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Liu X, Jing Y, Xu C, Wang X, Xie X, Zhu Y, Dai L, Wang H, Wang L, Yu S. Medical Imaging Technology for Micro/Nanorobots. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2872. [PMID: 37947717 PMCID: PMC10648532 DOI: 10.3390/nano13212872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
Due to their enormous potential to be navigated through complex biological media or narrow capillaries, microrobots have demonstrated their potential in a variety of biomedical applications, such as assisted fertilization, targeted drug delivery, tissue repair, and regeneration. Numerous initial studies have been conducted to demonstrate the biomedical applications in test tubes and in vitro environments. Microrobots can reach human areas that are difficult to reach by existing medical devices through precise navigation. Medical imaging technology is essential for locating and tracking this small treatment machine for evaluation. This article discusses the progress of imaging in tracking the imaging of micro and nano robots in vivo and analyzes the current status of imaging technology for microrobots. The working principle and imaging parameters (temporal resolution, spatial resolution, and penetration depth) of each imaging technology are discussed in depth.
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Affiliation(s)
- Xuejia Liu
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Yizhan Jing
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Chengxin Xu
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Xiaoxiao Wang
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Xiaopeng Xie
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Yanhe Zhu
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Lizhou Dai
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Haocheng Wang
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Lin Wang
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150001, China; (X.L.); (Y.J.); (C.X.); (X.W.); (X.X.); (Y.Z.); (L.D.); (L.W.)
| | - Shimin Yu
- College of Engineering, Ocean University of China, Qingdao 266100, China
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2
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McCollough CH, Rajiah PS. Milestones in CT: Past, Present, and Future. Radiology 2023; 309:e230803. [PMID: 37847140 PMCID: PMC10644676 DOI: 10.1148/radiol.230803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
In 1971, the first patient CT examination by Ambrose and Hounsfield paved the way for not only volumetric imaging of the brain but of the entire body. From the initial 5-minute scan for a 180° rotation to today's 0.24-second scan for a 360° rotation, CT technology continues to reinvent itself. This article describes key historical milestones in CT technology from the earliest days of CT to the present, with a look toward the future of this essential imaging modality. After a review of the beginnings of CT and its early adoption, the technical steps taken to decrease scan times-both per image and per examination-are reviewed. Novel geometries such as electron-beam CT and dual-source CT have also been developed in the quest for ever-faster scans and better in-plane temporal resolution. The focus of the past 2 decades on radiation dose optimization and management led to changes in how exposure parameters such as tube current and tube potential are prescribed such that today, examinations are more customized to the specific patient and diagnostic task than ever before. In the mid-2000s, CT expanded its reach from gray-scale to color with the clinical introduction of dual-energy CT. Today's most recent technical innovation-photon-counting CT-offers greater capabilities in multienergy CT as well as spatial resolution as good as 125 μm. Finally, artificial intelligence is poised to impact both the creation and processing of CT images, as well as automating many tasks to provide greater accuracy and reproducibility in quantitative applications.
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Affiliation(s)
- Cynthia H. McCollough
- Department of Radiology, Mayo Clinic, 200 First St SW Rochester, MN, United States 55905
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3
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Klingensmith JD, Karlapalem A, Kulasekara MM, Fernandez-Del-Valle M. Spectral analysis of ultrasound radiofrequency backscatter for the identification of epicardial adipose tissue. J Med Imaging (Bellingham) 2022; 9:017001. [PMID: 35005059 DOI: 10.1117/1.jmi.9.1.017001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 12/21/2021] [Indexed: 11/14/2022] Open
Abstract
Purpose: The coronary arteries are embedded in a layer of fat known as epicardial adipose tissue (EAT). The EAT influences the development of coronary artery disease (CAD), and increased EAT volume can be indicative of the presence and type of CAD. Identification of EAT using echocardiography is challenging and only sometimes feasible on the free wall of the right ventricle. We investigated the use of spectral analysis of the ultrasound radiofrequency (RF) backscatter for its potential to provide a more complete characterization of the EAT. Approach: Autoregressive (AR) models facilitated analysis of the short-time signals and allowed tuning of the optimal order of the spectral estimation process. The spectra were normalized using a reference phantom and spectral features were computed from both normalized and non-normalized data. The features were used to train random forests for classification of EAT, myocardium, and blood. Results: Using an AR order of 15 with the normalized data, a Monte Carlo cross validation yielded accuracies of 87.9% for EAT, 84.8% for myocardium, and 93.3% for blood in a database of 805 regions-of-interest. Youden's index, the sum of sensitivity, and specificity minus 1 were 0.799, 0.755, and 0.933, respectively. Conclusions: We demonstrated that spectral analysis of the raw RF signals may facilitate identification of the EAT when it may not otherwise be visible in traditional B-mode images.
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Affiliation(s)
- Jon D Klingensmith
- Southern Illinois University Edwardsville, Department of Electrical and Computer Engineering, Edwardsville, Illinois, United States
| | - Akhila Karlapalem
- Southern Illinois University Edwardsville, Department of Electrical and Computer Engineering, Edwardsville, Illinois, United States
| | - Michaela M Kulasekara
- Southern Illinois University Edwardsville, Department of Electrical and Computer Engineering, Edwardsville, Illinois, United States
| | - Maria Fernandez-Del-Valle
- Southern Illinois University Edwardsville, Department of Applied Health, Edwardsville, Illinois, United States
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4
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Tridandapani S, Banait-Deshmane S, Aziz MU, Bhatti P, Singh SP. Coronary computed tomographic angiography: A review of the techniques, protocols, pitfalls, and radiation dose. J Med Imaging Radiat Sci 2021; 52:S1-S11. [PMID: 34565701 DOI: 10.1016/j.jmir.2021.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/13/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022]
Abstract
Coronary computed tomographic angiography (CCTA) is a viable alternative to catheter coronary angiography for several clinical indications, chiefly because it is fast and non-invasive. For effective clinical use of CCTA, various technical and patient factors should be considered. In this brief review article, we discuss the indication and contraindications for CCTA, technical requirements for CCTA including radiation dose, patient preparation principles, image post-processing, and pitfalls and artifacts of CCTA.
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Affiliation(s)
- Srini Tridandapani
- Department of Radiology, University of Alabama, Birmingham, AL, USA; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
| | | | | | - Pamela Bhatti
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Satinder P Singh
- Department of Radiology, University of Alabama, Birmingham, AL, USA
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5
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Schnabel RB, Camen S, Knebel F, Hagendorff A, Bavendiek U, Böhm M, Doehner W, Endres M, Gröschel K, Goette A, Huttner HB, Jensen C, Kirchhof P, Korosoglou G, Laufs U, Liman J, Morbach C, Nabavi DG, Neumann-Haefelin T, Pfeilschifter W, Poli S, Rizos T, Rolf A, Röther J, Schäbitz WR, Steiner T, Thomalla G, Wachter R, Haeusler KG. Expert opinion paper on cardiac imaging after ischemic stroke. Clin Res Cardiol 2021; 110:938-958. [PMID: 34143285 PMCID: PMC8238761 DOI: 10.1007/s00392-021-01834-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 03/01/2021] [Indexed: 12/19/2022]
Abstract
This expert opinion paper on cardiac imaging after acute ischemic stroke or transient ischemic attack (TIA) includes a statement of the "Heart and Brain" consortium of the German Cardiac Society and the German Stroke Society. The Stroke Unit-Commission of the German Stroke Society and the German Atrial Fibrillation NETwork (AFNET) endorsed this paper. Cardiac imaging is a key component of etiological work-up after stroke. Enhanced echocardiographic tools, constantly improving cardiac computer tomography (CT) as well as cardiac magnetic resonance imaging (MRI) offer comprehensive non- or less-invasive cardiac evaluation at the expense of increased costs and/or radiation exposure. Certain imaging findings usually lead to a change in medical secondary stroke prevention or may influence medical treatment. However, there is no proof from a randomized controlled trial (RCT) that the choice of the imaging method influences the prognosis of stroke patients. Summarizing present knowledge, the German Heart and Brain consortium proposes an interdisciplinary, staged standard diagnostic scheme for the detection of risk factors of cardio-embolic stroke. This expert opinion paper aims to give practical advice to physicians who are involved in stroke care. In line with the nature of an expert opinion paper, labeling of classes of recommendations is not provided, since many statements are based on expert opinion, reported case series, and clinical experience.
