Evaluation of image quality on low contrast media with deep learning image reconstruction algorithm in prospective ECG-triggering coronary CT angiography.

To assess the impact of low-dose contrast media (CM) injection protocol with deep learning image reconstruction (DLIR) algorithm on image quality in coronary CT angiography (CCTA). In this prospective study, patients underwent CCTA were prospectively and randomly assigned to three groups with different contrast volume protocols (at 320mgI/mL concentration and constant flow rate of 5ml/s). After pairing basic information, 210 patients were enrolled in this study: Group A, 0.7mL/kg (n = 70); Group B, 0.6mL/kg (n = 70); Group C, 0.5mL/kg (n = 70). All patients were examined via a prospective ECG-triggered scan protocol within one heartbeat. A high level DLIR (DLIR-H) algorithm was used for image reconstruction with a thickness and interval of 0.625mm. The CT values of ascending aorta (AA), descending aorta (DA), three main coronary arteries, pulmonary artery (PA), and superior vena cava (SVC) were measured and analyzed for objective assessment. Two radiologists assessed the image quality and diagnostic confidence using a 5-point Likert scale. The CM doses were 46.81 ± 6.41mL, 41.96 ± 7.51mL and 34.65 ± 5.38mL for Group A, B and C, respectively. The objective assessments on AA, DA and the three main coronary arteries and the overall subjective scoring showed no significant difference among the three groups (all p > 0.05). The subjective assessment proved that excellent CCTA images can be obtained from the three different contrast media protocols. There were no significant differences in intracoronary attenuation values between the higher HR subgroup and the lower HR subgroup among three groups. CCTA reconstructed with DLIR could be realized with adequate enhancement in coronary arteries, excellent image quality and diagnostic confidence at low contrast dose of a 0.5mL/kg. The use of lower tube voltages may further reduce the contrast dose requirement.

Radiomics-based discrimination of coronary chronic total occlusion and subtotal occlusion on coronary computed tomography angiography.

OBJECTIVES: Differentiating chronic total occlusion (CTO) from subtotal occlusion (SO) is often difficult to make from coronary computed tomography angiography (CCTA). We developed a CCTA-based radiomics model to differentiate CTO and SO. METHODS: A total of 66 patients with SO underwent CCTA before invasive angiography and were matched to 66 patients with CTO. Comprehensive imaging analysis was conducted for all lesioned vessels, involving the automatic identification of the lumen within the occluded segment and extraction of 1,904 radiomics features. Radiomics models were then constructed to assess the discriminative value of these features in distinguishing CTO from SO. External validation of the model was performed using data from another medical center. RESULTS: Compared to SO patients, CTO patients had more blunt stumps (internal: 53/66 (80.3%) vs. 39/66 (59.1%); external: 36/50 (72.0%) vs. 20/50 (40.0%), both p < 0.01), longer lesion length (internal: median length 15.4 mm[IQR: 10.4-22.3 mm] vs. 8.7 mm[IQR: 4.9-12.6 mm]; external:11.8 mm[IQR: 6.1-23.4 mm] vs. 6.2 mm[IQR: 3.5-9.1 mm]; both p < 0.001). Sixteen unique radiomics features were identified after the least absolute shrinkage and selection operator regression. When added to the combined model including imaging features, radiomics features provided increased value for distinguishing CTO from SO (AUC, internal: 0.772 vs. 0.846; p = 0.023; external: 0.718 vs. 0.781, p = 0.146). CONCLUSIONS: The occluded segment vessels of CTO and SO have different radiomics signatures. The combined application of radiomics features and imaging features based on CCTA extraction can enhance diagnostic confidence.

Protective effect of naringin against radiation-induced heart disease in rats via Sirt1/NF-κB signaling pathway and endoplasmic reticulum stress.

