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Archive for the ‘CT’ Category

The MVA planimetrically decided by MDCT is methodically larger than that measured by cardiac catheterization and Doppler transthoracic echocardiogram;

Due to good correlation amid methods and regulation for the systematic bias, MDCT may facilitate steady quantification of MVS, and effective distinction amid severity grades.

 

The medical research was contributed by Alexander Lembcke, Tahir Durmus, Yvonne Westermann, Anja Geigenmueller, Benjamin Claus, Craig Butler and Holger Thiele from the Department of Radiology and Cardiovascular Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany; Department of Medicine, Division of Cardiology, University of Alberta, Edmonton, AB, Canada; and Department of Cardiology, Heart Center, University of Leipzig, Leipzig, Saxony, Germany. (Courtesy: American Journal of Roentgenology)

The research objective was to equate diagnostic performance of helical MDCT over cardiac catheterization, and transthoracic echocardiography, for the quantification of mitral valve stenosis (MVS).

About 28 patients with mitral valve stenosis passed through ECG-gated contrast-enhanced MDCT scan. The mitral valve area (MVA) was planimetrically established by MDCT; it was equated with Doppler TTE (transthoracic echocardiogram) through pressure half-time method. Gorlin formula was used for equation with cardiac catheterization.

Of results, planimetry of the mitral valve area with MDCT was plausible in all the cases; the MVA on MDCT was considerably larger than the same with cardiac catheterization, or transthoracic echocardiogram. (vide: Cardiology)

Correlation amid TTE & MDCT, cardiac catheterization & MDCT were good and identical to the correlation amid cardiac catheterization & TTE; the best cutoff level (concentration) for discovering moderate-severe stenosis at MDCT was an MVA of 1.70 cm2.

Conclusion: the MVA planimetrically decided by MDCT is methodically larger than that measured by cardiac catheterization and Doppler transthoracic echocardiogram; due to good correlation amid methods and regulation for the systematic bias, MDCT may facilitate steady quantification of MVS, and effective distinction amongst severity grades.

64-MDCT with volume image reading directed to apparent benefits in the radiologic trauma workflow, in contrast with 4-MDCT: study

 

The medical research study was contributed by Markus Körner, Lucas L. Geyer, Stefan Wirth, Maximilian F. Reiser and Ulrich Linsenmaier from the Department of Clinical Radiology, Munich University Hospital, Nussbaumstrasse, Munich, Germany.

The research objective was to assess the effect of 64-MDCT and volume reading on radiologic workflow, on a mass casualty incident model. (Courtesy: American Journal of Roentgenology)

For the model/imitation, casualties were taken to level I trauma center; triage was done, through with whole-body 64-MDCT.

Uninterpreted/raw data of thin-section images were passed over to dedicated 3D workstation; the new reading mode is referred to as volume image reading.

For workflow evaluation, subsequent were recorded: examination time, time required to process image, and transfer rates (mean image); the findings were equated with that of previous study through a 4-MDCT with axial images only, and transmission of data to a PACS.

The time for complete image processing for 64-MDCT – that is to acquire, reconstruct and transfer was 4.1 minutes; for 4-MDCT, it was 9.0 minutes.

About image processing capacity: for 64-MDCT – it was 14.8 examinations/h; while for 4-MDCT – it was 6.7 examinations/h.

Mean number of images in case of 64-MDCT was 953, in contrast to 4-MDCT which had 202.

No considerable deviations were established amid 64-MDCT and 4-MDCT, for the time required to organize patients.

Conclusion: 64-MDCT with volume image reading directed to apparent benefits in the radiologic trauma workflow, in contrast with 4-MDCT.

The novel technology is feasible for rapid, accurate heart scans: to measure blood supply to the heart muscle, and to view blood vessels – at one go; this will subject patients to less radiation: research study

 

About 39 patients encompassed the study; second-generation, 128 slice dual-source CT was utilized for preliminary examinations – it captured images of the heart, and allowed doctors for improved visualization of artery blockages, and lessened blood flow through the heart. (Courtesy: American Heart Association)

The technology utilized 1/10th of radiation of standard CT approaches for heart disorders; high-pitch (Flash) CT ensures extremely fast scan time.

