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Lee JS, Choi GM, Kim BS, Ko SY, Lee KR, Kim JJ, Kim DR. [Comparison of True and Virtual Non-Contrast Images of Liver Obtained with Single-Source Twin Beam and Dual-Source Dual-Energy CT]. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:170-184. [PMID: 36818703 PMCID: PMC9935954 DOI: 10.3348/jksr.2021.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/14/2022] [Accepted: 05/02/2022] [Indexed: 06/18/2023]
Abstract
PURPOSE To assess the magnitude of differences between attenuation values of the true non-contrast image (TNC) and virtual non-contrast image (VNC) derived from twin-beam dual-energy CT (tbDECT) and dual-source DECT (dsDECT). MATERIALS AND METHODS This retrospective study included 62 patients who underwent liver dynamic DECT with tbDECT (n = 32) or dsDECT (n = 30). Arterial VNC (AVNC), portal VNC (PVNC), and delayed VNC (DVNC) were reconstructed using multiphasic DECT. Attenuation values of multiple intra-abdominal organs (n = 11) on TNCs were subsequently compared to those on multiphasic VNCs. Further, we investigated the percentage of cases with an absolute difference between TNC and VNC of ≤ 10 Hounsfield units (HU). RESULTS For the mean attenuation values of TNC and VNC, 33 items for each DECT were compared according to the multiphasic VNCs and organs. More than half of the comparison items for each DECT showed significant differences (tbDECT 17/33; dsDECT 19/33; Bonferroni correction p < 0.0167). The percentage of cases with an absolute difference ≤ 10 HU was 56.7%, 69.2%, and 78.6% in AVNC, PVNC, and DVNC in tbDECT, respectively, and 70.5%, 78%, and 78% in dsDECT, respectively. CONCLUSION VNCs derived from the two DECTs were insufficient to replace TNCs because of the considerable difference in attenuation values.
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Shyu JY, Khurana B, Soto JA, Biffl WL, Camacho MA, Diercks DB, Glanc P, Kalva SP, Khosa F, Meyer BJ, Ptak T, Raja AS, Salim A, West OC, Lockhart ME. ACR Appropriateness Criteria® Major Blunt Trauma. J Am Coll Radiol 2020; 17:S160-S174. [PMID: 32370960 DOI: 10.1016/j.jacr.2020.01.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 01/22/2020] [Indexed: 11/20/2022]
Abstract
This review assesses the appropriateness of various imaging studies for adult major blunt trauma or polytrauma in the acute setting. Trauma is the leading cause of mortality for people in the United States <45 years of age, and the fourth leading cause of death overall. Imaging, in particular CT, plays a critical role in the management of these patients, and a number of indications are discussed in this publication, including patients who are hemodynamically stable or unstable; patients with additional injuries to the face, extremities, chest, bowel, or urinary system; and pregnant patients. Excluded from consideration in this review are penetrating traumatic injuries, burns, and injuries to pediatric patients. Patients with suspected injury to the head and spine are also discussed more specifically in other appropriateness criteria documents. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Jeffrey Y Shyu
- Research Author, Brigham & Women's Hospital, Boston, Massachusetts
| | - Bharti Khurana
- Principal Author, Brigham & Women's Hospital, Boston, Massachusetts.