This study was designed to explore the protective effect and mechanism of naringin (NG) on radiation-induced heart disease (RIHD) in rats. Rats were divided into four x-ray (XR) irradiation groups with different absorbed doses (0/10/15/20 Gy), or into three groups (control, XR, and XR + NG groups). Subsequently, the ultrasonic diagnostic apparatus was adopted to assess and compare the left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular internal diameter at end diastole (LVIDd), and left ventricular internal diameter at end systole (LVIDs) in rats. Hematoxylin-eosin (H&E) staining and Masson staining were applied to detect the pathological damage and fibrosis of heart tissue. Western blot was used to measure the expression levels of myocardial fibrosis-related proteins, endoplasmic reticulum stress-related proteins, and Sirt1 (silent information regulator 1)/NF-κB (nuclear factor kappa-B) signaling pathway-related proteins in cardiac tissues. Additionally, enzyme-linked immunosorbent assay was utilized to detect the activities of pro-inflammatory cytokines, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) in cardiac tissue. The results showed that NG treatment significantly attenuated the 20 Gy XR-induced decline of LVEF and LVFS and the elevation of LVIDs. Cardiac tissue damage and fibrosis caused by 20 Gy XR were significant improved after NG treatment. Meanwhile, in rats irradiated by XR, marked downregulation was identified in the expressions of fibrosis-related proteins (Col I, collagen type I; α-SMA, α-smooth muscle actin; and TGF-ß1, transforming growth factor-beta 1) and endoplasmic reticulum stress-related proteins (GRP78, glucose regulatory protein 78; CHOP, C/EBP homologous protein; ATF6, activating transcription factor 6; and caspase 12) after NG treatment. Moreover, NG treatment also inhibited the production of pro-inflammatory cytokines [interleukin-6, interleukin-1ß, and monocyte chemoattractant protein-1 (MCP-1)], reduced the expression of MDA, and promoted the activities of SOD and CAT. Also, NG treatment promoted Sirt1 expression and inhibited p65 phosphorylation. Collectively, XR irradiation induced cardiac injury in rats in a dose-dependent manner. NG could improve the cardiac injury induced by XR irradiation by inhibiting endoplasmic reticulum stress and activating Sirt1/NF-κB signaling pathway.

Exploring the Associations Between Non-Traditional Lipid Parameters and Epicardial Adipose Tissue Volume.

The aim of this retrospective study was to determine the relationship between non-traditional lipid parameters and epicardial adipose tissue (EAT). A total of 770 patients with coronary computed tomography angiography examinations were included. The non-traditional lipid parameters included the atherogenic index of plasma (AIP), the atherogenic coefficient (AC), monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR), and lipoprotein combined index (LCI). To investigate the association between non-conventional lipid markers and the EAT-volume (EAT-v), a univariate and multivariate analyses were conducted. The receiver operating characteristic (ROC) analysis was used to compare the predictive ability among the four non-traditional lipid parameters. In the univariate analysis, we identified factors that might have effects on EAT-v (all P<.05) and adjusted for these in the multivariate analysis. We found that except for MHR, other non-traditional lipid parameters were still associated with high EAT-v after adjustment (all P<.05). In the ROC analysis, the area under the curve (AUC) of AIP was greater than that of other non-traditional lipid parameters and lipid profiles. There was an association between both non-traditional lipid parameters and EAT-v. After adjustment, the AIP remained an independent predictor of EAT-v and it outperformed other non-traditional lipid parameters.

Image quality improvement in head and neck CT angiography: Individualized post-trigger delay versus fixed delay.