A medical contrast medium and vasodilatator was used for to accentuate specific regions, of interest; the examination is convenient and faster for the patient, corroborates Gudrun M. Feuchtner (M.D., Department of Radiology, Innsbruck Medical University in Innsbruck, Austria)

In about 0.3 seconds entire heart gets captured by, through the technology; traditional CT scans take 6 seconds and several heart beats, for the same.

For precision, the technology was equated to cardiac MRI and invasive angiogram – both sometimes call for contrast dyes.

In comparison to cardiac MRI, the new CT technology precisely recognized restricted blood flow 78-95% of times, and exactly rejected it 84-94% of times.

Analogy with invasive angiography, the new CT technology showed 90% accuracy for considerable blockages; when combined with CT perfusion, it showed the accuracy of 95%.

Diabetic patients with nerve damage may miss to experience the chest pain; but, the scan demonstrated well for diabetic patients (poor coronary blood flow), and other with advanced heart disorders.

Precise heart surgeries can be planned effectively after the study findings, asserts André Plass (Co-author, Cardiac surgeon, University Hospital Zurich in Switzerland).

The technology addresses two concerns, with a single scan, of: reduced blood flow and narrowed blood vessels of the heart. Two studies at one go through the new CT technology ensure cost benefits, and increased efficiency, for the care units.

Further studies are required prior the new technology is extensively utilized, conclude researchers.

Enhanced visualization of central/peripheral arteries can be acquired with low-energy pulmonary CT angiography, without a considerable decrease in image quality: study report

 

The medical research was contributed by Naama R. Bogot, Alexander Fingerle, Dorith Shaham, Izhak Nissenbaum and Jacob Sosna from Department of Radiology – Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel; University of Michigan Hospitals, Ann Arbor, MI; Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Beth Israel Deaconess Medical Center, Boston, MA.

The research objective was to potentially equate visualization of central/peripheral pulmonary arteries on concurrently obtained standard and low-energy pulmonary CT angiography. (Courtesy: American Journal of Roentgenology)

About 33 patients with doubtful pulmonary embolism passed through single-source dual-layer dual energy MDCT scan; image noise and attenuation were gauged at main/segmental pulmonary arteries; SNRs (signal-to-noise ratios) were measured; through maximum-intensity projection (MIP) algorithm, segmental/sub-segmental artery visibility was evaluated by two-blinded radiologists, in agreement. Kappa statistics and non-parametric sign test were utilized for statistical analysis.

Of results, pulmonary embolism was recognized in about 3 patients; subsegmental emboli and segmental vessel were observed in low-energy images; higher attenuation was found in standard over low-energy images for all arteries assessed; low-energy images enhanced visualization of segmental/sub-segmental arteries.

A larger amount of sub-segmental vessels was observed on low-energy MIP restoration in majority of studies (69.7%), in comparison to 9.1% on standard images; through low-energy imaging, visualization of subsegmental vessels was higher in 55.5% of cases; mean SNR (signal-to-noise ratio) did not show any considerable deviation in standard over low-energy CT images.

Conclusion: enhanced visualization of central/peripheral arteries can be acquired with low-energy pulmonary CT angiography, without a considerable decrease in image quality.

pneumo-64-MDCT proves feasible for esophageal wall thickening, and to stage esophageal cancer

 

The medical research was contributed by Marina Ulla, Ernestina María José Gentile, Demetrio Cavadas, Ezequiel Levy Yeyati, Laura Frank, Javier Ithurralde Argerich and Ricardo Garcia Mónaco from Department of Radiology and Surgery; Hospital Italiano, Universidad de Buenos Aires, Argentina. (Courtesy: SpringerLink)

Early identification and precise staging of esophageal cancer are fundamental for therapeutic schemes.

CT, PET, and endoscopic ultrasound have been well utilized, individually and otherwise in combination for pre-operative staging of esophageal cancer.

