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van der Werf NR, Rodesch PA, Si-Mohamed S, van Hamersvelt RW, Greuter MJW, Leiner T, Boussel L, Willemink MJ, Douek P. Improved coronary calcium detection and quantification with low-dose full field-of-view photon-counting CT: a phantom study. Eur Radiol 2022; 32:3447-3457. [PMID: 34997284 DOI: 10.1007/s00330-021-08421-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 08/31/2021] [Accepted: 10/17/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of the current study was to systematically assess coronary artery calcium (CAC) detection and quantification for spectral photon-counting CT (SPCCT) in comparison to conventional CT and, in addition, to evaluate the possibility of radiation dose reduction. METHODS Routine clinical CAC CT protocols were used for data acquisition and reconstruction of two CAC containing cylindrical inserts which were positioned within an anthropomorphic thorax phantom. In addition, data was acquired at 50% lower radiation dose by reducing tube current, and slice thickness was decreased. Calcifications were considered detectable when three adjacent voxels exceeded the CAC scoring threshold of 130 Hounsfield units (HU). Quantification of CAC (as volume and mass score) was assessed by comparison with known physical quantities. RESULTS In comparison with CT, SPCCT detected 33% and 7% more calcifications for the small and large phantoms, respectively. At reduced radiation dose and reduced slice thickness, small phantom CAC detection increased by 108% and 150% for CT and SPCCT, respectively. For the large phantom size, noise levels interfered with CAC detection. Although comparable between CT and SPCCT, routine protocols CAC quantification showed large deviations (up to 134%) from physical CAC volume. At reduced radiation dose and slice thickness, physical volume overestimations decreased to 96% and 72% for CT and SPCCT, respectively. In comparison with volume scores, mass score deviations from physical quantities were smaller. CONCLUSION CAC detection on SPCCT is superior to CT, and was even preserved at a reduced radiation dose. Furthermore, SPCCT allows for improved physical volume estimation. KEY POINTS • In comparison with conventional CT, increased coronary artery calcium detection (up to 156%) for spectral photon-counting CT was found, even at 50% radiation dose reduction. • Spectral photon-counting CT can more accurately measure physical volumes than conventional CT, especially at reduced slice thickness and for high-density coronary artery calcium. • For both conventional and spectral photon-counting CT, reduced slice thickness reconstructions result in more accurate physical mass approximation.
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Affiliation(s)
- N R van der Werf
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. .,Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - P A Rodesch
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - S Si-Mohamed
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - R W van Hamersvelt
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M J W Greuter
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L Boussel
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - M J Willemink
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - P Douek
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
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van der Werf NR, Si-Mohamed S, Rodesch PA, van Hamersvelt RW, Greuter MJW, Boccalini S, Greffier J, Leiner T, Boussel L, Willemink MJ, Douek P. Coronary calcium scoring potential of large field-of-view spectral photon-counting CT: a phantom study. Eur Radiol 2021; 32:152-162. [PMID: 34255159 PMCID: PMC8660747 DOI: 10.1007/s00330-021-08152-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/05/2021] [Accepted: 06/14/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the current study was, first, to assess the coronary artery calcium (CAC) scoring potential of spectral photon-counting CT (SPCCT) in comparison with computed tomography (CT) for routine clinical protocols. Second, improved CAC detection and quantification at reduced slice thickness were assessed. METHODS Raw data was acquired and reconstructed with several combinations of reduced slice thickness and increasing strengths of iterative reconstruction (IR) for both CT systems with routine clinical CAC protocols for CT. Two CAC-containing cylindrical inserts, consisting of CAC of different densities and sizes, were placed in an anthropomorphic phantom. A specific CAC was detectable when 3 or more connected voxels exceeded the CAC scoring threshold of 130 Hounsfield units (HU). For all reconstructions, total CAC detectability was compared between both CT systems. Significant differences in CAC quantification (Agatston and volume scores) were assessed with Mann-Whitney U tests. Furthermore, volume scores were compared with the known CAC physical. RESULTS CAC scores for routine clinical protocols were comparable between SPCCT and CT. SPCCT showed 34% and 4% higher detectability of CAC for the small and large phantom, respectively. At reduced slice thickness, CAC detection increased by 142% and 169% for CT and SPCCT, respectively. In comparison with CT, volume scores from SPCCT were more comparable with the physical volume of the CAC. CONCLUSION CAC scores using routine clinical protocols are comparable between conventional CT and SPCCT. The increased spatial resolution of SPCCT allows for increased detectability and more accurate CAC volume estimation. KEY POINTS • Coronary artery calcium scores using routine clinical protocols are comparable between conventional CT and spectral photon-counting CT. • In comparison with conventional CT, increased coronary artery calcium detectability was shown for spectral photon-counting CT due to increased spatial resolution. • Volumes scores were more accurately determined with spectral photon-counting CT.
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Affiliation(s)
- Niels R van der Werf
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. .,Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - S Si-Mohamed
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - P A Rodesch
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - R W van Hamersvelt
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M J W Greuter
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - S Boccalini
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - J Greffier
- Department of medical imaging, Medical Imaging Group, Univ Montpellier, CHU Nimes, 2415, Nimes, EA, France
| | - T Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L Boussel
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - M J Willemink
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - P Douek
- Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
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3
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Greffier J, Si-Mohamed S, Dabli D, de Forges H, Hamard A, Douek P, Beregi JP, Frandon J. Performance of four dual-energy CT platforms for abdominal imaging: a task-based image quality assessment based on phantom data. Eur Radiol 2021; 31:5324-5334. [PMID: 33449188 DOI: 10.1007/s00330-020-07671-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/08/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To compare the spectral performance of dual-energy CT (DECT) platforms using task-based image quality assessment based on phantom data. MATERIALS AND METHODS Two CT phantoms were scanned on four DECT platforms: fast kV-switching CT (KVSCT), split filter CT (SFCT), dual-source CT (DSCT), and dual-layer CT (DLCT). Acquisitions on each phantom were performed using classical parameters of abdomen-pelvic examination and a CTDIvol at 10 mGy. Noise power spectrum (NPS) and task-based transfer function (TTF) were evaluated from 40 to 140 keV of virtual monoenergetic images. A detectability index (d') was computed to model the detection task of two contrast-enhanced lesions as function of keV. RESULTS The noise magnitude decreased from 40 to 70 keV for all DECT platforms, and the highest noise magnitude values were found for KVSCT and SFCT and the lowest for DSCT and DLCT. The average NPS spatial frequency shifted towards lower frequencies as the energy level increased for all DECT platforms, smoothing the image texture. TTF values decreased with the increase of keV deteriorating the spatial resolution. For both simulated lesions, higher detectability (d' value) was obtained at 40 keV for DLCT, DSCT, and SFCT but at 70 keV for KVSCT. The detectability of both simulated lesions was highest for DLCT and DSCT. CONCLUSION Highest detectability was found for DLCT for the lowest energy levels. The task-based image quality assessment used for the first time for DECT acquisitions showed the benefit of using low keV for the detection of contrast-enhanced lesions. KEY POINTS • Detectability of both simulated contrast-enhanced lesions was higher for dual-layer CT for the lowest energy levels. • The image noise increased and the image texture changed for the lowest energy levels. • The detectability of both simulated contrast-enhanced lesions was highest at 40 keV for all dual-energy CT platforms except for fast kV-switching platform.
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Affiliation(s)
- J Greffier
- Department of Medical Imaging, CHU Nimes, Medical Imaging Group Nimes, EA 2415, Univ Montpellier, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France.