PURPOSE: To compare the contrast media opacification of head and neck CT angiography (CTA) between conventional fixed trigger delay and individualized post-trigger delay (PTD). METHODS: In this prospective study (April-October 2022), 196 consecutive participants were randomly divided into two groups to perform head and neck CTA in bolus tracking with either an individualized PTD (Group A) or a fixed 4-second PTD (Group B). All CT and contrast media protocol parameters were consistent between the two groups. One reader evaluated objective image quality, while two readers rated subjective image quality. Objective image quality was compared between groups via two-sample t-test, while the subjective ratings were compared with chi-square analysis. RESULTS: Participants' clinical information including sex, age, weight, body weight index (BMI), and heart rate were not statistically different between two groups (all p > 0.05). Individualized PTD ranging from 3.5 to 7.9 s (average 5.6 s), which is shorter than fixed delays (p < 0.05). Both readers rated better subjective image quality for the Group A (p < 0.05). The mean vessel enhancement was significantly higher in Group A in all vessels (all p < 0.05). CONCLUSIONS: Compared to the fixed post-trigger delay in bolus tracking technique, individualized post-trigger delay could achieve reliable scan timing, optimize vessel opacification and obtain better image quality for head and neck CT angiography.

A cross-calibration study using a novel dual X-ray absorptiometry system for bone mineral density measurements with the European Spine Phantom.

Background: For bone health assessment, dual-energy X-ray absorptiometry (DEXA) is recommended to measure bone mineral content and areal bone mineral density (aBMD) in the lumbar spine. However, intermachine differences were not taken into account when developing these recommendations. According to the International Society of Clinical Densitometry (ISCD), phantom-based cross-calibration is adequate after replacing the DEXA system from a different manufacturer. For different DEXA equipment, individual calibration equations were found to be necessary to fit the observed values with the given densities. Methods: The BMD European Spine Phantom (ESP) measurements (L1, L2, and L3) were assessed on 3 machines. We used the Welch test in the one-way analysis of variance (ANOVA) with a post-hoc Tamhane T2 test, linear regressions, and Bland-Altman analysis to assess the consistency of measurements and establish cross-calibration equations. Results: The coefficients of variation (CV)% of the phantom BMD values measured using the 3 systems were less than 3.0%. The 3 DEXA systems were highly correlated with BMD in the lumbar spine, with correlation values ranging from 0.933 to 0.984 (P<0.0001). The cross-calibration regression models of the ESP measurements yielded the highest prediction accuracies with the lowest prediction errors (the standard error of the estimate ranged from 0.004 to 0.008 g/cm2; P<0.0001). After the regression equations were applied, the differences in BMD values among the 3 systems were negligible. In addition, the Bland-Altman plot showed that almost all data points were within the 95% limits of agreement. Conclusions: A strong agreement for BMD measurement was established between the 3 DEXA systems. Cross-calibration equations for the lumbar spine BMD values need to be applied to transform the Hologic Discovery A or GE Lunar iDXA measurements into SONIALVISION SMIT measurements to comply with the ISCD standards for patient continuity of care in assessment during clinical diagnosis.

Development and validation of a CT-based radiomics model for differentiating pneumonia-like primary pulmonary lymphoma from infectious pneumonia: A multicenter study.

BACKGROUND: Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia. METHODS: In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared. RESULTS: A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05). CONCLUSIONS: The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.

Patient-specific post-trigger delay in coronary CT angiography: A prospective study comparing with fixed delay.

OBJECTIVES: To validate the peak enhancement timing of a patient-specific post-trigger delay (PTD) in Coronary CT angiography (CCTA) and compare its image quality against a fixed PTD. METHODS: In this prospective study, 204 consecutive participants were randomly divided into two groups to perform CCTA in bolus tracking with either a fixed 5-second PTD (Group A) or a patient-specific PTD (Group B). Test bolus was also performed in Group B to determine the reference peak enhancement timing. One reader evaluated objective image quality, while two readers rated subjective image quality. The predicted PTD was validated through correlation and agreement analysis with the reference measurement. Objective image quality was compared between groups via two-sample t-test and linear regression, while the subjective ratings were compared with chi-square analysis. RESULTS: The two groups each had 102 participants with comparable characteristics (52.9 ± 11.3 versus 52.1 ± 11.3 years of age, and 53 versus 52 males). The scan timing from patient-specific PTD demonstrated strong correlation (R = 0.77) and consistency (ICC = 0.618) with the reference peak timing. Both readers rated better subjective image quality for the Group B (p < 0.001). The mean vessel enhancement was significantly higher in Group B in all coronary vessels (all p < 0.05). After adjusting for the participant variation, the patient-specific PTD strategy was associated with an average of 33.5 HU higher enhancement compared to the fixed PTD. CONCLUSIONS: Patient-specific delay could achieve reliable scan timing, optimize vessel opacification and obtain better image quality in CCTA.