| | - Jorge A Soto
- Research Author, Boston University School of Medicine, Boston, Massachusetts
| | - Walter L Biffl
- Scripps Memorial Hospital La Jolla, La Jolla, California; American Association for the Surgery of Trauma
| | - Marc A Camacho
- The University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Deborah B Diercks
- University of Texas Southwestern Medical Center, Dallas, Texas; American College of Emergency Physicians
| | - Phyllis Glanc
- University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | | - Faisal Khosa
- Vancouver General Hospital, Vancouver, British Columbia, Canada
| | | | - Thomas Ptak
- University of Maryland Medical Center, Baltimore, Maryland
| | - Ali S Raja
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Society for Academic Emergency Medicine
| | - Ali Salim
- Brigham & Women's Hospital, Boston, Massachusetts; American College of Surgeons
| | - O Clark West
- UTHealth McGovern Medical School, Houston, Texas
| | - Mark E Lockhart
- Specialty Chair, University of Alabama at Birmingham, Birmingham, Alabama
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Attenuation values of renal parenchyma in virtual noncontrast images acquired from multiphase renal dual-energy CT: Comparison with standard noncontrast CT. Eur J Radiol 2018; 101:103-110. [PMID: 29571782 DOI: 10.1016/j.ejrad.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/31/2018] [Accepted: 02/03/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To compare the renal parenchyma attenuation of virtual noncontrast (VNC) images derived from multiphase renal dual-energy computed tomography (DECT) with standard noncontrast (SNC) images, and to determine the optimum phase for VNC images. MATERIALS AND METHODS Twenty-nine men and 16 women (mean age, 61 ± 13 years; range, 37-89 years) underwent dynamic renal DECT (100/Sn140 kVp) were included in this institutional review board-approved retrospective study. There were four phases of the scan, which included noncontrast, corticomedullary (CMP), nephrographic (NP), and excretory phases (EP). The VNC images was generated from CMP, NP and EP. CT numbers of SNC images and VNC images of each phases were measured in the renal cortex and medulla. Mean standard deviation of subcutaneous fat was measured as image noise on SNC and VNC images. Radiation dose was recorded and potential radiation dose reduction was estimated. Results were tested for statistical significance using the unpaired t-test and agreement using Bland-Altman plot analysis. RESULTS The difference in mean attenuation between SNC and each phase of VNC images were ≤4 HU. The mean attenuation of renal cortex and medulla was 33.2 ± 4.4 HU, and 34.2 ± 4.8 HU in SNC, 33.6 ± 7.6 HU and 31.1 ± 8.3 HU in VNC of CMP, 34.8 ± 8.6 HU and 35.6 ± 8.5 HU in VNC of NP, 31.5 ± 7.6 HU and 32.4 ± 7.5 HU in VNC of EP. In VNC of CMP, the attenuation of the cortex was higher than the medulla (p < 0.05), and the attenuation of medulla was significant lower than that of SNC (p < 0.01). In VNC of NP, the attenuation of renal cortex was higher than SNC (p < 0.05). In VNC of EP, the attenuation of cortex and medulla were lower than SNC (p < 0.05), and inadequate iodine subtraction in collecting system was noted. Image noise was significantly greater in SNC (p < 0.001). Mean radiation dose reduction achievable by removing the SNC was 12.3% ± 0.9%. CONCLUSIONS VNC images from multiphase renal DECT were similar to SNC images. Using the nephrographic phase can gives more comparable VNC images to SNC images in renal parenchyma than other phases.
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Esposito A, Zilocchi M, Fasani P, Giannitto C, Maccagnoni S, Maniglio M, Campoleoni M, Brambilla R, Casiraghi E, Biondetti P. The value of precontrast thoraco-abdominopelvic CT in polytrauma patients. Eur J Radiol 2015; 84:1212-8. [DOI: 10.1016/j.ejrad.2015.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 02/15/2015] [Accepted: 02/20/2015] [Indexed: 10/24/2022]
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Zeng Y, Zhang D, Wu M, Liu Y, Zhang X, Li L, Li Z, Han X, Wei X, Liu X. Lipid-AuNPs@PDA nanohybrid for MRI/CT imaging and photothermal therapy of hepatocellular carcinoma. ACS APPLIED MATERIALS & INTERFACES 2014; 6:14266-14277. [PMID: 25090604 DOI: 10.1021/am503583s] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Multifunctional theranostic nanoparticles represent an emerging agent with the potential to offer extremely sensitive diagnosis and targeted cancer therapy. Herein, we report the synthesis and characterization of a multifunctional theranostic agent (referred to as LA-LAPNHs) for targeted magnetic resonance imaging/computed X-ray tomography (MRI/CT) dual-mode imaging and photothermal therapy of hepatocellular carcinoma. The LA-LAPNHs were characterized as having a core-shell structure with the gold nanoparticles (AuNPs)@polydopamine (PDA) as the inner core, the indocyanine green (ICG), which is electrostatically absorbed onto the surface of PDA, as the photothermal therapeutic agent, and the lipids modified with gadolinium-1,4,7,10-tetraacetic acid and lactobionic acid (LA), which is self-assembled on the outer surface as the shell. The LA-LAPNHs could be selectively internalized into the hepatocellular cell line (HepG2 cells) but not into HeLa cells due to the specific recognition ability of LA to asialoglycoprotein receptor. Additionally, the dual-mode imaging ability of the LA-LAPNH aqueous solution was confirmed by enhanced MR and CT imaging showing a shorter T1 relaxation time and a higher Hounsfield unit value, respectively. In addition, the LA-LAPNHs showed significant photothermal cytotoxicity against liver cancer cells with near-infrared irradiation due to their strong absorbance in the region between 700 and 850 nm. In summary, this study demonstrates that LA-LAPNHs may be a promising candidate for targeted MR/CT dual-mode imaging and photothermal therapy of hepatocellular carcinoma.
