1
|
Scheschenja M, König A, Viniol S, Bastian MB, Wessendorf J, Mahnken AH. CT angiography of the lower limbs: combining small field of view with large matrix size and iterative reconstruction further improves image quality of below-the-knee arteries. Acta Radiol 2024:2841851241258655. [PMID: 38841768 DOI: 10.1177/02841851241258655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Image quality and diagnostic accuracy in computed tomography angiography (CTA) reach their limits in imaging of below-the-knee vessels. PURPOSE To evaluate whether image quality in CTA of lower limbs is further improvable by combining side-separate reconstruction with a larger matrix size and whether resulting noise can be compromised with iterative reconstruction (IR). MATERIAL AND METHODS From CTA of the lower extremities of 26 patients (5 women, 21 men; mean age = 68.5 ± 10.3 years), the lower legs were reconstructed side-separately with different reconstruction algorithms and matrix sizes including filtered back projection (FBP) with a 512 × 512 matrix, FBP with a 1024 × 1024 matrix, IR (SAFIRE) with a 512 × 512 matrix, and IR (SAFIRE) with a 1024 × 1024 matrix. A total of 208 CT series were evaluated. Subjective image quality was assessed by two readers using a 5-point Likert scale. Image noise was assessed by measuring signal-to-noise and contrast-to-noise ratios. RESULTS Subjective image quality was rated significantly higher when using a 1024 × 1024 matrix (P < 0.001) and could further be increased with IR. Vessel sharpness was rated significantly better with a larger matrix (P < 0.001). Visible and measured image noise was significantly higher with a 1024 × 1024 matrix but could be reduced by using IR (P < 0.001), even to a level below FBP with a 512 × 512 matrix while reconstructing with a larger matrix (P < 0.001). CONCLUSION Image quality, image noise, and vessel sharpness can be further improved in CTA of the lower extremities with side-separate reconstruction using a 1024 × 1024 matrix size and IR.
Collapse
Affiliation(s)
- Michael Scheschenja
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, Marburg, Germany
| | - Alexander König
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, Marburg, Germany
| | - Simon Viniol
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, Marburg, Germany
| | - Moritz B Bastian
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, Marburg, Germany
| | - Joel Wessendorf
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, Marburg, Germany
| | - Andreas H Mahnken
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, Marburg, Germany
| |
Collapse
|
2
|
Salimova N, Hinrichs JB, Gutberlet M, Meyer BC, Wacker FK, von Falck C. The impact of the field of view (FOV) on image quality in MDCT angiography of the lower extremities. Eur Radiol 2021; 32:2875-2882. [PMID: 34902060 PMCID: PMC9038851 DOI: 10.1007/s00330-021-08391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/14/2021] [Accepted: 10/07/2021] [Indexed: 11/30/2022]
Abstract
Objectives To evaluate the impact of the reconstructed field-of-view (FOV) on image quality in computed-tomography angiography (CTA) of the lower extremities.
Methods A total of 100 CTA examinations of the lower extremities were acquired on a 2 × 192-slice multidetector CT (MDCT) scanner. Three different datasets were reconstructed covering both legs (standard FOV size) as well as each leg separately (reduced FOV size). The subjective image quality was evaluated for the different vessel segments (femoral, popliteal, crural, pedal) by three readers using a semi-quantitative Likert scale. Additionally, objective image quality was assessed using an automated image quality metric on a per-slice basis. Results The subjective assessment of the image quality showed an almost perfect interrater agreement. The image quality of the small FOV datasets was rated significantly higher as compared to the large datasets for all patients and vessel segments (p < 0.05) with a tendency towards a higher effect in smaller vessels. The difference of the mean scores between the group with the large FOV and small FOV was 0.68 for the femoral level, 0.83 for the popliteal level, 1.12 for the crural level, and 1.08 for the pedal level. The objective image quality metric also demonstrated a significant improvement of image quality in the small FOV datasets. Conclusions Side-separated reconstruction of each leg in CTA of the lower extremities using a small reconstruction FOV significantly improves image quality as compared to a standard reconstruction with a large FOV covering both legs. Key Points • In CT angiography of the lower legs, the side-separated reconstruction of each leg using a small field-of-views improves image quality as compared to a standard reconstruction covering both legs. • The side-separated reconstruction can be readily implemented at every commercially available CT scanner. • There is no need for additional hardware or software and no additional burden to the patient.