Camptothecin Delivery via Tumor-Derived Exosome for Radiosensitization by Cell Cycle Regulation on Patient-Derived Xenograft Mice.

Purpose: While radiotherapy remains the leading clinical treatment for many tumors, its efficacy can be significantly hampered by the insensitivity of cells in the S phase of the cell cycle to such irradiation. Methods: Here, we designed a highly targeted drug delivery platform in which exosomes were loaded with the FDA-approved anti-tumor drug camptothecin (CPT) which is capable of regulating cell cycle. The utilized exosomes were isolated from patient tumors, enabling the personalized treatment of individuals to ensure better therapeutic outcomes. Results: This exosome-mediated delivery strategy was exhibited robust targeted to patient-derived tumor cells in vitro and in established patient-derived xenograft models. By delivering CPT to tumor cells, this nanoplatform was able to decrease cell cycle arrest in the S phase, increasing the frequency of cells in the G1 and G2/M phases such that they were more radiosensitive. Conclusion: This therapeutic approach was able to substantially enhance the sensitivity of patient-derived tumors to ionizing radiation, thereby improving the overall efficacy of radiotherapy without the need for a higher radiation dose.

A case with primary cardiac paraganglioma: imaging findings.

A 67-yeary-old middle-aged woman admitted to the hospital with chief complaints of intermittent palpitation, fatigue for more than 3 months, and bilateral lower extremity edema about 2 months. A solid mass was discovered in the right atrium by echocardiographic examination, and computerized tomography (CT) guided needle biopsy of the mass was performed and revealed a neurogenic tumor, which was a paraganglioma. She underwent surgical excision of the tumor and had uneventful recovery at a month post-operation.

Influence of deep learning image reconstruction and adaptive statistical iterative reconstruction-V on coronary artery calcium quantification.

BACKGROUND: Deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-V (ASIR-V) has been used for cardiac computed tomography imaging. However, DLIR and ASIR-V may influence the quantification of coronary artery calcification (CAC). METHODS: CT images of 96 patients were reconstructed using filtered back projection (FBP), ASIR-V 50%, and three levels of DLIR [low (L), medium (M), and high (H)]. Image noise and the Agatston, volume, and mass scores were compared between the reconstructions. Patients were stratified into six Agatston score-based risk categories and five CAC percentile risk categories adjusted by Agatston score, age, sex, and race. The number of patients who were switched to another risk stratification group when ASIR-V and DLIR were used was compared. Bland-Altman plots were used to present the agreement of Agatston scores between FBP and the different reconstruction techniques. RESULTS: Compared to that with FBP, image noise was significantly decreased with ASIR-V 50%, and DLIR-L, -M, and -H (all P<0.001). The Agatston, volume, and mass scores with ASIR-V 50% and DLIR-L, -M, and -H showed significant decreases in comparison to those calculated with FBP (all P<0.001). Severity classification showed no significant differences between the five reconstruction techniques in any of the CAC score-based risk categories (all P>0.05). CONCLUSIONS: DLIR and ASIR-V show great potential for improving CT image quality, and appear to have no pronounced impact on CAC quantification or Agatston score-based risk stratification.

Assessment of left ventricular systolic function by non-invasive pressure-strain loop area in young male strength athletes.

