BACKGROUND No study on dual energy computed tomography(DECT)has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019(COVID-19)patients.Myocardial perfusion d...BACKGROUND No study on dual energy computed tomography(DECT)has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019(COVID-19)patients.Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion,and these deficits can be shown via DECT with a perfect interrater agreement.AIM To assess lung perfusion alterations in COVID-19 patients.To our knowledge,no study using DECT has been performed to evaluate possibly fatal cardiac/myocardial problems in COVID-19 patients.The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases.METHODS Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association’s classification of the segmentation of the left ventricular myocardium.Additionally,intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated.Following segment-by-segment analysis,perfusion deficiencies identified on the iodine map pictures on DECT were identified.RESULTS The study enrolled a total of 87 patients.Forty-two of these individuals were classified as COVID-19 positive,and 45 were classified as controls.Perfusion deficits were identified in 66.6%(n=30)of the cases.All control patients had a normal iodine distribution map.Perfusion deficits were found on DECT iodine map images with subepicardial(n=12,40%),intramyocardial(n=8,26.6%),or transmural(n=10,33.3%)anatomical locations within the left ventricular wall.There was no subendocardial involvement in any of the patients.CONCLUSION Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion.These deficits can be shown via DECT with a perfect interrater agreement.Additionally,the presence of perfusion deficit is positively correlated with D-dimer levels.展开更多
BACKGROUND Regional lymph node metastasis in patients with hepatocellular carcinoma(HCC)is not uncommon, and is often under-or misdiagnosed. Regional lymph node metastasis is associated with a negative prognosis in pa...BACKGROUND Regional lymph node metastasis in patients with hepatocellular carcinoma(HCC)is not uncommon, and is often under-or misdiagnosed. Regional lymph node metastasis is associated with a negative prognosis in patients with HCC, and surgical resection of lymph node metastasis is considered feasible and efficacious in improving the survival and prognosis. It is critical to characterize lymph node preoperatively. There is currently no consensus regarding the optimal method for the assessment of regional lymph nodes in patients with HCC.AIM To evaluate the diagnostic value of single source dual energy computed tomography(CT) in regional lymph node assessment for HCC patients.METHODS Forty-three patients with pathologically confirmed HCC who underwent partial hepatectomy with lymphadenectomy were retrospectively enrolled. All patients underwent dual-energy CT preoperatively. Regional lymph nodes(n = 156) were divided into either a metastatic(group P, n = 52) or a non-metastasis group(group N, n = 104), and further, according to pathology, divided into an active hepatitis(group P1, n = 34; group N1, n = 73) and a non-active hepatitis group(group P2, n = 18; group N2, n = 31). The maximal short axis diameter(MSAD),iodine concentration(IC), normalized IC(NIC), and the slope of the spectralcurve(λ_(HU)) of each group in the arterial phase(AP), portal phase(PP), and delayed phase(DP) were analyzed.RESULTS Analysis of the MSAD, IC, NIC, and λ_(HU) showed statistical differences between groups P and N(P < 0.05) during all three phases. To distinguish benign from metastatic lymph nodes, the diagnostic efficacy of IC, NIC, and λ_(HU) in the PP was the best among the three phases(AP, PP, and DP), with a sensitivity up to 81.9%,83.9%, and 81.8%, and a specificity up to 82.4%, 84.1% and 84.1%, respectively.The diagnostic value of combined analyses of MSAD with IC, NIC, or λ_(HU) in the PP was superior to the dual energy CT parameters alone, with a sensitivity up to84.5%, 86.9%, and 86.2%, and a specificity up to 83.0%, 93.6% and 89.8%,respectively. Between groups P1 and P2 and groups N1 and N2, only IC, NIC,and λ_(HU) between groups N1 and N2 in the PP had a statistically significant difference(P < 0.05).CONCLUSION Dual-energy CT contributes beneficially to regional lymph node assessment in HCC patients. Combination of MSAD with IC, NIC, or λ_(HU) values in the PP is superior to using any single parameter alone. Active hepatitis does not deteriorate the capabilities for characterization of metastatic lymph nodes.展开更多