| | - S Si-Mohamed
- Department of Radiology, Hospices Civils de Lyon, 69500, Lyon, France.,INSA-Lyon, Université Lyon, Université Claude-Bernard Lyon 1, UJM-Saint-Étienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621, Lyon, France
| | - D Dabli
- Department of Medical Imaging, CHU Nimes, Medical Imaging Group Nimes, EA 2415, Univ Montpellier, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - H de Forges
- Department of Medical Imaging, CHU Nimes, Medical Imaging Group Nimes, EA 2415, Univ Montpellier, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - A Hamard
- Department of Medical Imaging, CHU Nimes, Medical Imaging Group Nimes, EA 2415, Univ Montpellier, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - P Douek
- Department of Radiology, Hospices Civils de Lyon, 69500, Lyon, France.,INSA-Lyon, Université Lyon, Université Claude-Bernard Lyon 1, UJM-Saint-Étienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621, Lyon, France
| | - J P Beregi
- Department of Medical Imaging, CHU Nimes, Medical Imaging Group Nimes, EA 2415, Univ Montpellier, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - J Frandon
- Department of Medical Imaging, CHU Nimes, Medical Imaging Group Nimes, EA 2415, Univ Montpellier, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France
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Brisset JC, Kremer S, Hannoun S, Bonneville F, Durand-Dubief F, Tourdias T, Barillot C, Guttmann C, Vukusic S, Dousset V, Cotton F, Ameli R, Anxionnat R, Audoin B, Attye A, Bannier E, Barillot C, Ben Salem D, Boncoeur-Martel MP, Bonhomme G, Bonneville F, Boutet C, Brisset J, Cervenanski F, Claise B, Commowick O, Constans JM, Cotton F, Dardel P, Desal H, Dousset V, Durand-Dubief F, Ferre JC, Gaultier A, Gerardin E, Glattard T, Grand S, Grenier T, Guillevin R, Guttmann C, Krainik A, Kremer S, Lion S, Champfleur NMD, Mondot L, Outteryck O, Pyatigorskaya N, Pruvo JP, Rabaste S, Ranjeva JP, Roch JA, Sadik JC, Sappey-Marinier D, Savatovsky J, Stankoff B, Tanguy JY, Tourbah A, Tourdias T, Brochet B, Casey R, Cotton F, De Sèze J, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Mansuy L, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Vukusic S, Debouverie M, Edan G, Ciron J, Lubetzki C, Vermersch P, Labauge P, Defer G, Berger E, Clavelou P, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Patry I, De Broucker T, Pottier C, Neau JP, Labeyrie C, Nifle C. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol 2020; 47:250-258. [DOI: 10.1016/j.neurad.2020.01.083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 01/04/2023]
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Si-Mohamed S, Moreau-Triby C, Tylski P, Tatard-Leitman V, Wdowik Q, Boccalini S, Dessouky R, Douek P, Boussel L. Head-to-head comparison of lung perfusion with dual-energy CT and SPECT-CT. Diagn Interv Imaging 2020; 101:299-310. [PMID: 32173289 DOI: 10.1016/j.diii.2020.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To compare the quantitative and qualitative lung perfusion data acquired with dual energy CT (DECT) to that acquired with a large field-of-view cadmium-zinc-telluride camera single-photon emission CT coupled to a CT system (SPECT-CT). MATERIALS AND METHODS A total of 53 patients who underwent both dual-layer DECT angiography and perfusion SPECT-CT for pulmonary hypertension or pre-operative lobar resection surgery were retrospectively included. There were 30 men and 23 women with a mean age of 65.4±17.5 (SD)years (range: 18-88years). Relative lobar perfusion was calculated by dividing the amount (of radiotracer or iodinated contrast agent) per lobe by the total amount in both lungs. Linear regression, Bland-Altman analysis, and Pearson's correlation coefficient were also calculated. Kappa test was used to test agreements in morphology and severity of perfusion defects assessed on SPECT-CT and on DECT iodine maps with a one-month interval. Wilcoxon rank sum test was used to compare the sharpness of perfusion defects and radiation dose among modalities. RESULTS Strong correlations for relative lobar perfusion using linear regression analysis and Pearson's correlation coefficient (r=0.93) were found. Bland-Altman analysis revealed a -0.10 bias, with limits of agreement between [-6.01; 5.81]. With respect to SPECT- CT as standard of reference, the sensitivity, specificity, PPV, NPV, accuracy for lobar perfusion defects were 89.4% (95%
CI: 82.6-93.4%), 96.5% (95% CI: 92.1-98.5%), 95.6% (95% CI:
90.9-97.8%), 91.4% (95% CI: 85.6-94.9%) and 93.0% (95% CI:
87.6-96.1%) respectively. High level of agreement was found for morphology and severity of perfusion defects between modalities (Kappa=0.84 and 0.86 respectively) and on DECT images among readers (Kappa=0.94 and 0.89 respectively). A significantly sharper delineation of perfusion defects was found on DECT images (P<0.0001) using a significantly lower equivalent dose of 4.1±2.3 (SD) mSv (range: 1.9-11.85mSv) compared to an equivalent dose of 5.3±1.1 (SD) mSv (range: 2.8-7.3mSv) for SPECT-CT, corresponding to a 21.2% dose reduction (P=0.0004). CONCLUSION DECT imaging shows strong quantitative correlations and qualitative agreements with SPECT-CT for the evaluation of lung perfusion.
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Affiliation(s)
- S Si-Mohamed
- Department of Radiology, Hospices Civils de Lyon, 69500 Bron, France; Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France.
| | - C Moreau-Triby
- Department of Nuclear Medicine, Hospices Civils de Lyon, 69500 Bron, France
| | - P Tylski
- Medical Physics and Radioprotection, Hospices Civils de Lyon, 69500 Bron, France
| | - V Tatard-Leitman
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France
| | - Q Wdowik
- Department of Radiology, Hospices Civils de Lyon, 69500 Bron, France
| | - S Boccalini
- Department of Radiology, Hospices Civils de Lyon, 69500 Bron, France
| | - R Dessouky
- Department of Radiology, Faculty of Medicine, Zagazig University, 44519 Zagazig, Egypt
| | - P Douek
- Department of Radiology, Hospices Civils de Lyon, 69500 Bron, France; Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France
| | - L Boussel
- Department of Radiology, Hospices Civils de Lyon, 69500 Bron, France; Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France
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Colevray M, Tatard-Leitman VM, Gouttard S, Douek P, Boussel L. Convolutional neural network evaluation of over-scanning in lung computed tomography. Diagn Interv Imaging 2018; 100:177-183. [PMID: 30497958 DOI: 10.1016/j.diii.2018.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/22/2018] [Accepted: 11/06/2018] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The purpose of this study was to develop a convolutional neural network (CNN) to determine the extent of over-scanning in the Z-direction associated with lung computed tomography (CT) examinations. MATERIALS AND METHODS The CT examinations of 250 patients were used to train the machine learning software and 100 were used to validate the results. Each lung CT examination was divided into cervical, lung, and abdominal areas by the CNN and 2 independent radiologists, and the length of each area was measured. Every part above or below the lung marks was labeled as over-scanning. The accuracy of the CNN was calculated after the training phase and agreement between CNN and radiologists was assessed using kappa statistics during the validation phase. After validation the software was used to estimate the length of each of the three areas and the total over-scanning in further 1000 patients. RESULTS An accuracy of 0.99 was found for the testing dataset and a very good agreement (kappa=0.98) between the CNN and the radiologists' evaluation was found for the validation dataset. Over-scanning was 22.8% with the CNN and 22.2% with the radiologists. The degree of over-scanning was 22.6% in 1000 lung CT examinations. CONCLUSION Our study shows a substantial over estimation of the length of the area to be scanned during lung CT and thus an unnecessary patient's over-exposure to ionizing radiation. This over-scanning can be assessed easily, reliably and quickly using CNN.
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Affiliation(s)
- M Colevray
- Department of radiology, hôpital de la Croix-Rousse, 103, Grande rue de la Croix-Rousse, 69004 Lyon, France
| | - V M Tatard-Leitman
- Unité CNRS UMR 5220, CREATIS, Inserm U1206, Insa Lyon, université Lyon 1, université Jean-Monnet Saint-Étienne, 7, avenue Jean-Capelle, 69100 Villeurbanne, France; Department of radiology, Louis-Pradel hospital, 59, boulevard Pinel, 69500 Bron, France
| | - S Gouttard
- Department of radiology, hôpital de la Croix-Rousse, 103, Grande rue de la Croix-Rousse, 69004 Lyon, France
| | - P Douek
- Department of radiology, hôpital de la Croix-Rousse, 103, Grande rue de la Croix-Rousse, 69004 Lyon, France; Department of radiology, Louis-Pradel hospital, 59, boulevard Pinel, 69500 Bron, France
| | - L Boussel
- Department of radiology, hôpital de la Croix-Rousse, 103, Grande rue de la Croix-Rousse, 69004 Lyon, France; Unité CNRS UMR 5220, CREATIS, Inserm U1206, Insa Lyon, université Lyon 1, université Jean-Monnet Saint-Étienne, 7, avenue Jean-Capelle, 69100 Villeurbanne, France.
