2007-01-01

    PURPOSE: To prospectively compare maximum intensity projection (MIP) and volume rendering (VR) of multidetector computed tomographic (CT) data for the detection of small intrapulmonary nodules. MATERIALS AND METHODS: This institutional review board-approved prospective study included 20 oncology

  17. The Utility of 64 Channel Multidetector CT Angiography for Evaluating the Renal Vascular Anatomy and Possible Variations: a Pictorial Essay

    International Nuclear Information System (INIS)

    Kumar, Sheo; Neyaz, Zafar; Gupta, Archna

    2010-01-01

    The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment

  18. The Utility of 64 Channel Multidetector CT Angiography for Evaluating the Renal Vascular Anatomy and Possible Variations: a Pictorial Essay

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Sheo; Neyaz, Zafar; Gupta, Archna [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow (India)

    2010-06-15

    The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

  19. The utility of 64 channel multidetector CT angiography for evaluating the renal vascular anatomy and possible variations: a pictorial essay.

    Science.gov (United States)

    Kumar, Sheo; Neyaz, Zafar; Gupta, Archna

    2010-01-01

    The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hoffstetter, P.; Schreyer, A.G.; Jung, E.M.; Heiss, P.; Zorger, N. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Regensburg (Germany); Schreyer, C.I.; Framme, C. [Klink und Poliklinik fuer Augenheilkunde, Universitaetsklinikum Regensburg (Germany)

    2010-02-15

    Purpose: To evaluate the significance of multislice CT for the diagnosis of uncertain penetrating globe injuries. Materials and Methods: 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. Results: 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

  1. Cancerogenesis Risks between 64 and 320 Row Detector CT for Coronary CTA Screening

    Directory of Open Access Journals (Sweden)

    Atif N Khan

    2014-01-01

    Full Text Available Objectives: This study compares cancerogenesis risks posed by the 64 row detector and the 320 row detector computed tomography scanners used during coronary computed tomography angiography (CCTA following decennial screening guidelines. Material and Methods: Data of the radiation absorbed after CCTA by lung, thyroid, and female breast in patients between 50 and 70 years of age obtained from prior published literature for the 64 row CT scanner were compared with data from our study using 320 row detector CT scanner. Data from the 64 row and the 320 row detector CT scanners was used to determine lifetime attributable risks (LAR of cancer based on the biological effects of ionizing radiation (BEIR VII report. Results: The relative reduction of LAR (% for 50-, 60-, and 70-year-old patients undergoing scanning with the 320 row detector CT scanner was 30% lower for lung, and more than 50% lower for female breast when compared with results from 64 row detector CT scanner. The use of 320 row detector CT would result in a combined cumulative cancer incidence of less than 1/500 for breast in women and less than 1/1000 for lung in men; By comparison, this is much lower than other more common risk factors: 16-fold for lung cancer in persistent smokers, 2-fold for breast cancer with a first degree family member history of breast cancer, and 10-fold for thyroid cancer with a family member with thyroid cancer. Decennial screening would benefit at least 355,000 patients from sudden cardiac death each year, 94% of whom have significant coronary artery disease, with at least one stenosis >75%. LAR for thyroid cancer was negligible for both scanners. Conclusion: Lung and female breast LAR reductions with 320 row detector compared with 64 row detector CT are substantial, and the benefits would outweigh increased cancer risks with decennial screening in the age group of 50-70 years.

  2. Renal replacement lipomatosis: multidetector-row computed tomography findings in one case

    International Nuclear Information System (INIS)

    Calisir, C.; Can, C.; Kebapci, M.

    2007-01-01

    Replacement lipomatosis of the kidney is the result of severe atrophy of the renal parenchyma often caused by chronic calculus disease with secondary marked benign proliferation of fibrofatty tissue replacing atrophied renal parenchyma. Different radiological modalities have been used to illustrate this entity, with magnetic resonance imaging, ultrasound, intravenous pyelogram, and computed tomography (CT) used most frequently. We report multidedector CT (MDCT) findings of replacement lipomatosis in a 50-year-old woman. We think that it accurately provides a complete one-step diagnostic workup and appropriate pre-surgical planning for patients for whom there is a suspicion of replacement lipomatosis

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

    International Nuclear Information System (INIS)

    Belge, Benedicte; Pasquet, Agnes; Vanoverschelde, Jean-Louis J.; Coche, Emmanuel; Gerber, Bernhard L.

    2006-01-01

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

  4. Multidetector row computed tomography and ultrasound characteristics of caudal vena cava duplication in dogs.

    Science.gov (United States)

    Bertolini, Giovanna; Diana, Alessia; Cipone, Mario; Drigo, Michele; Caldin, Marco

    2014-01-01

    Caudal vena cava duplication has been rarely reported in small animals. The purpose of this retrospective study was to describe characteristics of duplicated caudal vena cava in a large group of dogs. Computed tomography (CT) and ultrasound databases from two hospitals were searched for canine reports having the diagnosis "double caudal vena cava." One observer reviewed CT images for 71 dogs and two observers reviewed ultrasound images for 21 dogs. In all CT cases, the duplication comprised two vessels that were bilaterally symmetrical and approximately the same calibre (similar to Type I complete duplication in humans). In all ultrasound cases, the duplicated caudal vena cava appeared as a distinct vessel running on the left side of the abdominal segment of the descending aorta and extending from the left common iliac vein to the left renal vein. The prevalence of caudal vena cava duplication was 0.46% for canine ultrasound studies and 2.08% for canine CT studies performed at these hospitals. Median body weight for affected dogs was significantly lower than that of unaffected dogs (P dogs, caudal vena cava duplication should be differentiated from other vascular anomalies when planning surgeries and for avoiding misdiagnoses. © 2014 American College of Veterinary Radiology.

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

    International Nuclear Information System (INIS)

    Tuerkvatan, Aysel; Oezdemir, Mustafa; Cumhur, Turhan; Oelcer, Tuelay

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-15

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

  7. Multidetector CT of blunt traumatic venous injuries in the chest, abdomen, and pelvis.

    Science.gov (United States)

    Holly, Brian P; Steenburg, Scott D

    2011-01-01

    Venous injuries as a result of blunt trauma are rare. Even though current protocols for multidetector computed tomography (CT) of patients with trauma are designed to evaluate primarily the solid organs and arteries, blunt venous injuries may nevertheless be identified, or at least suspected, on the basis of the multidetector CT findings. Venous injuries are associated with high morbidity and mortality rates. Diagnosis of a possible venous injury is crucial because the physical findings of a venous injury are nonspecific and may be absent. This article aims to make the radiologist aware of various venous injuries caused by blunt trauma and to provide helpful hints to aid in the identification of venous injuries. Multidetector CT technology, in combination with interactive manipulation of the raw dataset, can be useful in the creation of multiplanar reconstructed images and in the identification of a venous injury caused by blunt trauma. Familiarity with direct and indirect signs of venous injuries, as well as with examples of blunt traumatic venous injuries in the chest, abdomen, and pelvis, will help in the diagnosis of these injuries.

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

    International Nuclear Information System (INIS)

    Tokue, Hiroyuki; Tokue, Azusa; Tsushima, Yoshito

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tokue Hiroyuki

    2012-12-01

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

  10. Assessment of hepatic arterial variation using multidetector helical CT-angiography

    International Nuclear Information System (INIS)

    Lee, Dong Hoon; Lee, Jun Woo; Jun, Woong Bae; Lee, Suk Hong

    2001-01-01

    To evaluate the anatomy of the hepatic artery and normal variants using oblique thick-slab maximal intensity projection (MIP) 3-D CT angiography and multidetector helical CT technology. In 70 patients, axial three-phase CT together with multidetector helical CT and a nonionic contrast agent was used to evaluate liver disease. During the early arterial phase, the parameters were as follow: slice thickness, 2.5 mm; table speed, 15 mm/rotation, pitch, 6; contrast material, 4 ml/sec; total 120 ml. Using the MIP technique and an Advantage window voxtal 3.03 system (GE), the images obtained were reconstructed as 3D angiograms. In each case, the arterial anatomy and its variants were recorded. A typical anatomy was found in 53 cases (75.7%). Common variants were a left hepatic artery arising from the left gastric artery(8 cases, 11.4 %) and a right hepatic artery arising from the superior mesenteric artery(3 cases, 4.3%). Other variant cases were right hepatic artery arising from the gastroduodenal artery(2 cases, 2.9%), a proper hepatic artery arising from the left gastric artery (1 case, 1.4%), a hepatomesenteric trunk (1 case), a hepatogastric/splenomesenteric trunk(1 case), and a celiomesenteric trunk (1 case). 3-D hepatic angiography using multidetector helical CT technology is non-invasive and as accurate as conventional angiography for the evaluation of hepatic arterial anatomy. It is thus considered that 3-D CT angiography is very helpful for the evaluation of hepatic arterial anatomy prior to liver surgery such as transplantation or the treatment of hepatocellular carinoma

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

    International Nuclear Information System (INIS)

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

    2006-01-01

    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

  12. Evaluation of tracheal bronchus in Chinese children using multidetector CT

    International Nuclear Information System (INIS)

    Ming, Zhu; Lin, Zhang

    2007-01-01

    Tracheal bronchus is a congenital bronchial anomaly. The diagnosis should be considered early in intubated patients. Multidetector computed tomography (MDCT) is the newest modality for evaluating tracheal bronchus. To evaluate the utility of 16-slice MDCT in children with tracheal bronchus and to characterize the frequency of tracheal bronchus in children with congenital heart disease. From June 2005 to May 2007, 3,187 consecutive children (1,124 with congenital heart disease and 2,063 without congenital heart disease) underwent MDCT examination. Minimum-intensity projection reconstruction was performed to show the tracheobronchial tree in every case. Tracheal bronchus was found in 42 children (3.74%) with congenital heart disease but in only 6 children (0.29%) without congenital heart disease. Among the 48 children with tracheal bronchus, 45 had right-side tracheal bronchus and 3 had bilateral tracheal bronchi with heterotaxy syndrome. The diagnostic sensitivity of MDCT was 100% (48/48). MDCT is a reliable imaging technique for the diagnosis of tracheal bronchus. Our data showed that right-side tracheal bronchus was more common and bilateral tracheal bronchi usually occurred with heterotaxy syndrome. In addition, tracheal bronchus often occurred with congenital heart disease. The angle between the tracheal bronchus and the trachea is important and should be measured. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

  14. Femoral head avascular necrosis: a frequently missed incidental finding on multidetector CT

    International Nuclear Information System (INIS)

    Barille, M.F.; Wu, Jim S.; McMahon, Colm J.

    2014-01-01

    Aim: To determine the incidence of missed femoral head avascular necrosis (AVN) on pelvic computed tomography (CT) performed for clinical indications other than assessment for AVN. Materials and methods: The study was a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. The picture archiving and communication system (PACS) database was queried for patients with diagnosis of femoral head AVN on magnetic resonance imaging (MRI), who also underwent pelvic multidetector CT after or <30 days before the MRI examination. The MRI and CT images of 144 hips of 72 patients (39 patients with reported AVN on MRI and 33 age-matched controls; mean age = 60 years, 28 male, 44 female), were reviewed in consensus by two readers in a randomized, blinded manner. Using MRI-proven CT-visible AVN as a reference standard, the incidence of missed AVN on initial CT interpretation was determined. Results: Readers confirmed AVN in 33 patients on the MRI images. Nine hips with AVN underwent joint replacement of the affected joint(s) prior to subsequent CT and were excluded. Forty-three MRI-proven AVN cases in 28 patients (15 bilateral, 13 unilateral) were available for analysis. The study readers diagnosed 35/43 (81%) MRI-proven AVN cases in 22/28 (79%) patients. Four of the 35 (11%) cases of MRI-proven, CT-visible AVN were prospectively reported in 3/22 (14%) patients at initial clinical interpretation, with a miss rate of 89% per hip and 86% per patient. Conclusion: Multidetector CT has high accuracy for detection of AVN; however, this is frequently missed as an incidental finding (89% missed in the present study). Assessment for signs of femoral AVN should be part of routine search pattern in interpretation of pelvic CT

  15. Dose-reduced 16-slice multidetector-row spiral computed tomography in children with bronchoscopically suspected vascular tracheal stenosis - initial results

    International Nuclear Information System (INIS)

    Honnef, D.; Wildberger, J.E.; Das, M.; Hohl, C.; Mahnken, A.; Guenther, R.W.; Staatz, G.; Schnoering, H.; Vazquez-Jimenez, J.

    2006-01-01

    Purpose: To evaluate the diagnostic accuracy of contrast-enhanced dose-reduced 16-slice multidetector-row CT (MDCT) in newborns and infants with fiberoptic bronchoscopically suspected vascular-induced tracheal stenosis. Materials and Methods: 12 children (4 days to 3 years, 1.2-13.5 kg body weight) were examined using i.v. contrast-enhanced 16-slice MDCT (SOMATOM Sensation 16, Forchheim, Germany) without breath-hold and under sedation (11/12). All MDCTs were performed with a dose reduction. The beam collimation was 16 x 0.75 mm, except in the case of one child. MPRs along the tracheal axis in the x-, y- and z-directions and volume-rendering-reconstructions (VRTs) were calculated based on a secondary raw data set in addition to conventional axial slices. 2 radiologists used a three-point grade scale to evaluate the image quality, motion, and contrast media artifacts as well as the usefulness of the 2D- and 3D-reconstructions for determining the diagnosis. Statistical analysis was performed on the basis of a Kappa test. Results: In all cases the cause of the fiberoptic bronchoscopically suspected tracheal stenosis was revealed: compression due to the brachiocephalic trunk (n=7), double aortic arch (n=2), lusorian artery (n=1), vascular compression of the left main bronchus (n=2). In 3 patients further thoracic anomalies, such as tracheobronchial (n=2), and vascular (n=2) and vertebral (n=1) anomalies were found. The attenuation in the anomalous vessels was 307±140 HU. The image noise was 9.8±1.9 HU. The mean dose reduction was 82.7±3.2% compared to a standard adult thoracic CT. All examinations were rated as diagnostically good (median 1, range 1, k=1). 3D images did not show any stair artifacts (median 2, range 1-2, k=1). The image noise was minor to moderate and hardly any motion artifacts were seen (median 1, range 1-2, k=0.8). Contrast media artifacts were rated zero to minor (median 1.5, range 1-2, k=0.676). MPRs (median 1, range 1, k=1) and VRTs (median 1

  16. Acute gastrointestinal bleeding: detection of source and etiology with multi-detector-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Scheffel, Hans; Pfammatter, Thomas; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Wildi, Stefan [University Hospital Zurich, Department of Visceral and Transplant Surgery, Zurich (Switzerland); Bauerfeind, Peter [University Hospital Zurich, Division of Gastroenterology, Zurich (Switzerland)

    2007-06-15

    This study was conducted to determine the ability of multi-detector-row computed tomography (CT) to identify the source and etiology of acute gastrointestinal bleeding. Eighteen patients with acute upper (n = 10) and lower (n = 8) gastrointestinal bleeding underwent 4-detector-row CT (n = 6), 16-detector-row CT (n = 11), and 64-slice CT (n = 1) with an arterial and portal venous phase of contrast enhancement. Unenhanced scans were performed in nine patients. CT scans were reviewed to determine conspicuity of bleeding source, underlying etiology, and for potential causes of false-negative prospective interpretations. Bleeding sources were prospectively identified with CT in 15 (83%) patients, and three (17%) bleeding sources were visualized in retrospect, allowing the characterization of all sources of bleeding with CT. Contrast extravasation was demonstrated with CT in all 11 patients with severe bleeding, but only in 1 of 7 patients with mild bleeding. The etiology could not be identified on unenhanced CT scans in any patient, whereas arterial-phase and portal venous-phase CT depicted etiology in 15 (83%) patients. Underlying etiology was correctly identified in all eight patients with mild GI bleeding. Multi-detector-row CT enables the identification of bleeding source and precise etiology in patients with acute gastrointestinal bleeding. (orig.)

  17. Acute gastrointestinal bleeding: detection of source and etiology with multi-detector-row CT

    International Nuclear Information System (INIS)

    Scheffel, Hans; Pfammatter, Thomas; Marincek, Borut; Alkadhi, Hatem; Wildi, Stefan; Bauerfeind, Peter

    2007-01-01

    This study was conducted to determine the ability of multi-detector-row computed tomography (CT) to identify the source and etiology of acute gastrointestinal bleeding. Eighteen patients with acute upper (n = 10) and lower (n = 8) gastrointestinal bleeding underwent 4-detector-row CT (n = 6), 16-detector-row CT (n = 11), and 64-slice CT (n = 1) with an arterial and portal venous phase of contrast enhancement. Unenhanced scans were performed in nine patients. CT scans were reviewed to determine conspicuity of bleeding source, underlying etiology, and for potential causes of false-negative prospective interpretations. Bleeding sources were prospectively identified with CT in 15 (83%) patients, and three (17%) bleeding sources were visualized in retrospect, allowing the characterization of all sources of bleeding with CT. Contrast extravasation was demonstrated with CT in all 11 patients with severe bleeding, but only in 1 of 7 patients with mild bleeding. The etiology could not be identified on unenhanced CT scans in any patient, whereas arterial-phase and portal venous-phase CT depicted etiology in 15 (83%) patients. Underlying etiology was correctly identified in all eight patients with mild GI bleeding. Multi-detector-row CT enables the identification of bleeding source and precise etiology in patients with acute gastrointestinal bleeding. (orig.)

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

    International Nuclear Information System (INIS)

    Tack, Denis; Jahnen, Andreas; Kohler, Sarah; Harpes, Nico; Back, Carlo; Maertelaer, Viviane de; Gevenois, Pierre Alain

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-01-15

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

  20. What is the best contrast injection protocol for 64-row multi-detector cardiac computed tomography?

    International Nuclear Information System (INIS)

    Lu Jinguo; Lv Bin; Chen Xiongbiao; Tang Xiang; Jiang Shiliang; Dai Ruping

    2010-01-01

    Streak artifacts and without image quality degradation. However, it is also important to visualize the right atrium and ventricle, so triphasic protocol (30%:70% contrast media-saline mixture was used in second phase) should be used for 64-MDCT coronary CT angiography.

  1. What is the best contrast injection protocol for 64-row multi-detector cardiac computed tomography?

    Energy Technology Data Exchange (ETDEWEB)

    Lu Jinguo [Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 167 Beilishi Road, Beijing (China); Lv Bin, E-mail: blu@vip.sina.co [Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 167 Beilishi Road, Beijing (China); Chen Xiongbiao; Tang Xiang; Jiang Shiliang; Dai Ruping [Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 167 Beilishi Road, Beijing (China)

    2010-08-15

    Streak artifacts and without image quality degradation. However, it is also important to visualize the right atrium and ventricle, so triphasic protocol (30%:70% contrast media-saline mixture was used in second phase) should be used for 64-MDCT coronary CT angiography.

  2. Patent foramen ovale: diagnosis with multidetector CT--comparison with transesophageal echocardiography.

    Science.gov (United States)

    Kim, Young Jin; Hur, Jin; Shim, Chi-Young; Lee, Hye-Jeong; Ha, Jong-Won; Choe, Kyu Ok; Heo, Ji Hoe; Choi, Eui-Young; Choi, Byoung Wook

    2009-01-01

    To evaluate the clinical feasibility and accuracy of 64-section multidetector computed tomography (CT) compared with transesophageal echocardiography (TEE) for diagnosis of a patent foramen ovale (PFO). Institutional review board approval was obtained for this retrospective study. The study included 152 consecutive stroke patients (mean age, 61.7 years; 98 men, 54 women) who underwent both cardiac multidetector CT and TEE. Electrocardiographically gated cardiac CT was performed with a 64-section CT scanner by using a saline-chaser contrast agent injection technique. A contrast agent jet from the contrast agent-filled left atrium (LA) to the saline-filled right atrium (RA) and channel-like appearance of the interatrial septum (IAS) were evaluated on axial and oblique sagittal CT images. Two-dimensional and Doppler TEE were performed to detect PFO. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT were obtained with TEE as the reference standard. A PFO was present in 26 patients at TEE. On CT images, a left-to-right contrast agent jet toward the inferior vena cava was noted in 21 patients (sensitivity, 73.1%; specificity, 98.4%; PPV, 90.5%; NPV, 94.7%). Channel-like appearance of the IAS was detected in 38 patients (sensitivity, 76.9%; specificity, 85.7%; PPV, 52.6%; NPV, 94.7%). Channel-like appearance of the IAS was noted in all patients who had a contrast agent jet. A contrast agent jet from LA to RA toward the inferior vena cava with channel-like appearance of the IAS on CT images confirms the presence of a PFO. (c) RSNA, 2008.