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Affiliation(s)
- Renate B Schnabel
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.,Atrial Fibrillation NETwork (AFNET) e.V., Münster, Germany
| | - Stephan Camen
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Fabian Knebel
- Department of Cardiology and Angiology, University of Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Hagendorff
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig , Leipzig, Germany
| | - Udo Bavendiek
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Michael Böhm
- Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital of Saarland, Saarland University, Homburg (Saar) , Germany
| | - Wolfram Doehner
- Berlin Institute of Health, Center for Regenerative Therapies, and Department of Cardiology (Virchow Klinikum), Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Endres
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany.,Klinik Und Hochschulambulanz Für Neurologie Mit Abteilung Für Experimentelle Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Berlin, Germany.,ExcellenceCluster NeuroCure, Berlin, Germany
| | - Klaus Gröschel
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Goette
- Atrial Fibrillation NETwork (AFNET) e.V., Münster, Germany.,Department of Cardiology & Intensive Care Medicine, St. Vincenz Hospital Paderborn, Paderborn, Germany
| | - Hagen B Huttner
- Department of Neurology, University Hospital Gießen, Gießen, Germany
| | - Christoph Jensen
- B. Braun Ambulantes Herzzentrum Kassel MVZ GmbH, Kassel, Germany.,Ruhr University Bochum, Bochum, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.,Atrial Fibrillation NETwork (AFNET) e.V., Münster, Germany.,Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, Medical School, University of Birmingham, Edgbaston, Birmingham, UK
| | - Grigorios Korosoglou
- Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Weinheim, Germany
| | - Ulrich Laufs
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig , Leipzig, Germany
| | - Jan Liman
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center and Department for Medicine I, University Hospital Würzburg, Würzburg, Germany
| | | | - Tobias Neumann-Haefelin
- Department of Neurology, Klinikum Fulda, Universitätsmedizin Marburg - Campus Fulda, Fulda, Germany
| | - Waltraud Pfeilschifter
- Department of Neurology, Goethe-University Hospital Frankfurt, Frankfurt, Germany.,Department of Neurology and Clinical Neurophysiology, Klinikum Lüneburg, Lüneburg, Germany
| | - Sven Poli
- Department of Neurology & Stroke, Eberhard-Karls University Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, Eberhard-Karls University Tübingen, Tübingen, Germany
| | - Timolaos Rizos
- Department of Neurology, Heidelberg University, Heidelberg, Germany
| | - Andreas Rolf
- Department of Cardiology, Kerckhoff-Heart-Center, Bad Nauheim, Germany and Campus Kerckhoff Justus-Liebig-University, Gießen, Germany
| | - Joachim Röther
- Department of Neurology, Asklepios Klinik Hamburg Altona, Hamburg, Germany
| | - Wolf Rüdiger Schäbitz
- Department of Neurology, Evangelisches Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Thorsten Steiner
- Department of Neurology, Heidelberg University, Heidelberg, Germany.,Department of Neurology, Klinikum Frankfurt Höchst, Frankfurt, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rolf Wachter
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig , Leipzig, Germany.,University Medical Center Goettingen, Göttingen, Germany
| | - Karl Georg Haeusler
- Atrial Fibrillation NETwork (AFNET) e.V., Münster, Germany. .,Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
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6
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Aziz A, Pane S, Iacovacci V, Koukourakis N, Czarske J, Menciassi A, Medina-Sánchez M, Schmidt OG. Medical Imaging of Microrobots: Toward In Vivo Applications. ACS NANO 2020; 14:10865-10893. [PMID: 32869971 DOI: 10.1021/acsnano.0c05530] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Medical microrobots (MRs) have been demonstrated for a variety of non-invasive biomedical applications, such as tissue engineering, drug delivery, and assisted fertilization, among others. However, most of these demonstrations have been carried out in in vitro settings and under optical microscopy, being significantly different from the clinical practice. Thus, medical imaging techniques are required for localizing and tracking such tiny therapeutic machines when used in medical-relevant applications. This review aims at analyzing the state of the art of microrobots imaging by critically discussing the potentialities and limitations of the techniques employed in this field. Moreover, the physics and the working principle behind each analyzed imaging strategy, the spatiotemporal resolution, and the penetration depth are thoroughly discussed. The paper deals with the suitability of each imaging technique for tracking single or swarms of MRs and discusses the scenarios where contrast or imaging agent's inclusion is required, either to absorb, emit, or reflect a determined physical signal detected by an external system. Finally, the review highlights the existing challenges and perspective solutions which could be promising for future in vivo applications.
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Affiliation(s)
- Azaam Aziz
- Institute for Integrative Nanosciences, Leibniz IFW Dresden, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Stefano Pane
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa 56025, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | - Veronica Iacovacci
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa 56025, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | - Nektarios Koukourakis
- Chair of Measurement and Sensor System Technique, School of Engineering, TU Dresden, Helmholtzstrasse 18, 01069 Dresden, Germany
- Center for Biomedical Computational Laser Systems, TU Dresden, 01062 Dresden, Germany
| | - Jürgen Czarske
- Chair of Measurement and Sensor System Technique, School of Engineering, TU Dresden, Helmholtzstrasse 18, 01069 Dresden, Germany
- Cluster of Excellence Physics of Life, TU Dresden, 01307 Dresden, Germany
- Center for Biomedical Computational Laser Systems, TU Dresden, 01062 Dresden, Germany
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa 56025, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | - Mariana Medina-Sánchez
- Institute for Integrative Nanosciences, Leibniz IFW Dresden, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Oliver G Schmidt
- Institute for Integrative Nanosciences, Leibniz IFW Dresden, Helmholtzstrasse 20, 01069 Dresden, Germany
- Center for Materials, Architectures, and Integration of Nanomembranes (MAIN), TU Chemnitz, Reichenhainer Strasse 10, 09107 Chemnitz, Germany
- School of Science, TU Dresden, 01062 Dresden, Germany
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Żabówka A, Hołda J, Strona M, Koziej M, Krawczyk‐Ożóg A, Jasińska KA, Kuniewicz M, Lelakowski J, Hołda MK. Morphology of the Vieussens valve and its imaging in cardiac multislice computed tomography. J Cardiovasc Electrophysiol 2019; 30:1325-1329. [DOI: 10.1111/jce.14018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/17/2019] [Accepted: 05/30/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Anna Żabówka
- HEART—Heart Embryology and Anatomy Research Team, Department of AnatomyJagiellonian University Medical College Cracow Poland
| | - Jakub Hołda
- HEART—Heart Embryology and Anatomy Research Team, Department of AnatomyJagiellonian University Medical College Cracow Poland
| | - Marcin Strona
- Department of Forensic MedicineJagiellonian University Medical College Cracow Poland
| | - Mateusz Koziej
- HEART—Heart Embryology and Anatomy Research Team, Department of AnatomyJagiellonian University Medical College Cracow Poland
| | - Agata Krawczyk‐Ożóg
- HEART—Heart Embryology and Anatomy Research Team, Department of AnatomyJagiellonian University Medical College Cracow Poland
| | - Katarzyna A. Jasińska
- HEART—Heart Embryology and Anatomy Research Team, Department of AnatomyJagiellonian University Medical College Cracow Poland
| | - Marcin Kuniewicz
- Department of Electrocardiology, Institute of Cardiology, The John Paul II Hospital in CracowJagiellonian University Medical College Cracow Poland
| | - Jacek Lelakowski
- Department of Electrocardiology, Institute of Cardiology, The John Paul II Hospital in CracowJagiellonian University Medical College Cracow Poland
| | - Mateusz K. Hołda
- HEART—Heart Embryology and Anatomy Research Team, Department of AnatomyJagiellonian University Medical College Cracow Poland
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Three-Dimensional Reconstruction of Ultrafast 16-Slice Computed Tomography Images and CT Angiography versus Conventional Coronary Angiography at One Year in Multivessel Coronary Artery Bypass Surgery. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2019; 1:92-5. [DOI: 10.1097/01243895-200500120-00008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background The aim of this study was to evaluate and compare the postoperative graft patency assessment by multislice spiral computed tomography (MSCT) scan and conventional coronary angiography (CCA) in coronary artery bypass grafting (CABG) patients 1 year after surgery. Methods Sixty-nine patients who underwent isolated CABG at least 1 year before the study, were subjected to both MSCT angiography with cardiac gating and CCA. The results were evaluated and compared. Results There were 209 grafts in 69 patients. All grafts were evaluated by both MSCT angiography and CCA. Seventy-eight grafts were on the anterior wall, 83 on the lateral wall and 48 on the inferior wall of the heart. On MSCT angiography, all left internal mammary arteries were visualized with 3-dimensional reconstruction and found to be patent. Of 209 grafts, 11 grafts (5.26%) were blocked, 6 grafts on the lateral wall and 5 on the inferior wall. All patent grafts were correctly evaluated by MSCT angiography (specificity 100%). However, 2 grafts that were found to be patent on MSCT angiography were blocked on CCA (MSCT sensitivity 81.8%). Conclusions Postoperative evaluation of coronary bypass grafts is possible with very good resolution by MSCT angiography. This method allows evaluation of the bypass grafts and the quality of anastomosis with a noninvasive method that is comparable with CCA.