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Mechtouff L, Sigovan M, Costes N, Douek P, Collet-Benzaquen D, Nighoghossian N, Berthezene Y. 18 F-NaF PET-MRI: an innovative tool to assess carotid artery plaque vulnerability. Eur J Neurol 2018; 25:e18-e19. [PMID: 29356260 DOI: 10.1111/ene.13502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/20/2017] [Indexed: 11/26/2022]
Affiliation(s)
- L Mechtouff
- Stroke Department, Neurological Hospital, Bron, France
| | - M Sigovan
- CNRS UMR5220, CREATIS, INSA-Lyon, Inserm U1206, UJM-Saint-Etienne, University of Lyon, Lyon, France
| | - N Costes
- CERMEP - Imagerie Du Vivant, Lyon, France
| | - P Douek
- CNRS UMR5220, CREATIS, INSA-Lyon, Inserm U1206, UJM-Saint-Etienne, University of Lyon, Lyon, France.,Department of Radiology, Cardiological Hospital, Bron, France
| | | | - N Nighoghossian
- Stroke Department, Neurological Hospital, Bron, France.,CREATIS, CNRS UMR 5220, INSERM U1044, University Lyon 1, Lyon, France
| | - Y Berthezene
- CREATIS, CNRS UMR 5220, INSERM U1044, University Lyon 1, Lyon, France.,Neuroradiology Department, Neurological Hospital, Bron, France
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Dangelmaier J, Bar-Ness D, Münzel D, Daerr H, Pfeiffer F, Proksa R, Rummeny E, Douek P, Noël P. Experimental feasibility of dual contrast agent based spectral photon-counting computed tomografy for detection of endoleaks following EVAR. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Dangelmaier
- Klinikum rechts der Isar der Technischen Universität München, Institut für diagnostische und interventionelle Radiologie, München
| | - D Bar-Ness
- Louis Pradel University Hospital, Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Bron
| | - D Münzel
- Klinikum Rechts der Isar der Technischen Universität München, Diagnostische und Interventionelle Radiologie, München
| | - H Daerr
- Philips GmbH, Innovative Technologies, Research Laboratories, Hamburg
| | - F Pfeiffer
- Technische Universität München, Lehrstuhl für Biomedizinische Physik, Physik-Department & Institut für Medizintechnik
| | - R Proksa
- Philips GmbH, Innovative Technologies, Research Laboratories, Hamburg
| | - E Rummeny
- Klinikum Rechts der Isar der Technischen Universität München, Diagnostische und Interventionelle Radiologie, München
| | - P Douek
- Louis Pradel University Hospital, Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Bron
| | - P Noël
- Klinikum Rechts der Isar der Technischen Universität München, Diagnostische und Interventionelle Radiologie, München
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Münzel D, Bar-Ness D, Roessl E, Fingerle A, Daerr H, Pfeiffer F, Proksa R, Rummeny E, Douek P, Noel P. Spektrale Photon-Counting Computertomografie: Anwendung für die virtuelle Koloskopie ohne Abführen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- D Münzel
- Klinikum rechts der Isar der TUM, Radiologie, München
| | - D Bar-Ness
- Louis Pradel University Hospital, Bron, France, Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Lyon
| | - E Roessl
- Philips GmbH Innovative Technologies, Hamburg
| | - A Fingerle
- Klinikum rechts der Isar der TUM, Institut für diagnostische und interventionelle Radiologie, München
| | - H Daerr
- Philips GmbH Innovative Technologies, Hamburg
| | - F Pfeiffer
- Technische Universität München, Lehrstuhl für Biomedizinische Physik, Garching
| | - R Proksa
- Philips GmbH Innovative Technologies, Hamburg
| | - E Rummeny
- Klinikum rechts der Isar der TUM, Institut für diagnostische und interventionelle Radiologie, München
| | - P Douek
- Louis Pradel University Hospital, Bron, France, Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Lyon
| | - P Noel
- Klinikum rechts der Isar der TUM, Institut für diagnostische und interventionelle Radiologie, München
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Münzel D, Daerr H, Proksa R, Fingerle A, Douek P, Pfeiffer F, Rummeny E, Noel P. Spektrale Photon-Counting Computertomografie für Mehrphasen-Leberdiagnostik mit zwei Kontrastmitteln. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- D Münzel
- Klinikum rechts der Isar der TUM, Radiologie, München
| | - H Daerr
- Philips GmbH Innovative Technologies, Hamburg
| | - R Proksa
- Philips GmbH Innovative Technologies, Hamburg
| | - A Fingerle
- Klinikum rechts der Isar der TUM, Institut für diagnostische und interventionelle Radiologie, München
| | - P Douek
- Louis Pradel University Hospital, Bron, France, Department of Interventional Radiology and Cardio-vascular and Thoracic Diagnostic Imaging, Lyon
| | - F Pfeiffer
- Technische Universität München, Lehrstuhl für Biomedizinische Physik, Garching
| | - E Rummeny
- Klinikum rechts der Isar der TUM, Institut für diagnostische und interventionelle Radiologie, München
| | - P Noel
- Klinikum rechts der Isar der TUM, Institut für diagnostische und interventionelle Radiologie, München
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11
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Mafalanka F, Etard C, Rehel JL, Pesenti-Rossi D, Amrar-Vennier F, Baron N, Christiaens L, Convers-Domart R, Defez D, Douek P, Gaxotte V, Georges JL, Leygnac S, Ou P, Sablayrolles JL, Salvat C, Schouman-Claeys E, Sirol M, Aubert B. Establishment of diagnostic reference levels in cardiac CT in France: a need for patient dose optimisation. Radiat Prot Dosimetry 2015; 164:116-119. [PMID: 25342609 DOI: 10.1093/rpd/ncu317] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of this study was to propose diagnostic reference levels (DRLs) for coronary computed tomography angiography (CCTA), in the context of a large variability in patient radiation dose, and the lack of European recommendations. Volume Computed Tomography Dose Index (CTDIvol) and dose-length product (DLP) were collected from 460 CCTAs performed over a 3-month period at eight French hospitals. CCTAs (∼50 per centre) were performed using the routine protocols of the centres, and 64- to 320-detector CT scanners. ECG gating was prospective (n = 199) or retrospective (n = 261). The large gap in dose between these two modes required to propose specific DRLs: 26 and 44 mGy for CTDIvol, and 370 and 970 mGy cm for DLP, respectively. This study confirms the large variability in patient doses during CCTA and underlines the need for the optimisation of cardiac acquisition protocols. Availability of national DRLs should be mandatory in this setting.
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Affiliation(s)
- F Mafalanka
- Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France
| | - C Etard
- Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France
| | - J L Rehel
- Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France
| | | | | | - N Baron
- Hôpital Mignot, Le Chesnay, France
| | | | | | - D Defez
- Centre Hospitalier Universitaire, Lyon, France
| | - P Douek
- Centre Hospitalier Universitaire, Lyon, France
| | - V Gaxotte
- Hôpital Bichat, AP-HP, Paris, France
| | | | - S Leygnac
- Hôpital Bichat, AP-HP, Paris, France
| | - P Ou
- Hôpital Bichat, AP-HP, Paris, France
| | | | - C Salvat
- Hôpital Lariboisière, AP-HP, Paris, France
| | | | - M Sirol
- Hôpital Lariboisière, AP-HP, Paris, France
| | - B Aubert
- Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France
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12
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Burckel LA, Defez D, Chaillot P, Douek P, Boussel L. Use of an automatic recording system for CT doses: Evaluation of the impact of iterative reconstruction on radiation exposure in clinical practice. Diagn Interv Imaging 2015; 96:265-72. [DOI: 10.1016/j.diii.2014.11.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Montant P, Sigovan M, Revel D, Douek P. MR imaging assessment of myocardial edema with T2 mapping. Diagn Interv Imaging 2015; 96:885-90. [PMID: 25697831 DOI: 10.1016/j.diii.2014.07.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 06/27/2014] [Accepted: 07/04/2014] [Indexed: 11/26/2022]
Abstract
Cardiac magnetic resonance (CMR) provides a high signal-to-noise ratio, high spatial and temporal resolutions, as well as a delayed-enhancement sequence and is therefore considered a reference technique in the field of cardiac imaging. However, currently available sequences are not adequate to assess some pathologic conditions, such as myocardial edema. T2 mapping sequences generate parametric images that are based on the transverse relaxation time (T2) for each voxel. In case of edema, the T2 relaxation time is longer. This review summarizes current knowledge on CMR T2 mapping for assessing myocardial edema.
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Affiliation(s)
- P Montant
- Department of Cardiology, centre hospitalier Alpes-Léman, 558, route de Findrol, 74130 Contamine-sur-Arve, France
| | - M Sigovan
- Pôle d'activité médicale imagerie, Hospices Civils de Lyon, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
| | - D Revel
- Department of Radiology, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France
| | - P Douek
- Department of Radiology, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France
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14
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Mesmann C, Sigovan M, Berner LP, Abergel A, Tronc F, Berthezène Y, Douek P, Boussel L. Evaluation of image quality of DWIBS versus DWI sequences in thoracic MRI at 3T. Magn Reson Imaging 2014; 32:1237-41. [PMID: 25159472 DOI: 10.1016/j.mri.2014.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 01/12/2014] [Accepted: 08/12/2014] [Indexed: 12/19/2022]
Abstract
PURPOSE To compare diffusion weighted imaging with background suppression (DWIBS) sequence with classic spectral diffusion sequence (DWI) with and without respiratory gating in mediastinal lymph node analysis at 3T. MATERIALS AND METHODS 26 patients scheduled for mediastinoscopic lymph node analysis, prospectively undergone a thoracic 3T MRI with DWIBS (FatSat=STIR; TR/TE=6674.1/44.7ms; IR=260 ms) and DWI sequences (FatSat=SPIR; TR/TE=1291/59.6 ms) (b=0-400-800 s/mm2) with and without (free breathing) respiratory gating. Images at b=800 were analyzed by two radiologists. They performed qualitative analysis of fat-sat homogeneity and motion artifacts, rated from 0 to 4, and quantitative evaluation by studying signal to background (STB) of lymph nodes. RESULTS Quality of fat suppression was significantly higher for DWIBS than for DWI both for free-breathing (score 3.48±0.65 vs. 1.76±0.96, p<0.0001) and respiratory-gated scans (3.17±0.77 vs. 1.72±0.73, p=0.0001). Similarly, artifacts were reduced with DWIBS (3.16±0.47 vs. 1.76±0.59, p<0.0001; 3.0±0.73 vs. 2.04±0.53, p=0.0001). Quantitative analysis showed higher STB with DWIBS (3.26±1.83 vs. 0.98±0.44, p<0.0001; 3.56±, 2.09 vs. 0.92±0.59, p<0.0001). Gating did not improve image quality and STB on DWIBS (p>0.05). CONCLUSION In thoracic MRI, ungated DWIBS sequence improves fat-sat homogeneity, reduces motion artifacts and increases STB of lymph nodes. Respiratory gating does not improve DWIBS image quality.