  3. Femoral head avascular necrosis: a frequently missed incidental finding on multidetector CT.

    Science.gov (United States)

    Barille, M F; Wu, Jim S; McMahon, Colm J

    2014-03-01

    To determine the incidence of missed femoral head avascular necrosis (AVN) on pelvic computed tomography (CT) performed for clinical indications other than assessment for AVN. The study was a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. The picture archiving and communication system (PACS) database was queried for patients with diagnosis of femoral head AVN on magnetic resonance imaging (MRI), who also underwent pelvic multidetector CT after or AVN on MRI and 33 age-matched controls; mean age = 60 years, 28 male, 44 female), were reviewed in consensus by two readers in a randomized, blinded manner. Using MRI-proven CT-visible AVN as a reference standard, the incidence of missed AVN on initial CT interpretation was determined. Readers confirmed AVN in 33 patients on the MRI images. Nine hips with AVN underwent joint replacement of the affected joint(s) prior to subsequent CT and were excluded. Forty-three MRI-proven AVN cases in 28 patients (15 bilateral, 13 unilateral) were available for analysis. The study readers diagnosed 35/43 (81%) MRI-proven AVN cases in 22/28 (79%) patients. Four of the 35 (11%) cases of MRI-proven, CT-visible AVN were prospectively reported in 3/22 (14%) patients at initial clinical interpretation, with a miss rate of 89% per hip and 86% per patient. Multidetector CT has high accuracy for detection of AVN; however, this is frequently missed as an incidental finding (89% missed in the present study). Assessment for signs of femoral AVN should be part of routine search pattern in interpretation of pelvic CT. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  4. In vivo location of the vermiform appendix in multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of); Choi, Byung Gil; Byun, Jae Young [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2014-04-15

    To provide a more detailed classification system regarding the position of the vermiform appendix within the right lower quadrant, as seen on multidetector computed tomography (MDCT) and to investigate the relative differences in frequency of appendiceal position according to patient gender and the pathologic state of appendix. Between January 2008 and December 2010, 1157 patients were included in our final analysis: 542 patients with preoperative MDCT and subsequent appendectomy and 615 patients with visible appendix seen on MDCT performed as part of a health checkup. We classified the appendix according to its position relative to the cecum, the terminal ileum, and the external iliac vessels: type 1: antececal; type 2: preileal; type 3: postileal; type 4: subileal; type 5: subcecal; type 6: deep pelvic; type 7: retrocecal; and type 8: paracecal. The relative incidence of various positions of the appendix found in all of our study patients was: type 1: 3.5%; type 2: 1.7%; type 3: 9.0%; type 4: 12.9%; type 5: 42.3%; type 6: 16.2%; type 7: 10.9%; and type 8: 3.0%. According to patient gender, type 1 (male: 3.7% vs. female: 3.3%), type 3 (8.6% vs. 9.8%), type 4 (14.3% vs. 9.8%), type 5 (47.5% vs. 32.7%), type 7 (9.2% vs. 14.4%), and type 8 (3.4% vs. 2.2%) positions showed a statistically significant male predominance. In terms of the inflamed state, type 2 preileal (normal: 0.8% vs. inflamed: 2.8%), type 3 (10.2% vs. 7.6%), type 4 (14.0% vs. 11.6%), and type 5 (14.1% vs. 18.5%) positions showed a statistically significant difference. Contrary to the common assumption that the retrocecal appendix is the most common position, the in vivo appendix is seen more often on MDCT in the subcecal and deep pelvic positions. The relative frequency of various positions of the appendix can also differ according to patient gender and the pathologic state.

  5. 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.)

  6. Assessment of chest pain in the emergency room: What is the role of multidetector CT?

    International Nuclear Information System (INIS)

    White, Charles; Read, Katrina; Kuo, Dick

    2006-01-01

    Chest pain is one of the most frequent complaints for patients seen in the emergency department. The current article describes the clinical stratification of patients who present to the emergency department with chest pain and discusses imaging options and analysis for these patients. It reviews conventional imaging approaches to assessing chest pain including chest radiography and stress testing. The main discussion focuses on the potential utility use of cross-sectional imaging, particularly multidetector CT, in the evaluation of chest pain in the emergency department

  7. Automated detection of lung nodules in multidetector CT: influence of different reconstruction protocols on performance of a software prototype

    International Nuclear Information System (INIS)

    Gurung, J.; Maataoui, A.; Khan, M.; Wetter, A.; Harth, M.; Jacobi, V.; Vogl, T.J.

    2006-01-01

    Purpose: To evaluate the accuracy of software for computer-aided detection (CAD) of lung nodules using different reconstruction slice thickness protocols in multidetector CT. Materials and Methods: Raw image data sets for 15 patients who had undergone 16-row multidetector CT (MDCT) for known pulmonary nodules were reconstructed at a reconstruction thickness of 5.0, 2.0 and 1.0 mm with a reconstruction increment of 1.5, 1.0 and 0.5 mm, respectively. The ''Nodule Enhanced Viewing'' (NEV) tool of LungCare for computer-aided detection of lung nodules was applied to the reconstructed images. The reconstructed images were also blinded and then evaluated by 2 radiologists (A and B). Data from the evaluating radiologists and CAD was then compared to an independent reference standard established using the consensus of 2 independent experienced chest radiologists. The eligible nodules were grouped according to their size (diameter >10, 5 - 10, <5 mm) for assessment. Statistical analysis was performed using the receiver operating characteristic (ROC) curve analysis, t-test and two-rater Cohen's Kappa co-efficient. Results: A total of 103 nodules were included in the reference standard by the consensus panel. The performance of CAD was marginally lower than that of readers at a 5.0-mm reconstruction thickness (AUC = 0.522, 0.517 and 0.497 for A, B and CAD, respectively). In the case of 2.0-mm reconstruction slices, the performance of CAD was better than that of the readers (AUC = 0.524, 0.524 and 0.614 for A, B and CAD, respectively). CAD was found to be significantly superior to radiologists in the case of 1.0-mm reconstruction slices (AUC = 0.537, 0.531 and 0.675 for A, B and CAD, respectively). The sensitivity at a reconstruction thickness of 1.0 mm was determined to be 66.99%, 68.93% and 80.58% for A, B and CAD, respectively. The time required for detection was shortest for CAD at reconstruction slices of 1.0 mm (mean t = 4 min). The performance of radiologists was greatly

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. Quantitative measurement of radiofrequency volumetric tissue reduction by multidetector CT in patients with inferior turbinate hypertrophy.

    Science.gov (United States)

    Bahadir, Osman; Kosucu, Polat

    2012-12-01

    To objectively assess the efficacy of radiofrequency thermal ablation of inferior turbinate hypertrophy. Thirty-five patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. Radiofrequency energy was delivered to four sites in each inferior turbinate. Patients were evaluated before and 8 weeks after intervention. Subjective evaluation of nasal obstruction was performed using a visual analogue scale (VAS), and objective evaluation of the turbinate volume reduction was calculated using multidetector CT. Volumetric measurements of the preoperative inferior turbinate were compared with postoperative values on both sides. The great majority of patients (91.4%) exhibited subjective postoperative improvement. Mean obstruction (VAS) improved significantly from 7.45±1.48 to 3.54±1.96. Significant turbinate volume reduction was achieved by the surgery on both right and left sides [(preoperative vs. postoperative, right: 6.55±1.62cm(3) vs. 5.10±1.47cm(3), (PRadiofrequency is a safe and effective surgical procedure in reducing turbinate volume in patients with inferior turbinate hypertrophy. Multidetector CT is an objective method of assessment in detecting radiofrequency turbinate volume reduction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. 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.)

  14. Peliosis Hepatis with Hemorrhagic Necrosis and Rupture: a Case Report with Emphasis on the Multi-Detector CT Findings

    OpenAIRE

    Kim, Eun-A; Yoon, Kwon-Ha; Jeon, Se-Jung; Cai, Quan-Yu; Lee, Young-Whan; Yoon, Seong Eon; Yoon, Ki-Jung; Juhng, Seon-Kwan

    2007-01-01

    We report here on an uncommon case of peliosis hepatis with hemorrhagic necrosis that was complicated by massive intrahepatic bleeding and rupture, and treated by emergent right lobectomy. We demonstrate the imaging findings, with emphasis on the triphasic, contrast-enhanced multidetector CT findings, as well as reporting the clinical outcome in a case of peliosis hepatis with fatal hemorrhage.

  15. Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid (Gd-EOB-DTPA)-Enhanced Magnetic Resonance Imaging and Multidetector-Row Computed Tomography for the Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ye, Feng; Liu, Jun; Ouyang, Han

    2015-08-01

    The purpose of this meta-analysis was to compare the diagnostic accuracy of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and multidetector-row computed tomography (MDCT) for hepatocellular carcinoma (HCC).Medline, Cochrane, EMBASE, and Google Scholar databases were searched until July 4, 2014, using combinations of the following terms: gadoxetic acid disodium, Gd-EOB-DTPA, multidetector CT, contrast-enhanced computed tomography, and magnetic resonance imaging. Inclusion criteria were as follows: confirmed diagnosis of primary HCC by histopathological examination of a biopsy specimen; comparative study of MRI using Gd-EOB-DTPA and MDCT for diagnosis of HCC; and studies that provided quantitative outcome data. The pooled sensitivity and specificity of the 2 methods were compared, and diagnostic accuracy was assessed with alternative-free response receiver-operating characteristic analysis.Nine studies were included in the meta-analysis, and a total of 1439 lesions were examined. The pooled sensitivity and specificity for 1.5T MRI were 0.95 and 0.96, respectively, for 3.0T MRI were 0.91 and 0.96, respectively, and for MDCT were 0.74 and 0.93, respectively. The pooled diagnostic odds ratio for 1.5T and 3.0T MRI was 242.96, respectively, and that of MDCT was 33.47. To summarize, Gd-EOB-DTPA-enhanced MRI (1.5T and 3.0T) has better diagnostic accuracy for HCC than MDCT.

  16. Focal Stenosis in Right Upper Lobe Bronchus in a Recurrently Wheezing Child Sequentially Studied by Multidetector-row Spiral Computed Tomography and Scintigraphy

    Directory of Open Access Journals (Sweden)

    I-Chen Chen

    2009-12-01

    Full Text Available Lower respiratory tract infections associated with wheezing are not uncommon in infants and young children. Among the wheezing-associated disorders, allergic etiologies are more commonly encountered than anatomic anomalies. We present a 3-year-old girl with a sudden attack of asthmatic symptoms including dyspnea, cyanosis and diffuse wheezing. Based on a history of choking, and atelectasis in the right upper lobe detected by chest films, flexible tracheobronchoscopy was arranged and incidentally detected a stenotic orifice in the right upper lobe bronchus. Multidetector-row spiral computed tomography and pulmonary scintigraphy subsequently also disclosed the focal stenosis. She suffered from recurrent wheezing, pneumonia and lung atelectasis during 1 year of follow-up. We emphasize the diagnosis, clinical course and management of focal stenosis in the right upper lobe bronchus.

  17. A Comparison of the Use of Contrast Media with Different Iodine Concentrations for Multidetector CT of the Kidney

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Chai; Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2011-11-15

    To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan.

  18. A Comparison of the Use of Contrast Media with Different Iodine Concentrations for Multidetector CT of the Kidney

    Science.gov (United States)

    Jung, Seung Chai; Cho, Jeong Yeon

    2011-01-01

    Objective To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. Materials and Methods A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. Results The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). Conclusion The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan. PMID:22043154

  19. Radiological evaluation with Doppler sonography and multidetector CT angiography in congenital hepatic arteriovenous malformation in a newborn

    Energy Technology Data Exchange (ETDEWEB)

    Adaletli, Ibrahim; Kurugoglu, Sebuh; Kilic, Fahrettin [Istanbul University, Department of Radiology, Cerrahpasa Medical Faculty (Turkey); Senyuz, Osman F. [Istanbul University, Department of Paediatric Surgery, Cerrahpasa Medical Faculty (Turkey); Dervisoglu, Sergulen [Istanbul University, Department of Pathology, Cerrahpasa Medical Faculty (Turkey)

    2006-11-15

    Although hepatic arteriovenous malformations are rarely reported, they frequently have life-threatening complications such as cardiac failure and are associated with a high mortality rate. Consequently, accurate prenatal and early postnatal diagnosis is important and therapeutic procedures depend on the imaging features. We report the early postnatal sonographic, Doppler sonographic, multidetector CT and CT angiography findings of a congenital hepatic arteriovenous malformation in a newborn. (orig.)

  20. Radiological evaluation with Doppler sonography and multidetector CT angiography in congenital hepatic arteriovenous malformation in a newborn

    International Nuclear Information System (INIS)

    Adaletli, Ibrahim; Kurugoglu, Sebuh; Kilic, Fahrettin; Senyuz, Osman F.; Dervisoglu, Sergulen

    2006-01-01

    Although hepatic arteriovenous malformations are rarely reported, they frequently have life-threatening complications such as cardiac failure and are associated with a high mortality rate. Consequently, accurate prenatal and early postnatal diagnosis is important and therapeutic procedures depend on the imaging features. We report the early postnatal sonographic, Doppler sonographic, multidetector CT and CT angiography findings of a congenital hepatic arteriovenous malformation in a newborn. (orig.)

  1. 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.)

  2. 64 multidetector CT findings of influenza A (H1N1) virus in patients with hematologic malignancies

    International Nuclear Information System (INIS)

    El-Badrawy, Adel; Zeidan, Amany; Ebrahim, Mohamed A.

    2012-01-01

    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

  3. 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.

  4. Multidetector CT angiography influences the choice of treatment for blunt carotid artery injury.

    Science.gov (United States)

    Beliaev, Andrei M; Civil, Ian

    2014-08-06

    A 43-year-old woman presented with a 2 h history of left neck pain after striking her neck against a marble bench while playing with her son. The patient was screened for blunt cerebrovascular injury (BCVI) and a left carotid bruit was identified. Subsequently, she underwent multidetector CT angiography (MCTA) of the aortic arch and neck vessels, which demonstrated a flow-limiting dissection of the left common carotid artery (CCA). The patient was started on heparin infusion and underwent an emergency operation. At surgery, a circumferential intimal dissection was excised and the arteriotomy defect closed with an autologous venous patch. This case emphasises the importance of adequately examining patients with direct injury to the neck, screening relevant patients for BCVI and investigating them with MCTA that influences the choice of a treatment option. 2014 BMJ Publishing Group Ltd.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    Berther, Ralph; Eckhardt, Boris; Zollikofer, Christoph L.; Patak, Michael A.; Erturk, Sukru M.

    2008-01-01

    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.)

  7. 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.)

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

    International Nuclear Information System (INIS)

    Chowdhury, F.U.; Kotwal, S.; Raghunathan, G.; Wah, T.M.; Joyce, A.; Irving, H.C.

    2007-01-01

    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

  9. A method to generate equivalent energy spectra and filtration models based on measurement for multidetector CT Monte Carlo dosimetry simulations

    International Nuclear Information System (INIS)

    Turner, Adam C.; Zhang Di; Kim, Hyun J.; DeMarco, John J.; Cagnon, Chris H.; Angel, Erin; Cody, Dianna D.; Stevens, Donna M.; Primak, Andrew N.; McCollough, Cynthia H.; McNitt-Gray, Michael F.

    2009-01-01

    The purpose of this study was to present a method for generating x-ray source models for performing Monte Carlo (MC) radiation dosimetry simulations of multidetector row CT (MDCT) scanners. These so-called ''equivalent'' source models consist of an energy spectrum and filtration description that are generated based wholly on the measured values and can be used in place of proprietary manufacturer's data for scanner-specific MDCT MC simulations. Required measurements include the half value layers (HVL 1 and HVL 2 ) and the bowtie profile (exposure values across the fan beam) for the MDCT scanner of interest. Using these measured values, a method was described (a) to numerically construct a spectrum with the calculated HVLs approximately equal to those measured (equivalent spectrum) and then (b) to determine a filtration scheme (equivalent filter) that attenuates the equivalent spectrum in a similar fashion as the actual filtration attenuates the actual x-ray beam, as measured by the bowtie profile measurements. Using this method, two types of equivalent source models were generated: One using a spectrum based on both HVL 1 and HVL 2 measurements and its corresponding filtration scheme and the second consisting of a spectrum based only on the measured HVL 1 and its corresponding filtration scheme. Finally, a third type of source model was built based on the spectrum and filtration data provided by the scanner's manufacturer. MC simulations using each of these three source model types were evaluated by comparing the accuracy of multiple CT dose index (CTDI) simulations to measured CTDI values for 64-slice scanners from the four major MDCT manufacturers. Comprehensive evaluations were carried out for each scanner using each kVp and bowtie filter combination available. CTDI experiments were performed for both head (16 cm in diameter) and body (32 cm in diameter) CTDI phantoms using both central and peripheral measurement positions. Both equivalent source model types

  10. Virtual endoscopy of the tracheo-bronchial system: sub-millimeter collimation with the 16-row multidetector scanner

    International Nuclear Information System (INIS)

    Khan, M. Fawad; Herzog, Christopher; Maataoui, Adel; Harth, Marc; Abolmaali, Nasreddin D.; Jacobi, Volkmar; Vogl, Thomas J.; Ackermann, Hanns; Wagner, Thomas O.F.

    2004-01-01

    The purpose of this study was to evaluate the scope of sub-millimeter collimation reconstruction parameters using 16-row computer tomography and ECG triggering on image quality in virtual bronchoscopy. Thirty-two patients (5 women, 27 men, mean age 66.6±1.4) who had been admitted for coronary artery bypass graft surgery underwent CT examination of the thorax (Sensation 16, Siemens, Inc., Forchheim, Germany). All patients were examined with 16 x 0.75-mm collimation. Image reconstruction was performed for two groups. In group A (n=32), slice thickness of 1.5 mm and an overlap of 0.75 mm were used. In group B (n=32), slice thickness of 0.75 mm and an overlap of 0.4 mm were applied. Retrospective ECG triggering was performed in all patients. The maximum order of recognizable bronchi was determined in each data set. In addition to assessing the maximum order of bronchial bifurcation, bronchial diameter was determined in truly perpendicular sections in each patient. For every segment proximal to a bifurcation, image quality was subjectively graded as poor (grade 1), moderate (grade 2) or good (grade 3). The observers were asked to identify the minimum cardiac movement ECG-triggered image sets assuming that they would be of better quality than the maximum cardiac movement ECG-triggered image sets. The Mann-Whitney U-test and the Fisher's Exact Test were used for statistical evaluation. In group A, a mean of 4.8±0.2 bifurcations was ascertained vs. 6.5±0.3 bifurcations in group B [P<0.0003]. For bronchial diameters in group A, a mean of 7.5±0.4 mm was determined vs. 4.6±0.4 mm in group B [P<0.0001]. In group B, two independent radiologists observed a significant shift to better image quality in all segments evaluated [P<0.006 to P<0.000001]. Motion artifacts were judged as being significantly reduced by minimum cardiac movement ECG-triggering in group B [observer 1: P=0.0007 (20/32); observer 2: P=0.008 (18/32)], but not in group A [observer 1: P=0.286 (13

  11. 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.

  12. 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.

  13. Correlation of Color Doppler with Multidetector CT Angiography Findings in Carotid Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Živorad N. Savic

    2010-01-01

    Full Text Available The aim of this paper was to examine the correlation between the Color Doppler ultrasound (CD-US and multidetector CT angiography (MDCTA diagnostic methods, and to define the degree and extent of stenosis in patients with internal carotid artery stenosis. This was a cross-sectional study with a consecutive series of patients. All US examinations were always carried out by the same physician-angiologist, while all CT examinations were always carried out by the same physician-radiologist. Both worked independently from each other. The stenosis area was measured at the narrowest point by NASCET criteria for US/CT. Peak systolic velocity (PSV over 210 cm/sec and end diastolic velocity (EDV over 110 cm/sec criteria were applied for stenoses with lumen narrowed over 70%, while PSV under 130 cm/sec and EDV under 100 cm/sec criteria were applied for those with lumen narrowed under 70%. A total of 124 carotid arteries were observed; namely, 89 narrowed and 68 surgically treated. All patients were reviewed by US and then by MDCTA; patients with 70–99% stenosis underwent surgery. The correlation coefficient between stenosis degree measured by US and MDCTA was 0.922; p 0.05. The US and CT matching level for stenoses from 70 to 99% was very high (κ = 0.778, p < 0.01. In conclusion, there is a highly significant statistical correlation among both diagnostic methods when measuring stenosis degree and extent. US is more dependent on the physician, while MDCTA is more objective and independent from the physician. We think it would be appropriate to undertake an MDCTA exam for those patients who are candidates for carotid endarterectomy.

  14. 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)

  15. 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.)

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

    International Nuclear Information System (INIS)

    Kimura, Masashi; Minamiguchi, Hiroki; Sahara, Shinya

    2002-01-01

    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. Optimal reconstructed section thickness for the detection of liver lesions with multidetector CT

    International Nuclear Information System (INIS)

    Soo, G.; Lau, K.K.; Yik, T.; Kutschera, P.

    2010-01-01

    Aim: To evaluate the impact of different reconstructed section thicknesses on liver lesion detection using multidetector computed tomography (CT). Methods: Fifty-three patients were examined using a 16-section CT machine with axial reconstructions provided at 2.5, 5, 7.5, and 10 mm section thicknesses. Images of different reconstructed section thicknesses from different patients were presented in random order to three independent, blinded radiologists for review at multiple sessions. All images were then reviewed by three radiologists in a common session. Consensus was reached following review of the previous interpretation results and results of follow-up imaging regarding the number of true liver lesions (n = 101) for comparison. Results: Mean detection rates were as follows: 93/101 lesions detected with the 2.5 mm section thickness, 98/101 lesions detected at the 5 mm section thickness, 78/101 lesions detected at the 7.5 mm section thickness, and 54/101 lesions detected at the 10 mm section thickness. Lesions missed at the 2.5 mm section thickness were due to masking by image noise. There was particular difficulty detecting subcapsular lesions and lesions adjacent to fissures or the gall bladder at the 7.5 mm and 10 mm section thicknesses. Conclusion: The optimal reconstructed section thickness for lesion detection in the liver was 5 mm.