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9
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Barrett HE, Van der Heiden K, Farrell E, Gijsen FJH, Akyildiz AC. Calcifications in atherosclerotic plaques and impact on plaque biomechanics. J Biomech 2019; 87:1-12. [PMID: 30904335 DOI: 10.1016/j.jbiomech.2019.03.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/09/2019] [Indexed: 12/13/2022]
Abstract
The catastrophic mechanical rupture of an atherosclerotic plaque is the underlying cause of the majority of cardiovascular events. The infestation of vascular calcification in the plaques creates a mechanically complex tissue composite. Local stress concentrations and plaque tissue strength properties are the governing parameters required to predict plaque ruptures. Advanced imaging techniques have permitted insight into fundamental mechanisms driving the initiating inflammatory-driven vascular calcification of the diseased intima at the (sub-) micron scale and up to the macroscale. Clinical studies have potentiated the biomechanical relevance of calcification through the derivation of links between local plaque rupture and specific macrocalcification geometrical features. The clinical implications of the data presented in this review indicate that the combination of imaging, experimental testing, and computational modelling efforts are crucial to predict the rupture risk for atherosclerotic plaques. Specialised experimental tests and modelling efforts have further enhanced the knowledge base for calcified plaque tissue mechanical properties. However, capturing the temporal instability and rupture causality in the plaque fibrous caps remains elusive. Is it necessary to move our experimental efforts down in scale towards the fundamental (sub-) micron scales in order to interpret the true mechanical behaviour of calcified plaque tissue interactions that is presented on a macroscale in the clinic and to further optimally assess calcified plaques in the context of biomechanical modelling.
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Affiliation(s)
- Hilary E Barrett
- Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Kim Van der Heiden
- Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric Farrell
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Frank J H Gijsen
- Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ali C Akyildiz
- Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
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10
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Gupta P, Agarwal NK, Kapoor A. Coronary artery plaque characterization using MDCT in symptomatic and asymptomatic subgroups of diabetic and non-diabetic population—a comparative retrospective study. Indian J Thorac Cardiovasc Surg 2018; 34:355-364. [DOI: 10.1007/s12055-017-0624-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/24/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022] Open
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11
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Computed tomographic arthrography of the normal dromedary camel carpus. Vet Comp Orthop Traumatol 2017; 29:188-94. [DOI: 10.3415/vcot-15-06-0112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 11/08/2015] [Indexed: 11/17/2022]
Abstract
SummaryThe aim of this prospective cadaveric study was to provide a detailed computed tomographic (CT) reference of the carpal joint in healthy dromedary camels. Twelve forelimbs of six apparently healthy camels were used. Computed tomographic imaging of 12 normal cadaveric camel carpal joints was performed before and after intra-articular administration of iodinated contrast medium. Transverse CT images were reconstructed in dorsal and parasagittal planes. The six carpal bones, the radial trochlea, and the proximal articular surface of the metacarpal bones were clearly visible on CT images with the bone setting window. Radiocarpal, carpometacarpal, transverse intercarpal, medial and lateral palmer intercarpal, middle intercarpal, accessory carpoulnar and medial and lateral collateral ligaments, carpal canal, joint capsule, and the extensor and flexor tendons were identified on CT images with the soft-tissue setting window. Postcontrast CT images provided better delineation of intercarpal ligaments, the capsular compartments and recesses. Results indicated that the osseous and the clinically important soft tissue structures of the dromedary camel carpal joint could be identified using CT and CT arthrography. The CT data of this study will serve as a basis for diagnosis of carpal problems in camels.
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12
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Hur J, Choi BW. Cardiac CT Imaging for Ischemic Stroke: Current and Evolving Clinical Applications. Radiology 2017; 283:14-28. [DOI: 10.1148/radiol.2016152043] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jin Hur
- From the Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, 120-752, Seoul, Republic of Korea
| | - Byoung Wook Choi
- From the Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, 120-752, Seoul, Republic of Korea
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Lewis MA, Pascoal A, Keevil SF, Lewis CA. Selecting a CT scanner for cardiac imaging: the heart of the matter. Br J Radiol 2016; 89:20160376. [PMID: 27302494 PMCID: PMC5124932 DOI: 10.1259/bjr.20160376] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/01/2016] [Accepted: 06/13/2016] [Indexed: 11/05/2022] Open
Abstract
Coronary angiography to assess the presence and degree of arterial stenosis is an examination now routinely performed on CT scanners. Although developments in CT technology over recent years have made great strides in improving the diagnostic accuracy of this technique, patients with certain characteristics can still be "difficult to image". The various groups will benefit from different technological enhancements depending on the type of challenge they present. Good temporal and spatial resolution, wide longitudinal (z-axis) detector coverage and high X-ray output are the key requirements of a successful CT coronary angiography (CTCA) scan. The requirement for optimal patient dose is a given. The different scanner models recommended for CTCA all excel in different aspects. The specification data presented here for these scanners and the explanation of the impact of the different features should help in making a more informed decision when selecting a scanner for CTCA.
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Affiliation(s)
- Maria A Lewis
- Department of Medical Physics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ana Pascoal
- King's Technology Evaluation Centre (KiTEC), King's College London, London, UK
- Department of Medical Engineering and Physics, King's College Hospital NHS Foundation Trust, London, UK
| | - Stephen F Keevil
- Department of Medical Physics, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Technology Evaluation Centre (KiTEC), King's College London, London, UK
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
| | - Cornelius A Lewis
- King's Technology Evaluation Centre (KiTEC), King's College London, London, UK
- Department of Medical Engineering and Physics, King's College Hospital NHS Foundation Trust, London, UK
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Cutroneo G, Bruschetta D, Trimarchi F, Cacciola A, Cinquegrani M, Duca A, Rizzo G, Alati E, Gaeta M, Milardi D. In Vivo CT Direct Volume Rendering: A Three-Dimensional Anatomical Description of the Heart. Pol J Radiol 2016; 81:21-8. [PMID: 26858778 PMCID: PMC4727493 DOI: 10.12659/pjr.895476] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 08/17/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Since cardiac anatomy continues to play an important role in the practice of medicine and in the development of medical devices, the study of the heart in three dimensions is particularly useful to understand its real structure, function and proper location in the body. MATERIAL/METHODS This study demonstrates a fine use of direct volume rendering, processing the data set images obtained by Computed Tomography (CT) of the heart of 5 subjects with age range between 18 and 42 years (2 male, 3 female), with no history of any overt cardiac disease. The cardiac structure in CT images was first extracted from the thorax by marking manually the regions of interest on the computer, and then it was stacked to create new volumetric data. RESULTS The use of a specific algorithm allowed us to observe with a good perception of depth the heart and the skeleton of the thorax at the same time. Besides, in all examined subjects, it was possible to depict its structure and its position within the body and to study the integrity of papillary muscles, the fibrous tissue of cardiac valve and chordae tendineae and the course of coronary arteries. CONCLUSIONS Our results demonstrated that one of the greatest advantages of algorithmic modifications of direct volume rendering parameters is that this method provides much necessary information in a single radiologic study. It implies a better accuracy in the study of the heart, being complementary to other diagnostic methods and facilitating the therapeutic plans.