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Affiliation(s)
- Caroline Mesmann
- Department of Radiology, Centre hospitalier de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
| | - Monica Sigovan
- Department of Radiology, Hopital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Lise-Prune Berner
- Department of Radiology, Hopital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Adva Abergel
- Department of Radiology, Centre hospitalier de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - François Tronc
- Department of Thoracic Surgery, Hopital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Y Berthezène
- Department of Radiology, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Université de Lyon, CREATIS; CNRS UMR5220; Inserm U1044; INSA-Lyon; Université Lyon 1, France
| | - P Douek
- Department of Radiology, Hopital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France; Université de Lyon, CREATIS; CNRS UMR5220; Inserm U1044; INSA-Lyon; Université Lyon 1, France
| | - Loic Boussel
- Department of Radiology, Centre hospitalier de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Université de Lyon, CREATIS; CNRS UMR5220; Inserm U1044; INSA-Lyon; Université Lyon 1, France
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15
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Boussel L, Coulon P, Thran A, Roessl E, Martens G, Sigovan M, Douek P. Photon counting spectral CT component analysis of coronary artery atherosclerotic plaque samples. Br J Radiol 2014; 87:20130798. [PMID: 24874766 DOI: 10.1259/bjr.20130798] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the capabilities of photon counting spectral CT to differentiate components of coronary atherosclerotic plaque based on differences in spectral attenuation and iodine-based contrast agent concentration. METHODS 10 calcified and 13 lipid-rich non-calcified histologically demonstrated atheromatous plaques from post-mortem human coronary arteries were scanned with a photon counting spectral CT scanner. Individual photons were counted and classified in one of six energy bins from 25 to 70 keV. Based on a maximum likelihood approach, maps of photoelectric absorption (PA), Compton scattering (CS) and iodine concentration (IC) were reconstructed. Intensity measurements were performed on each map in the vessel wall, the surrounding perivascular fat and the lipid-rich and the calcified plaques. PA and CS values are expressed relative to pure water values. A comparison between these different elements was performed using Kruskal-Wallis tests with pairwise post hoc Mann-Whitney U-tests and Sidak p-value adjustments. RESULTS RESULTS for vessel wall, surrounding perivascular fat and lipid-rich and calcified plaques were, respectively, 1.19 ± 0.09, 0.73 ± 0.05, 1.08 ± 0.14 and 17.79 ± 6.70 for PA; 0.96 ± 0.02, 0.83 ± 0.02, 0.91 ± 0.03 and 2.53 ± 0.63 for CS; and 83.3 ± 10.1, 37.6 ± 8.1, 55.2 ± 14.0 and 4.9 ± 20.0 mmol l(-1) for IC, with a significant difference between all tissues for PA, CS and IC (p < 0.012). CONCLUSION This study demonstrates the capability of energy-sensitive photon counting spectral CT to differentiate between calcifications and iodine-infused regions of human coronary artery atherosclerotic plaque samples by analysing differences in spectral attenuation and iodine-based contrast agent concentration. ADVANCES IN KNOWLEDGE Photon counting spectral CT is a promising technique to identify plaque components by analysing differences in iodine-based contrast agent concentration, photoelectric attenuation and Compton scattering.
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Affiliation(s)
- L Boussel
- 1 Department of Radiology, CREATIS, UMR CNRS 5515, INSERM U1044, Croix-Rousse Hospital, Lyon, France
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16
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Courtial EJ, Orkisz M, Douek P, Fulchiron R. P11.3 DEVELOPMENT AND VALIDATION OF REALISTIC AORTIC PHANTOM TAILORED FOR EACH PATIENT. Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Affiliation(s)
- J-L Lamboley
- Department of radiology, hôpital d'instruction des armées Desgenettes, 108 boulevard Pinel, Lyon cedex 3, France.
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18
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Nonent M, Ben Salem D, Serfaty JM, Buthion V, Pasco-Papon A, Rotaru C, Bressollette L, Papon X, Pachai C, Fortrat JO, Gouny P, Badra A, Berge J, Le Bras Y, Cottier JP, Gauvrit JY, Douek P. Overestimation of moderate carotid stenosis assessed by both Doppler US and contrast enhanced 3D-MR angiography in the CARMEDAS study. J Neuroradiol 2010; 38:148-55. [PMID: 20728218 DOI: 10.1016/j.neurad.2010.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Revised: 05/01/2010] [Accepted: 05/20/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the agreement and diagnostic accuracy of Contrast enhanced magnetic resonance angiography (CE-MRA), Doppler ultrasound (DUS) and Digital subtraction angiography (DSA) in the assessment of carotid stenosis. METHODS DUS, CE-MRA and DSA were performed in 56 patients included in the Carotide-angiographie par résonance magnétique-échographie-doppler-angioscanner (CARMEDAS) multicenter study with a carotid stenosis ≥ 50%. Three readers evaluated stenoses on CE-MRA and DSA (NASCET criteria). Velocities criteria were used for stenosis estimation on DUS. RESULTS CE-MRA had a sensitivity and specificity of 96-98% and 66-83% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 94% and 76-84% respectively for carotid stenoses ≥ 70%. The interobserver agreement of CE-MRA was excellent, except for moderate stenoses (50-69%). DUS had a sensitivity and specificity of 88 and 75% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 83 and 86% respectively for carotid stenoses ≥ 70%. Combined concordant CE-MRA and DUS had a sensitivity and specificity of 100 and 85-90% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 96-100% and 80-87% respectively for carotid stenoses ≥ 70%. The positive predictive value of the association CE-MRA and DUS for carotid stenoses ≥ 70% is calculated between 77 and 82% while the negative predictive value is calculated between 97 and 100%. CE-MRA and DUS have concordant findings in 63-72%, and the overestimations cases were recorded only for carotid stenosis ≤ 69%. CONCLUSION Combined DUS-CE-MRA is excellent for evaluation of severe stenosis but remains debatable in moderate stenosis (50-69%) due to the risk of overestimations.
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Affiliation(s)
- M Nonent
- Department of Radiology, University Hospital Center, hôpital de la Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest cedex, France
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19
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Boussel L, Saloner D, Gamondes D, Serfaty J, Canet-Soulas E, Nighoghossian N, Douek P. [State of the art: high resolution MR imaging of carotid atherosclerotic plaque]. J Radiol 2010; 91:185-94. [PMID: 20389265 DOI: 10.1016/s0221-0363(10)70023-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A third of cerebrovascular accidents are a complication from carotid artery plaque. In addition to the degree of stenosis, plaque composition and morphology are key elements in determining the probability of complication from the atherosclerotic plaque. High resolution MRI can characterize plaque composition and morphology and therefore help identify unstable plaque. The purpose of this review is to summarize recent concepts on unstable plaque and underlying inflammation. The signal characteristics of the different components of plaque on high resolution MRI then be reviewed. Finally, current morphological and functional criteria for unstable plaque will be discussed.
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Affiliation(s)
- L Boussel
- Department of radiology, University of California, San Francisco, CA 94143, USA.
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20
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Lehot JJ, Revel D, Douek P, Catherine H, Desgranges FP, Neidecker J. 019 Optimisation of imaging orders in intensive care units. BMJ Qual Saf 2010. [DOI: 10.1136/qshc.2010.041624.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Skilton M, Boussel L, Bonnet F, Bernard S, Douek P, Moulin P, Serusclat A. Measurement of Carotid Wall Thickness Using Ultrasound and Magnetic Resonance Imaging: Relative Contributions of the Intima-media and Adventitia. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The recent and future advancements that are known in the field of cardiac imaging imply an optimal training of the operators. This training concerns medical specialists whether originating from radiology or cardiology. The training of the medical specialists in cardiac imaging entitles 3 main essential steps: The basic training taking place within each specialty, allowing the fellow to get acquainted with the clinical and technical basics. The specialized training, delivered principally in post-residency. This training must include an upgrading of each specialty in the domain that does not concern it (a technical base for the cardiologist, a physio-pathological and clinical base for the radiologist). It must include a specific theoretical training covering all aspects of cardiac imaging as well as practical training in a certified training centre. The continuous medical training and maintenance of skills that allow a sustained activity in the field and the obligation to regularly participate in the actions of specific validated training. The different aspects of these rules are exposed in this chapter.
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Affiliation(s)
- F Joffre
- Service de Radiologie, Hôpital Rangueil, 1 avenue Jean Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
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23
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Bozio G, Tronc F, Douek P, Bozio A, Louis D. Dorsalis pedis artery pseudoaneurysm: an uncommon cause of soft tissue mass of the dorsal foot in children. Eur J Pediatr Surg 2009; 19:113-6. [PMID: 19242907 DOI: 10.1055/s-2008-1039196] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Pseudoaneurysm of the dorsalis pedis artery is an extremely rare entity with only 3 pediatric cases previously presented in the English literature. We describe a new case and discuss the clinical presentation and surgical management. A 6-year-old boy was referred to our clinic because of a pulsatile tumor of the right dorsal foot increasing in size. A focused history found a low grade trauma to the dorsal foot one year previously. Magnetic resonance imaging revealed a pseudoaneurysm of the DPA. Resection of the pseudoaneurysm was completed without complications. Pseudoaneurysm of the DPA is a very uncommon cause of soft tissue mass of the dorsal foot. It can appear after low grade trauma. Treatment is surgical.