  18. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-15

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

  20. Evaluation of 16 detector row spiral CT in diagnosing pulmonary embolism

    International Nuclear Information System (INIS)

    Yu Xiaokun; Li Lei

    2008-01-01

    Objective: To investigate the value of 16 detector row spiral CT in the diagnosis of pulmonary embolism(PE). Methods: Imaging data of 20 patients (plain 16 detector row spiral CT scanning plus enhanced scanning imaging) highly suspected of PE was retrospectively analyzed. Results: Among the 20 cases, embolism was showed in 13 patients on 16 detector row spiral CT pulmonary angiography (MSCTPA). 6 cases of the 13 PE's patients have masculine findings on plain MSCT scanning images. Localized tenuous lung markings, dilated pulmonary artery, 'mosaic' sign, pleural or pericardial effusion, local high attenuation centrally in the pulmonary arteries and lung infarction occurred respectively. Conclusion: MSCTPA may be an effective, simple and safe technique for the diagnosis of PE. It was a reliable means in defecting PE However, for the cases unfit for contrast media and cases only suitable for unenhanced CT because of nonspecific heart-pulmonary symptom, noticeable abnormal signs of plain MSCT scanning could suggest the occurrence of pulmonary embolism. (authors)

  1. Detection of pulmonary metastatic nodules: usefulness of low-dose multidetector CT in comparison with chest radiograph

    International Nuclear Information System (INIS)

    Kim, Ki Nam; Lee, Ki Nam; Yang, Doo Kyung; Lee, Soo Keol

    2006-01-01

    We wanted to evaluate the usefulness of low-dose multidetector CT for the detection and follow-up of pulmonary metastatic nodules in patients suffering with malignancy. We retrospectively reviewed the conventional chest radiographs and low-dose multidetector CT (low-dose CT) scans of 81 patients who had been under the diagnosis of malignancy. We reviewed the detection of pulmonary nodules and we counted the number of nodules detected by each method. The nodules were confirmed by surgical operation and by the radiologic criteria. The accuracy, sensitivity, specificity and positive and negative predictive values of each method for detecting metastatic nodules were compared with χ 2 tests. Low-dose CT depicted more nodules than did chest radiograph, and the indeterminate nodules seen on chest radiograph may be clearly benign on low-dose CT (eg. calcified granulomas or bony lesions). The accuracy of low-dose CT (75.3%) was significantly higher than that of chest radiograph (49.4%) for the detection for metastatic nodules (ρ < 0.05). Low-dose CT may provide better information than does chest radiograph for diagnosing pulmonary metastasis

  2. Multi-detector row computed tomographic evaluation of a rare type of complete vascular ring: Double aortic arch with atretic left arch distal to the origin of left subclavian artery

    Energy Technology Data Exchange (ETDEWEB)

    Hung, Ying Ying; Fu, Ching Yun; Wei, Hao Ji; Tsai, I Chen; Chen, Clayton Chi Chang [Taichung Veterans General Hospital, Taichung (China)

    2013-10-15

    Double aortic arch with an atretic left arch distal to the origin of left subclavian artery was diagnosed with multi-detector row computed tomography (MDCT) in two children with dysphagia. This rare type of complete vascular ring is clinically important because it may be confused with right aortic arch in mirror imaging. Anatomic details of this rare type of complete vascular ring demonstrated on MDCT facilitated appropriate surgical treatment.

  3. Valuation of using saline flush technique of contrast medium on abdominal multidetector row CT scanning

    International Nuclear Information System (INIS)

    Zhao Hong; Wang Ying; He Yanli; Liu Xiaobing; Bao Shiliang; Han Mingjun

    2006-01-01

    Objective: The purpose of this study was to compare the enhancement degree of abdomen organs and vessels after different amount of contrast medium using saline flush in abdomen MDCT scanning, which aimed to not affect contrast enhancement, decreased the amount of contrast medium, and reduced the side-effect. Methods: This study group consisted of 75 patients who were referred for contrast enhanced abdominal MDCT for various reasons. Patients were allocated into three groups: injection of 100ml of contrast medium only (A group), injection of 80ml pushed with 20ml of saline solution (B group), and injection of 70ml pushed with 30ml of saline solution (C group). Attenuation values were measured from the liver, spleen, pancreas, kidney, aorta, portal vein, and inferior vena cava in 33 second and 80 second of imaging after injection contrast medium. Results: The portal venous phases of the spleen, pancreas, kidney, aorta, portal vein had statistically significant difference among groups A, B and C. Post hoc test showed statistically significant difference between A group and C group, But no statistically significant difference during the portal venous phases of the pancreas and the kidney between A group and B group. Conclusion: Using a saline flush technique after the injection contrast medium in abdominal MDCT reduced waste of contrast medium and decrease in nephrotoxicity, at the same time, it would not lose important diagnostic information and saved patients cost for the contrast medium. (authors)

  4. Current status of multi-detector row helical CT in imaging of adult ...

    African Journals Online (AJOL)

    Mary Y. Tadros

    2016-06-22

    Jun 22, 2016 ... Pancreatic cancer is one of the most lethal diseases, with a poor prognosis. .... pseudocyst, pancreatic abscess, and inflammatory changes of ..... metastasize to the pancreas are from lung, breast, kidney, and melanoma.

  5. Detection, visualization and evaluation of anomalous coronary anatomy on 16-slice multidetector-row CT

    NARCIS (Netherlands)

    van Ooijen, P.M.A.; Dorgelo, J.; Zijlstra, F.; Oudkerk, M.

    2004-01-01

    Early identification and evaluation of relatively frequent anomalous coronary anatomy is quite relevant because of the occurrence of sudden cardiac death or related symptoms of myocardial ischemia. Selective coronary angiography (CAG) is invasive, expensive and cannot always provide the required

  6. Accuracy of intermediate dose of furosemide injection to improve multidetector row CT urography

    International Nuclear Information System (INIS)

    Roy, Catherine; Jeantroux, Jeremy; Irani, Farah G.; Sauer, Benoit; Lang, Herve; Saussine, Christian

    2008-01-01

    Objective: Evaluate the usefulness of intermediate dose furosemide to improve visualization of the intrarenal collecting system and ureter using MDCTU. Materials and methods: Two groups of 100 patients without urinary tract disease or major abdominal pathology underwent MDCTU. Group I (various abdominal indications) was performed without any additional preparation and Group II (suspicion of urinary tract disease) 10 min after injection of furosemide (20 mg). MIP images of the excretory phase were post-processed. Maximal short-axis diameter of the pelvis and ureter were measured on axial images for all phases. Visualization of the collecting system wall and the identification of the whole ureter were assessed. Results: Mean pelvic diameter before contrast was (7.4 mm, S.D. ± 2.7; 13.4 mm, S.D. ± 4.1), on cortico-medullary phase (8.4 mm, S.D. ± 4.2; 14.3 mm, S.D. ± 4), on nephrographic phase (8.1 mm, S.D. ± 2.5; 14.8 mm, S.D. ± 4) and on excretory phase (9.7 mm, S.D. ± 3.4; 14.9 mm, S.D. ± 4.5), respectively, for Groups I and II. Intrarenal collecting system wall was clearly identified on both corticomedullary and nephrographic phases in 91% of Group II against 20% of Group I. Opacification of the entire ureter was excellent on excretory phase in 96% of Group II against 13% of Group I. The difference between the mean values for the two groups was statistically significant for all phases (p -9 ). Conclusion: Intermediate-dose furosemide (20 mg) before MDCTU is a very simple add-on for accurate depiction of pelvicalyceal details and collecting system wall without artefacts. The procedure is associated with a constant and complete visualisation of the entire urete

  7. Accuracy of intermediate dose of furosemide injection to improve multidetector row CT urography

    Energy Technology Data Exchange (ETDEWEB)

    Roy, Catherine [Department of Radiology B, Universitary Hospital of Strasbourg-Civil Hospital, 1, Place de l' hopital BP 426, 67091 Strasbourg Cedex (France)], E-mail: catherine.roy@chru-strasbourg.fr; Jeantroux, Jeremy; Irani, Farah G.; Sauer, Benoit [Department of Radiology B, Universitary Hospital of Strasbourg-Civil Hospital, 1, Place de l' hopital BP 426, 67091 Strasbourg Cedex (France); Lang, Herve; Saussine, Christian [Department of Urology, Universitary Hospital of Strasbourg-Civil Hospital, 1, Place de l' hopital BP 426, 67091 Strasbourg Cedex (France)

    2008-05-15

    Objective: Evaluate the usefulness of intermediate dose furosemide to improve visualization of the intrarenal collecting system and ureter using MDCTU. Materials and methods: Two groups of 100 patients without urinary tract disease or major abdominal pathology underwent MDCTU. Group I (various abdominal indications) was performed without any additional preparation and Group II (suspicion of urinary tract disease) 10 min after injection of furosemide (20 mg). MIP images of the excretory phase were post-processed. Maximal short-axis diameter of the pelvis and ureter were measured on axial images for all phases. Visualization of the collecting system wall and the identification of the whole ureter were assessed. Results: Mean pelvic diameter before contrast was (7.4 mm, S.D. {+-} 2.7; 13.4 mm, S.D. {+-} 4.1), on cortico-medullary phase (8.4 mm, S.D. {+-} 4.2; 14.3 mm, S.D. {+-} 4), on nephrographic phase (8.1 mm, S.D. {+-} 2.5; 14.8 mm, S.D. {+-} 4) and on excretory phase (9.7 mm, S.D. {+-} 3.4; 14.9 mm, S.D. {+-} 4.5), respectively, for Groups I and II. Intrarenal collecting system wall was clearly identified on both corticomedullary and nephrographic phases in 91% of Group II against 20% of Group I. Opacification of the entire ureter was excellent on excretory phase in 96% of Group II against 13% of Group I. The difference between the mean values for the two groups was statistically significant for all phases (p < 10{sup -9}). Conclusion: Intermediate-dose furosemide (20 mg) before MDCTU is a very simple add-on for accurate depiction of pelvicalyceal details and collecting system wall without artefacts. The procedure is associated with a constant and complete visualisation of the entire urete.

  8. Comparison of effective dose for imaging of mandible between multi-detector CT and cone-beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Dae Kyo; Lee, Sang Chul; Huh, Kyung Hoe; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2012-06-15

    The aim of this study was to compare the effective dose for imaging of mandible between multi-detector computed tomography (MDCT) and cone-beam computed tomography (CBCT). An MDCT with low dose technique was also compared with them. Thermoluminescent dosimeter (TLD) chips were placed at 25 organ sites of an anthropomorphic phantom. The mandible of the phantom was exposed using 2 different types of MDCT units (Somatom Sensation 10 for standard-dose MDCT, Somatom Emotion 6 for low-dose MDCT) and 3 different CBCT units (AZ3000CT, Implagraphy, and Kavo 3D eXaM). The radiation absorbed dose was measured and the effective dose was calculated according to the ICRP 2007 report. The effective dose was the highest for Somatom Sensation 10 (425.84 {mu}Sv), followed by AZ3000CT (332.4 {mu}Sv), Somatom Emotion 6 (199.38 {mu}Sv), and 3D eXaM (111.6 {mu}Sv); it was the lowest for Implagraphy (83.09 {mu}Sv). The CBCT showed significant variation in dose level with different device. The effective doses of MDCTs were not significantly different from those of CBCTs for imaging of mandible. The effective dose of MDCT could be markedly decreased by using the low-dose technique.

  9. Comparison of effective dose for imaging of mandible between multi-detector CT and cone-beam CT

    International Nuclear Information System (INIS)

    Jeong, Dae Kyo; Lee, Sang Chul; Huh, Kyung Hoe; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul

    2012-01-01

    The aim of this study was to compare the effective dose for imaging of mandible between multi-detector computed tomography (MDCT) and cone-beam computed tomography (CBCT). An MDCT with low dose technique was also compared with them. Thermoluminescent dosimeter (TLD) chips were placed at 25 organ sites of an anthropomorphic phantom. The mandible of the phantom was exposed using 2 different types of MDCT units (Somatom Sensation 10 for standard-dose MDCT, Somatom Emotion 6 for low-dose MDCT) and 3 different CBCT units (AZ3000CT, Implagraphy, and Kavo 3D eXaM). The radiation absorbed dose was measured and the effective dose was calculated according to the ICRP 2007 report. The effective dose was the highest for Somatom Sensation 10 (425.84 μSv), followed by AZ3000CT (332.4 μSv), Somatom Emotion 6 (199.38 μSv), and 3D eXaM (111.6 μSv); it was the lowest for Implagraphy (83.09 μSv). The CBCT showed significant variation in dose level with different device. The effective doses of MDCTs were not significantly different from those of CBCTs for imaging of mandible. The effective dose of MDCT could be markedly decreased by using the low-dose technique.

  10. Multidetector CT: a new gold standard in the diagnosis of pulmonary embolism? State of the art and diagnostic algorithms

    International Nuclear Information System (INIS)

    Russo, Vincenzo; Piva, Tommaso; Lovato, Luigi; Fattori, Rossella; Gavelli, Giampaolo

    2005-01-01

    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 [it

  11. Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners.

    Science.gov (United States)

    Stratis, Andreas; Zhang, Guozhi; Lopez-Rendon, Xochitl; Politis, Constantinus; Hermans, Robert; Jacobs, Reinhilde; Bogaerts, Ria; Shaheen, Eman; Bosmans, Hilde

    2017-09-01

    To calculate organ doses and estimate the effective dose for justification purposes in patients undergoing orthognathic treatment planning purposes and temporal bone imaging in dental cone beam CT (CBCT) and Multidetector CT (MDCT) scanners. The radiation dose to the ICRP reference male voxel phantom was calculated for dedicated orthognathic treatment planning acquisitions via Monte Carlo simulations in two dental CBCT scanners, Promax 3D Max (Planmeca, FI) and NewTom VGi evo (QR s.r.l, IT) and in Somatom Definition Flash (Siemens, DE) MDCT scanner. For temporal bone imaging, radiation doses were calculated via MC simulations for a CBCT protocol in NewTom 5G (QR s.r.l, IT) and with the use of a software tool (CT-expo) for Somatom Force (Siemens, DE). All procedures had been optimized at the acceptance tests of the devices. For orthognathic protocols, dental CBCT scanners deliver lower doses compared to MDCT scanners. The estimated effective dose (ED) was 0.32mSv for a normal resolution operation mode in Promax 3D Max, 0.27mSv in VGi-evo and 1.18mSv in the Somatom Definition Flash. For temporal bone protocols, the Somatom Force resulted in an estimated ED of 0.28mSv while for NewTom 5G the ED was 0.31 and 0.22mSv for monolateral and bilateral imaging respectively. Two clinical exams which are carried out with both a CBCT or a MDCT scanner were compared in terms of radiation dose. Dental CBCT scanners deliver lower doses for orthognathic patients whereas for temporal bone procedures the doses were similar. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  12. [Chronic pancreatitis: which is the role of 320-row CT for the staging?].

    Science.gov (United States)

    Stabile Ianora, Amato Antonio; Rubini, Giuseppe; Lorusso, Filomenamila; Ambriola, Angela; Rella, Leonarda; Di Crescenzo, Vincenzo; Moschetta, Marco

    2013-01-01

    The purpose of this study was to evaluate the diagnostic potential of multi-planar and volumetric reconstructions obtained from isotropic data by using 16-slice computed tomography (CT) in the diagnosis and staging of chronic pancreatitis. In a group of 42 patients CT images were evaluated searching for alterations in morphology and structure of the pancreas, alterations of the Wirsung duct, dilatation of the bile ducts, fluid collections, and vascular involvement of the digestive tract. The disease was then staged in mild, moderate and severe and correlated with the clinical staging. CT allowed the recognition of chronic pancreatitis in all cases. The staging was correct in 25/42 patients, with an accuracy rate of 59.5%. In the staging of moderate and severe forms, CT correlation with clinical and laboratory data was valid, but in mild forms it appeared less significant. Multi-detector CT is accurate in the recognition of moderate, advanced forms of chronic pancreatitis and in the identification of its complications, while it is poorly correlated with the clinical staging in mild forms of the disease.

  13. Cardiac imaging using 256-detector row four-dimensional CT. Preliminary clinical report

    International Nuclear Information System (INIS)

    Kido, Teruhito; Kurata, Akira; Higashino, Hiroshi

    2007-01-01

    Along with the increase of detector rows on the z-axis and a faster gantry rotation speed, the spatial and temporal resolutions of the multislice computed tomography (CT) have been improved for noninvasive coronary artery imaging. We investigated the feasibility of the second specification prototype 256-detector row four-dimensional CT for assessing coronary artery and cardiac function. The subjects were five patients with coronary artery disease. Contrast medium (40-60 ml) was intravenously administered at the rate of 3-4 ml/s. The patient's whole heart was scanned for 1.5 s to cover at least one cardiac cycle during breathholding without electrocardiographic gating. Parameters used were 0.5 mm slice thickness, 0.5 s/rotation, 120 Kv, and 350 mA, with a half-scan reconstruction algorithm (temporal resolution 250 ms). Twenty-six transaxial datasets were reconstructed at intervals of 50 ms. The assessability of the coronary arteries in American Heart Association (AHA) segments 1, 2, 3, 5, 6, 7, 9, and 11 was visually evaluated, resulting in 29 of 32 (90.9%) segments being assessable. Functional assessment was also performed using animated movies without banding artifacts in all cases. The 256-detector row four-dimensional CT can assess the coronary artery and cardiac function using data during 1.5 s without banding artifacts. (author)

  14. Optimal dose and injection duration (injection rate) of contrast material for depiction of hypervascular hepatocellular carcinomas by multidetector CT

    International Nuclear Information System (INIS)

    Yanaga, Yumi; Awai, Kazuo; Nakayama, Yoshiharu; Nakaura, Takeshi; Tamura, Yoshitaka; Yamashita, Yasuyuki; Funama, Yoshinori; Aoyama, Masahito; Asada, Naoki

    2007-01-01

    The aim of this study was to investigate the optimal dose and injection duration of contrast material (CM) for depicting hypervascular hepatocellular carcinomas (HCCs) during the hepatic arterial phase with multidetector row computed tomography (CT). The study population consisted of 71 patients with hypervascular HCCs. After unenhanced scans, the first (early arterial phase, or EAP), second (late arterial phase, or LAP), and third (equilibrium phase) scanning was started at 30, 43, and 180 s after injection of contrast material (CM). During a 33-s period, patients with a body weight ≤50 kg received 100 ml of non-ionic CM with an iodine concentration of 300 mgI/ml; patients whose body weight was >50 kg received 100 ml of CM with an iodine concentration of 370 mgI/ml. First, we measured enhancement in the abdominal aorta and tumor-to-liver contrast (TLC) during the EAP and LAP. Next, to investigate the relation between aortic enhancement and TLC during the LAP, two radiologists visually assessed the conspicuity of hypervascular HCCs during the LAP using a 3-point scale: grade 1, poor; grade 2, fair; grade 3, excellent. Finally, to examine the effect of the CM dose and injection duration on aortic enhancement during the EAP, we simulated aortic enhancement curves using test bolus data obtained for 10 HCC patients and the method of Fleischmann and Hittmair. A relatively strong correlation was observed between aortic enhancement during the EAP and TLC during the LAP (correlation coefficient r=0.75, P 280 HU for aortic enhancement simulations during EAP, the injection duration should be <25 s for patients receiving a CM dose of 1.7 ml/kg with 300 mgI/ml iodine and <30 s for those receiving 2.0 ml/kg. For excellent depiction of hypervascular HCCs during the hepatic arterial phase, the injection duration should be <25 s in patients receiving a CM dose of 1.7 ml/kg with 300 mgI/ml iodine and <30 s for patients receiving 2.0 ml/kg. (author)

  15. Contrast enhancement in multidetector-row computed tomography (MDCT) of the abdomen: intraindividual comparison of contrast media containing 300 mg versus 370 mg iodine per ml

    International Nuclear Information System (INIS)

    Behrendt, F.F.; Mahnken, A.H.; Keil, S.; Das, M.; Hohl, C.; Guenther, R.W.; Muehlenbruch, G.; Bauer, D.; Seidensticker, P.; Jost, E.; Wildberger, J.E.

    2008-01-01

    The purpose of this study was to intraindividually evaluate the difference in intraluminal vessel and parenchyma contrast enhancement of two different iodine concentrations in multidetector-row computed tomography (MDCT) of the abdomen. Eighty-three patients underwent baseline and follow-up MDCT-scanning (Somatom Sensation 16; Siemens, Forchheim, Germany) of the abdomen using contrast media containing 370 mg iodine/ml (protocol A; Ultravist 370, Bayer Schering Pharma, Berlin, Germany) and 300 mg iodine/ml (protocol B; Ultravist 300). The total iodine load (37 g iodine) and the iodine delivery rate (1.29 g iodine/s) were identical for both protocols. Contrast enhancement in the portal venous phase was measured in the abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney. Mean attenuation values were compared using paired t-test. Intraindividual comparison revealed no statistically significant differences of the mean attenuation values between protocols A and B for all anatomic sites: abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney (all P > 0.05). Given an injection protocol with constant total iodine load and constant iodine delivery rate, the iodine concentration of contrast media does not significantly influence abdominal contrast enhancement in the portal venous phase. (orig.)