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Affiliation(s)
- Giuseppina Cutroneo
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Daniele Bruschetta
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Fabio Trimarchi
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Alberto Cacciola
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Maria Cinquegrani
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Antonio Duca
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Giuseppina Rizzo
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Emanuela Alati
- Division of Cardiac Surgery, Ospedale Vita e Salute, San Raffaele, Milano, Italy
| | - Michele Gaeta
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Demetrio Milardi
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy; IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
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Kwong Y, Mel AO, Wheeler G, Troupis JM. Four-dimensional computed tomography (4DCT): A review of the current status and applications. J Med Imaging Radiat Oncol 2015; 59:545-54. [DOI: 10.1111/1754-9485.12326] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 04/19/2015] [Indexed: 01/16/2023]
Affiliation(s)
- Yune Kwong
- Department of Diagnostic Imaging; Monash Health; Melbourne Victoria Australia
| | - Alexandra Olimpia Mel
- Department of Biomedical Radiation Science; Faculty of Medicine; Dentistry and Nursing; Monash University; Melbourne Victoria Australia
| | - Greg Wheeler
- Department of Radiation Oncology and Cancer Imaging; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - John M Troupis
- Department of Diagnostic Imaging; Monash Health; Melbourne Victoria Australia
- Department of Biomedical Radiation Science; Faculty of Medicine; Dentistry and Nursing; Monash University; Melbourne Victoria Australia
- Monash Cardiovascular Research Centre; Monash University; Melbourne Victoria Australia
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Vehian AV, Choi BG, Rekhi SS, Young HA, Dusaj RS, Zeman RK. Clinical Significance of Left Atrial Anatomic Abnormalities Identified by Cardiac Computed Tomography. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/act.2015.41001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kochav J, Simprini L, Weinsaft JW. Imaging of the right heart--CT and CMR. Echocardiography 2014; 32 Suppl 1:S53-68. [PMID: 25244072 DOI: 10.1111/echo.12212] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Right ventricular (RV) structure and function is of substantial importance in a broad variety of clinical conditions. Cardiac magnetic resonance (CMR) and computed tomography (CT) each provide three-dimensional RV imaging, high-resolution evaluation of RV structure/anatomy, and accurate functional assessment without geometric assumptions. This is of particular significance for the RV, where complex geometry compromises reliance on indices derived from two-dimensional (2D) imaging planes. CMR flow-based imaging can be applied to right-sided heart valves, enabling evaluation of hemodynamic and valvular dysfunction that may contribute to or result from RV dysfunction. Tissue characterization imaging by both CMR and CT provides valuable complementary assessment of the RV. Changes in myocardial tissue composition provide a mechanistic substrate for RV dysfunction and cardiac arrhythmias. This review provides an overview of RV imaging by both CMR and CT, with focus on assessment of RV structure/function, flow, and tissue characterization. Emerging evidence and established guidelines are discussed in the context of imaging contributions to diagnosis, prognostic risk stratification and disease management of clinical conditions that impact the right ventricle.
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Affiliation(s)
- Jonathan Kochav
- Duke University School of Medicine, Durham, North Carolina; Weill Cornell Medical College, New York, New York
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18
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Baliga RR, Nienaber CA, Bossone E, Oh JK, Isselbacher EM, Sechtem U, Fattori R, Raman SV, Eagle KA. The Role of Imaging in Aortic Dissection and Related Syndromes. JACC Cardiovasc Imaging 2014; 7:406-24. [DOI: 10.1016/j.jcmg.2013.10.015] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 10/21/2013] [Accepted: 10/25/2013] [Indexed: 10/25/2022]
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Spectral CT demonstration of the superior mesenteric artery: comparison of monochromatic and polychromatic imaging. Acad Radiol 2014; 21:364-8. [PMID: 24360636 DOI: 10.1016/j.acra.2013.11.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 10/31/2013] [Accepted: 11/03/2013] [Indexed: 12/11/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate the performance of spectral computed tomography (CT) in depiction of the superior mesenteric artery (SMA) compared to conventional polychromatic CT. MATERIALS AND METHODS This prospective study had institutional review board approval, and written informed consent was obtained. Fifty patients underwent spectral CT examination using gemstone spectral imaging with a single-tube, fast dual-tube voltage-switching technique. Spectrum analysis was used to select the monochromatic images that provide the optimal contrast-to-noise ratio (CNR) for SMA angiography. The CNR for SMA at the selected monochromatic level was compared with that from the conventional polychromatic images. Image quality and visibility of the branch order of SMA were also assessed and compared. RESULTS The monochromatic images at 50 keV (mean 50.09 ± 1.98) provided the optimal CNR for SMA angiography. At this energy level, the monochromatic images had higher (20.8 vs 9.2) CNR than the polychromatic images, and the image quality was superior to conventional polychromatic images (P < .05). Fourth to fifth (mean 4.3) and third to fourth (mean 3.5) order branches of SMA were demonstrated at monochromatic and polychromatic images, respectively. CONCLUSIONS Gemstone spectral imaging with monochromatic images at 50 keV by spectral CT could improve the CTA image quality and demonstrate more branch order in depiction of normal SMA compared to conventional polychromatic imaging.
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Crown years for non-invasive cardiovascular imaging (Part IV): 30 years of cardiac computed tomography. Neth Heart J 2013; 21:315-8. [PMID: 23640578 PMCID: PMC3722385 DOI: 10.1007/s12471-013-0427-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Petcherski O, Gaspar T, Halon DA, Peled N, Jaffe R, Molnar R, Lewis BS, Rubinshtein R. Diagnostic accuracy of 256-row computed tomographic angiography for detection of obstructive coronary artery disease using invasive quantitative coronary angiography as reference standard. Am J Cardiol 2013. [PMID: 23206926 DOI: 10.1016/j.amjcard.2012.10.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
We assessed the performance of a new-generation, 256-row computed tomography (CT) scanner for detection of obstructive coronary artery disease (CAD) compared to invasive quantitative coronary angiography. A total 121 consecutive symptomatic patients without known CAD referred for invasive coronary angiography (age 59 ± 12 years, 37% women) underwent clinically driven 256-row coronary computed tomographic angiography (CCTA) before the invasive procedure. Obstructive CAD (>50% diameter stenosis) was assessed visually on CCTA by 2 independent observers using the 18-segment society of cardiovascular CT model and on invasive angiograms using quantitative coronary angiography (the reference standard). Observers were unaware of the findings from the alternate modality. Nonassessable coronary computed tomographic angiographic segments were considered obstructive for the purpose of analysis. Quantitative coronary angiography demonstrated obstructive CAD in 145 segments in 82 of 121 patients (68%). Overall, 1,677 coronary segments were available for comparative analysis, of which 39 (2.3%) were nonassessable by CCTA, mostly because of heavy calcification. Patient-based and segment-based analysis showed a sensitivity of 100% and 97% (95% confidence interval 95% to 100%) and specificity of 69% (95% confidence interval 55% to 84%) and 97% (confidence interval 96% to 98%), respectively. Four segments with obstructive CAD in 4 patients were not detected by CCTA. All 4 patients had additional coronary obstructions identified by CCTA. The predictive accuracy was 90% (range 85% to 95%) for patient based and 97% (96% to 98%) for segment based analysis. In conclusion, 256-row CCTA showed high sensitivity and high predictive accuracy for detection of obstructive CAD in patients without previously known disease. Although coronary calcification might still interfere with analysis, the rate of nonassessable segments was low.