BACKGROUND Amiodarone is the drug most commonly used to manage arrhythmias.Long-term amiodarone administration causes hepatotoxicity due to iodine accumulation in the liver.Here,we present three cases of amiodarone-in...BACKGROUND Amiodarone is the drug most commonly used to manage arrhythmias.Long-term amiodarone administration causes hepatotoxicity due to iodine accumulation in the liver.Here,we present three cases of amiodarone-induced hepatotoxicity in patients on long-term oral amiodarone therapy who underwent dual-energy computed tomography(DECT).CASE SUMMARY We report the clinical and iodine density in the liver using DECT in three patients with amiodarone-induced hepatotoxicity.Liver enzymes were increased in these three patients,and abdominal DECT without contrast medium showed highly increased attenuation in the liver.Furthermore,the iodine concentration in the liver was increased.The first patient with amiodarone-induced reversible hepatotoxicity,showed a reversible course of liver function and a decrease in CT values after discontinuation of amiodarone.The second patient on long-term oral amiodarone had increased iodine concentration in the liver and liver damage,the patient eventually developed rapidly progressive pneumonia and died of multiple organ failure.The third patient,showed an increased iodine concentration in the liver and elevated liver enzymes.However,the patient refused radiofrequency ablation for atrial fibrillation and continued oral amiodarone to control atrial fibrillation,and routine liver function tests were required every 3-6 mo in this patient.CONCLUSION DECT is a potentially noninvasive diagnostic tool for quantifying iodine concentration in the liver and monitoring adverse reactions due to amiodarone.展开更多
Dual-energy computed-tomography(DECT) has been suggested as the method of choice for imaging urinary calculi due to the modality's high sensitivity for detect-ing stones and its capability of accurately differenti...Dual-energy computed-tomography(DECT) has been suggested as the method of choice for imaging urinary calculi due to the modality's high sensitivity for detect-ing stones and its capability of accurately differentiat-ing between uric-acid(UA) and non-UA(predominantly calcium) stones. The clinical significance of the latter feature relates to the differences in management of UA vs non-UA calculi. Like calculi, ureteral stents are assigned color by the dual-energy post-processing algorithm, which may lead to improved or worsened stone visualization based on the resulting stent/stone contrast. Herein we depict the case of a nephrolithiasis patient with bilateral stents, each with different color, clearly displaying the effect of stent color on stone vi-sualization. Further, three-dimensional reconstruction of the DECT images illustrates advantages of this enhancement compared to conventional two-dimensional computed tomography. The resulting stent/stone contrast produces an unanticipated potential advantage of DECT in patients with urolithiasis and stents and may promote improved management decision-making.展开更多
Dual-energy X-ray absorptiometry provides two modes of head computed tomography (CT) angiography scanning: neuro-digital subtraction angiography and dual-energy CT angiography (DE-CTA). Previous studies have comp...Dual-energy X-ray absorptiometry provides two modes of head computed tomography (CT) angiography scanning: neuro-digital subtraction angiography and dual-energy CT angiography (DE-CTA). Previous studies have compared image quality, radiation exposure, and bone removal between neuro-digital subtraction angiography and DE-CTA. However, the number of cases was relatively small. The present study examined 300 suspected cases of cerebrovascular disease and observed the methods and duration of post-processing, examination time, and data volume. Results demonstrated similar image quality between the two methods, but lower radiation doses and shorter examination time in DE-CTA. DE-CTA allowed for faster and more stable scanning performance and post-processing methods, facilitating accurate and direct diagnosis of cerebrovascular disease.展开更多
Objective: To explore whether single and fused monochromatic images can improve liver tumor detection and delineation by single source dual energy CT (ssDECT) in patients with hepatocellular carcinoma (HCC) durin...Objective: To explore whether single and fused monochromatic images can improve liver tumor detection and delineation by single source dual energy CT (ssDECT) in patients with hepatocellular carcinoma (HCC) during arterial phase. Methods: Fifty-seven patients with HCC who underwent ssDECT scanning at Beijing Cancer Hospital were enrolled retrospectively. Twenty-one sets of monochromatic images from 40 to 140 keV were reconstructed at 5 keV intervals in arterial phase. The optimal contrast-noise ratio (CNR) monochromatic images of the liver tumor and the lowest-noise monochromatic images were selected for image fusion. We evaluated the image quality of the optimal-CNR monochromatic images, the lowest-noise monochromatic images and the fused monochromatic images, respectively. The evaluation indicators included the spatial resolution of the anatomical structure, the noise level, the contrast and CNR of the tumor. Results: In arterial phase, the anatomical structure of the liver can be