This review paper aims to summarize cardiac CT blooming artifacts,how they present clinically and what their root causes and potential solutions are.A literature survey was performed covering any publications with a s...This review paper aims to summarize cardiac CT blooming artifacts,how they present clinically and what their root causes and potential solutions are.A literature survey was performed covering any publications with a specific interest in calcium blooming and stent blooming in cardiac CT.The claims from literature are compared and interpreted,aiming at narrowing down the root causes and most promising solutions for blooming artifacts.More than 30 journal publications were identified with specific relevance to blooming artifacts.The main reported causes of blooming artifacts are the partial volume effect,motion artifacts and beam hardening.The proposed solutions are classified as high-resolution CT hardware,high-resolution CT reconstruction,subtraction techniques and post-processing techniques,with a special emphasis on deep learning(DL)techniques.The partial volume effect is the leading cause of blooming artifacts.The partial volume effect can be minimized by increasing the CT spatial resolution through higherresolution CT hardware or advanced high-resolution CT reconstruction.In addition,DL techniques have shown great promise to correct for blooming artifacts.A combination of these techniques could avoid repeat scans for subtraction techniques.展开更多
Background: Cardiac output can be estimated during retrospectively gated CT coronary angiography by anatomically determining left ventricular volumes;prospective triggering to minimize radiation precludes this methodo...Background: Cardiac output can be estimated during retrospectively gated CT coronary angiography by anatomically determining left ventricular volumes;prospective triggering to minimize radiation precludes this methodology. We propose an alternative method for cardiac output estimation based on preclinical models suggesting that cardiac output may be inversely related to contrast washout from the aortic root during timing bolus scanning, as measured by peak aortic root contrast attenuation. Methods: 34 patients had CT coronary angiography timing bolus performed with 20 ml iodixanol at 5.5 ml/s followed by 20 ml normal saline at 5.5 ml/s through an 18-Ga antecubital catheter. Peak aortic root contrast attenuation was correlated to cardiac output calculated by echocardiography using heart rate stroke volume from biplane Simpson’s method.Results: Mean age was 58 ± 13 years;body surface area, 2.0 ± 0.5 m2. 53% were women. Stroke volume, cardiac output and cardiac index were 67 ± 19 ml, 4.5 ± 1.6 L/min, and 2.2 ± 0.7 L/min/m2, respectively. Peak aortic root contrast attenuation was 207 ± 46 HU and correlated to cardiac output and cardiac index with r = –0.64, p Conclusion: This novel method for cardiac output estimation by CTCA appears feasible. The CT physiologic parameters using the timing test-bolus data moderately correlated with echocardiographic assessment of cardiac output. The calculation of cardiac output adds important hemodynamic data to anatomic information provided by CTCA, and further development of this method may preserve assessment of left ventricular performance in prospective triggering.展开更多
Objectives: The purpose of this study is to identify how to manage oversensing of pacemakers in chest CT. Methods: Four different models of pacemakers were examined to select the pacemaker generating oversensing. To t...Objectives: The purpose of this study is to identify how to manage oversensing of pacemakers in chest CT. Methods: Four different models of pacemakers were examined to select the pacemaker generating oversensing. To the pacemaker with oversensing, intermittent switching X-ray was exposed using ECG-gated CT helical scan system at prospective CTA mode. IVY Model was used to synchronize the ECG. Only during in the alert period that is non-refractory and sensing is available, intermittent switching X-ray (300 msec/sec) was exposed in chest CT. For comparison, the same intermittent switching X-ray (300 msec/sec) was exposed in the refractory period when sensing was not available. Results: Oversensing was detected only in one of the four pacemakers tested. In this pacemaker, oversensing was generated by exposure of the intermittent switching X-ray in the alert (non-refractory) period, but oversensing was not observed in the refractory period. Conclusion: A pacemaker has alert and refractory periods. Oversensing of a pacemaker was found to be inhibited by selective ECG-synchronized exposure in the refractory period. Since all pacemakers have the refractory period, the results of this study can be widely applied to the patients with pacemakers in chest CT, and their chest CT can be operated safely.展开更多