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Kraima A, Smit N, Jansma D, Wallner C, Bleys R, Velde CVD, Botha C, DeRuiter M. Toward a highly-detailed 3D pelvic model: Approaching an ultra-specific level for surgical simulation and anatomical education. Clin Anat 2012; 26:333-8. [DOI: 10.1002/ca.22207] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 10/25/2012] [Accepted: 10/31/2012] [Indexed: 01/10/2023]
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Moroi M, Nakazato R, Jesmin S, Akter S, Kunimasa T, Masai H, Furuhashi T, Fukuda H, Kohda E, Sugi K. Coronary Artery CT Low-Density Plaque Area and Its Ratio to the Whole Area of a Non-Calcified Plaque at the Culprit Lesion in Patients With Unstable and Stable Coronary Artery Disease. Int Heart J 2012; 53:341-6. [DOI: 10.1536/ihj.53.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Masao Moroi
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
- Department of Cardiology, National Center for Global Health and Medicine
| | | | - Subrina Jesmin
- Department of Cardiology, National Center for Global Health and Medicine
| | - Shamima Akter
- Department of Cardiology, National Center for Global Health and Medicine
| | - Taeko Kunimasa
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
| | - Hirofumi Masai
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
| | | | - Hiroshi Fukuda
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
| | - Ehiichi Kohda
- Department of Radiology, Toho University Ohashi Medical Center
| | - Kaoru Sugi
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
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Cardiothoracic CT angiography: current contrast medium delivery strategies. AJR Am J Roentgenol 2011; 196:W260-72. [PMID: 21343473 DOI: 10.2214/ajr.10.5814] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Over the last decade, rapid technologic evolution in CT has resulted in improved spatial and temporal resolution and acquisition speed, enabling cardiothoracic CT angiography to become a viable and effective noninvasive alternative in the diagnostic algorithm. These new technologic advances have imposed new challenges for the optimization of contrast medium delivery and image acquisition strategies. CONCLUSION Thorough understanding of contrast medium dynamics is essential for the design of effective acquisition and injection protocols. This article provides an overview of the fundamentals affecting contrast enhancement, emphasizing the modifications to contrast material delivery protocols required to optimize cardiothoracic CT angiography.
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Hur J, Kim YJ, Shim HS, Lee HJ, Nam JE, Choe KO, Choi BW. Assessment of atherosclerotic plaques in a rabbit model by delayed-phase contrast-enhanced CT angiography: comparison with histopathology. Int J Cardiovasc Imaging 2011; 28:353-63. [PMID: 21279690 DOI: 10.1007/s10554-011-9801-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Accepted: 01/08/2011] [Indexed: 11/27/2022]
Abstract
The aim of this study was to compare delayed-phase computed tomography angiography (CTA) attenuation values with histopathology, in ability to differentiate between fibrous and lipid-rich plaques in an experimental rabbit model. Twelve atherosclerotic rabbits underwent CTA of the abdominal aorta. The scan protocol included early-phase scans (EP), delayed scans at 90 s after contrast injection (DP(90s)), delayed scans at 10 min after contrast injection (DP(10min)), and delayed scan with saline infusion (DP(Saline)). Plaque composition was analyzed by histopathology (% of lipid-rich, fibrous and macrophage areas) and CT attenuation values in Hounsfield units. Using histopathology as the reference standard (n = 119), the overall sensitivity, specificity and accuracy of 64-slice CTA for the detection of plaques was 59, 100 and 79% for the EP scans; 88, 100 and 94% for the DP(90s) scans; 81, 100 and 90% for the DP(10min) scans; and 53, 100 and 76% for the DP(Saline) scans. CT density measurements showed a substantial overlap between fibrous and lipid-rich plaques, and poor correlations with the percentage of macrophage areas in both fibrous and lipid-rich plaques (r = 0.408, and r = 0.333). In delayed-phase 64-slice CTA, DP(90s) images have the best diagnostic performance for the detection of aortic plaques.
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Affiliation(s)
- Jin Hur
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 250 Seongsanno, 134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
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In vivo assessment of coronary stents with 64-row multidetector computed tomography: analysis of metal artifacts. J Comput Assist Tomogr 2011; 34:921-6. [PMID: 21084910 DOI: 10.1097/rct.0b013e3181ddbbc0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate stent-induced artifacts by 64-row multidetector computed tomography (MDCT). METHODS We studied 26 stented patients with MDCT before conventional coronary angiography (CCA). The CT values were measured. Stents were classified as occluded, with significant stenosis, with nonsignificant stenosis, or patent. For the patent stents, mean in-stent and out-stent CT values were compared; stents 3 mm or smaller were compared with stents larger than 3 mm. Multidetector CT was compared with CCA. RESULTS We analyzed 42 stents. At CCA, 34 stents were patent, 5 were nonsignificantly stenosed, 1 was significantly stenosed, and 2 were occluded. At MDCT, 33 of 34 patent stents, 2 occluded stents, and 1 stent with significant stenosis were correctly diagnosed; nonsignificant stenoses were undetected, 1 patent stent was misdiagnosed as occluded (κ = 0.727). The out-stent CT value was lower than in-stent CT value both in stents 3 mm or smaller (P = 0.001) and stents larger than 3 mm (P < 0.001). The in-stent CT value of stents 3 mm or smaller was higher (P = 0.011) than that of stents larger than 3 mm. CONCLUSIONS Metal artifacts cause overlooking of nonsignificant stenosis.
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Holalkere NS, Matthes K, Kalva SP, Brugge WR, Sahani DV. 64-Slice multidetector row CT angiography of the abdomen: comparison of low versus high concentration iodinated contrast media in a porcine model. Br J Radiol 2010; 84:221-8. [PMID: 21081582 DOI: 10.1259/bjr/14535110] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
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.
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Affiliation(s)
- N-S Holalkere
- Boston Medical Center, Department of Radiology, Boston, MA 02118, USA.
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Arai T, Kondo T, Morita H, Sano T, Matsutani H, Sekine T, Shigoka N, Orihara T, Kondo M, Kodama T, Ooida A, Takase S. [What factors affected image quality in coronary multidetector-row computed tomography?]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2010; 66:1204-12. [PMID: 20975241 DOI: 10.6009/jjrt.66.1204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although it is well known that we usually cannot acquire a high quality coronary MDCT in patients with arrhythmia or incomplete breath-hold, we sometimes also cannot obtain a high quality coronary MDCT in patients without arrhythmia or incomplete breath-hold. PURPOSE We studied what factors other than arrhythmia or incomplete breath-hold affected image quality. METHODS Coronary MDCT and echocardiography were performed within one month in 2145 patients, and 452 cases of arrhythmia or 102 cases of incomplete breath-hold during scanning were eliminated. The remaining 1591 patients were studied. Those patients were divided into two groups (mid-diastolic phase reconstruction (MD) group (N=1377) and end-systolic phase reconstruction (ES) group (N=214)). Age, body weight, mean heart rate (HR) during scanning, temporal resolution (TR) and left ventricular ejection fraction (LVEF) by echocardiography were estimated. Image quality (A: Excellent (3 points), B: Acceptable (2 points), C: Unacceptable (1 point)) was evaluated. RESULTS The mean image quality points of the MD group (2.9±0.3) were significantly (P<0.0001) higher than the mean image quality points of the ES group (2.3±0.7), and the mean HR of the MD group (57±6 bpm) was significantly (P<0.0001) lower than that of the ES group (81±15 bpm). In the MD group, HR and TR were selected as significant factors affecting image quality by stepwise regression analysis. In the ES group, TR and HR were selected. In the ES subgroup with HR<90 bpm, TR and HR were selected; however, in the ES subgroup with HR≥90 bpm, TR and LVEF were selected. CONCLUSION In the MD group, low HR was important for high quality coronary MDCT. In the ES subgroup with HR<90, short TR and low HR were important; however, in the ES subgroup with HR≥90 bpm, TR and LVEF were more important than HR.
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Affiliation(s)
- Takehiro Arai
- Department of Radiological Technology, Takase Clinic
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Singh JP, Steward MJ, Booth TC, Mukhtar H, Murray D. Evolution of imaging for abdominal perforation. Ann R Coll Surg Engl 2010; 92:182-8. [PMID: 20412668 DOI: 10.1308/003588410x12664192075251] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Gastrointestinal (GI) perforation is a common surgical presentation. In recent years, computed tomography (CT) has been shown to be accurate for predicting the site of GI perforation, and has become the investigation of choice. However the signs may be subtle or only indirectly related to the site or aetiology of perforation. SUBJECTS AND METHODS A MEDLINE and PubMed search was performed for journals before June 2009 with MeSH major terms 'CT' and 'perforation'. Non-English speaking literature was excluded. RESULTS Examples of GI perforation of various aetiologies are reviewed (inflammatory, neoplastic, traumatic and iatrogenic) high-lighting characteristic CT appearances as well as pitfalls in diagnosis. Features of perforation include the presence of free gas or fluid within the supra- and/or inframesocolic compartments, segmental bowel wall thickening, bowel wall discontinuity, stranding of the mesenteric fat and abscess formation. CONCLUSIONS These differentiating features facilitate accurate multidisciplinary pre-operative evaluation, necessary to plan patient management and potential surgical approach.