Collapse
Affiliation(s)
- Nigar Salimova
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Jan B Hinrichs
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Marcel Gutberlet
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Bernhard C Meyer
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Frank K Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Christian von Falck
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| |
Collapse
|
3
|
Kan H, van der Zant FM, Wondergem M, Knol RJJ. Incidental extra-cardiac findings on 13N-ammonia myocardial perfusion PET/CT. J Nucl Cardiol 2017; 24:1860-1868. [PMID: 28390039 DOI: 10.1007/s12350-017-0824-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 02/06/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The objective of this study was to describe the prevalence of incidental extra-cardiac findings (IECFs) on myocardial perfusion PET/CTs and the prevalence of potentially clinically relevant and clinically irrelevant IECFs, as well as detection rate of previously unknown malignancies. METHODS AND RESULTS From September 2013 until February 2016, a total of 1397 consecutive patients referred for the evaluation of possible ischemia by 13NH3 PET/CT were prospectively included in a database. IECFs were categorized into three groups: potentially clinically relevant IECFs, IECFs that could potentially cause chest pain, and clinically irrelevant IECFs. Additionally, the prevalence of previously unknown malignancies was determined. In 717 (51%) of these patients, 775 IECFs were reported and 115 IECFs were categorized as potentially clinically relevant in 109 (8%) patients. A total of 145 IECFs that could potentially cause chest pain were detected in 139 (10%) patients and 515 clinically irrelevant IECFs were detected in 469 (34%) of the patients. An unknown primary malignancy was histologically proven in 19 patients (1.4%). CONCLUSIONS IECFs are detected on myocardial perfusion PET/CT in approximately half of the patients. In the present study, IECFs were potentially clinically relevant in 8% of the patients and in 1.4% an unknown malignancy was found, most of which were lung cancers.
Collapse
Affiliation(s)
- H Kan
- Cardiac Imaging Division Alkmaar, Northwest Clinics, Alkmaar, The Netherlands.
- Department of Nuclear Medicine, Northwest Clinics, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
| | - F M van der Zant
- Cardiac Imaging Division Alkmaar, Northwest Clinics, Alkmaar, The Netherlands
- Department of Nuclear Medicine, Northwest Clinics, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands
| | - M Wondergem
- Cardiac Imaging Division Alkmaar, Northwest Clinics, Alkmaar, The Netherlands
- Department of Nuclear Medicine, Northwest Clinics, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands
| | - R J J Knol
- Cardiac Imaging Division Alkmaar, Northwest Clinics, Alkmaar, The Netherlands
- Department of Nuclear Medicine, Northwest Clinics, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands
| |
Collapse
|
4
|
Htwe Y, Cham MD, Henschke CI, Hecht H, Shemesh J, Liang M, Tang W, Jirapatnakul A, Yip R, Yankelevitz DF. Coronary artery calcification on low-dose computed tomography: comparison of Agatston and Ordinal Scores. Clin Imaging 2015; 39:799-802. [PMID: 26068098 DOI: 10.1016/j.clinimag.2015.04.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/03/2015] [Accepted: 04/07/2015] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To compare Agatston with Ordinal Scores for the extent of coronary artery calcification (coronary artery calcium) using nongated low-dose computed tomography (CT) scans. MATERIALS AND METHODS A total of 631 asymptomatic participants had CT scans from 2010 to 2013. Their Ordinal and Agatston Score were classified into categories. RESULTS The Ordinal Score Categories showed excellent agreement (weighted kappa of 0.83; 95% confidence interval: 0.79-0.88) with the Agatston Score Categories. CONCLUSIONS The use of the Ordinal Score is readily obtained on low-dose CT scans that are used for CT screening for lung cancer and these scores are useful for risk stratification of coronary artery disease.