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Affiliation(s)
- Yongyi Zeng
- Liver Disease Center, The First Affiliated Hospital of Fujian Medical University , Fuzhou 350005, P. R. China
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Naulet P, Wassel J, Gervaise A, Blum A. Evaluation of the value of abdominopelvic acquisition without contrast injection when performing a whole body CT scan in a patient who may have multiple trauma. Diagn Interv Imaging 2013; 94:410-7. [DOI: 10.1016/j.diii.2013.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lethal visceral traumatic injuries secondary to child abuse: A case of practical application of autopsy, radiological and microscopic studies. Forensic Sci Int 2011; 206:e62-6. [DOI: 10.1016/j.forsciint.2010.08.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Revised: 07/18/2010] [Accepted: 08/31/2010] [Indexed: 12/26/2022]
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Christe A, Flach P, Ross S, Spendlove D, Bolliger S, Vock P, Thali MJ. Clinical radiology and postmortem imaging (Virtopsy) are not the same: Specific and unspecific postmortem signs. Leg Med (Tokyo) 2010; 12:215-22. [PMID: 20630787 DOI: 10.1016/j.legalmed.2010.05.005] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 04/07/2010] [Accepted: 05/13/2010] [Indexed: 10/19/2022]
Abstract
The aim of this article is to disclose the characteristics of postmortem forensic imaging; give an overview of the several possible findings in postmortem imaging, which are uncommon or new to clinical radiologists; and discuss the possible pitfalls. Unspecific postmortem signs are enlisted and specific signs shall be presented, which are typical for one cause of death. Unspecific signs. Livor mortis may not only be seen from the outside, but also inside the body in the lungs: in chest CT internal livor mortis appear as ground glass opacity in the dependent lower lobes. The aortic wall is often hyperdense in postmortem CT due to wall contraction and loss of luminal pressure. Gas bubbles are very common postmortem due to systemic gas embolism after major open trauma, artificial respiration or initial decomposition; in particular putrefaction produces gas bubbles globally. Specific signs. Intracranial bleeding is hyperattenuating both in radiology and in postmortem imaging. Signs of strangulation are hemorrhage in the soft tissue of the neck like skin, subcutaneous tissue, platysma muscle and lymph nodes. The "vanishing" aorta is indicative for exsanguination. Fluid in the airways with mosaic lung densities and emphysema (aquosum) is typical for fresh-water drowning.
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Affiliation(s)
- Andreas Christe
- Department of Radiology, Inselspital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland.