Delineation of anatomic location of tumor facilitate for surgical plan; PET and endoscopic ultrasound are potent, but neither support for surgical plans.

Computed tomography has restrictions for hollow organs, with shortage of lumen distension; optical esophageal distension is beneficial to surmount these restraints; the possible disadvantage is vital at gastro-esophageal junction (GE junction), particularly difficult to assess.

For optimal tumor visualization in the GE junction and esophageal wall, the team developed a method – pneumo-64-MDCT.

Maximum lumen distension is achieved that portrays the thickened regions in association to the regular esophageal wall.

The team executed 200 studies through this method, and it showed beneficial, secure and precise for esophageal wall thickening, and for to stage esophageal cancer.

The extra stomach distension led to a sufficient explanation of lower and upper regions of the lesion in tumors situated in the gastro-esophageal junction; this in turn was beneficial to fabricate surgical approach.

Due to high sensitivity, nuclear medicine is feasible for early stage disorders, for timely interventions;

Practitioners should be well acquainted of radiation risk and dosimetry, for better patient outcomes.

 

The significance of pediatric nuclear medicine is well constituted; pediatric patients are directed to nuclear medicine from all related specialties, inclusive of orthopedics, oncology, urology, cardiology, to name a few.

Pediatric nuclear medicine aids with fundamental and significant information required for to diagnose, stage, treat and follow-through a range of disorders, inclusive of endocrine, renal, cardiopulmonary, gastrointestinal and central nervous systems. (Courtesy: The Journal of Nuclear Medicine)

Due to high sensitivity, nuclear medicine is feasible for early stage disorders, for timely interventions; the non-invasive approach makes it significant for assessment of children, and is far effective than other diagnostic imaging approaches.

It provides valuable information that may not be easy through other diagnostic approaches, some of which may be more invasive or result in higher radiation exposures.

Small amounts of radiopharmaceuticals are administered to the patient; these radiopharmaceuticals give off subsequent radiations: positrons, x-rays, γ-rays, β-particles etc.

There has been a remarkable increase in medical imaging, across the U.S.; following procedures were being found common with patients: CT, plain radiograph, fluoroscopy/angiography, nuclear medicine etc.

Number of CT scans rose 4-times in past few decades; in the U.S., from 1984-2006 it showed 3-fold increase in nuclear medicine procedures, and about 1% of these are done on children.

Risk associated with radiation exposure is high in younger patients, as increased hazard due to medical imaging is a prime concern; medical practitioners of pediatric nuclear medicine should be well acquainted of radiation risk and dosimetry, for better patient outcomes.

For to image the urinary tract, CT urography has taken precedence over intravenous urography: various study reports suggest

 

Many urological conditions/symptoms have become easy now through CT urography; speed and spatial resolution of CT scanners, with multiplanar and volume-rendered construction make it feasible for kidneys, ureters, urinary bladder etc.!

For patients with asymptomatic microscopic hematuria, CT urography/IV have been suggested across the urological association; and so for assessment of hematuria, for blood in the urine.

Most CT urography approaches are triphasic; the technology is plausible for benign/malignant renal masses, especially during nephrographic phase, and doable for type of bladder injury, and posterior urethral ruptures, to name a few.

Its applications are unlimited; for more on the thread and related, stay attuned with MedicExchange!

Dynamic CT-based stress myocardial perfusion imaging is plausible for  hemodynamically significant coronary artery stenosis.

 

The medical research was contributed by Fabian Bamberg, MD, MPH; Alexander Becker, MD; Florian Schwarz, MD; Roy P. Marcus, BS; Martin Greif, MD; Franz von Ziegler, MD; Ron Blankstein, MD, MPH; Udo Hoffmann, MD, MPH; Wieland H. Sommer, MD; Verena S. Hoffmann, PhD; Thorsten R. C. Johnson, MD; Hans-Christoph R. Becker, MD; Bernd J. Wintersperger, MD; Maximilian F. Reiser, MD and Konstantin Nikolaou, MD from the Departments of Clinical Radiology and Cardiology, Ludwig-Maximilians University, Klinikum Grosshadern, Munich, Germany; Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; and Institute of Biomedical Epidemiology, Ludwig-Maximilians University, Munich, Germany.