Collapse
Affiliation(s)
- Yu Htwe
- Department of Radiology, Mount Sinai School of Medicine, New York, NY
| | - Matthew D Cham
- Department of Radiology, Mount Sinai School of Medicine, New York, NY; Division of Cardiology, Mount Sinai School of Medicine, New York, NY
| | | | - Harvey Hecht
- Division of Cardiology, Mount Sinai School of Medicine, New York, NY
| | - Joseph Shemesh
- Department of Cardiology, The Grace Ballas Cardiac Research Unit Sheba Medical Center, Tel Hashomer, Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Mingzhu Liang
- Department of Radiology, Mount Sinai School of Medicine, New York, NY; Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wei Tang
- Department of Radiology, Mount Sinai School of Medicine, New York, NY; Department of Diagnostic Radiology, Cancer Hospital Chinese Academy of Medical Sciences and National Cancer Center of China, Beijing, China
| | | | - Rowena Yip
- Department of Radiology, Mount Sinai School of Medicine, New York, NY
| | | |
Collapse
|
5
|
Sohns C, Sossalla S, Vollmann D, Luethje L, Seegers J, Schmitto JD, Zabel M, Obenauer S. Extra cardiac findings by 64-multidetector computed tomography in patients with symptomatic atrial fibrillation prior to pulmonal vein isolation. Int J Cardiovasc Imaging 2010; 27:127-34. [PMID: 20549365 PMCID: PMC3035788 DOI: 10.1007/s10554-010-9653-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Accepted: 06/03/2010] [Indexed: 12/21/2022]
Abstract
The aim of this study was to investigate the prevalence of extracardiac findings diagnosed by 64-multidetector computed tomography (MDCT) examinations prior to circumferential pulmonary vein (PV) ablation of atrial fibrillation (AF). A total of 158 patients (median age, 60.5 years; male 68%) underwent 64-MDCT of the chest and upper abdomen to characterize left atrial and PV anatomy prior to AF ablation. MDCT images were evaluated by a thoracic radiologist and a cardiologist. For additional scan interpretation, bone, lung, and soft tissue window settings were used. CT scans with extra-cardiac abnormalities categorized for the anatomic distribution and divided into two groups: Group 1—exhibiting clinically significant or potentially significant findings, and Group 2—patients with clinically non-significant findings. Extracardiac findings (n = 198) were observed in 113/158 (72%) patients. At least one significant finding was noted in 49/158 patients (31%). Group 1 abnormalities, such as malignancies or pneumonias, were found in 85/198 findings (43%). Group 2 findings, for example mild degenerative spine disease or pleural thickening, were observed in 113/198 findings (72%). 74/198 Extracardiac findings were located in the lung (37%), 35/198 in the mediastinum (18%), 8/198 into the liver (4%) and 81/198 were in other organs (41). There is an appreciable prevalence of prior undiagnosed extracardiac findings detected in patients with AF prior to PV-Isolation by MDCT. Clinically significant or potentially significant findings can be expected in ~40% of patients who undergo cardiac MDCT. Interdisciplinary trained personnel is required to identify and interpret both cardiac and extra cardiac findings.
Collapse
Affiliation(s)
- Christian Sohns
- Department of Cardiology and Pneumology/Heart Center, Georg-August-University, Göttingen, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Influence of pixel size on quantification of airway wall thickness in computed tomography. J Comput Assist Tomogr 2009; 33:725-30. [PMID: 19820501 DOI: 10.1097/rct.0b013e318190699a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The purpose of this study was to determine the point where a further decrease in voxel size does not result in better automatic quantification of the bronchial wall thickness by using 2 different assessment techniques. MATERIALS AND METHODS The results from the commonly used full-width-at-half-maximum (FWHM) principle and a new technique (integral-based method [IBM]) were compared for thin-section multidetector computed tomography (MDCT) data sets from an airway phantom containing 10 different tubular airway phantoms and in a human subsegmental bronchus in vivo. Correlation with the actual wall thickness and comparison of the wall thicknesses assessed for different voxel sizes were performed, and the image resolutions were also compared subjectively. RESULTS The relative error ranged from 0% (biggest phantom) to 330% (smallest phantom, biggest field of view, smaller matrix, and FWHM). Using IBM, the maximum relative error was 10% in the same setting. For FWHM, the improvement was marginal for most settings with a pixel spacing less than 0.195 x 0.195 x 0.8 mm; however, it still decreases the relative error from 290% to 273.6% for a wall thickness of 0.3 mm and a pixel spacing of 0.076 x 0.076 x 0.8 mm. CONCLUSIONS (1) Using a special technique such as IBM to account for computed tomography's blurring effect in assessing airway wall thickness had the greatest impact on correct quantification. (2) The visual impression and the automatic quantification using the FWHM technique improved marginally by decreasing the voxel size to less than 0.195 x 0.195 x 0.8 mm. (3) The FWHM technique as a model for visual quantification is not reliable for airway wall thicknesses less than 1.5 mm.