displayed most clearly in the 65-keV monochromatic images, with the lowest image noise. The optimal-CNR monochromatic images of HCC tumor were 50-keV monochromatic images in which the internal structural features of the liver tumors were displayed most clearly and meticulously. For tumor detection, the fused monochromatic images and the 50-keV monochromatic images had similar performances, and were more sensitive than 65-keV monochromatic images. Conclusions: We achieved good arterial phase images by fusing the optimal-CNR monochromatic images of the HCC tumor and the lowest-noise monochromatic images. The fused images displayed liver tumors and anatomical structures more clearly, which is potentially helpful for identifying more and smaller HCC tumors.展开更多
AIM:To correlate dual-energy computed tomography(DECT) pulmonary angiography derived iodine maps with parameter maps of quantitative pulmonary perfusion magnetic resonance imaging(MRI).METHODS:Eighteen patients with p...AIM:To correlate dual-energy computed tomography(DECT) pulmonary angiography derived iodine maps with parameter maps of quantitative pulmonary perfusion magnetic resonance imaging(MRI).METHODS:Eighteen patients with pulmonary perfusion defects detected on DECT derived iodine maps were included in this prospective study and additionally underwent time-resolved contrast-enhanced pulmonary MRI [dynamic contrast enhanced(DCE)-MRI].DCE-MRI data were quantitatively analyzed using a pixel-by-pixel deconvolution analysis calculating regional pulmonary blood flow(PBF),pulmonary blood volume(PBV) and mean transit time(MTT) in visually normal lung parenchyma and perfusion defects.Perfusion parameterswere correlated to mean attenuation values of normal lung and perfusion defects on DECT iodine maps.Two readers rated the concordance of perfusion defects in a visual analysis using a 5-point Likert-scale(1 = no correlation,5 = excellent correlation).RESULTS:In visually normal pulmonary tissue mean DECT and MRI values were:22.6 ± 8.3 Hounsfield units(HU);PBF:58.8 ± 36.0 mL/100 mL per minute;PBV:16.6 ± 8.5 mL;MTT:17.1 ± 10.3 s.In areas with restricted perfusion mean DECT and MRI values were:4.0 ± 3.9 HU;PBF:10.3 ± 5.5 mL/100 mL per minute,PBV:5 ± 4 mL,MTT:21.6 ± 14.0 s.The differences between visually normal parenchyma and areas of restricted perfusion were statistically significant for PBF,PBV and DECT(P < 0.0001).No linear correlation was found between MRI perfusion parameters and attenuation values of DECT iodine maps(PBF:r = 0.35,P = 0.15;PBV:r = 0.34,P = 0.16;MTT:r = 0.41,P = 0.08).Visual analysis revealed a moderate correlation between perfusion defects on DECT iodine maps and the parameter maps of DCE-MRI(mean score 3.6,k 0.45).CONCLUSION:There is a moderate visual but not statistically significant correlation between DECT iodine maps and perfusion parameter maps of DCE-MRI.展开更多
Objective To retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced(VNE) dual-energy computed tomography(CT), and to evaluate the possibility of VNE images i...Objective To retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced(VNE) dual-energy computed tomography(CT), and to evaluate the possibility of VNE images in diagnosis for those lesions. Methods A total of 128 gall stones and calcifications of the liver found in 110 patients were examined with triple phase abdominal CT scan from July 2007 to December 2011, in which true nonenhanced(TNE) phase and arterial phase were performed with single-energy CT(120 kVp) and portal venous phase was performed with dual-energy CT(100 kVp and 140 kVp). VNE images were generated from the portal venous phase dual-energy CT data sets by using commercially VNC software. The mean CT values for the stone, liver, bile and paraspinal muscle, mean lesion density and size in area dimension, contrast-to-noise ratio(CNR) of lesion to the liver or bile, and image noise were assessed and compared between VNE and TNE images. The effective dose and size-specific dose estimate(SSDE) were also calculated. Results The mean CT values of the lesions measured on VNE images declined significantly compared with those measured on TNE images(164.51±102.13 vs. 290.72±197.80 HU, P<0.001), so did the lesion-to-liver CNR(10.80±11.82 vs.18.81±17.06, P<0.001) and the lesion-to-bile CNR(17.24±14.41 vs. 21.32±17.31, P<0.001). There was no significant difference in size of lesions area between VNE and TNE images(0.69±0.88 vs. 0.72±0.85 cm2, P=0.062). Compared to the 128 lesions found in TNE images, VNE images showed the same density in 30(23.4%) lesions, lighter density in 88(68.8%) lesions, while failed to show 10(7.8%) lesions, and showed the same size in 61(47.7%) lesions and smaller size in 57(44.5%)lesions. The CT cutoff values of lesion and size were 229.21 HU and 0.15 cm2, respectively. The total effective dose for triple phase scan protocol with TNE images was 19.51±7.03 mS v, and the SSDE was 39.84±11.10 mGy. The effective dose for dual phase scan protocol with VNE images instead of TNE images was 13.29±4.89 m Sv, and the SSDE was 27.83±9.99 mGy. Compared with TNE images, the effective dose and SSDE of VNE images were down by 32.05%±3.69 % and 30.63%±2.34 %, respectively. Conclusions Although the CT values and CNR of the lesions decreased in VNE images, the lesions of which attenuation greater than 229.21 HU and size larger than 0.15 cm^2 could be detected with good reliability and obvious dose reduction. There was good consistency in the size of stones and calcifications in hepatobiliary system between VNE images and TNE images, which ensured the possibility of the clinical application of VNE images.展开更多