  16. Sixteen multidetector row computed tomography of pulmonary veins: 3-months' follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

    International Nuclear Information System (INIS)

    Maksimovic, Ruzica; Cademartiri, Filippo; Pattynama, Peter M.T.; Scholten, Marcoen F.; Jordaens, Luc J.

    2005-01-01

    The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months' follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1±2.4 preprocedural versus 18.6±2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2±0.2 versus 1.2±0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1±2.5 mm versus 16.5±2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months' follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up. (orig.)

  17. Sixteen multidetector row computed tomography of pulmonary veins: 3-months' follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Maksimovic, Ruzica; Cademartiri, Filippo; Pattynama, Peter M.T. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Scholten, Marcoen F.; Jordaens, Luc J. [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands)

    2005-06-01

    The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months' follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1{+-}2.4 preprocedural versus 18.6{+-}2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2{+-}0.2 versus 1.2{+-}0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1{+-}2.5 mm versus 16.5{+-}2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months' follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up. (orig.)

  18. Multidetector-row computed tomography for prosthetic heart valve dysfunction: is concomitant non-invasive coronary angiography possible before redo-surgery?

    Energy Technology Data Exchange (ETDEWEB)

    Tanis, Wilco [Haga Teaching Hospital, Department of Cardiology, The Hague (Netherlands); Haga Teaching Hospital, The Hague (Netherlands); Sucha, Dominika; Habets, Jesse [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Laufer, Ward; Chamuleau, Steven [University Medical Center Utrecht, Department of Cardiology, Utrecht (Netherlands); Herwerden, Lex.A. van [University Medical Center Utrecht, Department of Cardiothoracic Surgery, Utrecht (Netherlands); Symersky, Petr [Vrije Universiteit, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Budde, Ricardo P.J. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands)

    2015-06-01

    Retrospective ECG-gated multidetector-row computed tomography (MDCT) is increasingly used for the assessment of prosthetic heart valve (PHV) dysfunction, but is also hampered by PHV-related artefacts/cardiac arrhythmias. Furthermore, it is performed without nitroglycerine or heart rate correction. The purpose was to determine whether MDCT performed before potential redo-PHV surgery is feasible for concomitant coronary artery stenosis assessment and can replace invasive coronary angiography (CAG). PHV patients with CAG and MDCT were identified. Based on medical history, two groups were created: (I) patients with no known coronary artery disease (CAD), (II) patients with known CAD. All images were scored for the presence of significant (>50 %) stenosis. CAG was the reference test. Fifty-one patients were included. In group I (n = 38), MDCT accurately ruled out significant stenosis in 19/38 (50 %) patients, but could not replace CAG in the remaining 19/38 (50 %) patients due to non-diagnostic image quality (n = 16) or significant stenosis (n = 3) detection. In group II (n = 13), MDCT correctly found no patients without significant stenosis, requiring CAG imaging in all. MDCT assessed patency in 16/19 (84 %) grafts and detected a hostile anatomy in two. MDCT performed for PHV dysfunction assessment can replace CAG (100 % accurate) in approximately half of patients without previously known CAD. (orig.)

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  20. Multidetector-row computed tomography for prosthetic heart valve dysfunction: is concomitant non-invasive coronary angiography possible before redo-surgery?

    International Nuclear Information System (INIS)

    Tanis, Wilco; Sucha, Dominika; Habets, Jesse; Laufer, Ward; Chamuleau, Steven; Herwerden, Lex.A. van; Symersky, Petr; Budde, Ricardo P.J.

    2015-01-01

    Retrospective ECG-gated multidetector-row computed tomography (MDCT) is increasingly used for the assessment of prosthetic heart valve (PHV) dysfunction, but is also hampered by PHV-related artefacts/cardiac arrhythmias. Furthermore, it is performed without nitroglycerine or heart rate correction. The purpose was to determine whether MDCT performed before potential redo-PHV surgery is feasible for concomitant coronary artery stenosis assessment and can replace invasive coronary angiography (CAG). PHV patients with CAG and MDCT were identified. Based on medical history, two groups were created: (I) patients with no known coronary artery disease (CAD), (II) patients with known CAD. All images were scored for the presence of significant (>50 %) stenosis. CAG was the reference test. Fifty-one patients were included. In group I (n = 38), MDCT accurately ruled out significant stenosis in 19/38 (50 %) patients, but could not replace CAG in the remaining 19/38 (50 %) patients due to non-diagnostic image quality (n = 16) or significant stenosis (n = 3) detection. In group II (n = 13), MDCT correctly found no patients without significant stenosis, requiring CAG imaging in all. MDCT assessed patency in 16/19 (84 %) grafts and detected a hostile anatomy in two. MDCT performed for PHV dysfunction assessment can replace CAG (100 % accurate) in approximately half of patients without previously known CAD. (orig.)

  1. Cirsoid Aneurysm of Coronary Arteries Associated with Arterioventricular Fistula Evaluated by 64-Multidetector CT Coronary Angiography: Depiction of a Case

    International Nuclear Information System (INIS)

    Marrone, Gianluca; Mamone, Giuseppe; Milazzo, Mariapina; Caruso, Settimo; Baravoglia, Cesar Hernandez; Vitulo, Patrizio; Gridelli, Bruno; Luca, Angelo

    2009-01-01

    A female patient with severe pulmonary hypertension was admitted for lung transplant evaluation. As an incidental finding, the chest CT showed diffuse and dilated coronaries, not detected at previous echocardiography. A coronary CT angiography was then performed using a 64-multidetector computed tomography (MDCT) scanner to better evaluate the coronary tree. The images obtained after postprocessing demonstrated tremendously aneurysmatic and tortuous coronary arteries and the presence of a septal branch deepening into the myocardium and penetrating the right ventricle cavity, forming an abnormal arterioventricular fistula. A causal relation between the aneurysms and the fistula is suspected.

  2. Myocardial enhancement pattern in patients with acute myocardial infarction on two-phase contrast-enhanced Ecg-gated multidetector-row computed tomography

    International Nuclear Information System (INIS)

    Ko, S.M.; Seo, J.B.; Hong, M.K.; Do, K.H.; Lee, S.H.; Lee, J.S.; Song, J.W.; Park, S.J.; Park, S.W.; Lim, T.H.

    2006-01-01

    Aim: To evaluate the myocardial enhancement pattern of the left ventricle on two-phase contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) images in patients with acute myocardial infarction (AMI). METHODS: Two-phase contrast-enhanced ECG-gated MDCT examinations were performed in 16 patients with AMI. The presence, location and pattern of myocardial enhancement were evaluated. MDCT findings were compared with the catheter angiographic results. RESULTS: Subendocardial (n=9) or transmural (n=6) area of early perfusion defects of the myocardium was detected in 15 of 16 patients (94%) on early-phase CT images. Variable delayed myocardial enhancement patterns on late-phase CT images were observed in 12 patients (75%): (1) subendocardial residual perfusion defect and subepicardial late enhancement (n=6); (2) transmural late enhancement (n=1); (3) isolated subendocardial late enhancement (n=1); and (4) isolated subendocardial residual perfusion defect (n=2). On catheter angiography, 14 of 15 corresponding coronary arteries showed significant stenosis. CONCLUSION: Variable abnormal myocardial enhancement pattern was seen on two-phase, contrast-enhanced ECG-gated MDCT in patients with AMI. Assessment of myocardial attenuation on CT angiography gives additional information of the location and extent of infarction

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  4. The postprocessing techniques in renal artery reconstructions and clinical application with multidetector spiral CT angiography

    International Nuclear Information System (INIS)

    Yu Yuanxin; Liang Changhong; Zhang Zhonglin; Xie Shufei; Liu Yubao; Tang Xiangzhou

    2005-01-01

    Objective: To investigate the value and predominance for imaging postprocessing techniques of renal artery variation and lesions by multidetector spiral CT angiography. Methods: 51 patients with renal artery disease including 12 artery variation, 27 artery stenosis, 3 renal anenrysm, 3 thrombosis of renal artery and 3 dissecting aneurysm of renal artery by SSD, MIP and CPR were enrolled. The effectiveness of these imaging postprocessing methods was compared, 29 of them were confirmed by DSA and 3 by operation, others were checked by MRA and follow up. Results: All abnormalities and diseases were cleariy displayed. The specificity and sensitivity were 100% respectively. In the all imaging postprocessing techniques, MPR can clearly display the calcification of the arteries, stenosis, embolism, aneurysm but do not display the anatomy satisfactorily. MIP can not only clearly display the anatomy but display the different configurations. VR can display the artery figures but can not display the information of lumen of blood vessels. SSD can display the complex vessel anatomy but it was influenced by its threshold selection. CPR can spread and display directly the tortuous renal artery and measure the section area of stenosis. Conclusions: MSCTA is helpful to accurately display the renal artery variation and lesions. Both MIP and VR are the best choice to illustrate the renal artery abnormalities. And MPR and SSD are assistant in the diagnosis of' renal artery lesions. (authors)

  5. Radiation dose of digital tomosynthesis for sinonasal examination: comparison with multi-detector CT.

    Science.gov (United States)

    Machida, Haruhiko; Yuhara, Toshiyuki; Tamura, Mieko; Numano, Tomokazu; Abe, Shinji; Sabol, John M; Suzuki, Shigeru; Ueno, Eiko

    2012-06-01

    Using an anthropomorphic phantom, we have investigated the feasibility of digital tomosynthesis (DT) of flat-panel detector (FPD) radiography to reduce radiation dose for sinonasal examination compared to multi-detector computed tomography (MDCT). A female Rando phantom was scanned covering frontal to maxillary sinus using the clinically routine protocol by both 64-detector CT (120 kV, 200 mAs, and 1.375-pitch) and DT radiography (80 kV, 1.0 mAs per projection, 60 projections, 40° sweep, and posterior-anterior projections). Glass dosimeters were used to measure the radiation dose to internal organs including the thyroid gland, brain, submandibular gland, and the surface dose at various sites including the eyes during those scans. We compared the radiation dose to those anatomies between both modalities. In DT radiography, the doses of the thyroid gland, brain, submandibular gland, skin, and eyes were 230 ± 90 μGy, 1770 ± 560 μGy, 1400 ± 80 μGy, 1160 ± 2100 μGy, and 112 ± 6 μGy, respectively. These doses were reduced to approximately 1/5, 1/8, 1/12, 1/17, and 1/290 of the respective MDCT dose. For sinonasal examinations, DT radiography enables dramatic reduction in radiation exposure and dose to the head and neck region, particularly to the lens of the eye. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  6. Anterior atlantodental and posterior atlantodental intervals on plain radiography, multidetector CT, and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Seung Woo; Ryu, Jeong Ah; Park, Dong Woo [Dept. of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Yoon, Ki Bo; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul(Korea, Republic of)

    2015-01-15

    To determine the normal values of the anterior atlantodental interval (AADI) and posterior atlantodental interval (PADI) on plain radiography, multidetector CT (MDCT) and MRI, as well as the dural sac width and spinal cord diameter at the atlantoaxial joint level on MRI. In total, 60 subjects underwent plain radiography, MRI and MDCT. We obtained values for AADI and PADI on plain radiography, MDCT, and MRI, and for dural sac width and spinal cord diameter on MRI. Two radiologists independently measured each value and a consensus was reached. The average AADI was 1.5 +/- 0.5 mm on plain radiography, 1.4 +/- 0.3 mm on MDCT, and 1.6 +/- 0.5 mm on MRI. The average PADI was 20.6 +/- 2.4 mm on plain radiography, 18.0 +/- 2.1 mm on MDCT, and 17.7 +/- 1.9 mm on MRI. The dural sac width was 13.7 +/- 1.8 mm, and the spinal cord diameter was 7.8 +/- 0.7 mm. Interobserver agreement was 0.701-0.927 and intraobserver agreement was 0.681-0.937. AADI values obtained on MDCT are significantly lower than those obtained on plain radiography or MRI. PADI values obtained on plain radiography are significantly higher than those obtained on MDCT or MRI. The dural sac width is most closely correlated with PADI values on MDCT. PADI seems to be easier to measure, more relevant, and clinically useful than AADI.

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

    International Nuclear Information System (INIS)

    Oh, Ki Ho; Choo, Ki Seok; Lim, Soo Jin; Lee, Hyoung Doo; Park, Ji Ae; Jo, Min Jung; Sung, Si Chan; Chang, Yun Hee; Jeong, Dong Wook; Kim, Siho

    2009-01-01

    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.)

  8. 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.

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

    International Nuclear Information System (INIS)

    Chalumeau-Lemoine, Ludivine; Khalil, Antoine; Prigent, Hélène; Carette, Marie-France; Fartoukh, Muriel; Parrot, Antoine

    2013-01-01

    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

  10. Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views

    International Nuclear Information System (INIS)

    Schmidt, Sabine; Chalaron, Marc; Schnyder, Pierre; Denys, Alban; Chevallier, Patrick; Bessoud, Bertrand; Verdun, Francis R.; Frascarolo, Philippe

    2005-01-01

    The purpose of this study was to compare the diagnostic performance of axial and coronal views in multidetector CT enteroclysis (MDCTE). We retrospectively evaluated 48 patients with pathological correlation investigated by MDCTE for small bowel disorders. After nasojejunal administration of 2 l of 5% methylcellulose axial arterial and venous acquisition of MDCTE was followed by coronal reconstructions using equal slice thicknesses of 2.5 mm with 2 mm increments. Spatial resolution of both planes was evaluated by phantom. Three radiologists independently read axial and coronal images concerning 12 pathological features. The interobserver agreement and time of reading was calculated. Sensitivity and specificity resulted from comparison with histopathology (n=39) or follow-up (n=9). Phantom study revealed higher spatial resolution for axial than coronal views, whatever reconstruction interval was used. However, spatial frequency always remained high. Most pathological signs, such as bowel wall thickening (BWT), bowel wall enhancement (BWE) and intraperitoneal fluid (IPF), showed better interobserver agreement on axial than coronal views (BWT: 0.61 vs. 0.44; BWE: 0.56 vs. 0.5; IPF:0.53 vs. 0.43). The Wilcoxon signed-rank test revealed significantly higher sensitivity for axial than coronal views (P=0.0453); the time of reading was significantly shorter for the latter (P=0.0146). The diagnostic value of axial slices is superior to coronal reconstructions despite the reduced data volume and display of the physiological course of bowel loops on the coronal plane. (orig.)

  11. Anterior atlantodental and posterior atlantodental intervals on plain radiography, multidetector CT, and MRI

    International Nuclear Information System (INIS)

    Cha, Seung Woo; Ryu, Jeong Ah; Park, Dong Woo; Yoon, Ki Bo; Lee, Seung Hun; Joo, Kyung Bin

    2015-01-01

    To determine the normal values of the anterior atlantodental interval (AADI) and posterior atlantodental interval (PADI) on plain radiography, multidetector CT (MDCT) and MRI, as well as the dural sac width and spinal cord diameter at the atlantoaxial joint level on MRI. In total, 60 subjects underwent plain radiography, MRI and MDCT. We obtained values for AADI and PADI on plain radiography, MDCT, and MRI, and for dural sac width and spinal cord diameter on MRI. Two radiologists independently measured each value and a consensus was reached. The average AADI was 1.5 +/- 0.5 mm on plain radiography, 1.4 +/- 0.3 mm on MDCT, and 1.6 +/- 0.5 mm on MRI. The average PADI was 20.6 +/- 2.4 mm on plain radiography, 18.0 +/- 2.1 mm on MDCT, and 17.7 +/- 1.9 mm on MRI. The dural sac width was 13.7 +/- 1.8 mm, and the spinal cord diameter was 7.8 +/- 0.7 mm. Interobserver agreement was 0.701-0.927 and intraobserver agreement was 0.681-0.937. AADI values obtained on MDCT are significantly lower than those obtained on plain radiography or MRI. PADI values obtained on plain radiography are significantly higher than those obtained on MDCT or MRI. The dural sac width is most closely correlated with PADI values on MDCT. PADI seems to be easier to measure, more relevant, and clinically useful than AADI.

  12. Multidetector CT predictors of prosthesis-patient mismatch in transcatheter aortic valve replacement.

    Science.gov (United States)

    Freeman, Melanie; Webb, John G; Willson, Alexander B; Wheeler, Miriam; Blanke, Philipp; Moss, Robert R; Thompson, Christopher R; Munt, Brad; Norgaard, Bjarne L; Yang, Tae-Hyun; Min, James K; Poulsen, Steen; Hansson, Nicolaj C; Binder, Ronald K; Toggweiler, Stefan; Hague, Cameron; Wood, David A; Pibarot, Philippe; Leipsic, Jonathon

    2013-01-01

    Prosthesis-patient mismatch (PPM) is a predictor of mortality after aortic valve replacement (AVR). We examined whether accurate 3-dimensional annular sizing with multidetector CT (MDCT) is predictive of PPM after transcatheter AVR (TAVR). One hundred twenty-eight patients underwent MDCT then TAVR. Moderate PPM was defined as an indexed effective orifice area ≤0.85 cm²/m² and severe ≤0.65 cm²/m². MDCT annular measurements (area, short and long axis) were compared with the size of the selected transcatheter heart valve (THV) to obtain (1) the difference between prosthesis size and CT-measured mean annular diameter and (2) the percentage of undersizing or oversizing (calculated as 100 × [MDCT annular area--THV nominal area]/THV nominal area). In addition, the MDCT annular area was indexed to body surface area. These measures were evaluated as potential PPM predictors. We found that 42.2% of patients had moderate PPM and 9.4% had severe PPM. Procedural characteristics and in-hospital outcomes were similar between patients with or without PPM. THV undersizing of the mean aortic annulus diameter was not predictive of PPM (odds ratio [OR], 0.84; 95% CI, 0.65-1.07; P = .16; area under the receiver-operating characteristic curve [AUC], 0.58). THV undersizing of annular area was not predictive of PPM (OR, 0.96; 95% CI, 0.80-1.16; P = .69; AUC, 0.52). Indexed MDCT annular area was, however, predictive of PPM (OR, 0.24; 95% CI, 0.10-0.59; P < .001; AUC, 0.66). PPM is frequent after TAVR. Appropriate annular oversizing does not reduce the rate or severity of PPM. Patient annulus size mismatch, identified by indexed MDCT annular area, is a significant predictor of PPM. Copyright © 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  13. Radiation dose reduction on multidetector abdominal CT using adaptive statistical iterative reconstruction technique in children

    International Nuclear Information System (INIS)

    Zhang Qifeng; Peng Yun; Duan Xiaomin; Sun Jihang; Yu Tong; Han Zhonglong

    2013-01-01

    Objective: To investigate the feasibility to reduce radiation doses on pediatric multidetector abdominal CT using the adaptive statistical iterative reconstruction technique (ASIR) associated with automated tube current modulation technique (ATCM). Methods: Thirty patients underwent abdominal CT with ATCM and the follow-up scan with ATCM cooperated with 40% ASIR. ATCM was used with age dependent noise index (NI) settings: NI = 9 for 0-5 year old and NI = 11 for > 5 years old for simple ATCM group, NI = 11 for 0-5 year old and NI = 15 for > 5 years old for ATCM cooperated with 40% ASIR group (AISR group). Two radiologists independently evaluated images for diagnostic quality and image noise with subjectively image quality score and image noise score using a 5-point scale. Interobserver agreement was assessed by Kappa test. The volume CT dose indexes (CTDIvol) for the two groups were recorded. Statistical significance for the CTDIvol value was analyzed by pair-sample t test. Results: The average CTDIvol for the ASIR group was (1.38 ± 0.64) mGy, about 60% lower than (3.56 ± 1.23) mGy for the simple ATCM group, and the CTDIvol of two groups had statistically significant differences. (t = 33.483, P < 0.05). The subjective image quality scores for the simple ATCM group were 4.43 ± 0.57 and 4.37 ±0.61, Kappa = 0.878, P < 0.01 (ASIR group: 4.70 ± 0.47 and 4.60 ± 0.50, Kappa = 0.783, P < 0.01), by two observers. The image noise score for the simple ATCM group were 4.03 ±0.56 and 3.83 ±0.53, Kappa = 0.572, P < 0.01 (ASIR group: 4.20 ± 0.48 and 4.10 ± 0.48, Kappa = 0.748, P < 0.01), by two observers. All images had acceptable diagnostic image quality. Conclusion: Lower radiation dose can be achieved by elevating NI with ASIR in pediatric CT abdominal studies, while maintaining diagnostically acceptable images. (authors)

  14. Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization

    International Nuclear Information System (INIS)

    Arnold, Raoul; Ley, Sebastian; Ley-Zaporozhan, Julia; Kauczor, Hans-Ulrich; Eichhorn, Joachim; Ulmer, Herbert; Schenk, Jens-Peter

    2007-01-01

    After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically. To compare the diagnostic quality of MDCT-A and MRI with that of CCC for coronary imaging in a group of patients with coronary artery pathology after childhood KS. A total of 16 patients (aged 5-27 years) underwent CCC and 16-row MDCT-A and 14 patients MRI (1.5 T). There was 100% agreement between MDCT-A and CCC in the detection of coronary aneurysms and stenoses. MDCT-A was superior for the visualization of calcified lesions. MRI and CCC showed 93% agreement for the detection of aneurysms. Visualization of coronary artery stenoses was difficult using MRI - one stenosis was missed. MDCT-A has excellent correlation with CCC regarding all changes affecting the coronary arteries in the follow-up of childhood KS. In comparison to MDCT-A and CCC, MRI is less precise in the detection of stenotic lesions. Due to its high image quality and ease of performance MDCT-A should be the primary diagnostic modality in patients following childhood KS. (orig.)