Collapse
|
7
|
Aglan I, Jodocy D, Hiehs S, Soegner P, Frank R, Haberfellner B, Klauser A, Jaschke W, Feuchtner GM. Clinical relevance and scope of accidental extracoronary findings in coronary computed tomography angiography: a cardiac versus thoracic FOV study. Eur J Radiol 2009; 74:166-74. [PMID: 19268514 DOI: 10.1016/j.ejrad.2009.01.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2008] [Revised: 01/26/2009] [Accepted: 01/29/2009] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the spectrum and clinical relevance of extracoronary findings in coronary CT angiography (CCTA), and to compare a small (cardiac) field of view (FOV) to a large (thoracic) FOV setting. MATERIAL AND METHODS 1084 consecutive patients (mean 57 years) with low-to-intermediate risk of coronary artery disease were enrolled. 542 CCTA scans were interpreted with small FOV (160-190mm(2)) encompassing the cardiac region. In another 542 CCTA (patients matched for age and gender), read-out of an additional full FOV (>320mm(2)) covering the thorax was performed. Clinical relevance of extracoronary findings was considered as either "significant" or "non-significant". "Significant" findings were subclassified as either score 1: findings necessitating immediate therapeutic actions, or score 2: findings with undoubted clinical or prognostic relevance, requiring clinical awareness, follow-up or further investigations (non-urgent). "Non-significant" findings were assigned to either score 3: findings not requiring follow-up or further tests, or as score 4: irrelevant incidental findings. RESULTS Significantly more patients with extracoronary findings were identified by using a full FOV with 43.2% (234/542) compared to a small FOV with 33.6% (182/542) (p=0.001). Similarly, a higher total number of extracoronary findings (n=394) was found on full FOV compared to small FOV (n=250) (p<0.001). The detection rate of clinically significant findings was higher by using full FOV compared to small FOV (25.6% versus 15.4%) (p<0.001), out of those 2.2% versus 1.8% of findings required immediate actions (score 1), and 23.4% versus 13.6% (p=0.0001), respectively were of clinical relevance (non-urgent, score 2). The rate of malign findings was 0.2%, and of acute pulmonary embolism 0.1%. More lung pathologies were observed by using full FOV compared to small FOV (22% versus 7%) (p<0.0001), and the detection rate of intrapulmonary nodules increased by 2.1%. Prevalence of aortic valve calcification (n=72) was 13.3%, out of those 7% had less than 2cm(2) aortic valve orifice area. CONCLUSIONS The interpretation of extracoronary findings on CCTA scans is mandatory given high prevalence of clinically significant findings by using a full "thoracic" FOV.