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Affiliation(s)
- G Bozio
- Department of Thoracic and Vascular Surgery, Hôpital Louis Pradel, Bron, France
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24
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Cakmak S, Boussel L, Nighoghossian N, Loffroy R, Derex L, Trouillas P, Douek P. MULTIDETECTOR RAW COMPUTERIZED TOMOGRAPHY AS A SINGLE TOOL FOR THE ETIOLOGICAL SCREENING OF ISCHEMIC STROKE AND MULTISITE EVALUATION OF ATHEROTHROMBOSIS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Attia C, Farhat F, Boussel L, Villard J, Revel D, Douek P. Endovascular repair of lesions involving the descending thoracic aorta. Mid-term morphological changes. Interact Cardiovasc Thorac Surg 2008; 7:595-9. [DOI: 10.1510/icvts.2008.175315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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26
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Sigovan M, Boussel L, Sulaiman A, Sappey-Marinier D, Desbleds-Mansard C, Ibarrola D, Gamondes D, Corot C, Lancelot E, Raynaud JS, Violas X, Douek P, Canet-Soulas E. CMR 2007: 1.04:In-vivo USPIO's follow-up and optimized MRI protocol for inflammation imaging in atherosclerotic plaques. Contrast Media Mol Imaging 2007. [DOI: 10.1002/cmmi.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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28
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Farhat F, Attia C, Boussel L, Staat P, Revel D, Douek P, Villard J. Endovascular repair of the descending thoracic aorta: mid-term results and evaluation of magnetic resonance angiography. J Cardiovasc Surg (Torino) 2007; 48:1-6. [PMID: 17308515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
AIM The endoluminal stent-grafting represents an alternative to surgery in the treatment of lesions of the descending thoracic aorta. The purpose of the present study was to evaluate the mid-term results of the Talent stent-graft in the different indications of aortic disease and the use of magnetic resonance angiography (MRA) in the diagnosis of complications. METHODS Over a 3-year period, 23 patients with a high surgical risk and presenting a localized lesion of the descending thoracic aorta had an implantation of a Talent stent-graft. Indications were degenerative aneurysm (n=13), false aneurysm (n=7) and penetrating atherosclerotic ulcer (n=3). The feasibility of the endovascular treatment and sizing of the aorta and stent-grafts were determined pre-operatively by MRA and intraoperative angiography. Immediate and mid-term technical and clinical success were assessed by clinical and MRA follow-up. RESULTS Endovascular treatment was completed successfully in all patients with no conversion to open repair. There was no intraoperative mortality. The mean operative time was 38+/-7 min. Primary success rate was 100%. We didn't have perioperative mortality. The mean follow-up period was 15+/-5 months. The survival rate was 97% (n=22). Regression of the aneurysmal size was observed in 70% (n=16). MRA diagnosed 3 over 4 postoperative endoleaks that were not diagnosed with the CT-scan, and did not interfere with the nitinol structure of the stent-graft. CONCLUSIONS Endovascular treatment of the various localized diseases of the descending thoracic aorta is a promising, feasible, alternative technique to open surgery in well selected patients. MRA is well adapted to diagnose postoperative endoleaks.
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MESH Headings
- Aged
- Aged, 80 and over
- Aneurysm, False/diagnosis
- Aneurysm, False/epidemiology
- Aneurysm, False/surgery
- Aorta, Thoracic/pathology
- Aorta, Thoracic/surgery
- Aortic Aneurysm, Thoracic/diagnosis
- Aortic Aneurysm, Thoracic/epidemiology
- Aortic Aneurysm, Thoracic/surgery
- Atherosclerosis/complications
- Atherosclerosis/diagnosis
- Atherosclerosis/surgery
- Blood Vessel Prosthesis Implantation/methods
- Diagnosis, Differential
- Female
- Follow-Up Studies
- Humans
- Incidence
- Magnetic Resonance Angiography
- Male
- Middle Aged
- Prospective Studies
- Reproducibility of Results
- Sensitivity and Specificity
- Stents
- Survival Rate/trends
- Time Factors
- Treatment Outcome
- Ulcer/diagnosis
- Ulcer/etiology
- Ulcer/surgery
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Affiliation(s)
- F Farhat
- Department of Cardiovascular Surgery, Louis Pradel Hospital, Claude Bernard University INSERM E0226, Bron, France.
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29
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Abstract
The recent developments in the multi-slice CT scanner require evaluation of the clinical indications of this new tool for imaging coronary arteries. Improvements in spatial and temporal resolution with this new generation of CT (16 slices and more) allow the acquisition of coronary arteries with a sufficient quality in the majority of cases. After a short review of the technical principles of the cardiac CT, this article considers the clinical indications of this new method in the general evaluation of coronary artery disease.
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Affiliation(s)
- L Boussel
- Service de radiologie, Hôpital Louis Pradel, 28 avenue Doyen Lépine, 69677 Bron cedex.
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30
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Chaabane L, Pellet N, Bourdillon MC, Desbleds Mansard C, Sulaiman A, Hadour G, Thivolet-Béjui F, Roy P, Briguet A, Douek P, Canet Soulas E. Contrast enhancement in atherosclerosis development in a mouse model: in vivo results at 2 Tesla. MAGMA 2004; 17:188-95. [PMID: 15565504 DOI: 10.1007/s10334-004-0055-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2004] [Accepted: 07/27/2004] [Indexed: 10/26/2022]
Abstract
To develop an MRI method for the evaluation of contrast enhancement in early atherosclerotic plaque development in the abdominal aorta of a mouse model. Male apoE-/- mice from three groups, respectively 4 (n = 6), 8 (n = 11) and 16 (n = 4) weeks were included. Axial T1 spin echo images of the abdominal aorta were obtained above and below the renal arteries (90 microm spatial resolution) before and over 1 h after the injection of a macromolecular contrast agent. Signal enhancement was measured in the vessel wall and compared to histological features. Maximal arterial wall signal enhancement was obtained from 16 to 32 min post injection. During this time, the signal-to-noise ratio increased by a factor up to 1.7 in 16 week mice and 2.7 and 2.4 in 8 and 4 weeks mice, respectively. The enhancement of the arterial wall appeared less pronounced in the oldest mice, 16 weeks old, exhibiting more advanced lesions. Using a macromolecular gadolinium agent, contrast uptake in atherogenesis varies with lesion stage and may be related to vessel-wall permeability. Dynamic contrast-enhanced MRI may be useful to evaluate the atherosclerotic plaque activity in mice.
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Affiliation(s)
- L Chaabane
- Laboratoire de RMN UMR CNRS 5012, UCB Lyon1-ESCPE, 69622, Villeurbanne, France
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Abstract
Magnetic resonance angiography (MRA) has been used to image abdominal vessels less frequently than renal arteries. Until the use of fast contrast-enhanced (CE) techniques, an important limitation was the acquisition time of phase-contrast or time-of-flight imaging and, consequently, the creation of motion artifacts. Recent advances in MRA technology have shortened acquisition times, so it is now possible to obtain successive images in the arterial and then the portal phase. MRA can be used as an adjunct to any MR examination to assess, e.g., the arterial feeding of hepatocellular carcinoma, the encasement of arteries, and segmental portal thrombosis in pancreatic carcinoma. However, MRA has been used mainly to study chronic mesenteric ischemia, portal vein diseases, and complications from liver transplantation. The portal venous system is exquisitely portrayed with this method; MRA is as accurate as digital subtraction angiography (DSA) in the diagnosis of portal vein diseases. Acute mesenteric ischemia is an emergency in which computed tomography is the most appropriate imaging modality. Conversely, chronic mesenteric ischemia is best examined with CE-MRA, which is almost as accurate as DSA. CE-MRA is superior to DSA for the simultaneous exploration of the aorta, renal arteries, and iliac arteries, thereby providing a panoramic view of abdominal vascular involvement. MRA can be coupled with measurements of flow. With this functional approach, MRA is the only modality that can completely assess vascular diseases of the abdomen.
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Affiliation(s)
- J P Laissy
- Department of Radiology Hôpital Bichat, 46 rue Henri Huchard, 75877 Paris Cedex 18, France
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Rode A, Bancel B, Douek P, Chevallier M, Vilgrain V, Picaud G, Henry L, Berger F, Bizollon T, Gaudin JL, Ducerf C. Small nodule detection in cirrhotic livers: evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver. J Comput Assist Tomogr 2001; 25:327-36. [PMID: 11351179 DOI: 10.1097/00004728-200105000-00001] [Citation(s) in RCA: 248] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this work was to evaluate the detection and characterization of nodules > or = 8 mm and small hepatocellular carcinomas (HCCs) in liver cirrhosis. METHOD Pathologic examination and results of US, helical CT, and dynamic MRI with gadolinium were compared after orthotopic liver transplantation (OLT) of 43 cirrhotic patients. Nodules were classified as macroregenerative nodules (MRNs), borderline nodules (BNs), and HCC. RESULTS Pathologic examination classified 69 nodules: 50 MRNs, 6 BNs, and 13 HCCs. Sensitivities of MRN, BN, and HCC detection were, respectively, for US imaging 2% (1/50), 33.3% (2/6), and 46.2% (6/13); for helical CT 2% (1/50), 50% (3/6), and 53.8% (7/13); and for MRI 42% (21/50), 50% (3/6), and 76.9% (10/13). MRI detected 21 MRNs. They presented on T1/T2-weighted images as hyperintense/hypointense (n = 8), hyperintense/isointense (n = 7), hypointense/hypointense (n = 4), hypointense/isointense (n = 1), and hypointense depicted only on echo planar imaging (n = 1). The three detected BNs were hyperintense/hypointense nodules. The 10 detected HCCs appeared hyperintense/isointense (n = 7), hyperintense/hypointense (n = 2), and hypointense/isointense (n = 1). None of the MRNs but eight HCCs and one BN were enhanced after gadolinium injection. CONCLUSION Contrast-enhanced MRI is the most sensitive technique for detecting liver nodules. No MR signal intensity pattern characteristic of small HCCs enables differentiation from benign nodules, however. Gadolinium enhancement is the most sensitive and specific characteristic of HCC.