The research objective was to determine possibility of CT-based dynamic myocardial perfusion imaging for hemodynamically important coronary artery stenosis, as determined with fractional flow reserve. (Courtesy: RSNA)

Subjects with known coronary artery disease passed through electrocardiographically stirred dynamic stress myocardial perfusion imaging (MPI).

Fractional flow reserve was measured with a luminal narrowing of 50%–85% (within main coronary arteries).

Calculated myocardial blood flow was gathered from CT images through parametric deconvolution for segments; was associated to hemodynamically substantial coronary artery stenosis with fractional flow reserve (0.75 or less) in a blinded manner.

Traditional estimates of diagnostic precision were obtained, and logistic regression analysis was put in use for discriminatory power analysis.

About 33 subjects finished the study procedure; diagnostic precision of CT for anatomically vital stenosis (coronary artery) was high; low for hemodynamically considerable stenosis.

Through with gauged myocardial blood blow, 43% coronary lesions were marked as not hemodynamically important, which considerably increased positive predictive value to 78%; the existence of a coronary artery stenosis with comparable myocardial blood flow less than 75 mL/100 mL/min had a high risk for hemodynamic significance.

Conclusion: dynamic CT-based stress myocardial perfusion imaging is feasible for hemodynamically significant coronary artery stenosis.

Sensitivity of CT enterography for small bowel masses/bleeding sources is higher than that to capsule endoscopy;

Multi-phase CT enterography for usual diagnostic approach in obscure gastrointestinal bleeding is feasible, especially with negative results through capsule endoscopy.

 

The medical research study was contributed by James E. Huprich, MD; Joel G. Fletcher, MD; Jeff L. Fidler, MD; Jeffrey A. Alexander, MD; Luís S. Guimarães, MD; Hassan A. Siddiki, MBBS and Cynthia H. McCollough, PhD from the Departments of Radiology, and Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

The research objective was to equate performance of multi-phase CT enterography with capsule endoscopy in patients with obscure gastrointestinal bleeding. (Courtesy: RSNA Journal)

Deprived of clinical data/results of capsule endoscopy, independent radiologists translated images from CT enterography; inconsistent translations were solved by agreement.

Findings were equated with that from reference standard and clinical re-examination; for each modality – confidence intervals and sensitivity were gauged.

About 58 patients referred for assessment of obscure gastrointestinal bleeding (OGIB); about 57% patients passed through both the tests; in 28% cases, small bowel bleeding origin was recognized out.

Sensitivity of CT enterography was considerably greater than capsule endoscopy; it showed more small bowel masses; follow-up examination did not show any small bowel tumors.

Conclusion: sensitivity of CT enterography for small bowel masses/bleeding sources was considerably greater than that to same of capsule endoscopy, in the reference populace; on grounds of it, multi-phase CT enterography for usual diagnostic approach in OGIB can be counted, especially with negative results through capsule endoscopy.

CT scans for appendicitis has soared across the U.S. among children and adults; increased use of X-rays has raised grave concern in the healthcare market: a study report

 

Appendicitis is an inflammation/rubor of the vermiform/cecal appendix; grave intricacies can result out of ruptured appendix.

Computed tomography is most precise for appendicitis but higher radiation compared to conventional X-ray is a worrisome factor, according to a study published in the Annals of Emergency Medicine.

The percentage of CT scan for appendicitis in the U.S. emergency rooms shot up to 69% (in 2006), from 6% in 1996, the study corroborates.

Most of opt for combination medical imaging; ultrasound is another feasible alternative over CT, as it does not expose patient to radiation.

More personalized approach with doctor-patients at emergency rooms, on symptoms and histories were found beneficial, than relying solely on diagnostic imaging, to manage their conditions.

Performance of CT for appendicitis is required to be explored fully, for more sensible use.