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

    International Nuclear Information System (INIS)

    Sabharwal, Rohan; Vladica, Philip; Coleman, Patrick

    2007-01-01

    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

    International Nuclear Information System (INIS)

    Damilakis, John; Tzedakis, Antonis; Perisinakis, Kostas; Papadakis, Antonios E.

    2010-01-01

    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. Multidetector CT features of pulmonary focal ground-glass opacity: differences between benign and malignant

    Science.gov (United States)

    Fan, L; Liu, S-Y; Li, Q-C; Yu, H; Xiao, X-S

    2012-01-01

    Objective To evaluate different features between benign and malignant pulmonary focal ground-glass opacity (fGGO) on multidetector CT (MDCT). Methods 82 pathologically or clinically confirmed fGGOs were retrospectively analysed with regard to demographic data, lesion size and location, attenuation value and MDCT features including shape, margin, interface, internal characteristics and adjacent structure. Differences between benign and malignant fGGOs were analysed using a χ2 test, Fisher's exact test or Mann–Whitney U-test. Morphological characteristics were analysed by binary logistic regression analysis to estimate the likelihood of malignancy. Results There were 21 benign and 61 malignant lesions. No statistical differences were found between benign and malignant fGGOs in terms of demographic data, size, location and attenuation value. The frequency of lobulation (p=0.000), spiculation (p=0.008), spine-like process (p=0.004), well-defined but coarse interface (p=0.000), bronchus cut-off (p=0.003), other air-containing space (p=0.000), pleural indentation (p=0.000) and vascular convergence (p=0.006) was significantly higher in malignant fGGOs than that in benign fGGOs. Binary logistic regression analysis showed that lobulation, interface and pleural indentation were important indicators for malignant diagnosis of fGGO, with the corresponding odds ratios of 8.122, 3.139 and 9.076, respectively. In addition, a well-defined but coarse interface was the most important indicator of malignancy among all interface types. With all three important indicators considered, the diagnostic sensitivity, specificity and accuracy were 93.4%, 66.7% and 86.6%, respectively. Conclusion An fGGO with lobulation, a well-defined but coarse interface and pleural indentation gives a greater than average likelihood of being malignant. PMID:22128130

  18. Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia

    International Nuclear Information System (INIS)

    Barmase, Meghna; Kang, Mandeep; Wig, Jaidev; Kochhar, Rakesh; Gupta, Rajesh; Khandelwal, Niranjan

    2011-01-01

    Objective: To assess the role of multidetector CT angiography (MDCTA) in the diagnosis of acute mesenteric ischemia (AMI) and to compare the diagnostic utility of axial images with reconstructed images. Materials and methods: In this Institute Review Board approved prospective study, MDCTA was performed on 31 patients who presented with the clinical suspicion of AMI (25M; 6F, age range: 16–73 years). Axial and reconstructed images of each patient were evaluated independently by two radiologists for evidence of bowel wall thickening, abnormal mucosal enhancement, bowel dilatation or obstruction, mesenteric stranding, ascites, solid organ infarcts, pneumatosis intestinalis or porto-mesenteric gas, and mesenteric arterial or venous occlusion. MDCT findings were correlated with the surgical findings and clinical outcome. Patients were later divided into two groups: a study group of patients with proven AMI and a control group of patients with an alternate diagnosis, for the purpose of statistical analysis. Results: AMI was correctly diagnosed in all 16 patients on MDCTA (100% sensitivity and specificity) of whom nine patients underwent surgical exploration. Three patients expired before surgery and the remaining 5 patients were proven based on positive clinical and laboratory findings. Mesenteric arterial occlusion was seen in 7 patients while 5 patients had portomesenteric venous thrombosis. Reconstructed images using minimum intensity projection, volume rendering and multiplanar volume reconstruction were found to perform better for the detection of vascular abnormalities and improved the diagnostic confidence of both radiologists in the evaluation of bowel and mesenteric abnormalities. Conclusion: MDCTA is an effective non-invasive modality for the diagnosis of mesenteric ischemia.

  19. Influence of the Quantity of Aortic Valve Calcium on the Agreement Between Automated 3-Dimensional Transesophageal Echocardiography and Multidetector Row Computed Tomography for Aortic Annulus Sizing.

    Science.gov (United States)

    Podlesnikar, Tomaz; Prihadi, Edgard A; van Rosendael, Philippe J; Vollema, E Mara; van der Kley, Frank; de Weger, Arend; Ajmone Marsan, Nina; Naji, Franjo; Fras, Zlatko; Bax, Jeroen J; Delgado, Victoria

    2018-01-01

    Accurate aortic annulus sizing is key for selection of appropriate transcatheter aortic valve implantation (TAVI) prosthesis size. The present study compared novel automated 3-dimensional (3D) transesophageal echocardiography (TEE) software and multidetector row computed tomography (MDCT) for aortic annulus sizing and investigated the influence of the quantity of aortic valve calcium (AVC) on the selection of TAVI prosthesis size. A total of 83 patients with severe aortic stenosis undergoing TAVI were evaluated. Maximal and minimal aortic annulus diameter, perimeter, and area were measured. AVC was assessed with computed tomography. The low and high AVC burden groups were defined according to the median AVC score. Overall, 3D TEE measurements slightly underestimated the aortic annulus dimensions as compared with MDCT (mean differences between maximum, minimum diameter, perimeter, and area: -1.7 mm, 0.5 mm, -2.7 mm, and -13 mm 2 , respectively). The agreement between 3D TEE and MDCT on aortic annulus dimensions was superior among patients with low AVC burden (AVC burden (≥3,025 arbitrary units). The interobserver variability was excellent for both methods. 3D TEE and MDCT led to the same prosthesis size selection in 88%, 95%, and 81% of patients in the total population, the low, and the high AVC burden group, respectively. In conclusion, the novel automated 3D TEE imaging software allows accurate and highly reproducible measurements of the aortic annulus dimensions and shows excellent agreement with MDCT to determine the TAVI prosthesis size, particularly in patients with low AVC burden. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  20. Whole tumour first-pass perfusion using a low-dose method with 64-section multidetector row computed tomography in oesophageal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Chen Tianwu; Yang Zhigang; Dong Zhihui; Li Yuan; Yao Jin; Wang Qiling; Qian Lingling

    2011-01-01

    Purpose: To propose a low-dose method at tube current-time product of 50 mAs for whole tumour first-pass perfusion of oesophageal squamous cell carcinoma using 64-section multidetector row computed tomography (MDCT), and to assess the original image quality and accuracy of perfusion parameters. Materials and methods: Fifty-nine consecutive patients with confirmed oesophageal squamous cell carcinomas were enrolled into our study, and underwent whole tumour first-pass perfusion scan with 64-section MDCT at 50 mAs. Image data were statistically reviewed focusing on original image quality demonstrated by image-quality scores and signal-to-noise (S/N) ratios; and perfusion parameters including perfusion (PF, in ml/min/ml), peak enhanced density (PED, in HU), time to peak (TTP, in seconds) and blood volume (BV, in ml/100 g) for the tumour. To test the interobserver agreement of perfusion measurements, perfusion analyses were repeatedly performed. Results: Original image-quality scores were 4.71 ± 0.49 whereas S/N ratios were 5.21 ± 2.05, and the scores were correlated with the S/N ratios (r = 0.465, p < 0.0001). Mean values for PF, PED, TTP and BV of the tumour were 33.27 ± 24.15 ml/min/ml, 24.06 ± 9.87 HU, 29.42 ± 8.61 s, and 12.45 ± 12.22 ml/100 g, respectively. Intraclass correlation coefficient between the replicated measurements of each perfusion parameter was greater than 0.99, and mean difference of the replicated measurements of each parameter was close to zero. Conclusion: Whole tumour first-pass perfusion with 64-section MDCT at low-dose radiation could be reproducible to assess microcirculation in oesophageal squamous cell carcinoma without compromising subjective original image quality of the tumour.

  1. Preoperative differentiation between T1a and ≥T1b gallbladder cancer: combined interpretation of high-resolution ultrasound and multidetector-row computed tomography

    International Nuclear Information System (INIS)

    Joo, Ijin; Baek, Jee Hyun; Kim, Jung Hoon; Han, Joon Koo; Choi, Byung Ihn; Lee, Jae Young; Park, Hee Sun

    2014-01-01

    To determine the diagnostic value of combined interpretation of high-resolution ultrasound (HRUS) and multidetector-row computed tomography (MDCT) for preoperative differentiation between T1a and ≥T1b gallbladder (GB) cancer. Eighty-seven patients with pathologically confirmed GB cancers (T1a, n = 15; ≥T1b, n = 72), who preoperatively underwent both HRUS and MDCT, were included in this retrospective study. Two reviewers independently determined the T-stages of the GB cancers on HRUS and MDCT using a five-point confidence scale (5, definitely T1a; 1, definitely ≥T1b). For individual modality interpretation, the lesions with scores ≥4 were classified as T1a, and, for combined modality interpretation, the lesions with all scores ≥4 in both modalities were classified as T1a. The McNemar test was used to compare diagnostic performance. The diagnostic accuracy of differentiation between T1a and ≥T1b GB cancer was higher using combined interpretation (90.8 % and 88.5 % for reviewers 1 and 2, respectively) than individual interpretation of HRUS (82.8 % and 83.9 %) or MDCT (74.7 % and 82.8 %) (P < 0.05, reviewer 1). Combined interpretations demonstrated 100 % specificity for both reviewers, which was significantly higher than individual interpretations (P < 0.05, both reviewers). Combined HRUS and MDCT interpretation may improve the diagnostic accuracy and specificity for differentiating between T1a and ≥T1b GB cancers. circle Differentiating between T1a and ≥T1b gallbladder cancer can help surgical planning. (orig.)

  2. 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.)

  3. Use of multidetector-row computed tomography scan to detect pannus formation in prosthetic mechanical aortic valves.

    Science.gov (United States)

    Aladmawi, Mohamed A; Pragliola, Claudio; Vriz, Olga; Galzerano, Domenico

    2017-04-01

    Obstruction of a mechanical aortic valve by pannus formation at the subvalvular level is a major long-term complication of aortic valve replacement (AVR). In fact, pannus is sometime difficult to differentiate from patient-prosthesis mismatch or valve thrombosis. In most cases cine-angiography and echocardiography, either transthoracic or transesophageal, cannot correctly visualize the complication when the leaflets show a normal mobility. Recent technological refinements made this difficult diagnosis possible by ECG-gated computed tomography (CT) scan which shows adequate images in 90% of the cases and can differentiate pannus from fresh and organized thrombus.

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

    International Nuclear Information System (INIS)

    Staser, Jonathan A.; Alam, Tariq; Applegate, Kimberly

    2006-01-01

    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.)

  5. Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study.

    Science.gov (United States)

    Mileto, Achille; Marin, Daniele; Alfaro-Cordoba, Marcela; Ramirez-Giraldo, Juan Carlos; Eusemann, Christian D; Scribano, Emanuele; Blandino, Alfredo; Mazziotti, Silvio; Ascenti, Giorgio

    2014-12-01

    To investigate whether dual-energy multidetector row computed tomographic (CT) imaging with iodine quantification is able to distinguish between clear cell and papillary renal cell carcinoma ( RCC renal cell carcinoma ) subtypes. In this retrospective, HIPAA-compliant, institutional review board-approved study, 88 patients (57 men, 31 women) with diagnosis of either clear cell or papillary RCC renal cell carcinoma at pathologic analysis, who underwent contrast material-enhanced dual-energy nephrographic phase study between December 2007 and June 2013, were included. Five readers, blinded to pathologic diagnosis, independently evaluated all cases by determining the lesion iodine concentration on color-coded iodine maps. The receiving operating characteristic curve analysis was adopted to estimate the optimal threshold for discriminating between clear cell and papillary RCC renal cell carcinoma , and results were validated by using a leave-one-out cross-validation. Interobserver agreement was assessed by using an intraclass correlation coefficient. The correlation between tumor iodine concentration and tumor grade was investigated. A tumor iodine concentration of 0.9 mg/mL represented the optimal threshold to discriminate between clear cell and papillary RCC renal cell carcinoma , and it yielded the following: sensitivity, 98.2% (987 of 1005 [95% confidence interval: 97.7%, 98.7%]); specificity, 86.3% (272 of 315 [95% confidence interval: 85.0%, 87.7%]); positive predictive value, 95.8% (987 of 1030 [95% confidence interval: 95.0%, 96.6%]); negative predictive value, 93.7% (272 of 290 [95% confidence interval: 92.8%, 94.7%]); overall accuracy of 95.3% (1259 of 1320 [95% confidence interval: 94.6%, 96.2%]), with an area under the curve of 0.923 (95% confidence interval: 0.913, 0.933). An excellent agreement was found among the five readers in measured tumor iodine concentration (intraclass correlation coefficient, 0.9990 [95% confidence interval: 0. 9987, 0.9993). A

  6. Estimation of aortic time-enhancement curve in pharmacokinetic analysis. Dynamic study by multi-detector row computed tomography

    International Nuclear Information System (INIS)

    Yamaguchi, Isao; Kidoya, Eiji; Higashimura, Kyoji; Hayashi, Hiroyuki; Suzuki, Masayuki

    2007-01-01

    This paper presents an introduction to the development of software that provides a physiologic model of contrast medium enhancement by incorporating available physiologic data and contrast medium pharmacokinetics to predict an organ-specific aortic time-enhancement curve (TEC) in computed tomography (CT) with various contrast medium injection protocols in patients of various heights, weights, cardiac output levels, and so on. The physiologic model of contrast medium enhancement was composed of six compartments for early contrast enhancement pharmacokinetics. Contrast medium is injected via the antecubital vein and distributed to the right side of the heart, the pulmonary compartment, the left side of the heart, and the aorta. It then circulates back to the right side of the heart via the systemic circulation. A computer-based, compartmental model of the aortic system was generated using human physiologic parameters and six differential equations to describe the transport of contrast medium. Aortic TEC generated by the computer-based physiologic model of contrast medium enhancement showed validity and agreement with clinical data and findings published previously. A computer-based physiologic model that may help predict organ-specific CT contrast medium enhancement for different injection protocols was developed. Such a physiologic model may have multiple clinical applications. (author)

  7. Chronic thromboembolic pulmonary hypertension: Evaluation with 64-detector row CT versus digital substraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Reichelt, Angela [Department of Diagnostic Radiology, Hannover Medical School, Carl Neuberg Str. 1, 30625 Hannover (Germany)], E-mail: Reichelt.Angela@mh-hannover.de; Hoeper, Marius M. [Department of Respiratory Medicine, Hannover Medical School (Germany); Galanski, Michael [Department of Diagnostic Radiology, Hannover Medical School, Carl Neuberg Str. 1, 30625 Hannover (Germany); Keberle, Marc [Department of Diagnostic Radiology and Nuclear Medicine, Bruederkrankenhaus St. Josef Paderborn (Germany)

    2009-07-15

    The aim of the study was to evaluate the role of 64-row CT in the diagnostic workup of patients with chronic thromboembolic pulmonary hypertension (CTEPH) using digital substraction angiography (DSA) as the method of diagnostic reference. CT and DSA studies of 27 patients (54 main, 162 lobar and 540 segmental arteries) with a clinical suspicion of CTEPH were included in this retrospective and blinded analysis. Axial images and multiplanar thin maximum intensity projections (MIPs) (3 mm) were consequently used for exact image interpretation whereas additional reconstructed thick MIPs gave an overview of the entire vascular tree comparable to DSA. Sensitivity and specificity of CT regarding CTEPH-related pathological changes in general were 98.3% and 94.8% at main/lobar level and 94.1% and 92.9% at segmental level, respectively. Sensitivity and specificity of CT regarding the different pathological criteria of CTEPH (complete obstruction, intimal irregularities, bands and webs, indirect signs) were 88.9-100% and 96.1-100% at main/lobar level and 84.3-90.5% and 92-98.7% at segmental level, respectively. Our results show that CT is an accurate and reliable non-invasive alternative to conventional DSA in the diagnostic workup in patients with CTEPH.

  8. Chronic thromboembolic pulmonary hypertension: Evaluation with 64-detector row CT versus digital substraction angiography

    International Nuclear Information System (INIS)

    Reichelt, Angela; Hoeper, Marius M.; Galanski, Michael; Keberle, Marc

    2009-01-01

    The aim of the study was to evaluate the role of 64-row CT in the diagnostic workup of patients with chronic thromboembolic pulmonary hypertension (CTEPH) using digital substraction angiography (DSA) as the method of diagnostic reference. CT and DSA studies of 27 patients (54 main, 162 lobar and 540 segmental arteries) with a clinical suspicion of CTEPH were included in this retrospective and blinded analysis. Axial images and multiplanar thin maximum intensity projections (MIPs) (3 mm) were consequently used for exact image interpretation whereas additional reconstructed thick MIPs gave an overview of the entire vascular tree comparable to DSA. Sensitivity and specificity of CT regarding CTEPH-related pathological changes in general were 98.3% and 94.8% at main/lobar level and 94.1% and 92.9% at segmental level, respectively. Sensitivity and specificity of CT regarding the different pathological criteria of CTEPH (complete obstruction, intimal irregularities, bands and webs, indirect signs) were 88.9-100% and 96.1-100% at main/lobar level and 84.3-90.5% and 92-98.7% at segmental level, respectively. Our results show that CT is an accurate and reliable non-invasive alternative to conventional DSA in the diagnostic workup in patients with CTEPH.

  9. Impact of imaging quality of change pitch on coronary CTA with 64-detector row CT

    International Nuclear Information System (INIS)

    Li Xiang; Jin Chaolin; Zhang Shutong

    2009-01-01

    Objective: To investigate the impact of imaging quality of pitch on coronary CT angiography (CTA) with 64-detector row CT. Methods: 566 patients were divided into four groups according to heart rate (≤ 50, 51 ∼ 70, 71 ∼ 80 and ≥ 80 bpm). Three dimensional reconstructions were used such as volume rendering (VR), maximum intensity projection(MIP) and curved planar reformation (CPR). Each group was divided into control group and experimential group randomly, using normal pitch and revised pitch respectively, and the imaging quality and influencing factors were analyzed among the four groups. Results: There was significant difference in imaging quality among the four groups (P < 0.05). Each group had difference in imaging quality with normal pitch and revised pitch. Conclusions: The revised pitch helps to improve the imaging quality and meet the demand of diagnosis. (authors)

  10. Study of Image Quality From CT Scanner Multi-Detector by using Americans College of Radiology (ACR) Phantom

    Science.gov (United States)

    Mulyadin; Dewang, Syamsir; Abdullah, Bualkar; Tahir, Dahlang

    2018-03-01

    In this study, the image quality of CT scan using phantom American College of Radiology (ACR) was determined. Scanning multidetector CT is used to know the image quality parameters by using a solid phantom containing four modules and primarily from materials that are equivalent to water. Each module is 4 cm in diameter and 20 cm in diameter. There is white alignment marks painted white to reflect the alignment laser and there are also “HEAD”, “FOOT”, and “TOP” marks on the phantom to help align. This test obtains CT images of each module according to the routine inspection protocol of the head. Acceptance of image quality obtained for determination: CT Number Accuracy (CTN), CT Number Uniformity and Noise, Linearity CT Number, Slice Technique, Low Contrast Resolution and High Contrast Resolution represent image quality parameters. In testing CT Number Accuracy (CTN), CT Uniform number and Noise are in the range of tolerable values allowed. In the test, Linearity CT Number obtained correlation value above 0.99 is the relationship between electron density and CT Number. In a low contrast resolution test, the smallest contrast groups are visible. In contrast, the high resolution is seen up to 7 lp/cm. The quality of GE CT Scan is very high, as all the image quality tests obtained are within the tolerance brackets of values permitted by the Nuclear Power Control Agency (BAPETEN). Image quality test is a way to get very important information about the accuracy of snoring result by using phantom ACR.