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Affiliation(s)
- A Rode
- Department of Radiology, Hôpital de la Croix Rousse, Lyon, France
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33
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Marchand B, Hernandez-Hoyos M, Orkisz M, Douek P. [Diagnosis of renal artery stenosis with magnetic resonance angiography and stenosis quantification]. J Mal Vasc 2000; 25:312-320. [PMID: 11148391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Atherosclerotic disease is the most common pathologic condition of renal artery stenosis, which typically compromises the ostium or the proximal 1-2 cm of renal arteries and is also usually present in the abdominal aorta. Fibromuscular dysplasia is the second most common cause of renal artery stenosis (RAS) which usually involves the distal two-third of the main renal artery with bed-like stenosis alternating with small fusiform or saccular aneurysms. Magnetic Resonance Angiography (MRA) was initially performed without contrast media injection using two- or three-dimensional Time-of-Flight (TOF) or Phase-Contrast (PC) techniques. Sensitivity and specificity of non-enhanced MRA in detection of proximal RAS are comprised between 53%-100% and 47%-97% respectively (table I). Main limitations of non-enhanced MRA are the long acquisition time, i.e. 5-8 min, the short field of view with lack of kidney visualization and major artifacts. Recent improvements allowed a three-dimensional acquisition during a single breath-hold (18-23 sec), associated to a bolus injection of a gadolinium chelate demonstrating a lack of nephrotoxicity. 3D gadolinium-enhanced ultrafast gradient-echo MRA techniques (3D enhanced-MRA) requires a precise technique. Firstly, kidney localization and morphologic imaging is performed before a 3D MRA data acquisition without injection (fig. 1). Secondly two successive 3D MRA sequences are performed synchronized with the gadolinium chelate bolus injection: the first acquisition corresponds to the arterial enhancement (fig. 4) and the second one to the venous enhancement. At last, a three-dimensional phase contrast could also be performed. After data acquisition, image post-processing is performed including image subtraction, maximum intensity projection (MIP) and reformation images of each renal artery, the abdominal aorta and its main branches (fig. 2, 3). The normal findings, pitfalls and anatomic variation are explained in detail. Particularly, when 3D enhanced MR angiography shows a normal artery, it is considered to be normal. It is also important to be aware of the existence of accessory or aberrant renal arteries that are well diagnosed by 3D enhanced MRA in 75% to 100% of the cases (fig. 2). 3D enhanced-MR angiography present several advantages in comparison to nonenhanced MRA: 1) a great field-of-view (30-36 cm) could be used allowing visualization of the abdominal aorta as well as its main branches; 2) the fast acquisition time allows an arterial imaging followed by a venous enhancement; 3) the kidneys are analyzed: kidney length, cortical thickness, corticomedullary differentiation and renal enhancement are well evaluated; 4) an accurate sensitivity and specificity in detection of proximal RAS comprised between 88%-100% and 71%-100% respectively (table II). Because a severe RAS (i.e. degree of stenosis > 50%) may cause renal ischemia leading to a blood pressure elevation that is often difficult to control with medical therapy, imaging has to assess the severity of RAS. MRA assessment of hemodynamic significance of RAS can be further refined by considering additional factors (fig. 4): arterial stop of signal, post stenotic dilatation, delayed renal enhancement and functional changes in the renal parenchyma (i.e. reduced kidney length and parenchymal thickness, loss of corticomedullary differentiation) (fig. 1). Precise evaluation of degree of stenosis requires the development of dedicated software such as MARACAS (MAgnetic Resonance Angiography Computer ASsisted analysis) software (fig. 5). In conclusions, 3D enhanced MRA allows an accurate diagnosis of proximal RAS, mainly due to atherosclerosis, without the risks associated with nephrotoxic contrast agents, ionizing radiation or arterial catheterization.
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Affiliation(s)
- B Marchand
- Service de radiologie, Hôpital de la Croix-Rousse, 103 Grande rue de la Croix-Rousse, 69317 Lyon Cedex 04
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Chaabane L, Canet E, Serfaty JM, Contard F, Guerrier D, Douek P, Briguet A. Microimaging of atherosclerotic plaque in animal models. MAGMA 2000; 11:58-60. [PMID: 11186989 DOI: 10.1007/bf02678496] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- L Chaabane
- Laboratoire de RMN, CNRS UMR 5012, UCB-CPE, Villeurbanne, France.
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Adham M, Blanc P, Douek P, Henri L, Ducerf C, Baulieux J. Laparoscopic resection of a proximal splenic artery aneurysm. Surg Endosc 2000; 14:372. [PMID: 10854524 DOI: 10.1007/s004640010051] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/1999] [Accepted: 09/15/1999] [Indexed: 10/25/2022]
Abstract
The usual treatment for splenic artery aneurysm is resection under laparotomy. In recent years, the laparoscopic approach has consisted of ligation without resection. More recently,laparoscopic resection was reported by the Cleveland Clinic. In this paper, we describe the technique used in the laparoscopic resection of our first case of laparoscopic resection of splenic artery aneurysm (SAA). The patient was a young woman with a 12-mm SAA discovered on systematic abdominal ultrasound. The laparoscopic procedure was done successfully, and the aneurysm was resected using an ultrasonic dissector. The postoperative course was uneventful, and the patient was discharged on the 3rd postoperative day. Pathological examination revealed the atherosclerotic origin of the aneurysm. The patient is doing well 12 months after surgery, with normal splanchnic Doppler ultrasound. This procedure offers a one-step definitive cure via a minimally invasive surgical procedure.
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Affiliation(s)
- M Adham
- Department of General and Gastrointestinal Surgery and Liver Transplantation, Croix Rousse Hospital, 103, Gde rue de la Croix Rousse, 69317 Lyon, France.
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36
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Abstract
This study attempted to assess the accuracy and potential of lung magnetic resonance (MR) perfusion imaging compared with perfusion scintigraphy in the evaluation of patients with suspected lung perfusion defects. The technique, which uses an inversion recovery turbo-FLASH sequence with ultra-short TE (1.4 msec), was tested in 24 patients suspected clinically of having acute pulmonary embolism (n = 19) and in patients with severe pulmonary emphysema (n = 5). Perfusion lung scintigraphy was performed within 48 hours prior to the MRI examination in both groups of patients. The dynamic study was acquired in the coronal plane and consisted of 10 images of 6 slices (a total of 60 images per series). Gadopentetate dimeglumine (0.1 mmol/kg) was manually injected as a compact bolus during the acquisition of the first image. Three senior radiologists reviewed all unprocessed two-dimensional coronal sections. They were blinded to clinical data and other imaging modalities. For the three observers, the average sensitivity and specificity of MR were 69% and 91%, respectively. The overall agreement between MR and scintigraphy appears to be good, with a good correlation between the two modalities (kappa = 0.63). However, the data showed variability depending on the location of the perfusion defect, with higher accuracy in the upper lobes. The agreement between MR perfusion and scintigraphy appears to be moderate in the left inferior lobe (kappa = 0.48). The data showed an overall good interobserver agreement (kappa = 0.66). MR perfusion of the lung is a promising technique in detecting lung perfusion defects.
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Affiliation(s)
- Y Berthezène
- Department of Radiology, CREATIS UMR 5515, Hôpital Cardiologique, Lyon, France.
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37
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Abstract
PURPOSE To assess the clinical feasibility of an experimental modified angiographic system capable of real-time digital stereofluoroscopy and stereography in X-ray angiography, using a twin-focus tube and a stereoscopic monitor. METHODS We report the experience obtained in 37 patients with a well-documented examination. The patients were examined for coronary angiography (11 cases), aortography (7 cases), pulmonary angiography (6 cases), inferior vena cava filter placement (2 cases), and cerebral angiography (11 cases). Six radiologists were asked to use stereoscopic features for fluoroscopy and angiography. A questionnaire was designed to record their subjective evaluation of stereoscopic image quality, ergonomics of the system, and its medical interest. RESULTS Stereofluoroscopy was successfully used in 25 of 37 cases; diplopia and/or ghost images were reported in 6 cases. It was helpful for aortic catheterization in 10 cases and for selective catheterization in 5 cases. In stereoangiography, depth was easily and accurately perceived in 27 of 37 cases; diplopia and/or ghost images were reported in 4 cases. A certain gain in the three-dimensional evaluation of the anatomy and relation between vessels and lesions was noted. As regards ergonomic considerations, polarized spectacles were not considered cumbersome. Visual fatigue and additional work were variously reported. Stereoshift tuning before X-ray acquisition was not judged to be a limiting factor. CONCLUSION A twin-focus X-ray tube and a polarized shutter for stereoscopic display allowed effective real-time three-dimensional perception of angiographic images. Our clinical study suggests no clear medical interest for diagnostic examinations, but the field of interventional radiology needs to be investigated.