Coronary computed tomography angiography(CCTA)has become an integral tool in the noninvasive diagnostic workup of patients with suspected coronary artery disease in both elective and emergency settings. Today, it repr...Coronary computed tomography angiography(CCTA)has become an integral tool in the noninvasive diagnostic workup of patients with suspected coronary artery disease in both elective and emergency settings. Today, it represents a mature technique providing accurate, non-invasive morphological assessment of the coronary arteries and atherosclerotic plaque burden. Iterative reconstruction algorithms, low kV imaging, and single-heart beat acquisitions hold promise to further reduce dose requirements and improve the safety and robustness of the technique in several circumstances including imaging of heavily calcified vessels, patients with morbid obesity or irregular heart rates, and assessment in the emergency setting. However, it has become clear over recent years that cardiac radiologists need to take further steps towards the development and integration of functional imaging with morphological CCTA assessment to truly provide a comprehensive evaluation of the heart. Computed tomography myocardial perfusion imaging, including both dynamic and static dual-energy approaches, has demonstrated the ability to directly assess and quantify myocardial ischemia with simultaneous CCTA acquisition with a reasonable contrast medium volume and radiation dose delivered to the patient. In order to promote CCTA in the clinical and research environments, radiologists should prepare to embrace the change from morphological to functional imaging, furnishing all the necessary resources and information to referring clinicians.展开更多
Purpose: To explore the significance of dual-source computed tomography (DECT) virtual monoenergetic reconstructions technology in improving the imaging quality of esophageal cancer patients. Materials and methods: 68...Purpose: To explore the significance of dual-source computed tomography (DECT) virtual monoenergetic reconstructions technology in improving the imaging quality of esophageal cancer patients. Materials and methods: 68 patients with clinically suspected esophageal cancer (all confirmed by pathology) were collected. Routine plain scan was performed with SIEMENS Force dual-energy CT and then dual-phase scans were performed. The venous phase images were respectively subjected to traditional virtual monoenergetic reconstructions (Mono_E) and new generation virtual monoenergetic reconstructions (Mono+). Mono_E 55 keV and Mono+ 55 keV virtual single-energy images were obtained respectively. The signal-to-noise ratio (SNR) of normal esophageal tissue and esophageal cancer lesions, noise and contrast noise ratio (CNR tumor) of normal esophageal tissue and esophageal cancer lesions were compared among 100 kV images, Mono_E images and Mono+ images. At the same time, two imaging physicians read the films and scored the images of each group by using a 5-point scoring method. Results: Mono+ 55 keV images, SNR, SNRtumor, noise and CNRtumor were statistically different from those of 100 kV images and Mono_E images (P < 0.05). And Mono+ 55 keV images also had the highest subjective score, with statistical significance (P 55 keV images had the best quality. Conclusion: The new generation of virtual monoenergetic reconstructions post-processing (Mono+) could reduce image noise and improve the contrast between esophageal cancer lesions and normal esophageal tissues, which was of great significance to improve the imaging quality of esophageal cancer patients and improve the early detection rate of esophageal cancer.展开更多
目的探讨双源CT双能量(DECT)成像技术对痛风患者不同临床时期尿酸盐结晶与血尿酸的关系,进而评估DECT成像在痛风筛查中的应用价值。方法回顾性分析120例高尿酸血症或痛风患者的DECT成像特点及临床资料,根据临床分期分为两组,男92...目的探讨双源CT双能量(DECT)成像技术对痛风患者不同临床时期尿酸盐结晶与血尿酸的关系,进而评估DECT成像在痛风筛查中的应用价值。方法回顾性分析120例高尿酸血症或痛风患者的DECT成像特点及临床资料,根据临床分期分为两组,男92例,女28例;对照组为非痛风患者30例,男26例,女4例。所有病例手、足均行DECT非增强扫捕,薄层再组后将原始数据传至MMWP:工作站选择Dual Energy GOUT软件,进行影像后处理,比较痛风患者两期尿酸盐沉积的差异与尿酸值相关性,以及DECT检测尿酸盐沉积部位与临床评估的差异。采用t检验、x2检验、Fisher精确概率进行统计学分析。结果:组性别及年龄比较,差异无统计学意义(P年龄=0.236,P性别=0.613,P〉0.005)。高尿酸组尿酸盐沉积量明显高于尿酸正常组,两组有显著统计学意义(P=0.00013,P〈0.001);痛风组检出率与对照组相比。差异有显著统计学意义(P=0.00015,P〈0.001)。结论DECT成像技术对尿酸盐结晶沉积有很好的显示能力,对高尿酸血症、痛风早期、疑似痛风患者均有较高的检出率,可作为痛风筛选的常规检查项目,具有较高的临床应用价值。展开更多