  11. Peliosis Hepatis with Hemorrhagic Necrosis and Rupture: a Case Report with Emphasis on the Multi-Detector CT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun-A; Yoon, Kwon-Ha; Jeon, Se-Jung; Cai, Quan-Yu; Lee, Young-Whan [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2007-02-15

    We demonstrate the imaging findings, with emphasis on the triphasic, contrast-enhanced multidetector CT findings, as well as reporting the clinical outcome in a case of peliosis hepatis with fatal hemorrhage. eliosis hepatis is an uncommon condition characterized by blood-filled cystic cavities in the liver. The clinical presentation is quite variable from an asymptomatic presentation to hepatic failure, portal hypertension or fatal intraabdominal hemorrhage. The exact incidence of intrahepatic or intraperitoneal hemorrhage by liver rupture has not been determined in the literature and these complications have been demonstrated only in the form of about 20 case reports. On angiography, peliosis hepatis can be suspected by multiple small contrast accumulations that become distinct during the parenchymal phase and are persistent during the venous phase. Examinations using multidetector CT (MDCT) scanners, which provide thin-section, contrast-enhanced dynamic images, are increasing nowadays. Thus, this entity has a better chance to be incidentally encountered and to be a diagnostic challenge to the radiologists. In this report, we present a case of peliosis hepatis with hemorrhagic necrosis that was complicated by massive intrahepatic bleeding and rupture. We demonstrate the imaging findings with emphasis on the contrast-enhanced dynamic MDCT features as well as the clinical outcome after treatment.

  12. Peliosis Hepatis with Hemorrhagic Necrosis and Rupture: a Case Report with Emphasis on the Multi-Detector CT Findings

    International Nuclear Information System (INIS)

    Kim, Eun-A; Yoon, Kwon-Ha; Jeon, Se-Jung; Cai, Quan-Yu; Lee, Young-Whan

    2007-01-01

    We demonstrate the imaging findings, with emphasis on the triphasic, contrast-enhanced multidetector CT findings, as well as reporting the clinical outcome in a case of peliosis hepatis with fatal hemorrhage. eliosis hepatis is an uncommon condition characterized by blood-filled cystic cavities in the liver. The clinical presentation is quite variable from an asymptomatic presentation to hepatic failure, portal hypertension or fatal intraabdominal hemorrhage. The exact incidence of intrahepatic or intraperitoneal hemorrhage by liver rupture has not been determined in the literature and these complications have been demonstrated only in the form of about 20 case reports. On angiography, peliosis hepatis can be suspected by multiple small contrast accumulations that become distinct during the parenchymal phase and are persistent during the venous phase. Examinations using multidetector CT (MDCT) scanners, which provide thin-section, contrast-enhanced dynamic images, are increasing nowadays. Thus, this entity has a better chance to be incidentally encountered and to be a diagnostic challenge to the radiologists. In this report, we present a case of peliosis hepatis with hemorrhagic necrosis that was complicated by massive intrahepatic bleeding and rupture. We demonstrate the imaging findings with emphasis on the contrast-enhanced dynamic MDCT features as well as the clinical outcome after treatment

  13. Multiple detector-row CT angiography of the renal and mesenteric vessels

    Energy Technology Data Exchange (ETDEWEB)

    Fleischmann, Dominik. E-mail: dominik.fleischmann@univie.ac.at

    2003-03-01

    Computed tomography angiography (CTA) of the abdomen with multiple detector-row computed tomography (MD-CT) is an effective technique for minimally invasive imaging of the renal arteries and the visceral vasculature. This article reviews the clinical and technical aspects of MD-CT angiography in terms of image acquisition and reconstruction parameters, contrast medium application, and three-dimensional visualization with special attention to renal and mesenteric vascular imaging. Because of its high sensitivity to detect renal artery stenosis on the one hand, and because a normal renal CTA virtually excludes the presence of a significant renal artery stenosis on the other hand, renal CTA plays a useful role in the management of patients with suspected renovascular hypertension. Mesenteric CTA is a useful tool for visualizing normal vascular anatomy and its variants--particularly in the setting of organ transplantation. Vascular pathology, e.g. atherosclerotic disease (abdominal angina), or aneurysms of the visceral arteries are reliably assessed with CTA. Mesenteric CTA is an invaluable adjunct to abdominal CT in the setting of abdominal emergencies, because of its ability to detect the causes of acute intestinal ischemia (superior mesenteric artery embolism or thrombosis, superior mesenteric vein thrombosis). Accurate timing of the CTA acquisition and the subsequent parenchymal phase acquisition relative to the contrast medium transit time is critical to obtain excellent image quality in double-pass abdominal CT acquisitions.

  14. Diagnosis of multidetector spiral CT and its reconstruction techniques in trachea and principal bronchus tumors

    Energy Technology Data Exchange (ETDEWEB)

    Mingyue, Luo; Hong, Shan; Zaibo, Jiang; Lufang, Li; Jiansheng, Zhang [Zhongshan Univ., Guangzhou (China). The Third Univ. Hospital, Dept. of Radiology; Lijia, Gu; Shaohong, Huang; Yi, Jin; Zhiqiang, Hou

    2003-12-01

    Objective: To investigate the clinical diagnostic value of multidetector spiral CT (MSCT) and its reconstruction techniques including multiplanar volume reformation (MPVR), volume rendering (VR), and virtual bronchoscopy (VB) in the trachea and principal bronchus tumors. Methods: Thin slice MSCT scanning was performed in 31 patients with suspected trachea or principal bronchus tumors, and image reconstruction data were formed after retro-reconstructing of initial scanning data. MPVR, VR, and VB images were obtained respectively by postprocessing of image reconstruction data with MPVR, VR, and VB image processing software in AW workstation. The findings of MSCT initial axial images, MPVR, VR, and VB images were compared with surgical and pathological results. Results: MSCT initial axial images combined with MPVR, VR, and VB images displayed the locations (tracheae, n=19; right principal bronchi, n=6; left principal bronchi, n=6), morphologies (endoluminal nodular tumors with narrow bases, n=2; endoluminal nodular tumors with wide bases, n=13; intraluminal and extraluminal massive tumors, n=16), internal features (1 had homogeneous density, 1 had low density, they both without obvious enhancement; 23 squamous cell carcinomas and 3 adenocarcinomas had fairly homogeneous density and rather obvious enhancement; 1 had homogeneous density, 1 had inhomogeneous density, 1 had punctate calcification, all with obvious enhancement), extramural invasion situations (broke through only serous membrane, n=1; no clear border with right atelectatic lung tissue, n=1; ranges of extramural invasion 4-56 mm, n=14), morphologies of luminal stenoses (eccentric, n=1; irregular, n=26; circular, n=3; conical interruption, n=1), extents (mild, n=5; moderate, n=7; severe, n=19); measured longitudinal invasion ranges (only 3 mm, n=1; invaded the whole right principal bronchus wall and carina, n=1; 5-68 mm, n=29), and distances between principal bronchus tumors and carina (invaded carina, n=1

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

    International Nuclear Information System (INIS)

    Ulu, Esra Meltem Kayahan; Kirbas, Ismail; Emiroglu, Feride Kural; Cakir, Banu; Harman, Ali; Coskun, Mehmet; Bakar, Coskun

    2008-01-01

    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

  16. 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

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

    International Nuclear Information System (INIS)

    McKinney, Alexander; Ott, Frederick; Short, James; McKinney, Zeke; Truwit, Charles

    2007-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-15

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

  19. 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...

  20. Phantom-Calibrated versus Automatic Coronary Artery Mass Quantification with Multidetector-Row Computed Tomography: In Vitro and In Vivo Study

    Energy Technology Data Exchange (ETDEWEB)

    Serafin, Z.; Lasek, W.; Laskowska, K. (Dept. of Radiology and Diagnostic Imaging, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland))

    2008-11-15

    Background: Coronary artery calcium scoring is used as a method for cardiovascular risk stratification and monitoring of coronary heart disease. Automatic software-based calcium mass calculation has been proposed to improve the performance of the procedure. Purpose: To compare two algorithms of calcium mass measurement, automatic and phantom calibrated, with respect to correlation, measurement error, and accuracy in vitro and in vivo. Material and Methods: A cardiac phantom with calcium cylinder inserts was scanned with sequential non-overlapping collimation 4x2.5 mm, at 120 kV and 165 mAs. Fifty adults (37 men; mean age 46.2 years) were examined with the same settings using prospective electrocardiographic triggering to detect and quantify coronary artery calcifications. Calculations were performed with two methods: software-based automatic calcium mass measurement (ACM) and phantom-calibrated calcium mass measurement (CCM). Results: The total phantom calcium masses measured with ACM and CCM were 175.0+-13.8 mg and 163.0+-4.4 mg, respectively (P<0.0001), and ACM produced a higher mean error (4.5 vs. 3.2; P<0.05). Results of ACM and CCM were strongly correlated to each other (R=0.73-0.96; P<0.0001). Mean image noise in the patient study was 8.72+-1.68 HU. Results of patient calcium scoring with ACM and CCM were significantly different (median 70.3 mg and 59.7 mg, respectively; P<0.0001), with a mean systematic error of 17.5% (limit of agreement between 14.6% and 20.4%). The use of ACM resulted in an altered quartile classification for 14% of patients, as compared to CCM; all of these patients were classified into a higher category. Conclusion: Our data indicate that multidetector-row computed tomography coronary calcium mass determination based on dedicated phantom calibration shows lower measurement error than an automatic software-based calculation method. The tested automatic software does not yet seem to be a reliable option for calcium mass measurement

  1. Phantom-Calibrated versus Automatic Coronary Artery Mass Quantification with Multidetector-Row Computed Tomography: In Vitro and In Vivo Study

    International Nuclear Information System (INIS)

    Serafin, Z.; Lasek, W.; Laskowska, K.

    2008-01-01

    Background: Coronary artery calcium scoring is used as a method for cardiovascular risk stratification and monitoring of coronary heart disease. Automatic software-based calcium mass calculation has been proposed to improve the performance of the procedure. Purpose: To compare two algorithms of calcium mass measurement, automatic and phantom calibrated, with respect to correlation, measurement error, and accuracy in vitro and in vivo. Material and Methods: A cardiac phantom with calcium cylinder inserts was scanned with sequential non-overlapping collimation 4x2.5 mm, at 120 kV and 165 mAs. Fifty adults (37 men; mean age 46.2 years) were examined with the same settings using prospective electrocardiographic triggering to detect and quantify coronary artery calcifications. Calculations were performed with two methods: software-based automatic calcium mass measurement (ACM) and phantom-calibrated calcium mass measurement (CCM). Results: The total phantom calcium masses measured with ACM and CCM were 175.0±13.8 mg and 163.0±4.4 mg, respectively (P<0.0001), and ACM produced a higher mean error (4.5 vs. 3.2; P<0.05). Results of ACM and CCM were strongly correlated to each other (R=0.73-0.96; P<0.0001). Mean image noise in the patient study was 8.72±1.68 HU. Results of patient calcium scoring with ACM and CCM were significantly different (median 70.3 mg and 59.7 mg, respectively; P<0.0001), with a mean systematic error of 17.5% (limit of agreement between 14.6% and 20.4%). The use of ACM resulted in an altered quartile classification for 14% of patients, as compared to CCM; all of these patients were classified into a higher category. Conclusion: Our data indicate that multidetector-row computed tomography coronary calcium mass determination based on dedicated phantom calibration shows lower measurement error than an automatic software-based calculation method. The tested automatic software does not yet seem to be a reliable option for calcium mass measurement

  2. Imaging patterns of hepatic steatosis on multidetector CT: Pearls and pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Kani, K.K., E-mail: khalatbarik@yahoo.com [Department of Radiology, Body Imaging, University of Washington Medical Center, Seattle, WA (United States); Moshiri, M.; Cuevas, C.; Lee, J.H.; Mitsumori, L.M.; Kolokythas, O. [Department of Radiology, Body Imaging, University of Washington Medical Center, Seattle, WA (United States)

    2012-04-15

    Fatty liver disease is an important cause of chronic liver disease in Western countries. The purpose of this article is to describe and illustrate the diagnostic criteria and various morphological patterns of fatty liver disease on multidetector computed tomography (MDCT) with an emphasis on potential limitations and diagnostic pitfalls.

  3. The clinical application studies of CT spinal angiography with 64-detector row spiral CT in diagnosing spinal vascular malformations

    International Nuclear Information System (INIS)

    Gao Sijia; Zhang Mengwei; Liu Xiping; Zh Yushen; Liu Jinghong; Wang Zhonghui; Zang Peizhuo; Shi Qiang; Wang Qiang; Liang Chuansheng; Xu Ke

    2009-01-01

    Background and purpose: To explore the value of CT spinal angiography with 64-detector row spiral CT in diagnosing spinal vascular malformations. Methods: Seventeen patients with initial MR and clinical findings suggestive of spinal vascular diseases underwent CT spinal angiography. Among these, 14 patients took DSA examination within 1 week after CT scan, 7 patients underwent surgical treatment, and 6 patients underwent vascular intervention embolotheraphy. CT protocol: TOSHIBA Aquilion 64 Slice CT scanner, 0.5 mm thickness, 0.5 s/r, 120 kV and 350 mA, positioned at the aortic arch level, and applied with 'sure start' technique with CT threshold of 180 Hu. Contrast agent Iohexol (370 mg I/ml) was injected at 6 ml/s velocity with total volume of 80 ml. The post-processing procedures included MPR, CPR, MIP, VR, etc. Among the 17 patients, four patients underwent fast dynamic contrast-enhanced 3D MR angiography imaging. CT spinal angiography and three-dimensional contrast-enhanced MR angiography (3D CE-MRA) images were compared and evaluated with DSA and operation results based on disease type, lesion range, feeding arteries, fistulas, draining veins of vascular malformation by three experienced neuroradiologists independently, using double blind method. The data were analyzed using SPSS analytic software with χ 2 -test. We compared the results with DSA and operation results. Results: The statistical analysis of the diagnostic results by the three experienced neuroradiologists had no statistical difference (P > 0.05). All of the 17 patients showed clearly the abnormality of spinal cord vessels and the range of lesions by CT spinal angiography. Among them, one patient was diagnosed as arteriovenous fistulas (AVF) by MRI and CT spinal angiography, which was verified by surgical operation. DSA of the same patient, however, did not visualize the lesion. One case was diagnosed as AVM complicated with AVF by DSA, but CT spinal angiography could only show AVM not AVF. The

  4. The clinical application studies of CT spinal angiography with 64-detector row spiral CT in diagnosing spinal vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Gao Sijia [Department of Radiology, No. 1 Affiliated Hospital of China Medical University, Shenyang 110001 (China)], E-mail: scarlettgao@126.com; Zhang Mengwei; Liu Xiping; Zh Yushen; Liu Jinghong; Wang Zhonghui [Department of Radiology, No. 1 Affiliated Hospital of China Medical University, Shenyang 110001 (China); Zang Peizhuo [Department of Neurosurgery, No. 1 Affiliated Hospital of China Medical University, Shenyang 110001 (China); Shi Qiang; Wang Qiang [Department of Radiology, No. 1 Affiliated Hospital of China Medical University, Shenyang 110001 (China); Liang Chuansheng [Department of Neurosurgery, No. 1 Affiliated Hospital of China Medical University, Shenyang 110001 (China); Xu Ke [Department of Radiology, No. 1 Affiliated Hospital of China Medical University, Shenyang 110001 (China)

    2009-07-15

    Background and purpose: To explore the value of CT spinal angiography with 64-detector row spiral CT in diagnosing spinal vascular malformations. Methods: Seventeen patients with initial MR and clinical findings suggestive of spinal vascular diseases underwent CT spinal angiography. Among these, 14 patients took DSA examination within 1 week after CT scan, 7 patients underwent surgical treatment, and 6 patients underwent vascular intervention embolotheraphy. CT protocol: TOSHIBA Aquilion 64 Slice CT scanner, 0.5 mm thickness, 0.5 s/r, 120 kV and 350 mA, positioned at the aortic arch level, and applied with 'sure start' technique with CT threshold of 180 Hu. Contrast agent Iohexol (370 mg I/ml) was injected at 6 ml/s velocity with total volume of 80 ml. The post-processing procedures included MPR, CPR, MIP, VR, etc. Among the 17 patients, four patients underwent fast dynamic contrast-enhanced 3D MR angiography imaging. CT spinal angiography and three-dimensional contrast-enhanced MR angiography (3D CE-MRA) images were compared and evaluated with DSA and operation results based on disease type, lesion range, feeding arteries, fistulas, draining veins of vascular malformation by three experienced neuroradiologists independently, using double blind method. The data were analyzed using SPSS analytic software with {chi}{sup 2}-test. We compared the results with DSA and operation results. Results: The statistical analysis of the diagnostic results by the three experienced neuroradiologists had no statistical difference (P > 0.05). All of the 17 patients showed clearly the abnormality of spinal cord vessels and the range of lesions by CT spinal angiography. Among them, one patient was diagnosed as arteriovenous fistulas (AVF) by MRI and CT spinal angiography, which was verified by surgical operation. DSA of the same patient, however, did not visualize the lesion. One case was diagnosed as AVM complicated with AVF by DSA, but CT spinal angiography could only show

  5. Bronchial and non-bronchial systemic arteries: value of multidetector CT angiography in diagnosis and angiographic embolisation feasibility analysis

    International Nuclear Information System (INIS)

    Lin, Yuning; Chen, Ziqian; Yang, Xizhang; Zhong, Qun; Zhang, Hongwen; Yang, Li; Xu, Shangwen; Li, Hui

    2013-01-01

    The aim of this study is to evaluate the diagnostic performance of multidetector CT angiography (CTA) in depicting bronchial and non-bronchial systemic arteries in patients with haemoptysis and to assess whether this modality helps determine the feasibility of angiographic embolisation. Fifty-two patients with haemoptysis between January 2010 and July 2011 underwent both preoperative multidetector CTA and digital subtraction angiography (DSA) imaging. Diagnostic performance of CTA in depicting arteries causing haemoptysis was assessed on a per-patient and a per-artery basis. The feasibility of the endovascular treatment evaluated by CTA was analysed. Sensitivity, specificity, and positive and negative predictive values for those analyses were determined. Fifty patients were included in the artery-presence-number analysis. In the per-patient analysis, neither CTA (P=0.25) nor DSA (P=1.00) showed statistical difference in the detection of arteries causing haemoptysis. The sensitivity, specificity, and positive and negative predictive values were 94%, 100%, 100%, and 40%, respectively, for the presence of pathologic arteries evaluated by CTA, and 98%, 100%, 100%, and 67%, respectively, for DSA. On the per-artery basis, CTA correctly identified 97% (107/110). Fifty-two patients were included in the feasibility analysis. The performance of CTA in predicting the feasibility of angiographic embolisation was not statistically different from the treatment performed (P=1.00). The sensitivity, specificity, and positive and negative predictive values were 96%, 80%, 98% and 67%, respectively, for CTA. Multidetector CTA is an accurate imaging method in depicting the presence and number of arteries causing haemoptysis. This modality is also useful for determining the feasibility of angiographic embolisation for haemoptysis.

  6. Bronchial and non-bronchial systemic arteries: value of multidetector CT angiography in diagnosis and angiographic embolisation feasibility analysis.

    Science.gov (United States)

    Lin, Yuning; Chen, Ziqian; Yang, Xizhang; Zhong, Qun; Zhang, Hongwen; Yang, Li; Xu, Shangwen; Li, Hui

    2013-12-01

    The aim of this study is to evaluate the diagnostic performance of multidetector CT angiography (CTA) in depicting bronchial and non-bronchial systemic arteries in patients with haemoptysis and to assess whether this modality helps determine the feasibility of angiographic embolisation. Fifty-two patients with haemoptysis between January 2010 and July 2011 underwent both preoperative multidetector CTA and digital subtraction angiography (DSA) imaging. Diagnostic performance of CTA in depicting arteries causing haemoptysis was assessed on a per-patient and a per-artery basis. The feasibility of the endovascular treatment evaluated by CTA was analysed. Sensitivity, specificity, and positive and negative predictive values for those analyses were determined. Fifty patients were included in the artery-presence-number analysis. In the per-patient analysis, neither CTA (P = 0.25) nor DSA (P = 1.00) showed statistical difference in the detection of arteries causing haemoptysis. The sensitivity, specificity, and positive and negative predictive values were 94%, 100%, 100%, and 40%, respectively, for the presence of pathologic arteries evaluated by CTA, and 98%, 100%, 100%, and 67%, respectively, for DSA. On the per-artery basis, CTA correctly identified 97% (107/110). Fifty-two patients were included in the feasibility analysis. The performance of CTA in predicting the feasibility of angiographic embolisation was not statistically different from the treatment performed (P = 1.00). The sensitivity, specificity, and positive and negative predictive values were 96%, 80%, 98% and 67%, respectively, for CTA. Multidetector CTA is an accurate imaging method in depicting the presence and number of arteries causing haemoptysis. This modality is also useful for determining the feasibility of angiographic embolisation for haemoptysis. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

  7. 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.

  8. A comparative study of FDG PET/CT and enhanced multi-detector CT for detecting liver metastasis according to the size and location.