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Affiliation(s)
- T Moll
- CREATIS, associated to CNRS (UMR 5515) and affiliated to INSERM, Service de Radiologie, Hôpital Cardiovasculaire et Pneumologique, BP Lyon Montchat, F-69394 Lyon cedex 03, France
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Finet G, Moll T, Tabib A, Ovize M, Douek P, Roriz R, Loire R, Amiel M, Beaune J. [Analysis of the diagnostic value of endovascular ultrasound with roc curves. Practical implications]. Arch Mal Coeur Vaiss 1997; 90:59-66. [PMID: 9137716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Intravascular ultrasound enables detection of the components of atherosclerotic plaques. The diagnostic value was assessed by ROC (receiver operating characteristic) curves on images acquired in vitro and correlated with the histological findings in 61 arteries. Five questions were asked of each operator; the reply was represented by a continuous variable in order to express all nuances of judgement. The area under the ROC curve, Az, was the criterion of performance (0.5 : chance response : 1.0 : all replies were accurate). Detection of plaque was satisfactory (Az = 0.89). The three layer appearance of muscular arteries was well recognised (Az = 0.94). The fibrous composition of a plaque was only just satisfactory (Az = 0.88) with 38.7% interindividual variability. The lipid composition of the plaque was poorly recognised (Az = 0.76) with large interindividual variability (52.8%) : hypoechogenicity was too ambiguous a sign from the acoustic point of view. A hypoechogenic zone must not be synonymous with a lipid plaque but a cellular zone. Calcium can almost always be detected (Az = 0.98) with a very low interindividual variability (10.7%), fibrohyaline progression of some plaques can be confusing. The authors present a more objective description of endovascular ultrasonographic images. They conclude that the diagnostic performance of 30 MHz intravascular ultrasound is satisfactory but several limitations are apparent in the interpretation of images, especially hypoechogenic zone and hyper-reflective zones with high attenuation.
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Affiliation(s)
- G Finet
- Services d'hémodynamique et de radiologie, hôpital cardiovasculaire et pneumologique, hospices civils de Lyon
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39
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Loubeyre P, Delignette A, Bonefoy L, Douek P, Amiel M, Revel D. Magnetic resonance imaging evaluation of the ascending aorta after graft-inclusion surgery: comparison between an ultrafast contrast-enhanced MR sequence and conventional cine-MRI. J Magn Reson Imaging 1996; 6:478-83. [PMID: 8724414 DOI: 10.1002/jmri.1880060311] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to compare the value of two magnitude-based MR sequences, a contrast-enhanced ultrafast MR sequence and a cine MR sequence, for the detection of flow around the graft in the postoperative ascending thoracic aorta. Thirteen patients who underwent ascending aortic surgery for dissection (n = 11) and aneurysm (n = 2) were enrolled. They were referred to MRI for mediastinum enlargement on the chest x-ray or mediastinal symptoms. All patients had replacement of the diseased ascending aorta using a graft-inclusion technique (with wrapping of the native aorta over the graft). Delays between surgery and MRI ranged from 15 days to 8 years (mean: 10 months). All patients were examined using a T1-weighted spin-echo sequence, a magnitude-based cine gradient-echo sequence, and an ultrafast contrast-enhanced MR sequence. MR images of the cine and the contrast-enhanced sequences were retrospectively and independently analyzed by two qualified radiologists for evidence of flow or thrombus around the graft, including perigraft structure and aneurysmal formations. Evidence of flow was detected by both methods in all aneurysmal formations of the ascending aorta located at suture level (n = 6). Evidence of flow in the perigraft structure was found in seven cases by contrast-enhanced MR sequence and in only four cases by cine MR sequence. Contrast-enhanced ultrafast MR sequence could be proposed as a minimally invasive and fast modality for assessing the perigraft structure, in graft-inclusion surgical procedures of the ascending aorta, when noncontrast enhanced MR sequences do not exclude the possibility of flowing blood in this structure.
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Affiliation(s)
- P Loubeyre
- Department de Radiologie, Höpital Cardiovasculaire et Pneumologique-L. Pradel, BP Lyon Montchat, France
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40
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Douek P, Revel D, Amiel M. [Magnetic resonance angiography]. Rev Prat 1996; 46:835-41. [PMID: 8761743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Magnetic resonance angiography (MRA) is a non invasive method for studying the morphology and the hemodynamic of vessels. MRA is becoming well-established for aorta examination and has replaced aortography. MRA is very competitive in screening for renovascular hypertension, intracranial aneurysm, for evaluation of the carotid bifurcation and diagnosis of venous sinus thrombosis. In the future, clinical applications will include pulmonary and coronary arteries.
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Affiliation(s)
- P Douek
- Service de radiologie, Hôpital de la Croix-Rousse, Lyon
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41
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Conord S, Thiesse P, Kaemmerlen P, Douek P. [Multiple malformation syndrome: situs inversus, multiple spleen and congenital anomaly of the inferior vena cava]. J Radiol 1996; 77:145-7. [PMID: 8729345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- S Conord
- Département de Radiologie, Centre Régional Léon-Bérard, Lyon
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Nourdine K, Nesme P, Perol M, Douek P, De La Roche E, Bejui-Thivolet F, Loire R, Champsaur P, Guerin JC. [Rare etiology of multiple pulmonary lacunae]. Rev Pneumol Clin 1996; 52:391-397. [PMID: 9033933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Sarcoma of the common pulmonary artery are rare malignant tumors which can mimic pulmonary embolism. In the case presented here, the inaugural signs were particularly misleading: multiple pulmonary lacunae on computed tomography. The unusual aspect and asymmetric localizations at pulmonary angiography then suggested the doubtful nature of the embolism etiology. Magnetic resonance imaging findings suggested the diagnosis of sarcoma of the pulmonary artery. Certain diagnosis was obtained at pathology examination of the surgical specimen after thoracotomy. A malignant fibrous histiocytoma was identified. Curative resection was not possible and chemotherapy was performed. Unusual parenchymal lesions were then evidenced on the radiography. Better and better magnetic resonance imaging criteria are described in the literature and help distinguish between thromboembolism and sarcoma of the pulmonary artery. Follow-up of the clinical course is thus improved. It is nevertheless necessary to evaluate intravascular extension to determine whether curative surgery is possible.
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Affiliation(s)
- K Nourdine
- Service de Pneumologie, Hôpital de la Croix-Rousse, Lyon
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43
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Douek P, Revel D, Amiel M. [Exploration of the thoracic aorta, excluding the aortic valve]. Ann Cardiol Angeiol (Paris) 1995; 44:552-60. [PMID: 8787331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
MRI has become the reference technique for the diagnosis and assessment of thoracic aortic aneurysms and subacute or chronic aortic dissections, and in the postoperative surveillance of the thoracic aorta. Several MRI techniques can now be used to investigate the thoracic aorta. The technique most widely used at the present time is Spin Echo imaging, which allows a multi-plane morphological approach to the thoracic aorta. It is often completed by a dynamic gradient echo sequence (cine-MRI) and, more recently, by ultra-rapid sequences (Turbo-Flash) following the injection of contrast agent. Phase-coding has also been proposed for the various intraluminal velocities. In the emergency situation, the examination of choice is less clearly defined due to the development of new techniques (transoesophageal ultrasonography, spiral computed tomography, MRI). The diagnostic strategy depends on the patient's clinical state, the respective advantages and limitations of each technique and the human and material resources available.
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Affiliation(s)
- P Douek
- Service de Radiologie, Hôpital de la Croix-Rousse, Lyon
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44
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Canet E, Douek P, Janier M, Bendid K, Amaya J, Millet P, Revel D. Influence of bolus volume and dose of gadolinium chelate for first-pass myocardial perfusion MR imaging studies. J Magn Reson Imaging 1995; 5:411-5. [PMID: 7549202 DOI: 10.1002/jmri.1880050407] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
First-pass MR myocardial perfusion measurements require a well-defined left ventricular (LV) blood pool input function. We used a peripheral intravenous (i.v.) injection of a gadolinium (Gd) chelate to obtain a well-characterized LV time-intensity curve. Using a strongly T1-weighted subsecond MR sequence, we performed cardiac MR imaging after administering an IV bolus injection of one of three different doses of the Gd chelate: a standard dose (0.1 mmol/kg, group I, n = 8); a low dose with two bolus volumes (0.01 mmol/kg, 1/10e bolus volume, group II, n = 7, and 0.01 mmol/kg diluted in saline, same bolus volume as group I, group III, n = 3); and an intermediate dose (0.05 mmol/kg, group IV, n = 5). Unlike in group I (high dose), in groups II and III (low dose), the LV curve had a well-defined first peak, followed by a downslope and a recirculation peak. With the intermediate dose (group IV), a saturation effect still remained on the LV curve. The signal intensity (SI) enhancement of the myocardium was respectively 580 +/- 77% at 0.1 mmol/kg, 362 +/- 95% at 0.05 mmol/kg, and at 0.01 mmol/kg, it was 184 +/- 33% in group II and 272 +/- 8% in group III. In conclusion, with subsecond T1-weighted MR imaging and a low dose of Gd chelate (i.e., 0.01 mmol/kg), the LV input function is a well-defined first step for MR perfusion modeling.