The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma,diffuse autoimmune pancreatitis and groove located mass lesions that may mimic groove pancreatitis.Dual energy compute...The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma,diffuse autoimmune pancreatitis and groove located mass lesions that may mimic groove pancreatitis.Dual energy computed tomography and diffusion weighted magnetic resonance imaging are useful in the early diagnosis of acute pancreatitis,and dual energy computed tomography is also useful in severity assessment and prognosis prediction.Walled off necrosis is an important complication in terms of prognosis,and it is important to know its radiological findings and distinguish it from pseudocyst.展开更多
文摘BACKGROUND No study on dual energy computed tomography(DECT)has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019(COVID-19)patients.Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion,and these deficits can be shown via DECT with a perfect interrater agreement.AIM To assess lung perfusion alterations in COVID-19 patients.To our knowledge,no study using DECT has been performed to evaluate possibly fatal cardiac/myocardial problems in COVID-19 patients.The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases.METHODS Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association’s classification of the segmentation of the left ventricular myocardium.Additionally,intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated.Following segment-by-segment analysis,perfusion deficiencies identified on the iodine map pictures on DECT were identified.RESULTS The study enrolled a total of 87 patients.Forty-two of these individuals were classified as COVID-19 positive,and 45 were classified as controls.Perfusion deficits were identified in 66.6%(n=30)of the cases.All control patients had a normal iodine distribution map.Perfusion deficits were found on DECT iodine map images with subepicardial(n=12,40%),intramyocardial(n=8,26.6%),or transmural(n=10,33.3%)anatomical locations within the left ventricular wall.There was no subendocardial involvement in any of the patients.CONCLUSION Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion.These deficits can be shown via DECT with a perfect interrater agreement.Additionally,the presence of perfusion deficit is positively correlated with D-dimer levels.
文摘BACKGROUND Regional lymph node metastasis in patients with hepatocellular carcinoma(HCC)is not uncommon, and is often under-or misdiagnosed. Regional lymph node metastasis is associated with a negative prognosis in patients with HCC, and surgical resection of lymph node metastasis is considered feasible and efficacious in improving the survival and prognosis. It is critical to characterize lymph node preoperatively. There is currently no consensus regarding the optimal method for the assessment of regional lymph nodes in patients with HCC.AIM To evaluate the diagnostic value of single source dual energy computed tomography(CT) in regional lymph node assessment for HCC patients.METHODS Forty-three patients with pathologically confirmed HCC who underwent partial hepatectomy with lymphadenectomy were retrospectively enrolled. All patients underwent dual-energy CT preoperatively. Regional lymph nodes(n = 156) were divided into either a metastatic(group P, n = 52) or a non-metastasis group(group N, n = 104), and further, according to pathology, divided into an active hepatitis(group P1, n = 34; group N1, n = 73) and a non-active hepatitis group(group P2, n = 18; group N2, n = 31). The maximal short axis diameter(MSAD),iodine concentration(IC), normalized IC(NIC), and the slope of the spectralcurve(λ_(HU)) of each group in the arterial phase(AP), portal phase(PP), and delayed phase(DP) were analyzed.RESULTS Analysis of the MSAD, IC, NIC, and λ_(HU) showed statistical differences between groups P and N(P < 0.05) during all three phases. To distinguish benign from metastatic lymph nodes, the diagnostic efficacy of IC, NIC, and λ_(HU) in the PP was the best among the three phases(AP, PP, and DP), with a sensitivity up to 81.9%,83.9%, and 81.8%, and a specificity up to 82.4%, 84.1% and 84.1%, respectively.The diagnostic value of combined analyses of MSAD with IC, NIC, or λ_(HU) in the PP was superior to the dual energy CT parameters alone, with a sensitivity up to84.5%, 86.9%, and 86.2%, and a specificity up to 83.0%, 93.6% and 89.8%,respectively. Between groups P1 and P2 and groups N1 and N2, only IC, NIC,and λ_(HU) between groups N1 and N2 in the PP had a statistically significant difference(P < 0.05).CONCLUSION Dual-energy CT contributes beneficially to regional lymph node assessment in HCC patients. Combination of MSAD with IC, NIC, or λ_(HU) values in the PP is superior to using any single parameter alone. Active hepatitis does not deteriorate the capabilities for characterization of metastatic lymph nodes.