基金Research reported in this publication was supported by the National Heart,Lung,And Blood Institute of the National Institutes of Health,No.R01HL151561The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
文摘This review paper aims to summarize cardiac CT blooming artifacts,how they present clinically and what their root causes and potential solutions are.A literature survey was performed covering any publications with a specific interest in calcium blooming and stent blooming in cardiac CT.The claims from literature are compared and interpreted,aiming at narrowing down the root causes and most promising solutions for blooming artifacts.More than 30 journal publications were identified with specific relevance to blooming artifacts.The main reported causes of blooming artifacts are the partial volume effect,motion artifacts and beam hardening.The proposed solutions are classified as high-resolution CT hardware,high-resolution CT reconstruction,subtraction techniques and post-processing techniques,with a special emphasis on deep learning(DL)techniques.The partial volume effect is the leading cause of blooming artifacts.The partial volume effect can be minimized by increasing the CT spatial resolution through higherresolution CT hardware or advanced high-resolution CT reconstruction.In addition,DL techniques have shown great promise to correct for blooming artifacts.A combination of these techniques could avoid repeat scans for subtraction techniques.
文摘Background: Cardiac output can be estimated during retrospectively gated CT coronary angiography by anatomically determining left ventricular volumes;prospective triggering to minimize radiation precludes this methodology. We propose an alternative method for cardiac output estimation based on preclinical models suggesting that cardiac output may be inversely related to contrast washout from the aortic root during timing bolus scanning, as measured by peak aortic root contrast attenuation. Methods: 34 patients had CT coronary angiography timing bolus performed with 20 ml iodixanol at 5.5 ml/s followed by 20 ml normal saline at 5.5 ml/s through an 18-Ga antecubital catheter. Peak aortic root contrast attenuation was correlated to cardiac output calculated by echocardiography using heart rate stroke volume from biplane Simpson’s method.Results: Mean age was 58 ± 13 years;body surface area, 2.0 ± 0.5 m2. 53% were women. Stroke volume, cardiac output and cardiac index were 67 ± 19 ml, 4.5 ± 1.6 L/min, and 2.2 ± 0.7 L/min/m2, respectively. Peak aortic root contrast attenuation was 207 ± 46 HU and correlated to cardiac output and cardiac index with r = –0.64, p Conclusion: This novel method for cardiac output estimation by CTCA appears feasible. The CT physiologic parameters using the timing test-bolus data moderately correlated with echocardiographic assessment of cardiac output. The calculation of cardiac output adds important hemodynamic data to anatomic information provided by CTCA, and further development of this method may preserve assessment of left ventricular performance in prospective triggering.
文摘Objectives: The purpose of this study is to identify how to manage oversensing of pacemakers in chest CT. Methods: Four different models of pacemakers were examined to select the pacemaker generating oversensing. To the pacemaker with oversensing, intermittent switching X-ray was exposed using ECG-gated CT helical scan system at prospective CTA mode. IVY Model was used to synchronize the ECG. Only during in the alert period that is non-refractory and sensing is available, intermittent switching X-ray (300 msec/sec) was exposed in chest CT. For comparison, the same intermittent switching X-ray (300 msec/sec) was exposed in the refractory period when sensing was not available. Results: Oversensing was detected only in one of the four pacemakers tested. In this pacemaker, oversensing was generated by exposure of the intermittent switching X-ray in the alert (non-refractory) period, but oversensing was not observed in the refractory period. Conclusion: A pacemaker has alert and refractory periods. Oversensing of a pacemaker was found to be inhibited by selective ECG-synchronized exposure in the refractory period. Since all pacemakers have the refractory period, the results of this study can be widely applied to the patients with pacemakers in chest CT, and their chest CT can be operated safely.