BACKGROUND: The health of athletes has been recognized as a worldwide public concern with more reported sudden cardiac deaths (SCD). Therefore, early detection of abnormal heart function in athletes can help reduce the risk of exercise. A novel valid non-invasive method to evaluate left ventricular (LV) myocardial work (MW) using LV pressure-strain loop (PSL), was used in this paper to explore LV systolic function in young male strength athletes. METHODS: Thirty-six professional young male strength athletes (the athlete group) and 32 healthy, age-matched young men (the control group) were involved in the study. The LVMW parameters were calculated as the area of PSL by two-dimensional speckle tracking echocardiography (2D-STE) and peak systolic LV pressure. The differences between two groups of data and the predictive efficacy of MW parameters for LV systolic function were analyzed. RESULTS: The athlete group had significantly higher values of global wasted myocardial work (GWW) and peak strain dispersion (PSD) than did the control group (P<0.05). Global myocardial work index (GWI), global constructive myocardial work (GCW) and global longitudinal strain (GLS) were lower in the athlete group than that in the control group, although statistical significance was not reached (P>0.05). Due to the proportion of GWW and GCW, statistically significant reduction was found in global myocardial work efficiency (GWE) in the athlete group. Conventional echocardiography parameters were well correlated with GWW and GWE (P<0.05). The best predictor of LV myocardial contractile performance in the athletes using receiver operating characteristic curve (ROC) was GWE, with the area under ROC (AUC) of 0.733, sensitivity of 83.3% and specificity of 59.4%. CONCLUSIONS: Subclinical changes have appeared in the hearts of young male strength athletes after long-term intensive exercise and LVMW parameters by PSL play an important role in the evaluation of athlete's LV contractile performance.

Identification of novel diagnostic and prognostic biomarkers for hepatocellular carcinoma.

The differential expression of a featured set of genes may serve as a diagnostic biomarker in hepatocellular carcinoma (HCC) patients. The aim of this study was to identify prognostic biomarkers for the diagnosis and survival of HCC based on the analysis of a large cohort of patients. Clinical and RNA­seq data were obtained from The Cancer Genome Atlas (TCGA) database. A transcriptomics analysis was conducted to detect differentially expressed genes (DEGs). Samples from 53 tumors and 20 normal tissues of HCC patients were obtained to further analyze the connection between overall survival (OS) and DEG levels. Based on the OS and progression­free survival (PFS), 4 DEGs (GABRR1, SOX11, COL24A1 and MYLK2) were identified from the TCGA dataset. Using gene ontology (GO) analysis, it was demonstrated that the DEGs were associated with several biological processes, including multicellular organismal and single­multicellular organism processes, which are involved in the development and migration of HCC. In addition, the four genes were significantly upregulated in tumor tissues. Notably, the mRNA expression of the four genes had a negative association with OS and PFS in HCC patients determined using a Kaplan­Meir analysis. The four­gene signature is a potential novel biomarker for the prediction of HCC patient survival.

TP53TG1 enhances cisplatin sensitivity of non-small cell lung cancer cells through regulating miR-18a/PTEN axis.

BACKGROUND: The acquisition of drug resistance has been considered as a main obstacle for cancer chemotherapy. Tumor protein 53 target gene 1 (TP53TG1), a p53-induced lncRNA, plays a vital role in the progression of human cancers. However, little is known about the detailed function and molecular mechanism of TP53TG1 in cisplatin resistance of NSCLC. METHODS: qRT-PCR analysis was used to detect the expression of TP53TG1, miR-18a and PTEN mRNA in NSCLC tissues and cells. Western blot analysis was performed to determine the protein level of PTEN and cleaved caspase-3. Cell viability and IC50 value were measured by MTT assay. Cell apoptosis was confirmed by flow cytometry assay. Subcellular fractionation assay was used to identify the subcellular location of TP53TG1. Dual-luciferase reporter assay, RNA pull down assay and RNA immunoprecipitation assay were carried out to verify the interaction between TP53TG1 and miR-18a. Xenografts in nude mice were established to verify the effect of TP53TG1 on cisplatin sensitivity of NSCLC cells in vivo. RESULTS: TP53TG1 level was downregulated in NSCLC tissues and cell lines. Upregulated TP53TG1 enhanced cisplatin sensitivity and apoptosis of A549/DDP cells, while TP53TG1 depletion inhibited cisplatin sensitivity and apoptosis of A549 cells. TP53TG1 suppressed miR-18a expression in A549 cells. Moreover, TP53TG1-mediated enhancement effect on cisplatin sensitivity was abated following the restoration of miR-18a expression in A549/DDP cells, while si-TP53TG1-induced decrease of cisplatin sensitivity and apoptosis was counteracted by miR-18a inhibitor in A549 cells. Furthermore, TP53TG1 promoted PTEN expression via inhibiting miR-18a. Finally, TP53TG1 sensitized NSCLC cells to cisplatin in vivo. CONCLUSION: TP53TG1 increased the sensitivity of NSCLC cells to cisplatin by modulating miR-18a/PTEN axis, elucidating a novel approach to boost the effectiveness of chemotherapy for NSCLC.