基金Science and Technology Bureau of Jiaxing,Zhejiang Province of China,No.2017BY18018。
文摘BACKGROUND Amiodarone is the drug most commonly used to manage arrhythmias.Long-term amiodarone administration causes hepatotoxicity due to iodine accumulation in the liver.Here,we present three cases of amiodarone-induced hepatotoxicity in patients on long-term oral amiodarone therapy who underwent dual-energy computed tomography(DECT).CASE SUMMARY We report the clinical and iodine density in the liver using DECT in three patients with amiodarone-induced hepatotoxicity.Liver enzymes were increased in these three patients,and abdominal DECT without contrast medium showed highly increased attenuation in the liver.Furthermore,the iodine concentration in the liver was increased.The first patient with amiodarone-induced reversible hepatotoxicity,showed a reversible course of liver function and a decrease in CT values after discontinuation of amiodarone.The second patient on long-term oral amiodarone had increased iodine concentration in the liver and liver damage,the patient eventually developed rapidly progressive pneumonia and died of multiple organ failure.The third patient,showed an increased iodine concentration in the liver and elevated liver enzymes.However,the patient refused radiofrequency ablation for atrial fibrillation and continued oral amiodarone to control atrial fibrillation,and routine liver function tests were required every 3-6 mo in this patient.CONCLUSION DECT is a potentially noninvasive diagnostic tool for quantifying iodine concentration in the liver and monitoring adverse reactions due to amiodarone.
文摘Dual-energy computed-tomography(DECT) has been suggested as the method of choice for imaging urinary calculi due to the modality's high sensitivity for detect-ing stones and its capability of accurately differentiat-ing between uric-acid(UA) and non-UA(predominantly calcium) stones. The clinical significance of the latter feature relates to the differences in management of UA vs non-UA calculi. Like calculi, ureteral stents are assigned color by the dual-energy post-processing algorithm, which may lead to improved or worsened stone visualization based on the resulting stent/stone contrast. Herein we depict the case of a nephrolithiasis patient with bilateral stents, each with different color, clearly displaying the effect of stent color on stone vi-sualization. Further, three-dimensional reconstruction of the DECT images illustrates advantages of this enhancement compared to conventional two-dimensional computed tomography. The resulting stent/stone contrast produces an unanticipated potential advantage of DECT in patients with urolithiasis and stents and may promote improved management decision-making.
文摘Dual-energy X-ray absorptiometry provides two modes of head computed tomography (CT) angiography scanning: neuro-digital subtraction angiography and dual-energy CT angiography (DE-CTA). Previous studies have compared image quality, radiation exposure, and bone removal between neuro-digital subtraction angiography and DE-CTA. However, the number of cases was relatively small. The present study examined 300 suspected cases of cerebrovascular disease and observed the methods and duration of post-processing, examination time, and data volume. Results demonstrated similar image quality between the two methods, but lower radiation doses and shorter examination time in DE-CTA. DE-CTA allowed for faster and more stable scanning performance and post-processing methods, facilitating accurate and direct diagnosis of cerebrovascular disease.
基金supported by the National Basic Research Program of China (973 Program) (Grant No. 2011CB707705)National Natural Science Foundation of China (Grant No. 81371715+1 种基金 81201215)the Capital Characteristic Clinical Application Research (Grant No. Z121107001012115)
文摘Objective: To explore whether single and fused monochromatic images can improve liver tumor detection and delineation by single source dual energy CT (ssDECT) in patients with hepatocellular carcinoma (HCC) during arterial phase. Methods: Fifty-seven patients with HCC who underwent ssDECT scanning at Beijing Cancer Hospital were enrolled retrospectively. Twenty-one sets of monochromatic images from 40 to 140 keV were reconstructed at 5 keV intervals in arterial phase. The optimal contrast-noise ratio (CNR) monochromatic images of the liver tumor and the lowest-noise monochromatic images were selected for image fusion. We evaluated the image quality of the optimal-CNR monochromatic images, the lowest-noise monochromatic images and the fused monochromatic images, respectively. The evaluation indicators included the spatial resolution of the anatomical structure, the noise level, the contrast and CNR of the tumor. Results: In arterial phase, the anatomical structure of the liver can be displayed most clearly in the 65-keV monochromatic images, with the lowest image noise. The optimal-CNR monochromatic images of HCC tumor were 50-keV monochromatic images in which the internal structural features of the liver tumors were displayed most clearly and meticulously. For tumor detection, the fused monochromatic images and the 50-keV monochromatic images had similar performances, and were more sensitive than 65-keV monochromatic images. Conclusions: We achieved good arterial phase images by fusing the optimal-CNR monochromatic images of the HCC tumor and the lowest-noise monochromatic images. The fused images displayed liver tumors and anatomical structures more clearly, which is potentially helpful for identifying more and smaller HCC tumors.