    Science.gov (United States)

    Park, Jung Mi; Kim, Il Young; Kim, Sang Won; Lee, Sang Mi; Kim, Hyun Gi; Kim, Shin Young; Shin, Hyung Chul

    2013-04-01

    The aim of this study was to compare the diagnosability between (18)F-fluorodeoxyglucose (FDG) PET/CT and enhanced multi-detector CT (MDCT) for the detection of liver metastasis (LM) according to the size and location in liver and to evaluate standard maximum standardized uptake values (SUVmax) of all liver metastatic lesions. One hundred two consecutive patients with malignancy who underwent both FDG PET/CT and MDCT for LM evaluation were retrospectively reviewed. Among them, 56 patients with LM were enrolled in this study. LM was confirmed by follow-up imaging studies after at least 6 months or by histopathology. FDG PET/CT and MDCT images were visually analyzed using three-point scale by the consensus of two radiologists and two nuclear medicine physicians. The size and location (central vs. sub-capsular) of the all liver lesions were evaluated using MDCT images. Furthermore, SUVmax of all liver lesions on FDG PET/CT images were calculated. A total of 146 liver lesions were detected by FDG PET/CT and MDCT and 142 of the lesions were diagnosed as LM. The detection rates of MDCT and FDG PET/CT for LM by visual analysis were 77 and 78%, respectively. There was no significant difference of detection rate according to the overall location and size of the lesions. However, FDG PET/CT was more sensitive than MDCT for detecting small and sub-capsular LM. The detection rate of FDG PET/CT for LM was 68% by the cutoff SUVmax of 2.7. Although the diagnosabilities of MDCT and FDG PET/CT for detecting LM were comparable, FDG PET/CT is superior to MDCT for detecting small LM located in the sub-capsular portion of liver.

  9. Noninvasive evaluation of cerebral arteriovenous malformations by 4D-CT angiography using 320-detector row CT

    International Nuclear Information System (INIS)

    Tajiri, H.; Jin, L.; Tsukiyama, M.; Suzuki, Y.; Sekine, S.; Shimizu, T.; Ohiwa, T.

    2012-01-01

    Full text: Objective: Four-dimensional computed tomography angiography (4D-CTA) is a new and promising technique in the diagnosis of patients with cerebral arteriovenous malformations (AVMs). The purpose of this retrospective study was to investigate the utility of 4D-CTA using whole-brain 320-detector row CT for assessing cerebral AVMs compared with conventional angiography (CA). Materials and methods: Participants included patients admitted to our institution from November 2010 to March 2012 due to cerebral AVMs who underwent both 4D-CTA and CA within 14 days. The diagnosis of AVM was finally confirmed by CA. Two readers reviewed 4D-CTA and CA under consensus regarding AVM detection rate and each component of the AVM (feeders, nidi, drainers) using a four-point grading scale (excellent=3, good=2, fair=1, poor=0), and the Spetzler-Martin (S-M) grade. Results: During the study period, 11 patients met the inclusion criteria. The average score for feeders, nidi, and drainers was 2.0, 2.3, and 2.5 in 4D-CTA and 2.4, 2.6, and 2.7 in CA, respectively. The average S-M grade score was 2.0 in all patients. There were no statistically significant differences between the two modalities (P<.005). Conclusion: 4D-CTA using 320-detector row CT is a very reliable method and offers diagnostic performance equivalent to CA for detecting and predicting S-M classification of cerebral AVMs.

  10. Volumetric measurements of pulmonary nodules at multi-row detector CT: in vivo reproducibility

    International Nuclear Information System (INIS)

    Wormanns, Dag; Marheine, Anke; Beyer, Florian; Heindel, Walter; Diederich, Stefan; Kohl, Gerhard; Klotz, Ernst

    2004-01-01

    The aim of this study was to assess the in vivo measurement precision of a software tool for volumetric analysis of pulmonary nodules from two consecutive low-dose multi-row detector CT scans. A total of 151 pulmonary nodules (diameter 2.2-20.5 mm, mean diameter 7.4±4.5 mm) in ten subjects with pulmonary metastases were examined with low-dose four-detector-row CT (120 kVp, 20 mAs (effective), collimation 4 x 1 mm, normalized pitch 1.75, slice thickness 1.25 mm, reconstruction increment 0.8 mm; Somatom VolumeZoom, Siemens). Two consecutive low-dose scans covering the whole lung were performed within 10 min. Nodule volume was determined for all pulmonary nodules visually detected in both scans using the volumetry tool included in the Siemens LungCare software. The 95% limits of agreement between nodule volume measurements on different scans were calculated using the Bland and Altman method for assessing measurement agreement. Intra- and interobserver agreement of volume measurement were determined using repetitive measurements of 50 randomly selected nodules at the same scan by the same and different observers. Taking into account all 151 nodules, 95% limits of agreement were -20.4 to 21.9% (standard error 1.5%); they were -19.3 to 20.4% (standard error 1.7%) for 105 nodules <10 mm. Limits of agreement were -3.9 to 5.7% for intraobserver and -5.5 to 6.6% for interobserver agreement. Precision of in vivo volumetric analysis of nodules with an automatic volumetry software tool was sufficiently high to allow for detection of clinically relevant growth in small pulmonary nodules. (orig.)

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

    International Nuclear Information System (INIS)

    Chung, Gi Chung; Han, Won Jeong; Kim, Eun Kyung

    2010-01-01

    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 μSv (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.

  12. 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.

  13. 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.)

  14. Prevalence and configuration of pulmonary nodules on multi-row CT in children without malignant diseases

    Energy Technology Data Exchange (ETDEWEB)

    Renne, Julius; Wacker, Frank; Berthold, Lars-Daniel; Weidemann, Juergen [Hannover Medical School, Institute for Diagnostic and Interventional Radiology, Hannover (Germany); Linderkamp, Christin [Hannover Medical School, Pediatric Oncology, Hannover (Germany)

    2015-09-15

    To assess the prevalence and morphologic characterization of pulmonary nodules in children on a chest computed tomography (CT). Two hundred and fifty-nine trauma chest CTs in children aged 0-18 years were retrospectively reviewed by two radiologists, each with more than 10 years of experience. Images were acquired on a 64-row CT. Pulmonary lobes with trauma affections such as contusion or haemorrhage were excluded. All pulmonary nodules were evaluated for distance from the pleural surface, location, calcification and size on axial slices. A total of 1,190/1,295 (92 %) pulmonary lobes without traumatic injury were included in this study. In 86 of 259 (33 %) patients, 131 pulmonary nodules were detected. Number of nodules per patient ranged from 1 to 4. Calcifications were seen in 19 % (25) of all nodules. Diameters ranged from 1 to 5 mm. 59 % (77) were located in the lower lobes, 9 % (12) in the middle lobe and 32 % (42) in the upper lobes. 84 % of the non-calcified nodules >2 mm showed a slightly angular or triangular (mostly pleural nodes) shape. Pulmonary nodules smaller than 5 mm can be detected frequently in children without malignant disease and are predominantly located in the lower lobes. (orig.)

  15. Radiation Dose and Image Quality from Coronary Angiography in 320-Detecor Row CT

    International Nuclear Information System (INIS)

    Thanomphudsa, J.; Krisanachinda, A.; Tumkosit, M.

    2012-01-01

    Introduction: Coronary Computed Tomography Angiography examinations are increasing rapidly. New Computed Tomography has been developed to improve image quality with the patient dose reduction. The purpose of this study is to evaluate radiation dose and image quality of Coronary Computed Tomography Angiography in patients using 320-detector row CT. Methods: Forty-one patients referred for cardiac CT examinations at King Chulalongkorn Memorial Hospital were included in this study. All coronary computed tomographic angiography (CCTA) examinations were performed on the 320-detector row CT, Toshiba Aquilion One. Scanning protocol was investigated on dose estimates and image quality. Patients were scanned base on heart rate (HR) by HR 75 bpm use retrospective with dose modulation. Scanning parameters, kVp, mAs, HR, BMI, CTDIvol(mGy) and DLP(mGy.cm), were recorded to study the factors affecting the image quality and patient dose. And mA and kVp setting depend on BMI of the patient. Effective dose is calculated from DLP using specific conversion factor. The image quality was evaluated in 4 vessels by two radiologists. Noise assessment was also studied quantitatively. Results: The patient effective dose in prospective gating 70-80% was 3.6 ± 0.9 mSv, prospective gating 30-80% (1R-R) was 6.3 ± 1.9 mSv, and 30-80% (2R-R) was 10.8 ± 1.8 mSv and in retrospective with tube current modulation was 12.1± 7.7 mSv. Image noise was highest in PGT 70-80% 1R-R and decreased in RGT with tube current modulation, PGT 30-80% 1R-R and lowest in PGT 30-80% 2 R-R. And overall qualitative image quality was mostly good to excellent score. Discussion: The heart rate, heart rate variability and disease of the patient are affecting in the radiation dose and image quality so the suitable acquisition protocol used could be necessary. the effective dose and the image noise for the image quality. (author)

  16. Impact of the use of contrast-enhancement multidetector CT for acute appendicitis: a prospective comparison with the Alvarado score

    International Nuclear Information System (INIS)

    Choi, Mi Young; Yoon, Seong Eon; Lee, Young Hwan; Choi, Shi Sung; Park, Seong Hoon; Juhng, Seong Kwan; Yoon, Kwon Ha; Park, Seong Ho

    2007-01-01

    To determine the diagnostic performance of contrast-enhanced multidetector CT (MDCT) and the Alvarado score for acute appendicitis. MDCT and determination of the Alvarado score were prospectively performed in 282 patients with 146 pathologically proven cases of acute appendicitis and 136 pathologically proven or clinically diagnosed cases of non-acute appendicitis. To compare the diagnostic performance of MDCT and the Alvarado score, the patients were subdivided according to age and sex, and receiver operating characteristics (ROC) analysis and Spearman rank correlation were performed. ROC analysis revealed that the optimal cut off value of the CT appendicitis grades was 2 in all patients, resulting in a sensitivity of 96.6% and a specificity of 94.9%. The optimal cut off values of the Alvarado score was different according to age and sex, resulting in a sensitivity of 85.6% and a specificity of 48.5%. There was a significant correlation between the CT appendicitis grades and the surgical-pathological grades (r = 0.496, ρ < .0001). However, no significant correlation was observed between the Alvarado score and the surgical-pathological grades. Contrast-enhanced MDCT has a higher diagnostic accuracy and significant correlation with pathological findings than those of the Alvarado score in patients with acute appendicitis

  17. Impact of the use of contrast-enhancement multidetector CT for acute appendicitis: a prospective comparison with the Alvarado score

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Mi Young; Yoon, Seong Eon; Lee, Young Hwan; Choi, Shi Sung; Park, Seong Hoon; Juhng, Seong Kwan; Yoon, Kwon Ha [Wonkwang University School of Medicine, Iksan (Korea, Republic of); Park, Seong Ho [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2007-12-15

    To determine the diagnostic performance of contrast-enhanced multidetector CT (MDCT) and the Alvarado score for acute appendicitis. MDCT and determination of the Alvarado score were prospectively performed in 282 patients with 146 pathologically proven cases of acute appendicitis and 136 pathologically proven or clinically diagnosed cases of non-acute appendicitis. To compare the diagnostic performance of MDCT and the Alvarado score, the patients were subdivided according to age and sex, and receiver operating characteristics (ROC) analysis and Spearman rank correlation were performed. ROC analysis revealed that the optimal cut off value of the CT appendicitis grades was 2 in all patients, resulting in a sensitivity of 96.6% and a specificity of 94.9%. The optimal cut off values of the Alvarado score was different according to age and sex, resulting in a sensitivity of 85.6% and a specificity of 48.5%. There was a significant correlation between the CT appendicitis grades and the surgical-pathological grades (r = 0.496, {rho} < .0001). However, no significant correlation was observed between the Alvarado score and the surgical-pathological grades. Contrast-enhanced MDCT has a higher diagnostic accuracy and significant correlation with pathological findings than those of the Alvarado score in patients with acute appendicitis.

  18. Using multi-detector-row CT to diagnose ampullary adenoma or adenocarcinoma in situ

    International Nuclear Information System (INIS)

    Lee, Myungsu; Kim, Myeong-Jin; Park, Mi-Suk; Choi, Jin-Young; Chung, Yong Eun

    2011-01-01

    Objective: To assess the diagnostic accuracy of multi-detector-row computed tomography (MDCT) for the detection of ampullary adenomas or adenocarcinomas in situ. Materials and methods: We retrospectively reviewed 21 computed tomography (CT) images from 20 patients with ampullary tumors, and 22 CT images from 22 patients without periampullary tumor. Three radiologists blindly and independently reviewed CT images. The sensitivities and specificities for identification of ampullary masses were calculated in all cases and in cases with adequate duodenal distension. The sensitivities and specificities for the diagnosis of ampullary tumors were calculated using the following criteria: identification of mass alone; presence of extrahepatic bile duct (EBD) dilation or identification of mass; presence of pancreatic duct (PD) dilation or identification of mass. Paired t-tests were performed to assess differences in mean values. Results: The mean sensitivity and specificity of MDCT for the detection of an ampullary mass in all cases were 47.6% and 86.4%, and in cases with adequate duodenal distension, 66.7% (p = 0.07) and 80.5% (p = 0.32), respectively. When the presence of EBD dilation or identification of mass were used as criteria, the mean sensitivity and specificity were 73.0% (p = 0.03) and 60.6% (p = 0.03), respectively. When presence of PD dilation or identification of mass were used as criteria, the mean sensitivity and specificity were 47.6% and 81.8% (p = 0.23). Conclusions: MDCT is moderately accurate for the diagnosis of ampullary adenoma or adenocarcinoma in situ. When EBD dilation or identification of mass were used as criteria, the sensitivity can be improved.

  19. Detection and evaluation of intracranial aneurysms with 16-row multislice CT angiography

    International Nuclear Information System (INIS)

    Tipper, G.; U-King-Im, J.M.; Price, S.J.; Trivedi, R.A.; Cross, J.J.; Higgins, N.J.; Farmer, R.; Wat, J.; Kirollos, R.; Kirkpatrick, P.J.; Antoun, N.M.; Gillard, J.H.

    2005-01-01

    AIM: The aim of this study was to assess the usefulness of 16-row multislice CT angiography (CTA) in evaluating intracranial aneurysms, by comparison with conventional digital subtraction angiography (DSA) and intraoperative findings. METHODS: A consecutive series of 57 patients, scheduled for DSA for suspected intracranial aneurysm, was prospectively recruited to have CTA. This was performed with a 16-detector row machine, detector interval 0.75 mm, 0.5 rotation/s, table speed 10 mm/rotation and reconstruction interval 0.40 mm. CTA studies were independently and randomly assessed by two neuroradiologists and a vascular neurosurgeon blinded to the DSA and surgical findings. Review of CTA was performed on workstations with an interactive 3D volume-rendered algorithm. RESULTS: DSA or intraoperative findings or both confirmed 53 aneurysms in 44 patients. For both independent readers, sensitivity and specificity per aneurysm of DSA were 96.2% and 100%, respectively. Sensitivity and specificity of CTA were also 96.2% and 100%, respectively. Mean diameter of aneurysms was 6.3 mm (range 1.9 to 28.1 mm, SD 5.2 mm). For aneurysms of less than 3 mm, CTA had a sensitivity of 91.7% for each reader. Although the neurosurgeon would have been happy to proceed to surgery on the basis of CTA alone in all cases, he judged that DSA might have provided helpful additional anatomical information in 5 patients. CONCLUSION: The diagnostic accuracy of 16-slice CTA is promising and appears equivalent to that of DSA for detection and evaluation of intracranial aneurysms. A strategy of using CTA as the primary imaging method, with DSA reserved for cases of uncertainty, appears to be practical and safe

  20. 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

    International Nuclear Information System (INIS)

    Delhaye, Damien; Remy-Jardin, Martine; Salem, Randa; Teisseire, Antoine; Khalil, Chadi; Remy, Jacques; Delannoy-Deken, Valerie; Duhamel, Alain

    2007-01-01

    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 β-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 β-blockers in patients with a heart rate below 80 bpm. (orig.)

  1. 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.

  2. High-definition multidetector computed tomography for evaluation of coronary artery stents: comparison to standard-definition 64-detector row computed tomography.

    Science.gov (United States)

    Min, James K; Swaminathan, Rajesh V; Vass, Melissa; Gallagher, Scott; Weinsaft, Jonathan W

    2009-01-01

    The assessment of coronary stents with present-generation 64-detector row computed tomography scanners that use filtered backprojection and operating at standard definition of 0.5-0.75 mm (standard definition, SDCT) is limited by imaging artifacts and noise. We evaluated the performance of a novel, high-definition 64-slice CT scanner (HDCT), with improved spatial resolution (0.23 mm) and applied statistical iterative reconstruction (ASIR) for evaluation of coronary artery stents. HDCT and SDCT stent imaging was performed with the use of an ex vivo phantom. HDCT was compared with SDCT with both smooth and sharp kernels for stent intraluminal diameter, intraluminal area, and image noise. Intrastent visualization was assessed with an ASIR algorithm on HDCT scans, compared with the filtered backprojection algorithms by SDCT. Six coronary stents (2.5, 2.5, 2.75, 3.0, 3.5, 4.0mm) were analyzed by 2 independent readers. Interobserver correlation was high for both HDCT and SDCT. HDCT yielded substantially larger luminal area visualization compared with SDCT, both for smooth (29.4+/-14.5 versus 20.1+/-13.0; P<0.001) and sharp (32.0+/-15.2 versus 25.5+/-12.0; P<0.001) kernels. Stent diameter was higher with HDCT compared with SDCT, for both smooth (1.54+/-0.59 versus1.00+/-0.50; P<0.0001) and detailed (1.47+/-0.65 versus 1.08+/-0.54; P<0.0001) kernels. With detailed kernels, HDCT scans that used algorithms showed a trend toward decreased image noise compared with SDCT-filtered backprojection algorithms. On the basis of this ex vivo study, HDCT provides superior detection of intrastent luminal area and diameter visualization, compared with SDCT. ASIR image reconstruction techniques for HDCT scans enhance the in-stent assessment while decreasing image noise.

  3. Monte Carlo simulations to assess the effects of tube current modulation on breast dose for multidetector CT

    International Nuclear Information System (INIS)

    Angel, Erin; Yaghmai, Nazanin; Jude, Cecilia Matilda; DeMarco, John J; Cagnon, Christopher H; Goldin, Jonathan G; McNitt-Gray, Michael F; Primak, Andrew N; McCollough, Cynthia H; Stevens, Donna M; Cody, Dianna D

    2009-01-01

    Tube current modulation was designed to reduce radiation dose in CT imaging while maintaining overall image quality. This study aims to develop a method for evaluating the effects of tube current modulation (TCM) on organ dose in CT exams of actual patient anatomy. This method was validated by simulating a TCM and a fixed tube current chest CT exam on 30 voxelized patient models and estimating the radiation dose to each patient's glandular breast tissue. This new method for estimating organ dose was compared with other conventional estimates of dose reduction. Thirty detailed voxelized models of patient anatomy were created based on image data from female patients who had previously undergone clinically indicated CT scans including the chest area. As an indicator of patient size, the perimeter of the patient was measured on the image containing at least one nipple using a semi-automated technique. The breasts were contoured on each image set by a radiologist and glandular tissue was semi-automatically segmented from this region. Previously validated Monte Carlo models of two multidetector CT scanners were used, taking into account details about the source spectra, filtration, collimation and geometry of the scanner. TCM data were obtained from each patient's clinical scan and factored into the model to simulate the effects of TCM. For each patient model, two exams were simulated: a fixed tube current chest CT and a tube current modulated chest CT. X-ray photons were transported through the anatomy of the voxelized patient models, and radiation dose was tallied in the glandular breast tissue. The resulting doses from the tube current modulated simulations were compared to the results obtained from simulations performed using a fixed mA value. The average radiation dose to the glandular breast tissue from a fixed tube current scan across all patient models was 19 mGy. The average reduction in breast dose using the tube current modulated scan was 17%. Results were

  4. Carotid artery wall thickness and ischemic symptoms: evaluation using multi-detector-row CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Caddeo, Giancarlo; Mallarini, Giorgio [Azienda Ospedaliero Universitaria Polo di Monserrato, Department of Radiology, Cagliari (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria Polo di Monserrato, Department of Vascular Surgery, Cagliari (Italy); Pascalis, Luigi [Azienda Ospedaliero Universitaria Polo di Cagliari, Division of II Internal Medicine, Cagliari (Italy)

    2008-09-15

    The purpose of this study was to determine if carotid artery wall thickness (CAWT) studied by using multi-detector-row CT angiography (MDCTA) can be considered an effective parameter predictive of increased risk of stroke. A total of 217 patients were retrospectively studied by using MDCTA. In all patients CAWT was measured with an internal digital caliper. Continuous data were described as the mean value {+-} standard deviation (SD), and they were compared with Student's t-test. Scatter plots to determine interobserver agreement were performed, and correlation coefficient was calculated with Pearson statistics. A P value <0.05 was considered to mean statistical significance. Measurements of the distal common CAWT ranged from 0.5 to 1.6 mm. In the patient group without stroke, average CAWT was 0.82 mm (0.22 SD), whereas in patient group with stroke it was 1.096 mm (0.21 SD). CAWT in patients without stroke showed statistical difference (P<0.0001) when compared to patients with stroke. By using a threshold of 1 mm, an important statistical association between thick CAWT and stroke was found (P<0.0001). In fact, patients with {>=}1 mm CAWT had stroke with an odds ratio of 8.16 when compared with patients with <1 mm CAWT. Resulting data suggested that an increased CAWT is an indicator for risk of stroke. This parameter should be considered in addition to other well-known risk factors such as diabetes, hypertension, smoking, and dyslipidemia. (orig.)