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Affiliation(s)
- J P Singh
- Department of Radiology, The Whittington Hospital, Royal Free and University College Medical School, London, UK
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Saeed M, Hetts S, Wilson M. Reperfusion injury components and manifestations determined by cardiovascular MR and MDCT imaging. World J Radiol 2010; 2:1-14. [PMID: 21160735 PMCID: PMC2999314 DOI: 10.4329/wjr.v2.i1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 01/06/2010] [Accepted: 01/13/2010] [Indexed: 02/06/2023] Open
Abstract
Advances in magnetic resonance (MR) and computed tomography (CT) imaging have improved visualization of acute and scar infarct. Over the past decade, there have been and continues to be many significant technical advancements in cardiac MR and multi-detector computed tomography (MDCT) technologies. The strength of MR imaging relies on a variety of pulse sequences and the ability to noninvasively provide information on myocardial structure, function and perfusion in a single imaging session. The recent technical developments may also allow CT technologies to rise to the forefront for evaluating clinical ischemic heart disease. Components of reperfusion injury including myocardial edema, hemorrhage, calcium deposition and microvascular obstruction (MO) have been demonstrated using MR and CT technologies. MR imaging can be used serially and noninvasively in assessing acute and chronic consequences of reperfusion injury because there is no radiation exposure or administration of radioactive materials. MDCT is better suited for assessing coronary artery stenosis and as an alternative technique for assessing viability in patients where MR imaging is contraindicated. Changes in left ventricular (LV) volumes and function measured on cine MR are directly related to infarct size measured on delayed contrast enhanced images. Recent MR studies found that transmural infarct, MO and peri-infarct zone are excellent predictors of poor post-infarct recovery and mortality. Recent MR studies provided ample evidence that growth factor genes and stem cells delivered locally have beneficial effects on myocardial viability, perfusion and function. The significance of deposited calcium in acute infarct detected on MDCT requires further studies. Cardiac MR and MDCT imaging have the potential for assessing reperfusion injury components and manifestations.
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Role of 64-slice cardiac computed tomography in the evaluation of patients with non-ST-elevation acute coronary syndrome. Radiol Med 2009; 115:341-53. [PMID: 20017003 DOI: 10.1007/s11547-009-0482-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2009] [Accepted: 04/27/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE This study was done to evaluate the feasibility, sensitivity and specificity of 64-slice computed tomography (CT) in identifying haemodynamically significant (>50%) coronary artery stenoses in patients with suspected acute coronary syndrome (ACS) by correlating the CT findings with the clinical event and data provided by conventional coronary angiography (CCA). MATERIALS AND METHODS Sixty-four patients (38 men and 26 women; mean age 65 years; range+/-10 years) presenting to our hospital's emergency department with a clinical suspicion of ACS were studied with 64-slice CT followed by CCA within 24 h of arrival. RESULTS Two patients (3.1%) were excluded from the analysis due to artefacts. Per-patient analysis in the remaining 62 patients identified 24 cases (38.7%) of negative CT findings (no stenoses or stenoses <50%), 35 cases of positive CT findings (56.4%) with identification of the culprit lesion, two cases in which the culprit lesion was not identified and one patient with unconfirmed stenosis. Sensitivity and specificity were 94.6% and 96%, respectively. Per-vessel analysis (186 vessels) revealed 17 non-evaluable vessels (9.1%) due to motion artefacts, 61 vessels (32.8%) with stenosis >50%, seven overestimated vessels (3.7%) due to extensive calcifications, three vessels (1.6%) with underestimated stenosis and 98 vessels (52.6%) without stenosis. Sensitivity and specificity were 95.3% and 93.3%, respectively. CONCLUSIONS In this type of emergency, coronary CT angiography could lead to considerably lower healthcare costs by identifying patients without coronary disease and allowing immediate discharge without any need for further diagnostic procedures.
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Rubinshtein R, Halon DA, Gaspar T, Peled N, Lewis BS. Cardiac computed tomographic angiography for risk stratification and prediction of late cardiovascular outcome events in patients with a chest pain syndrome. Int J Cardiol 2009; 137:108-15. [PMID: 18718681 DOI: 10.1016/j.ijcard.2008.06.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 05/30/2008] [Accepted: 06/28/2008] [Indexed: 01/07/2023]
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Ertel D, Pflederer T, Achenbach S, Kalender WA. Real-time determination of the optimal reconstruction phase to control ECG pulsing in spiral cardiac CT. Phys Med 2009; 25:122-7. [DOI: 10.1016/j.ejmp.2008.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 07/10/2008] [Accepted: 08/19/2008] [Indexed: 10/21/2022] Open
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How many CT detector rows are necessary to perform adequate three dimensional visualization? Eur J Radiol 2009; 74:e144-8. [PMID: 19559549 DOI: 10.1016/j.ejrad.2009.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2008] [Accepted: 05/18/2009] [Indexed: 11/23/2022]
Abstract
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 differences did not reach statistical difference (p=0.53, Kruskal-Wallis test). CONCLUSION Even though 3D visualization is useful in operation planning, the quality of the 3D images appears to be not dependent of the number of CT detector rows.
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Tatsugami F, Kanamoto T, Nakai G, Takeda Y, Morita H, Morinaga I, Yoshikawa S, Narabayashi I. Reduction of the total injection volume of contrast material with a short injection duration in 64-detector row CT coronary angiography. Br J Radiol 2009; 83:35-9. [PMID: 19505968 DOI: 10.1259/bjr/23203690] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The ability of short injection duration of contrast material to reduce the total injection volume in 64-detector row CT coronary angiography was investigated. 45 patients were divided into three groups: (i) those receiving 0.8 ml kg(-1) of contrast material (350 mgI ml(-1)) injected with a fixed duration of 14 s (Group A; n = 16); (ii) those receiving 0.8 ml kg(-1) of contrast material injected with a fixed duration of 10 s (Group B; n = 15); and (iii) those receiving 0.7 ml kg(-1) of contrast material injected with a fixed duration of 10 s (Group C; n = 14). All patients then received 20 ml of saline. Contrast densities of the ascending aorta and proximal and distal coronary arteries were assessed where vessel diameters were >2.0 mm. The mean enhancement value in the ascending aorta for Group B was significantly higher than that for Groups A and C (p<0.05), whereas there was no significant difference between Groups A and C. All enhancement values in the coronary arteries were higher than 250 Hounsfield units. The mean enhancement value for each coronary artery in Group B was significantly higher than that for Group A (p<0.05), whereas there was no significant difference between Groups A and C. In conclusion, a short injection duration allows a reduction in the total volume of contrast material from 0.8 ml kg(-1) to 0.7 ml kg(-1) while a steady contrast enhancement is maintained in the ascending aorta and coronary arteries.
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Affiliation(s)
- F Tatsugami
- Department of Radiology, Osaka Medical College,Takatsuki City, Osaka 569-8686, Japan.
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Hur J, Kim YJ, Lee HJ, Ha JW, Heo JH, Choi EY, Shim CY, Kim TH, Nam JE, Choe KO, Choi BW. Cardiac Computed Tomographic Angiography for Detection of Cardiac Sources of Embolism in Stroke Patients. Stroke 2009; 40:2073-8. [DOI: 10.1161/strokeaha.108.537928] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jin Hur
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Jin Kim
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye-Jeong Lee
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong-Won Ha
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Hoe Heo
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Eui-Young Choi
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chi-Young Shim
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae Hoon Kim
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Eun Nam
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyu Ok Choe
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Wook Choi
- From Department of Diagnostic Radiology (J.H., Y.J.K., H.-J.L., T.H.K., J.E.N., K.O.C., B.W.C.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology (J.-W.H., E.-Y.C., C.-Y.S.), Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (J.H.H.), Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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Maffei E, Palumbo A, Martini C, Weustink A, Mollet N, Cademartiri F. Breast cancer in the heart. J Cardiovasc Med (Hagerstown) 2009; 10:423-4. [PMID: 19449456 DOI: 10.2459/jcm.0b013e3283293333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We present a case of a 46-year-old woman who presented to our institution with a history of quadrantectomy and a current progressive dyspnea. Multislice computed tomography of the heart and coronary arteries was performed with standard protocol. The investigation demonstrated a hypodense mass infiltrating the interventricular septum, the cardiac apex and the right ventricular chamber. The mass also surrounded the left anterior descending coronary artery without any sign of occlusion. Cardiac computed tomography is performed in the follow-up of almost all cancer patients. Therefore, we expect that the increased survival of patients with advanced stages of cancer will lead to more frequent encounters with this kind of finding in routine clinical investigations.