Collapse
Affiliation(s)
- Iman Aglan
- Department of Radiology II, Innsbruck Medical University, Innsbruck, Austria
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Sarwar A, Rieber J, Mooyaart EAQ, Seneviratne SK, Houser SL, Bamberg F, Raffel OC, Gupta R, Kalra MK, Pien H, Lee H, Brady TJ, Hoffmann U. Calcified Plaque: Measurement of Area at Thin-Section Flat-Panel CT and 64-Section Multidetector CT and Comparison with Histopathologic Findings. Radiology 2008; 249:301-6. [PMID: 18710960 DOI: 10.1148/radiol.2483072003] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Ammar Sarwar
- Cardiac MR PET CT Program, Massachusetts General Hospital, 165 Cambridge St, 4th Floor, Suite 400, Boston, MA 02114, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Thomaz FB, Lopez GE, Marchiori E, Magalhães FV, Magalhães IFD, Kuroki IR, Caramalho MF, Domingues RC. Avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores. Radiol Bras 2008. [DOI: 10.1590/s0100-39842008000400003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Este estudo tem como objetivo a avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores. MATERIAIS E MÉTODOS: Foram analisadas, retrospectivamente, angiotomografias de 166 pacientes (137 homens e 29 mulheres) com idade média de 73 anos portadores de aneurisma da aorta abdominal submetidos a terapêutica endovascular, no período de junho de 2005 a agosto de 2006. Os exames foram feitos em tomógrafo multidetector de 64 canais e os parâmetros adotados foram: colimação, 0,625 mm; pitch, 0,6-1; mAs, 300-400; kV, 120. Em todos os casos foi utilizado meio de contraste iodado não-iônico (350 mg/ml) administrado por meio de bomba infusora, com fluxo de 4 ml/s a 5 ml/s e com volume variável de 70 ml a 100 ml. Os exames foram avaliados quanto à presença de complicações. RESULTADOS: Dos 166 exames realizados, 93 pacientes não apresentaram complicações e 73 apresentaram os seguintes achados: endoleak (n=37), trombose circunferencial da endoprótese (n=29), angulação (n=17), coleção no sítio de punção (n=10), migração da prótese (n=7), dissecção dos vasos de acesso (n=7) e oclusão (n=6). CONCLUSÃO: O endoleak foi a complicação mais prevalente em nosso estudo, sendo o tipo II o mais comum.
Collapse
Affiliation(s)
| | | | - Edson Marchiori
- Universidade Federal Fluminense; Universidade Federal do Rio de Janeiro, Brasil
| | | | | | | | | | | |
Collapse
|
10
|
Law YM, Huang J, Chen K, Cheah FK, Chua T. Prevalence of significant extracoronary findings on multislice CT coronary angiography examinations and coronary artery calcium scoring examinations. J Med Imaging Radiat Oncol 2008; 52:49-56. [PMID: 18373827 DOI: 10.1111/j.1440-1673.2007.01911.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The purpose of the study was to review the prevalence of significant extracoronary findings in patients who underwent multislice CT coronary angiography examinations and coronary artery calcium scoring examinations. We reviewed the reports of 295 consecutive patients who underwent multislice CT coronary angiography examinations and 140 consecutive patients who had separate coronary calcium scoring examinations from September 2004 to March 2006 in our department's radiology information system. Additional investigations carried out as a result of these findings were also recorded. Fifty-six (19%) out of 295 patients had significant extracoronary findings on coronary CT angiography requiring clinical or radiological follow up. There were 60 significant extracoronary findings. These included 24 patients who had pulmonary abnormalities, 4 who had mediastinal abnormalities, 20 who had upper abdominal abnormalities and 5 who had non-coronary cardiac abnormalities. Three patients had both pulmonary and upper abdominal abnormalities. Eleven (8%) out of 140 patients had significant pulmonary, breast, mediastinal, upper abdominal and cardiac abnormalities on coronary artery calcium scoring examinations, yielding a total of 12 significant findings. In our experience, 19% of the patients who underwent multislice CT coronary angiography and 8% of the patients who underwent coronary artery calcium scoring examinations had significant extracoronary findings requiring follow up. It is therefore imperative for the reporting physician to review the entire examination after the coronary arteries have been assessed. The prevalence of extracoronary findings on these examinations may be of significance, resulting in additional 'hidden costs' if widespread 'screening' is adopted.