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Affiliation(s)
- E Canet
- Service de Radiologie, Professeur M. Amiel Hôpital Cardiovasculaire et Pneumologique, Lyon, France
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45
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Matar FA, Mintz GS, Douek P, Farb A, Virmani R, Javier SP, Popma JJ, Pichard AD, Kent KM, Satler LF. Coronary artery lumen volume measurement using three-dimensional intravascular ultrasound: validation of a new technique. Cathet Cardiovasc Diagn 1994; 33:214-20. [PMID: 7874714 DOI: 10.1002/ccd.1810330305] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To validate an automated algorithm for the measurement of lumen volumes of coronary arteries. BACKGROUND Current intravascular ultrasound systems use absolute measurements of and changes in areas and diameters for the assessment of coronary artery disease. However, the coronary artery is a three-dimensional structure of complex geometry and volume. METHODS We used a comprehensive imaging system designed to reconstruct planar intravascular ultrasound images in three dimensions. This system consisted of a 25 MHz transducer-tipped rigid probe (for in vitro studies) or a 25 MHz transducer-tipped catheter within a 3.9F monorail imaging sheath (for in vivo studies), a motorized catheter pullback device that withdrew the transducer at 0.5 mm/sec, and an image processing computer that stacked 15 image slices/mm of vessel axial length and then performed threshold-based three-dimensional image rendering and lumen volume measurement. We imaged 13 human coronary vessels (6 RCA, 6 LAD, 1 LCX) in vitro and 16 vessels (8 LAD, 6 RCA, 2 SVG) in vivo. RESULTS IN VITRO STUDIES Lumen volumes derived by three-dimensional intravascular ultrasound were 171 +/- 121 mm3 and compared very well with those derived by histology (160 +/- 109 mm3, r = 0.97, SEE = 29 mm3, P < 0.001) and with those derived by manual planimetry of planar intravascular ultrasound images (150 +/- 106 mm3, r = 0.97, SEE = 30 mm3, P < 0.001). In vivo studies: Lumen volumes derived by three-dimensional intravascular ultrasound were 74 +/- 35 mm3 and compared well with those derived by quantitative angiography (52 +/- 20 mm3, r = 0.71, SEE = 25 mm3, P < 0.002). CONCLUSIONS Three-dimensional intravascular ultrasound is a new technique that can accurately measure coronary artery lumen volumes. Further technical improvements may help to establish this technique as the new standard for lumen volume measurement.
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Affiliation(s)
- F A Matar
- Cardiac Catheterization Laboratory, Washington Hospital Center, DC
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Matar FA, Mintz GS, Farb A, Douek P, Pichard AD, Kent KM, Satler LF, Popma JJ, Keller MB, Pinnow E. The contribution of tissue removal to lumen improvement after directional coronary atherectomy. Am J Cardiol 1994; 74:647-50. [PMID: 7942520 DOI: 10.1016/0002-9149(94)90303-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The contribution of tissue removal to lumen improvement after directional coronary atherectomy remains controversial. The purpose of this study was to validate the intravascular ultrasound measurement of plaque volume and use it to study the contribution of tissue removal to lumen improvement after directional coronary atherectomy. With use of intravascular ultrasound, 12 human coronary vessels were imaged in vitro. With use of computer-assisted planimetry, the external elastic membrane and lumen cross-sectional areas were manually traced and the plaque+media area was calculated at 1 mm axial intervals. Then, plaque+media volume was calculated by Simpson's rule. After imaging, ultrasound measurements of plaque+media volume were compared with histologic measurements. Similarly, volumetric intravascular ultrasound imaging was performed before and after directional atherectomy in 47 patients. In vitro, the mean plaque+media volume measured by intravascular ultrasound was 134.0 +/- 94.8 mm3 and compared well with that derived by histology (187.4 +/- 128.8 mm3, r = 0.96, p < 0.001). In vivo, the lumen volume increased from 27.2 +/- 12.3 to 58.7 +/- 30.3 mm3, and the mean plaque+media volume decreased from 122.0 +/- 74.0 to 97.5 +/- 63.5 mm3. The mean intravascular ultrasound atherectomy index was 76 +/- 23%. In 11 of the 47 patients (23.4%), tissue removal alone accounted for lumen improvement. Volumetric intravascular ultrasound image analysis indicates that the mechanism of directional coronary atherectomy primarily is tissue removal. As a result, the contribution of arterial remodeling (expansion and dissection) probably is less important.
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Affiliation(s)
- F A Matar
- Intravascular Ultrasound Imaging Laboratory, Washington Hospital Center, D.C
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47
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Loubeyre P, Revel D, Douek P, Delignette A, Baldy C, Genin G, Amiel M. Dynamic contrast-enhanced MR angiography of pulmonary embolism: comparison with pulmonary angiography. AJR Am J Roentgenol 1994; 162:1035-9. [PMID: 8165977 DOI: 10.2214/ajr.162.5.8165977] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Subsecond contrast-enhanced MR angiography, which is not a flow-based technique and does not require cardiac gating or breath-holding, provides multiplanar, rapid, dynamic visualization of the pulmonary arteries. Accordingly, we evaluated the use of this technique in the diagnosis of thrombi in both the proximal and peripheral portions of the pulmonary arteries. Digital subtraction angiography was used as the gold standard for the diagnosis. SUBJECTS AND METHODS Twenty-three consecutive patients with suspected pulmonary embolism were included in the study. All patients had intraarterial digital subtraction angiography, which showed emboli in 12 patients (13 proximal and six peripheral emboli). MR angiography was done within 24 hr of digital subtraction angiography. Subsecond contrast-enhanced MR angiograms were obtained in the long axis of each pulmonary artery after a unique injection of contrast medium (0.1 mmol/kg) in an antecubital vein. Fifteen dynamic frames of each pulmonary artery were alternately obtained in less than 1 min. MR angiograms were interpreted by two observers who had no knowledge of the findings on digital subtraction angiography. A diagnosis of pulmonary emboli was made when MR angiograms showed a constant intraluminal filling defect or an abrupt vascular cutoff. RESULTS All thrombi in the proximal branches of the pulmonary arteries were visualized on MR angiograms (n = 13), whereas none of the thrombi in the distal part of the pulmonary arteries were seen (n = 6). In the 11 patients in whom no pulmonary emboli were shown by digital subtraction angiography, findings on MR angiograms were normal (sensitivity, 0.7; specificity, 1.0). CONCLUSION Our results suggest that dynamic contrast-enhanced MR angiography is an accurate method for detecting emboli in the proximal portions of the pulmonary arteries but is of no value in detecting peripheral emboli.
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Affiliation(s)
- P Loubeyre
- Département de Radiologie, Hôpital Cardiovasculaire et Pneumologique, Lyon Montchat, France
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48
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Finet G, Tabib A, Maurincomme E, Douek P, Roriz R, Amiel M, Beaune J. [Artefacts and intravascular ultrasonography. Analysis and implications for a better reliability in the interpretation of images and measurements]. Arch Mal Coeur Vaiss 1994; 87:271-80. [PMID: 7802536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Intravascular ultrasound catheters provide cross-sectional images of vessel walls and surrounding tissues with rotating transducers, and the behavior of ultrasound in heterogeneous media both cause degradation of image quality. Qualitative and quantitative analyses of in vivo studies are operator-dependent and limited by artifacts. We investigated these limitations by an in vitro study on plexiglass phantoms and segments of fresh arteries. We observed, analyzed and interpreted the most specific reasons for image artifacts: geometric distortions, the point spread function of the imaging system and the near field effects. Various practical implications have resulted from this study. Knowledge of the most obvious pitfalls will enable the user to obtain maximum benefits from intravascular ultrasound imaging, and to appreciate its limitations.
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Affiliation(s)
- G Finet
- Service d'hémodynamique, Hôpital cardiologique et pneumologique, BP Lyon-Monchat
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49
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Baldy C, Douek P, Croisille P, Magnin IE, Revel D, Amiel M. Automated myocardial edge detection from breath-hold cine-MR images: evaluation of left ventricular volumes and mass. Magn Reson Imaging 1994; 12:589-98. [PMID: 8057763 DOI: 10.1016/0730-725x(94)92453-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This paper describes an automated edge detection method for the delineation of the endo- and epicardial borders of the left ventricle from magnetic resonance (MR) images. The feasibility of this technique was demonstrated by processing temporal series of cardiac MR images obtained in 12 healthy subjects and acquired from the apex to the base of the heart in multiple anatomic short axis planes with a breath-hold cine-MR acquisition sequence. This procedure allows the entire heart to be imaged in less than 5 min. The automatic program correctly identified the edges in most cases. In poor contrasted images, a fast and user-friendly interactive procedure was used to correct the border delineation. The proposed method for the contour tracing requires a limited degree of control by the user and thus considerably reduces the tedious and long operator time inherent in the usual manual contour tracing tool. The left ventricular volumes were directly measured from these sets of contours by using the Simpson rule, allowing the end-diastolic volumes (EDV), the end-systolic volumes (ESV), the ejection fraction (EF) and the myocardial mass to be determined. The values measured in this study with the dedicated software were similar to the literature values (EDV = 78.3 ml/m2; ESV = 21.1 ml/m2; EF = 73%). Associated with the ultrafast breath-hold cine-MR imaging, the described edge detection method provides an efficient clinical tool for the direct assessment of cardiac function.
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Affiliation(s)
- C Baldy
- URA CNRS 1216, Departement de Radiologie, Hôpital Cardiovasculaire et Pneumologique, BP Lyon Montchat, France
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50
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Finet G, Tabib A, Douek P, Maurincomme E, Roriz R, Loire R, Amiel M, Beaune J. [Intravascular echographic imaging: experimental validations and limits. An in vitro study]. Arch Mal Coeur Vaiss 1993; 86:1373-81. [PMID: 8129556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Intravascular ultrasound is a new method of visualizing details of vascular pathology, providing (real time) high resolution images of vascular walls. Most of the research on the technique has explored its qualitative and quantitative capabilities to improve the assessment of atherosclerotic vascular disease in vivo. Intravascular ultrasound differs from angiography and angioscopy in its ability to penetrate below the surface of the vessel lumen, demonstrating specific appearances of the distribution and composition of plaque. Image analysis is operator dependent. Although this technology is very promising limitations such as artefacts and loss of image quality in heavily calcified vessels hinder its use. There is hope that this imaging technique may ultimately improve the results of endovascular interventions.
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Affiliation(s)
- G Finet
- Services d'hémodynamiques et de radiologie, hôpital cardiologique et pneumologique, Lyon
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