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Abdominal trauma--sensitivity and specificity of postmortem noncontrast imaging findings compared with autopsy findings. ACTA ACUST UNITED AC 2009; 66:1302-7. [PMID: 19430230 DOI: 10.1097/ta.0b013e31818c1441] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to determine the sensitivity and specificity for typical abdominal injuries after major blunt trauma in postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI). MATERIAL Thirty-four cases of accidental death underwent postmortem pre-autopsy MSCT and MRI. The imaging findings were correlated with the autopsy findings. RESULTS Sensitivity and specificity for liver injury in computed tomography (CT) alone were 53% and 84%. In MRI, a sensitivity of 58% and a specificity of 46% were found. CT and MRI together (when either one was positive, liver-injury was considered) had a sensitivity of 73% and a specificity of 63%. For major liver lacerations (grades II-VI) a slightly higher sensitivity of 81% and a better specificity of 100% were noted. CT and MRI together showed a sensitivity of 50% for injuries of the spleen, specificity was 89%. CT and MRI together had a sensitivity of only 25% for trauma of the kidney, but a specificity of 100%. CONCLUSION A lot of cases with small organ injuries (such as superficial liver-laceration) seemed that could not be found by MSCT or by MRI, leading to a rather low sensitivity. Nevertheless, most of the life-threatening liver injuries could be detected, which is essential in forensic pathology.
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Grandjean P, Danse E, Feye F. [CT imaging findings during cardiac arrest in a polytrauma patient]. JOURNAL DE RADIOLOGIE 2009; 90:503-505. [PMID: 19503033 DOI: 10.1016/s0221-0363(09)74011-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
CT performed without oral or intravenous contrast is the initial imaging study of choice in many situations for the detection of hemorrhage anywhere in the abdomen and pelvis. The presence or absence of hemorrhage can be determined rapidly, and the amount and precise location of hemorrhage can also be evaluated. This article reviews the appearances and the common and unusual etiologies of abdominal and pelvic hemorrhage on unenhanced CT. The role of intravenous contrast-enhanced CT in patients with known or suspected abdominal and pelvic hemorrhage is also examined.
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Affiliation(s)
- D S Katz
- Department of Radiology, Winthrop-University Hospital, Mineola, NY 11501, USA
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Yeung KW, Sheu RS, Chen CY, Kuo YT, Liu GC. Evaluation of significance of clinical information and intravenous contrast administration for diagnostic accuracy during emergent abdominal computed tomographic examination. Emerg Radiol 1997. [DOI: 10.1007/bf01461732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
OBJECTIVE Re-examination of routine pre-contrast computed tomography (CT) through liver. MATERIALS AND METHODS 852 abdominal CTs including pre- and post-contrast images were retrospectively reviewed regarding detection of hepatic lesions. RESULTS 103 cases demonstrated hepatic abnormalities. More liver lesions were identified post-contrast in 89; equal numbers were seen pre- and post-contrast in 10; more lesions were seen pre-contrast in one case. Tiny calcifications were detected only pre-contrast in three cases. CONCLUSIONS Routine pre-contrast scanning through liver is not cost-effective.
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Affiliation(s)
- N A Yassa
- Department of Radiology, University of Southern California, Los Angeles, USA
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Flattened inferior vena cava: A normal finding on unenhanced abdominal computed tomographic scan. Emerg Radiol 1996. [DOI: 10.1007/bf01508160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Despite its protected location inside the rib cage, the spleen remains the most commonly injured organ after blunt abdominal trauma. The clinical decision-making process of splenic injury management continues to evolve due to improvements in surgical technique and noninvasive assessment. Splenic preservation techniques and splenic injury grading systems using computerized tomography were developed due to an increased understanding of the spleen's importance in the body's immunological defense system and awareness of the spleen's resiliency after injury. The concept of splenic salvage using splenorrhaphy and nonoperative management was initially applied to the pediatric population during the 1970s, with great success. Application of splenic salvage to hemodynamically stable adult patients with known or unknown splenic injury has demonstrated that adults can be less predictable in their clinical course. Despite the rigorous attention splenic trauma has received, it remains a controversial subject in the surgical and the radiological literature.
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Affiliation(s)
- D E Dupuy
- Massachusetts General Hospital, Boston, USA
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Taylor GA, Kaufman RA. Commentary: emergency department sonography in the initial evaluation of blunt abdominal injury in children. Pediatr Radiol 1993; 23:161-3. [PMID: 8332398 DOI: 10.1007/bf02013820] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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