文摘AIM:To correlate dual-energy computed tomography(DECT) pulmonary angiography derived iodine maps with parameter maps of quantitative pulmonary perfusion magnetic resonance imaging(MRI).METHODS:Eighteen patients with pulmonary perfusion defects detected on DECT derived iodine maps were included in this prospective study and additionally underwent time-resolved contrast-enhanced pulmonary MRI [dynamic contrast enhanced(DCE)-MRI].DCE-MRI data were quantitatively analyzed using a pixel-by-pixel deconvolution analysis calculating regional pulmonary blood flow(PBF),pulmonary blood volume(PBV) and mean transit time(MTT) in visually normal lung parenchyma and perfusion defects.Perfusion parameterswere correlated to mean attenuation values of normal lung and perfusion defects on DECT iodine maps.Two readers rated the concordance of perfusion defects in a visual analysis using a 5-point Likert-scale(1 = no correlation,5 = excellent correlation).RESULTS:In visually normal pulmonary tissue mean DECT and MRI values were:22.6 ± 8.3 Hounsfield units(HU);PBF:58.8 ± 36.0 mL/100 mL per minute;PBV:16.6 ± 8.5 mL;MTT:17.1 ± 10.3 s.In areas with restricted perfusion mean DECT and MRI values were:4.0 ± 3.9 HU;PBF:10.3 ± 5.5 mL/100 mL per minute,PBV:5 ± 4 mL,MTT:21.6 ± 14.0 s.The differences between visually normal parenchyma and areas of restricted perfusion were statistically significant for PBF,PBV and DECT(P < 0.0001).No linear correlation was found between MRI perfusion parameters and attenuation values of DECT iodine maps(PBF:r = 0.35,P = 0.15;PBV:r = 0.34,P = 0.16;MTT:r = 0.41,P = 0.08).Visual analysis revealed a moderate correlation between perfusion defects on DECT iodine maps and the parameter maps of DCE-MRI(mean score 3.6,k 0.45).CONCLUSION:There is a moderate visual but not statistically significant correlation between DECT iodine maps and perfusion parameter maps of DCE-MRI.
基金Supported by the Health Industry Special Scientific Research Project(201402019)
文摘Objective To retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced(VNE) dual-energy computed tomography(CT), and to evaluate the possibility of VNE images in diagnosis for those lesions. Methods A total of 128 gall stones and calcifications of the liver found in 110 patients were examined with triple phase abdominal CT scan from July 2007 to December 2011, in which true nonenhanced(TNE) phase and arterial phase were performed with single-energy CT(120 kVp) and portal venous phase was performed with dual-energy CT(100 kVp and 140 kVp). VNE images were generated from the portal venous phase dual-energy CT data sets by using commercially VNC software. The mean CT values for the stone, liver, bile and paraspinal muscle, mean lesion density and size in area dimension, contrast-to-noise ratio(CNR) of lesion to the liver or bile, and image noise were assessed and compared between VNE and TNE images. The effective dose and size-specific dose estimate(SSDE) were also calculated. Results The mean CT values of the lesions measured on VNE images declined significantly compared with those measured on TNE images(164.51±102.13 vs. 290.72±197.80 HU, P<0.001), so did the lesion-to-liver CNR(10.80±11.82 vs.18.81±17.06, P<0.001) and the lesion-to-bile CNR(17.24±14.41 vs. 21.32±17.31, P<0.001). There was no significant difference in size of lesions area between VNE and TNE images(0.69±0.88 vs. 0.72±0.85 cm2, P=0.062). Compared to the 128 lesions found in TNE images, VNE images showed the same density in 30(23.4%) lesions, lighter density in 88(68.8%) lesions, while failed to show 10(7.8%) lesions, and showed the same size in 61(47.7%) lesions and smaller size in 57(44.5%)lesions. The CT cutoff values of lesion and size were 229.21 HU and 0.15 cm2, respectively. The total effective dose for triple phase scan protocol with TNE images was 19.51±7.03 mS v, and the SSDE was 39.84±11.10 mGy. The effective dose for dual phase scan protocol with VNE images instead of TNE images was 13.29±4.89 m Sv, and the SSDE was 27.83±9.99 mGy. Compared with TNE images, the effective dose and SSDE of VNE images were down by 32.05%±3.69 % and 30.63%±2.34 %, respectively. Conclusions Although the CT values and CNR of the lesions decreased in VNE images, the lesions of which attenuation greater than 229.21 HU and size larger than 0.15 cm^2 could be detected with good reliability and obvious dose reduction. There was good consistency in the size of stones and calcifications in hepatobiliary system between VNE images and TNE images, which ensured the possibility of the clinical application of VNE images.