  5. Estimation of eye lens dose during brain scans using Gafchromic XR-QA2 film in various multidetector CT scanners

    International Nuclear Information System (INIS)

    Akhilesh, Philomina; Jamhale, Shramika H.; Sharma, S.D.; Kumar, Rajesh; Datta, D.; Kulkarni, Arti R.

    2017-01-01

    The purpose of this study was to estimate eye lens dose during brain scans in 16-, 64-, 128- and 256-slice multidetector computed tomography (CT) scanners in helical acquisition mode and to test the feasibility of using radiochromic film as eye lens dosemeter during CT scanning. Eye lens dose measurements were performed using Gafchromic XR-QA2 film on a polystyrene head phantom designed with outer dimensions equivalent to the head size of a reference Indian man. The response accuracy of XR-QA2 film was validated by using thermoluminescence dosemeters. The eye lens dose measured using XR-QA2 film on head phantom for plain brain scanning in helical mode ranged from 43.8 to 45.8 mGy. The XR-QA2 film measured dose values were in agreement with TLD measured dose values within a maximum variation of 8.9%. The good correlation between the two data sets confirms the viability of using XR-QA2 film for eye lens dosimetry. (authors)

  6. 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.

  7. The value of contrast-enhanced 64-row CT in differentiating benign from malignant serous ovarian neoplasms

    International Nuclear Information System (INIS)

    Dong Tianfa; Wu Meixian; Zhang Jiayun; Song Ting

    2009-01-01

    Objective: To assess the diagnostic value of contrast-enhanced 64-row CT scanning in deciding benign or malignant serous ovarian tumors. Methods: Fifty-eight cases of serous ovarian tumors proved pathologically were reviewed, including 25 malignant tumors, 25 benign, 8 borderline tumors. All patients underwent 64-row CT scanning, including plain scanning and contrast-enhance scanning. The tumors' shape, density, blood supply and enhancement features were evaluated. Results: Twenty-five cases of benign serous cystic adenoma were mostly unicameral, and showed a moderate mural enhancement only in 4 cases (16%) due to chronic pelvic infection and the others (21/25, 84%) had no of slight enhancement. Malignant tumors were cystic-solid mass with unclear margin, irregular shape and septa. Twenty-two cases of serous cystadenocarcinoma out of 25 cases (88%) appeared obvious enhancement and other 3 cases no enhancement. And 7 cases out of 8 (87.5%) borderlined serous cystadenomas showed different enhancement patterns. Conclusion: Benign ovarian serous neoplasms were mostly unicameral and no strong mural enhancement, suggesting a lack of blood supply. While, there were obvious enhancement in the ovarian serous cystadenocarcinoma and borderline serous cystadenoma with malignant potential. The 64-row CT is helpful for differentiating the nature of the serous ovarian neoplasm. (authors)

  8. 3D automatic exposure control for 64-detector row CT: Radiation dose reduction in chest phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Keiko, E-mail: palm_kei@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Department of Radiology, Yamanashi University, Shimokato, Yamanashi (Japan); Ohno, Yoshiharu; Koyama, Hisanobu; Kono, Atsushi [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Inokawa, Hiroyasu [Toshiba Medical Systems, Ohtawara, Tochigi (Japan); Onishi, Yumiko [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Image-Based Medicine, Institute of Biomedical Research and Innovation, Kobe, Hyogo (Japan); Takenaka, Daisuke [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Araki, Tsutomu [Department of Radiology, Yamanashi University, Shimokato, Yamanashi (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan)

    2011-03-15

    Purpose: The purpose of this study was to determine the utility of three-dimensional (3D) automatic exposure control (AEC) for low-dose CT examination in a chest phantom study. Materials and methods: A chest CT phantom including simulated focal ground-glass opacities (GGOs) and nodules was scanned with a 64-detector row CT with and without AEC. Performance of 3D AEC included changing targeted standard deviations (SDs) of image noise from scout view. To determine the appropriate targeted SD number for identification, the capability of overall identification with the CT protocol adapted to each of the targeted SDs was compared with that obtained with CT without AEC by means of receiver operating characteristic analysis. Results: When targeted SD values equal to or higher than 250 were used, areas under the curve (Azs) of nodule identification with CT protocol using AEC were significantly smaller than that for CT protocol without AEC (p < 0.05). When targeted SD numbers at equal to or more than 180 were adapted, Azs of CT protocol with AEC had significantly smaller than that without AEC (p < 0.05). Conclusion: This phantom study shows 3D AEC is useful for low-dose lung CT examination, and can reduce the radiation dose while maintaining good identification capability and good image quality.

  9. The relationship between coronary artery calcification detected by non-gated multi-detector CT in patients with suspected ischemic heart disease and myocardial ischemia detected by thallium exercise stress testing

    International Nuclear Information System (INIS)

    Nishida, Chikako; Okajima, Kaoru; Yamamoto, Takashi; Hattori, Ryuichi; Kudo, Takashi; Nishimura, Yasumasa

    2005-01-01

    The objective of this study was to examine whether we could predict myocardial ischemia when coronary artery calcification is detected by non-gated multidetector CT in patients with suspected ischemic heart disease. Eighty-three patients suspected of having ischemic heart disease (55 men, 28 women; age range 36-83 years; mean age 68 years) underwent multidetector CT and Tl-201 single photon emission computed tomography. Prediction of myocardial ischemia by coronary arterial calcification detected on CT was evaluated by comparing the coronary artery territories that showed calcification with the area of myocardial ischemia determined by SPECT. The sensitivity, specificity, positive predictive value, and negative predictive value of multidetector CT for predicting myocardial ischemia were calculated. Coronary angiography was also examined and compared with multidetector CT. Risk factors, including hypertension, smoking, hyperlipidemia, diabetes, and family history, were compared for evidence of coronary artery calcification detected by multidetector CT and myocardial ischemia detected by thallium nuclear scans. For analysis by patients, the sensitivity, specificity, positive predictive value, and negative predictive value of coronary artery calcification for myocardial ischemia detection were 65, 63, 56, and 71%, respectively. Similarly, for analysis by coronary arterial territories, those values were 56, 77, 41 and 86%, respectively. Coronary stenosis on CAG was also related to the ischemia determined by SPECT and calcification on multidetector CT. Ischemia was better influenced by risk factors than was coronary arterial calcification. For analysis by coronary arterial territories, the specificity and negative predictive value of coronary arterial calcification seen by multidetector CT are relatively high. (author)

  10. Semi-quantitative assessment of tricuspid regurgitation on contrast-enhanced multidetector CT

    International Nuclear Information System (INIS)

    Groves, A.M.; Win, T.; Charman, S.C.; Wisbey, C.; Pepke-Zaba, J.; Coulden, R.A.

    2004-01-01

    AIM: To assess whether the early regurgitation of intravenous contrast medium into the inferior vena cava (IVC) and/or hepatic veins on computed tomography (CT), indicates tricuspid regurgitation (TR), and if so, whether it be used to grade severity. MATERIALS AND METHODS: We identified 86 consecutive patients that had been investigated for possible pulmonary endarterectomy at Papworth Hospital. From these, 61 patients were selected in whom CT, transthoracic echocardiography, and right heart catheterization (RHC) had been performed within 6 weeks. Using an arbitrary visual scale, the degree of TR assessed by intravenous contrast-enhanced CT was compared with echocardiography. Results were analysed using a kappa weighted statistical test. In addition, CT and echocardiographic assessments of TR severity were correlated with pulmonary artery pressure measurements obtained by RHC (Spearman's rank correlation coefficient). RESULTS: CT assessment of TR had a sensitivity of 90.4% and a specificity of 100% in detecting echocardiographic TR. For TR graded as more than trivial by echocardiography, sensitivity of CT was 100%. With respect to RHC data, the correlation between severity assessment of TR between CT and echocardiography using the Kappa weighted coefficient was 0.56 (moderately good agreement). With respect to RHC data, the correlation between mean pulmonary pressure and TR grading on CT and echocardiography was r=0.685 (p<0.001) and r=0.727 (p<0.001), respectively. CONCLUSION: Early opacification of the IVC or hepatic veins on first-pass contrast-enhanced CT almost invariably indicates TR. There is moderately good agreement between CT and echocardiographic assessment of the severity of TR. Both CT and echocardiographic grading of TR correlate well with RHC measurements of pulmonary artery pressure

  11. Acute pulmonary embolism in the era of multi-detector CT: a reality in sub-Saharan Africa

    International Nuclear Information System (INIS)

    Tambe, Joshua; Moifo, Boniface; Fongang, Emmanuel; Guegang, Emilienne; Juimo, Alain Georges

    2012-01-01

    The advantages of multi-detector computed tomography (MDCT) have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism (PE) is an exponent. The aim of this study was to assess the incidence of PE in patients with clinical suspicion of acute PE using MDCT in a sub-Saharan setting, and to describe the demographic characteristics of these patients. Consecutive records of patients who underwent MDCT pulmonary angiography for suspected acute PE over a two-year period at the Radiology Department of a university-affiliated hospital were systematically reviewed. All MDCT pulmonary angiograms were performed with a 16-detector computed tomography (CT) scanner using real-time bolus tracking technique. Authorization for the study was obtained from the institutional authorities. Forty-one MDCT pulmonary angiograms were reviewed of which 37 were retained. Of the 4 excluded studies, 3 were repeat angiograms and 1 study was not technically adequate. Twelve of 37 patients (32.4%) had CT angiograms that were positive for PE, of which 7 were males. The mean age of these patients was 47.6±10.5 years (age range from 33 to 65 years). Twenty five patients out of 37 (67.6%) had CT angiograms that were negative for PE. Eleven PE-positive patients (91.7%) had at least 1 identifiable thromboembolic risk factor whilst 5 PE-negative patients (20%) also had at least a thromboembolic risk factor. The relative risk of the occurrence of PE in patients with at least a thromboembolic risk factor was estimated at 14.4. Acute PE is a reality in sub-Saharan Africa, with an increased likelihood of MDCT evidence in patients with clinical suspicion of PE who have at least a thromboembolic risk factor. The increasing availability of MDCT will help provide more information on the occurrence of PE in these settings

  12. 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.

  13. Three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT: applications and limitations

    International Nuclear Information System (INIS)

    Kim, Su Yeon; Choi, Sun Seob; Kang, Myung Jin; Shin, Tae Beom; Lee, Ki Nam; Kang, Myung Koo

    2005-01-01

    This study was conducted to know the applications and limitations of three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT. This study examined 25 patients who underwent temporal bone CT using a 16-row detector CT as a result of hearing problems or trauma. The axial CT scan of the temporal bone was performed with a 0.6 mm collimation, and a reconstruction was carried out with a U70u sharp of kernel value, a 1 mm thickness and 0.5-1.0 mm increments. After observing the ossicles in the axial and coronal images, virtual endoscopy was performed using a three dimensional volume rendering technique with a threshold value of-500 HU. The intra-operative otoendoscopy was performed in 12 ears, and was compared with the virtual endoscopy findings. Virtual endoscopy of the 29 ears without hearing problems demonstrated hypoplastic or an incomplete depiction of the stapes superstructures in 25 ears and a normal depiction in 4 ears. Virtual endoscopy of 21 ears with hearing problems demonstrated no ossicles in 1 ears, no malleus in 3 ears, a malleoincudal subluxation in 6 ears, a dysplastic incus in 5 ears, an incudostapedial subluxation in 9 ears, dysplastic stapes in 2 ears, a hypoplastic or incomplete depiction of the stapes in 16 ears and no stapes in 1 ears. In contrast to the intra-operative otoendoscopy, 8 out of 12 ears showed a hypoplastic or deformed stapes in the virtual endoscopy. Volume rendering virtual endoscopy using a multi-row detector CT is an excellent method for evaluation the ossicles in three dimension, even thought the partial volume effect for the stapes superstructures needs to be considered

  14. Carotid artery wall thickness and ischemic symptoms: evaluation using multi-detector-row CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Caddeo, Giancarlo; Mallarini, Giorgio [Azienda Ospedaliero Universitaria Polo di Monserrato, Department of Radiology, Cagliari (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria Polo di Monserrato, Department of Vascular Surgery, Cagliari (Italy); Pascalis, Luigi [Azienda Ospedaliero Universitaria Polo di Cagliari, Division of II Internal Medicine, Cagliari (Italy)

    2008-09-15

    The purpose of this study was to determine if carotid artery wall thickness (CAWT) studied by using multi-detector-row CT angiography (MDCTA) can be considered an effective parameter predictive of increased risk of stroke. A total of 217 patients were retrospectively studied by using MDCTA. In all patients CAWT was measured with an internal digital caliper. Continuous data were described as the mean value {+-} standard deviation (SD), and they were compared with Student's t-test. Scatter plots to determine interobserver agreement were performed, and correlation coefficient was calculated with Pearson statistics. A P value <0.05 was considered to mean statistical significance. Measurements of the distal common CAWT ranged from 0.5 to 1.6 mm. In the patient group without stroke, average CAWT was 0.82 mm (0.22 SD), whereas in patient group with stroke it was 1.096 mm (0.21 SD). CAWT in patients without stroke showed statistical difference (P<0.0001) when compared to patients with stroke. By using a threshold of 1 mm, an important statistical association between thick CAWT and stroke was found (P<0.0001). In fact, patients with {>=}1 mm CAWT had stroke with an odds ratio of 8.16 when compared with patients with <1 mm CAWT. Resulting data suggested that an increased CAWT is an indicator for risk of stroke. This parameter should be considered in addition to other well-known risk factors such as diabetes, hypertension, smoking, and dyslipidemia. (orig.)

  15. Carotid artery wall thickness and ischemic symptoms: evaluation using multi-detector-row CT angiography

    International Nuclear Information System (INIS)

    Saba, Luca; Caddeo, Giancarlo; Mallarini, Giorgio; Sanfilippo, Roberto; Montisci, Roberto; Pascalis, Luigi

    2008-01-01

    The purpose of this study was to determine if carotid artery wall thickness (CAWT) studied by using multi-detector-row CT angiography (MDCTA) can be considered an effective parameter predictive of increased risk of stroke. A total of 217 patients were retrospectively studied by using MDCTA. In all patients CAWT was measured with an internal digital caliper. Continuous data were described as the mean value ± standard deviation (SD), and they were compared with Student's t-test. Scatter plots to determine interobserver agreement were performed, and correlation coefficient was calculated with Pearson statistics. A P value <0.05 was considered to mean statistical significance. Measurements of the distal common CAWT ranged from 0.5 to 1.6 mm. In the patient group without stroke, average CAWT was 0.82 mm (0.22 SD), whereas in patient group with stroke it was 1.096 mm (0.21 SD). CAWT in patients without stroke showed statistical difference (P<0.0001) when compared to patients with stroke. By using a threshold of 1 mm, an important statistical association between thick CAWT and stroke was found (P<0.0001). In fact, patients with ≥1 mm CAWT had stroke with an odds ratio of 8.16 when compared with patients with <1 mm CAWT. Resulting data suggested that an increased CAWT is an indicator for risk of stroke. This parameter should be considered in addition to other well-known risk factors such as diabetes, hypertension, smoking, and dyslipidemia. (orig.)

  16. Case report: Isolated unilateral pulmonary vein atresia diagnosed on 128-slice multidetector CT

    Directory of Open Access Journals (Sweden)

    Rashmi Dixit

    2011-01-01

    Full Text Available Unilateral pulmonary venous atresia is an uncommon entity that is generally believed to be congenital. Most patients present in infancy or childhood with recurrent chest infections or hemoptysis. Pulmonary angiography is usually used for definitive diagnosis. However, the current multislice CT scanners may obviate the need for pulmonary angiography. We report two cases diagnosed using 128-slice CT angiography. On the CT angiography images both these cases demonstrated absent pulmonary veins on the affected side, with a small pulmonary artery and prominent bronchial or other systemic arterial supply.

  17. Evaluation of the anomalous retroesophageal left brachiocephalic vein in Chinese children using multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Ming, Zhu; Aimin, Sun; Rui, He [Shanghai Children' s Medical Center, Department of Radiology, Shanghai (China)

    2009-04-15

    Anomalous retroesophageal left brachiocephalic vein is a very rare anomaly of the brachiocephalic vein. At the time of writing only one case had been reported worldwide. The purpose of this study was to report four cases of anomalous retroesophageal left brachiocephalic vein and to evaluate the utility of multidetector computed tomography (MDCT) for investigation of the anomaly. From June 2005 to May 2008, we examined 2,146 children with congenital heart disease and 4,082 children without congenital heart disease using MDCT. The patients ranged in age from 1 day to 12 years. Maximum intensity projection reconstruction was performed to show the brachiocephalic vein. A retroesophageal left brachiocephalic vein was found in 4 of the 2,146 patients (0.19%) with congenital heart disease and in 0 of the 4,082 patients without congenital heart disease. In all four patients, the condition was confirmed during surgery for the congenital heart disease. MDCT is a good modality for evaluating the anomalous retroesophageal left brachiocephalic vein. An anomalous retroesophageal left brachiocephalic vein was more common in patients with congenital heart disease. (orig.)

  18. Multi-detector CT features of acute intestinal ischemia and their prognostic correlations.

    Science.gov (United States)

    Moschetta, Marco; Telegrafo, Michele; Rella, Leonarda; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe

    2014-05-28

    Acute intestinal ischemia is an abdominal emergency occurring in nearly 1% of patients presenting with acute abdomen. The causes can be occlusive or non occlusive. Early diagnosis is important to improve survival rates. In most cases of late or missed diagnosis, the mortality rate from intestinal infarction is very high, with a reported value ranging from 60% to 90%. Multi-detector computed tomography (MDCT) is a fundamental imaging technique that must be promptly performed in all patients with suspected bowel ischemia. Thanks to the new dedicated reconstruction program, its diagnostic potential is much improved compared to the past and currently it is superior to that of any other noninvasive technique. The increased spatial and temporal resolution, high-quality multi-planar reconstructions, maximum intensity projections, vessel probe, surface-shaded volume rending and tissue transition projections make MDCT the gold standard for the diagnosis of intestinal ischemia, with reported sensitivity, specificity, positive and negative predictive values of 64%-93%, 92%-100%, 90%-100% and 94%-98%, respectively. MDCT contributes to appropriate treatment planning and provides important prognostic information thanks to its ability to define the nature and extent of the disease. The purpose of this review is to examine the diagnostic and prognostic role of MDCT in bowel ischemia with special regard to the state of art new reconstruction software.

  19. 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.)

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

    International Nuclear Information System (INIS)

    Cappelli, Carla; Boggi, Ugo; Mazzeo, Salvatore; Cervelli, Rosa; Contillo, Benedetta Pontillo; Bartolozzi, Carlo; Campani, Daniela; Funel, Niccola

    2015-01-01

    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.)

  1. Multidetector CT angiography in living donor renal transplantation: accuracy and discrepancies in right venous anatomy.

    Science.gov (United States)

    Kulkarni, S; Emre, S; Arvelakis, A; Asch, W; Bia, M; Formica, R; Israel, G

    2011-01-01

    Multidetector computed tomography (MDCT) angiography is a reliable technique for assessing pre-operative renal anatomy in living kidney donors. The method has largely evolved into protocols that eliminate dedicated venous phase and instead utilize a combined arterial/venous phase to delineate arterial and venous anatomy simultaneously. Despite adoption of this protocol, there has been no study to assess its accuracy. To assess whether or not MDCT angiography compares favorably to intra-operative findings, 102 donors underwent MDCT angiography without a dedicated venous phase with surgical interpretation of renal anatomy. Anatomical variants included multiple arteries (12%), multiple veins (7%), early arterial bifurcation (13%), late venous confluence (5%), circumaortic renal veins (5%), retroaortic vein (1%), and ureteral duplication (2%). The sensitivity and specificity of multiple arterial anomalies were 100% and 97%, respectively. The sensitivity and specificity of multiple venous anomalies were 92% and 98%, respectively. The most common discrepancy was noted exclusively in the interpretation of right venous anatomy as it pertained to the renal vein/vena cava confluence (3%). MDCT angiography using a combined arterial/venous contrast-enhanced phase provides suitable depiction of renal donor anatomy. Careful consideration should be given when planning a right donor nephrectomy whether the radiographic interpretation is suggestive of a late confluence. © 2010 John Wiley & Sons A/S.

  2. Evaluation of the anomalous retroesophageal left brachiocephalic vein in Chinese children using multidetector CT

    International Nuclear Information System (INIS)

    Ming, Zhu; Aimin, Sun; Rui, He

    2009-01-01

    Anomalous retroesophageal left brachiocephalic vein is a very rare anomaly of the brachiocephalic vein. At the time of writing only one case had been reported worldwide. The purpose of this study was to report four cases of anomalous retroesophageal left brachiocephalic vein and to evaluate the utility of multidetector computed tomography (MDCT) for investigation of the anomaly. From June 2005 to May 2008, we examined 2,146 children with congenital heart disease and 4,082 children without congenital heart disease using MDCT. The patients ranged in age from 1 day to 12 years. Maximum intensity projection reconstruction was performed to show the brachiocephalic vein. A retroesophageal left brachiocephalic vein was found in 4 of the 2,146 patients (0.19%) with congenital heart disease and in 0 of the 4,082 patients without congenital hear