Collapse
Affiliation(s)
- Y M Law
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
| | | | | | | | | |
Collapse
|
11
|
Coronary artery calcium score: has anything changed? Radiol Med 2007; 112:949-58. [DOI: 10.1007/s11547-007-0195-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 02/26/2007] [Indexed: 10/22/2022]
|
12
|
Haller S, Kaiser C, Buser P, Bongartz G, Bremerich J. Coronary Artery Imaging with Contrast-Enhanced MDCT: Extracardiac Findings. AJR Am J Roentgenol 2006; 187:105-10. [PMID: 16794163 DOI: 10.2214/ajr.04.1988] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of our study was to evaluate the incidence of extracardiac findings on contrast-enhanced MDCT of the coronary arteries and to assess the effect of different field-of-view settings. SUBJECTS AND METHODS Patients with suspected coronary artery disease (n = 166) were examined with contrast-enhanced MDCT (16 x 0.75 mm focused on the heart) during injection of contrast material (80 mL injected at a rate of 4 mL/sec) followed by saline (20 mL injected at 4 mL/sec). Retrospectively gated images were reconstructed at a 1-mm slice thickness and a 0.5-mm increment with isotropic voxels of 1 mm3. Images were reviewed for extracardiac findings, which were then classified as none, minor, or major with respect to their impact on patient management and treatment. In a different group of patients (n = 20), chest scans (16 x 1.5 mm) were used for measuring volumes of displayed body structures on wholechest scans, coronary artery MDCT images, and coronary artery MDCT images reconstructed with the maximum field of view. RESULTS Extracardiac findings were detected in 41 patients (24.7%). Findings were classified as minor (19.9%) or major (4.8%). Among the major findings, which had an immediate impact on patient management and treatment, were bronchial carcinoma and pulmonary emboli. Volume analysis revealed that 35.5% of the total chest volume was displayed on dedicated coronary artery MDCT focused on the heart, whereas 70.3% of the chest was visible when coronary artery MDCT raw data were reconstructed with the maximal field of view (p < 0.001). CONCLUSION Coronary artery MDCT can reveal important findings and disease in extracardiac structures. Thus, the entire examination should be reconstructed with the maximum field of view and should be reviewed by a qualified radiologist.
Collapse
Affiliation(s)
- Sabine Haller
- Department of Radiology, University Hospital Basel, Petersgraben 4, Basel CH-4054, Switzerland
| | | | | | | | | |
Collapse
|
13
|
Mahnken AH, Mühlenbruch G, Koos R, Das M, Pohl S, Stanzel S, Günther RW, Wildberger JE. Influence of a small field-of-view size on the detection of coronary artery calcifications with MSCT: in vitro and in vivo study. Eur Radiol 2005; 16:358-64. [PMID: 16132923 DOI: 10.1007/s00330-005-2881-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2005] [Revised: 07/03/2005] [Accepted: 07/28/2005] [Indexed: 10/25/2022]
Abstract
The purpose of this study is to asses the impact of small field-of-view (FOV) sizes on the detection of coronary artery calcifications using multislice-spiral computed tomography (MSCT). First, a static chest phantom containing calcium inserts was scanned 10 times using a standardized scan protocol. Secondly, 50 patients (28 male, 63.6+/-10.6 years) underwent cardiac MSCT using the same protocol. Images were reconstructed with three different FOV sizes (180x180, 220x220, 380x380 mm(2)). Coronary calcium scoring and risk stratification were performed for each image series. In the phantom study, the Agatston score calculated with a FOV size of 180x180 mm(2) was 657.80+/-20.05. At a FOV of 220x220 mm(2) and 380x380 mm(2), the corresponding values were 657.04+/-21.36 and 655.04+/-20.74, respectively. The corresponding values in the patient study were 541.65+/-869.87, 541.91+/-872.57 and 536.61+/-867.81. No statistically significant differences in the calcium score were found comparing different FOV sizes. Significantly more lesions (p=0.00149) were detected in the patient study. Comparing the different FOV sizes of 180x180 mm(2) and 220x220 mm(2) (380x380 mm(2)), four (six) patients had to be assigned to different risk groups. The use of small FOV sizes resulted in an improved detection of coronary calcifications influencing the risk stratification for further cardiac events in MSCT coronary calcium scoring.
Collapse
Affiliation(s)
- Andreas H Mahnken
- Department of Diagnostic Radiology, Aachen University of Technology, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | | | | | | | | | | | | | | |
Collapse
|