文摘Coronary computed tomography angiography(CCTA)has become an integral tool in the noninvasive diagnostic workup of patients with suspected coronary artery disease in both elective and emergency settings. Today, it represents a mature technique providing accurate, non-invasive morphological assessment of the coronary arteries and atherosclerotic plaque burden. Iterative reconstruction algorithms, low kV imaging, and single-heart beat acquisitions hold promise to further reduce dose requirements and improve the safety and robustness of the technique in several circumstances including imaging of heavily calcified vessels, patients with morbid obesity or irregular heart rates, and assessment in the emergency setting. However, it has become clear over recent years that cardiac radiologists need to take further steps towards the development and integration of functional imaging with morphological CCTA assessment to truly provide a comprehensive evaluation of the heart. Computed tomography myocardial perfusion imaging, including both dynamic and static dual-energy approaches, has demonstrated the ability to directly assess and quantify myocardial ischemia with simultaneous CCTA acquisition with a reasonable contrast medium volume and radiation dose delivered to the patient. In order to promote CCTA in the clinical and research environments, radiologists should prepare to embrace the change from morphological to functional imaging, furnishing all the necessary resources and information to referring clinicians.
文摘Purpose: To explore the significance of dual-source computed tomography (DECT) virtual monoenergetic reconstructions technology in improving the imaging quality of esophageal cancer patients. Materials and methods: 68 patients with clinically suspected esophageal cancer (all confirmed by pathology) were collected. Routine plain scan was performed with SIEMENS Force dual-energy CT and then dual-phase scans were performed. The venous phase images were respectively subjected to traditional virtual monoenergetic reconstructions (Mono_E) and new generation virtual monoenergetic reconstructions (Mono+). Mono_E 55 keV and Mono+ 55 keV virtual single-energy images were obtained respectively. The signal-to-noise ratio (SNR) of normal esophageal tissue and esophageal cancer lesions, noise and contrast noise ratio (CNR tumor) of normal esophageal tissue and esophageal cancer lesions were compared among 100 kV images, Mono_E images and Mono+ images. At the same time, two imaging physicians read the films and scored the images of each group by using a 5-point scoring method. Results: Mono+ 55 keV images, SNR, SNRtumor, noise and CNRtumor were statistically different from those of 100 kV images and Mono_E images (P < 0.05). And Mono+ 55 keV images also had the highest subjective score, with statistical significance (P 55 keV images had the best quality. Conclusion: The new generation of virtual monoenergetic reconstructions post-processing (Mono+) could reduce image noise and improve the contrast between esophageal cancer lesions and normal esophageal tissues, which was of great significance to improve the imaging quality of esophageal cancer patients and improve the early detection rate of esophageal cancer.
文摘目的探讨双源CT双能量(DECT)成像技术对痛风患者不同临床时期尿酸盐结晶与血尿酸的关系,进而评估DECT成像在痛风筛查中的应用价值。方法回顾性分析120例高尿酸血症或痛风患者的DECT成像特点及临床资料,根据临床分期分为两组,男92例,女28例;对照组为非痛风患者30例,男26例,女4例。所有病例手、足均行DECT非增强扫捕,薄层再组后将原始数据传至MMWP:工作站选择Dual Energy GOUT软件,进行影像后处理,比较痛风患者两期尿酸盐沉积的差异与尿酸值相关性,以及DECT检测尿酸盐沉积部位与临床评估的差异。采用t检验、x2检验、Fisher精确概率进行统计学分析。结果:组性别及年龄比较,差异无统计学意义(P年龄=0.236,P性别=0.613,P〉0.005)。高尿酸组尿酸盐沉积量明显高于尿酸正常组,两组有显著统计学意义(P=0.00013,P〈0.001);痛风组检出率与对照组相比。差异有显著统计学意义(P=0.00015,P〈0.001)。结论DECT成像技术对尿酸盐结晶沉积有很好的显示能力,对高尿酸血症、痛风早期、疑似痛风患者均有较高的检出率,可作为痛风筛选的常规检查项目,具有较高的临床应用价值。
文摘The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma,diffuse autoimmune pancreatitis and groove located mass lesions that may mimic groove pancreatitis.Dual energy computed tomography and diffusion weighted magnetic resonance imaging are useful in the early diagnosis of acute pancreatitis,and dual energy computed tomography is also useful in severity assessment and prognosis prediction.Walled off necrosis is an important complication in terms of prognosis,and it is important to know its radiological findings and distinguish it from pseudocyst.