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Affiliation(s)
- Erica Maffei
- Department of Radiology, Azienda Ospedaliero-Universitaria di Parma, Italy
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Quantification and characterization of obstructive coronary plaques using 64-slice computed tomography: a comparison with intravascular ultrasound. J Comput Assist Tomogr 2009; 33:186-92. [PMID: 19346843 DOI: 10.1097/rct.0b013e31817c420f] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to determine the diagnostic accuracy of 64-slice computed tomography (CT) coronary angiography in the quantification and characterization of obstructive coronary plaques in comparison with intravascular ultrasound (IVUS). MATERIALS AND METHODS Thirty-nine patients were selected who underwent both CT coronary angiography (CTCA) and IVUS. For each stenotic site (n = 61), the maximum vessel cross-sectional area, lumen cross-sectional area, plaque area, and percentage of luminal obstruction were measured. Plaque composition was analyzed according to IVUS (plaque echogenicity and classified into several types: calcified, mixed, fibrous, and soft plaques) and CTCA criteria (Hounsfield units [HU]). The correlation between CTCA and IVUS measurements was determined using Pearson correlation coefficient. The statistical significance of differences in the CT densities of plaques among plaque types determined by IVUS was assessed using the Scheffe method. RESULTS The correlation coefficients for the measurements of the lumen, vessel, plaque area, and percentage of luminal obstruction were r = 0.712, r = 0.654, r = 0.753, and r = 0.799, respectively. The mean CT density values for soft (n = 10), fibrous (n = 11), mixed (n = 31), and calcified plaques (n = 9) were 54 +/- 13 HU, 82 +/- 17 HU, 162 +/- 57 HU, and 392 +/- 155 HU, respectively. Computed tomography density measurements were not significantly different between soft and fibrous plaques (P = 0.224). CONCLUSIONS Sixty-four-slice CTCA is a noninvasive modality that allows quantification of coronary artery plaques. However, reliable classification of noncalcified plaques as vulnerable or stable plaques based on CT density measurements is currently limited.
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Tsiflikas I, Brodoefel H, Reimann AJ, Thomas C, Ketelsen D, Schroeder S, Kopp AF, Claussen CD, Burgstahler C, Heuschmid M. Coronary CT angiography with dual source computed tomography in 170 patients. Eur J Radiol 2009; 74:161-5. [PMID: 19261419 DOI: 10.1016/j.ejrad.2009.01.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2008] [Revised: 01/08/2009] [Accepted: 01/30/2009] [Indexed: 12/21/2022]
Abstract
INTRODUCTION In preliminary studies DSCT provides robust image quality over a wide range of heart rates and excludes CAD with high accuracy. The aim of the present study was to evaluate the reproducibility of these results in a large, unselected and consecutive group of patients scheduled for invasive coronary angiography (ICA). MATERIAL AND METHODS 170 patients (124 men, 46 women; mean age: 64+/-9 years) with known CAD (101 patients) or suspected CAD (69 patients) scheduled for ICA were examined by coronary CTA prior to ICA. All coronary segments were assessed for image quality (1: excellent; 5: non-diagnostic). The presence of significant vessel stenosis (>50%) was calculated using ICA as standard of reference. RESULTS A total of 680 vessels were analyzed. Despite of 45 arrythmic patients all analyzed coronary segments were diagnostically evaluable. Mean Agatston score equivalent was 686 (range 0-4950). ICA revealed 364 lesions with > or =50% diameter stenosis. DSCT correctly identified 336 of these lesions. 115 lesions with a diameter stenosis < or =50% were overestimated by DSCT and thus considered as false-positive findings. On a per-segment basis, sensitivity was 92%, specificity 93%, positive predictive value (PPV) was 75% and negative predictive value (NPV) 98%. On a per-vessel basis DSCT revealed a sensitivity of 93%, a specificity of 88%, a PPV of 78% and a NPV of 97%. On a per-patient basis sensitivity was 94%, specificity 79%, PPV 88% and NPV 90%. CONCLUSIONS Initial results of preliminary studies showing robust image quality and high accuracy in DSCT cardiac imaging could be approved with the present study enclosing a large consecutive population. However severe coronary calcifications and irregular heart rate still remain limiting factors for coronary CTA. Despite improved image quality and high accuracy of coronary DSCT angiography, proof of indication is necessary, due to still remaining limiting factors.
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Affiliation(s)
- Ilias Tsiflikas
- University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.
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Fei X, Du X, Bai M, Li Y, Li P, Wei L, Li K. An Objective Evaluation Method Designed for Pulsating Cardiac Phantom with 64-row MDCT. J Med Syst 2009; 34:349-55. [DOI: 10.1007/s10916-008-9247-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ibanez B, Cimmino G, Bénézet-Mazuecos J, Santos-Gallego CG, Pinero A, Prat-González S, Speidl WS, Fuster V, García MJ, Sanz J, Badimon JJ. Quantification of serial changes in plaque burden using multi-detector computed tomography in experimental atherosclerosis. Atherosclerosis 2009; 202:185-91. [DOI: 10.1016/j.atherosclerosis.2008.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 02/28/2008] [Accepted: 03/20/2008] [Indexed: 10/22/2022]
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Pan X, Sidky EY, Vannier M. Why do commercial CT scanners still employ traditional, filtered back-projection for image reconstruction? INVERSE PROBLEMS 2009; 25:1230009. [PMID: 20376330 PMCID: PMC2849113 DOI: 10.1088/0266-5611/25/12/123009] [Citation(s) in RCA: 190] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Despite major advances in x-ray sources, detector arrays, gantry mechanical design and especially computer performance, one component of computed tomography (CT) scanners has remained virtually constant for the past 25 years-the reconstruction algorithm. Fundamental advances have been made in the solution of inverse problems, especially tomographic reconstruction, but these works have not been translated into clinical and related practice. The reasons are not obvious and seldom discussed. This review seeks to examine the reasons for this discrepancy and provides recommendations on how it can be resolved. We take the example of field of compressive sensing (CS), summarizing this new area of research from the eyes of practical medical physicists and explaining the disconnection between theoretical and application-oriented research. Using a few issues specific to CT, which engineers have addressed in very specific ways, we try to distill the mathematical problem underlying each of these issues with the hope of demonstrating that there are interesting mathematical problems of general importance that can result from in depth analysis of specific issues. We then sketch some unconventional CT-imaging designs that have the potential to impact on CT applications, if the link between applied mathematicians and engineers/physicists were stronger. Finally, we close with some observations on how the link could be strengthened. There is, we believe, an important opportunity to rapidly improve the performance of CT and related tomographic imaging techniques by addressing these issues.
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Affiliation(s)
- Xiaochuan Pan
- Department of Radiology MC-2026, The University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
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Matsutani H, Sano T, Kondo T, Sekine T, Arai T, Morita H, Takase S. [Optimization of helical pitch in cardiac MDCT acquisition in patients with arrhythmia requiring ECG-edit]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2008; 64:1343-1351. [PMID: 19060428 DOI: 10.6009/jjrt.64.1343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The ECG-edit is necessary in cardiac MDCT in arrhythmias [premature atrial contraction (PAC) or premature ventricular contraction (PVC)]; however, it sometimes results in a data deficit. Therefore, a thinner helical pitch (HP) should be set to avoid data deficits. The thinner helical pitch creates more radiation exposure. The purpose is to optimize HP in PAC or PVC. In a phantom study, an acrylic phantom (10x10x500 mm) was scanned by MDCT (Aquilion 64) using an artificial pacemaker at various gantry rotation speeds (r) and HP. We evaluated the relationships between HP and the maximal table moving length (Lmax) in the border of data deficit, and among r, HP, and the maximum data collection time interval (Tmax). In the clinical study, cardiac MDCT was performed in 44 cases (M/F: 26/18, 71.4+/-10.6yrs) including 30 PAC and 14 PVC using the optimal HP derived from Tmax+10%. In the phantom study, there were significant correlations between HP and Lmax (Lmax=34.94-0.32 HP... (1), r=0.999, P<0.0001), and Tmax [Tmax= (69.88/HP-0.64)xr] was calculated using formula (1). In 42/44 patients, high-quality images were obtained using the optimal HP; however, it resulted in data deficits in 2 patients, because of heart rate decreasing and a couple of PAC during scanning. Optimal HP significantly (P<0.0001) reduced radiation dose (-11.4%) compared with conventional HP. In conclusion, the optimal HP in PAC or PVC was calculated from the phantom study, provided fine images in 95% patients, and could reduce radiation dose.
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Choi BJ, Kang DK, Tahk SJ, Choi SY, Yoon MH, Lim HS, Kang SJ, Yang HM, Park JS, Zheng M, Hwang GS, Shin JH. Comparison of 64-slice multidetector computed tomography with spectral analysis of intravascular ultrasound backscatter signals for characterizations of noncalcified coronary arterial plaques. Am J Cardiol 2008; 102:988-93. [PMID: 18929698 DOI: 10.1016/j.amjcard.2008.05.060] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 05/23/2008] [Accepted: 05/23/2008] [Indexed: 01/17/2023]
Abstract
In vivo identification of plaque composition may allow the detection of vulnerable plaques before rupture. However, the clinical relevance of multidetector computed tomography (MDCT) in characterizing coronary plaques is currently a subject of debate. We compared 64-slice MDCT with virtual histology to investigate the potential role of 64-slice MDCT in the differentiation of composition of noncalcified coronary plaques. Fifty-nine consecutive patients (stable/unstable angina 34/21) were enrolled. Mean computed tomographic (CT) density (Hounsfield units) of noncalcified coronary plaques (n = 80) was compared with a relative volume of each plaque component (fibrous, fibrofatty, calcium, and necrotic core) analyzed by virtual histology. Mean heart rate during MDCT was 58 +/- 9 beats/min. There was a negative correlation between mean CT density and the necrotic core (r = -0.539, p <0.001) and a positive correlation between mean CT density and the fibrotic tissue component (r = 0.571, p <0.001). Mean CT density of the plaques with a <10% necrotic core was significantly higher than that of a >or=10% necrotic core (93.1 +/- 37.5 vs 41.3 +/- 26.4 HU, p <0.001). However, overlapping of mean CT densities between plaques with a <10% necrotic core and those with a >or=10% necrotic core was found. In conclusion, mean CT density of noncalcified coronary plaques measured by 64-slice MDCT may depend on the relative volumes of the necrotic core and fibrotic component. Sixty-four-slice MDCT may have the potential for determining composition of noncalcified coronary plaques, which needs further studies for clinical application.
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Hur J, Kim YJ, Nam JE, Choe KO, Choi EY, Shim CY, Choi BW. Thrombus in the Left Atrial Appendage in Stroke Patients: Detection with Cardiac CT Angiography—A Preliminary Report. Radiology 2008; 249:81-7. [DOI: 10.1148/radiol.2491071544] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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64-MDCT coronary angiography: phantom study of effects of vascular attenuation on detection of coronary stenosis. AJR Am J Roentgenol 2008; 191:43-9. [PMID: 18562723 DOI: 10.2214/ajr.07.2653] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of vascular attenuation on the accuracy of stenosis evaluation with 64-MDCT coronary angiography. MATERIALS AND METHODS A pulsating cardiac phantom was used to simulate the beating heart and coronary arteries of 5 and 3 mm in diameter with three degrees of stenosis (25%, 50%, and 75%) at a heart rate of 55 beats per minute. Coronary vascular enhancement had four attenuation levels: low, 200 H; moderately low, 300 H; moderately high, 350 H; and high, 500 H. Cardiac scans were obtained with 64-MDCT. Percentage stenosis, plaque area, and plaque density were measured on axial images. RESULTS For 50% and 75% stenosis in 5-mm vessels, there were no significant differences among the four attenuation groups. For 50% and 75% stenosis in 3-mm vessels, significant underestimation of percentage stenosis occurred in the high-attenuation group compared with the moderate- and low-attenuation groups (p < 0.05). For 25% stenosis in 5-mm vessels, low attenuation led to significant overestimation of degree of stenosis compared with the moderate and high attenuation levels (p < 0.05). None of the instances of 25% stenosis in 3-mm vessels were detected in the high-attenuation group. Underestimation was found only for 3-mm vessels. For 75% stenosis, all plaques were detected irrespective of contrast attenuation and vessel size. CONCLUSION Use of higher attenuation leads to a significant underestimation of stenosis in smaller vessels. Lower attenuation leads to slight and clinically acceptable overestimation of stenosis. The optimal vascular attenuation for stenosis detection in coronary 64-MDCT angiography is approximately 350 H.
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Fei X, Du X, Li P, Liao J, Shen Y, Li K. Effect of dose-reduced scan protocols on cardiac coronary image quality with 64-row MDCT: A cardiac phantom study. Eur J Radiol 2008; 67:85-91. [PMID: 17765422 DOI: 10.1016/j.ejrad.2007.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2007] [Revised: 07/23/2007] [Accepted: 07/23/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the feasibility of using relative low-dose scan protocols in coronary imaging with 64-row MDCT. MATERIALS AND METHODS A pulsating cardiac phantom was used to simulate coronary arteries of two sizes (3 and 5mm in diameter) with three stenosis degrees (25, 50 and 75%) at 55bpm heart rate. Cardiac scans were performed on a 64-row MDCT scanner (GE LightSpeed VCT) with rotation time of 350ms and pitch of 0.2 under six different scan protocols: 120kV/650mA, 1137.5mAs (effective) (CTDI(vol) 121.69mGy), 120kV/550mA, 962.5mAs (CTDI(vol) 102.96mGy), 120kV/450mA, 787.5mAs (CTDI(vol) 84.24mGy), 120kV/350mA, 612.5mAs (CTDI(vol) 65.52mGy), 100kV/590mA, 1032.5mAs (CTDI(vol) 65.17mGy) and 140kV/390mA, 682.5mAs (CTDI(vol) 102.22mGy). The simulative coronary arteries were filled with contrast media to reach 300HU in the lumen. Background noise was measured to describe the basic image quality accordingly. CNR, SNR and contour sharpness represented in slope of CT density curve was calculated as well. Measured stenosis area and rates, described by the percentage area of stenosis on the cross-section images were also calculated. RESULTS The corresponding image noise levels described in standard deviation of background signals varied with radiation dose, CNR and SNR mainly varied with tube current. The contour sharpness, which can reflect actual spatial resolution, is affected mainly by tube voltage. The first five protocols depicted obviously steeper curves than the sixth one (P<0.05). As for 25% stenosis, there was no significant difference among the stenosis rates of the six protocols (P>0.05). As for evaluation on 50 and 75% stenosis, there was no significant difference between the first two protocols, and between the second two protocols as well. However, significant difference presented between these two groups (P>0.05). When comparing the groups with similar radiation dose, protocols with lower tube voltage gain more accuracy in representing stenosis area and rate. CONCLUSION Dose level and corresponding image quality is relevant to the accuracy of stenosis evaluation on simulated coronary arteries with 64-row MDCT. In this study, we find relative low-dose protocols with acceptable image quality showed a tendency of overestimating stenosis. Furthermore, using a lower tube voltage and higher tube current to gain accurate imaging result is more applicable than other protocols with the same radiation dose level.
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Affiliation(s)
- Xiaolu Fei
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China.
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Anomalous origin of the left circumflex artery from the right coronary sinus with an interarterial course: diagnosis with multidetector row computed tomography. J Thorac Imaging 2008; 23:142-4. [PMID: 18520575 DOI: 10.1097/rti.0b013e31815b8993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a case of an anomalous origin of the left circumflex coronary artery from the right coronary sinus passing between the pulmonary artery and the aorta (interarterial course) diagnosed by multidetector row computed tomography.
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