Chest CT with iterative reconstruction algorithms for airway stent evaluation in patients with malignant obstructive tracheobronchial diseases.

The aim of the study was to investigate the image quality of low-dose CT images with different reconstruction algorithms including filtered back projection (FBP), hybrid iterative reconstruction (HIR), and iterative model reconstruction (IMR) algorithms by comparison of routine dose images with FBP reconstruction, in patients with malignant obstructive tracheobronchial diseases.In total, 60 patients (59 ±â€Š9.3 years, 37 males) with airway stent who are randomly assigned into 2 groups (routine-dose [RD] and low-dose [LD] group, 30 for each) underwent chest CT on a 256-slice CT (RD-group 120 kV, 250 mAs, LD-group 120 kV, 120 mAs). Images were reconstructed with filtered back projection (FBP) algorithm in the RD group, whereas with FBP, HIR and IMR algorithms in the LD group. Effective radiation dose of both groups was recorded. Image-quality assessment was performed by 2 radiologists according to structure demarcation near stents, artifacts, noise, and diagnostic confidence using a 5-point scale (1 [poor] to 5 [excellent]). Image noise and CNR were measured.The effective radiation dose of LD group was reduced 52.7% compared with the RD group (10.8 mSv ±â€Š0.58 vs 5.1 mSv ±â€Š0.26, P = 0.00). LD-IMR images enabled lowest image noise and best subjective image quality scores of all 4 indices, when compared with RD images reconstructed with FBP (RD-FBP) images (all P < 0.05). LD images reconstructed with and with HIR (LD-HIR) images enabled higher score in subjective image quality of artifacts (P < 0.05), whereas it showed no difference in the other subjective image-quality indices and image noise. Significant higher image noise and lower score of subjective image quality were observed in LD-FBP images (all P < 0.05).Both IMR and HIR improved image quality of low-dose chest CT by comparison of routine dose images reconstructed with FBP. Meanwhile, IMR allows further image quality improvement than HIR.

Aortic dual-energy CT angiography with low contrast medium injection rate.

The contrast medium (CM) induced nephropathy required new CT imaging protocol. This study evaluated the feasibility of low contrast medium (CM) volume and injection flow using aortic dual-energy CT (DECT) angiography with non-linear blending technique. Sixty patients were randomly assigned to two groups: control group (n=30), single-energy CT 70 ml CM at injection rate of 5 ml/s; study group (n=30), DECT mode, 0.5 ml per kg of patient weight CM at injection rate=(weight × 0.5 ml/kg)/(4+scan time). Non-linear blending technique was used for dual-energy images. Mean attention, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of aorta were compared. The level of visible renal artery branches was scored. There was no significant difference between the two groups in the mean aortic attention, SNR and CNR (all P > 0.05). Significant difference was showed in CM injection rate (p < 0.001) and volume (P < 0.001). The renal artery score had no statistically significant difference (P=0.771). Compared conventional scan and CM injection protocol, DECT with non-linear blending technique maintained the image quality of aortic CT angiography with reduced CM volume and flow rate, which could reduce the risks associated with CM injection.

[Early screening of developmental dysplasia of the hip among hospitalized children].

OBJECTIVE: To summarize retrospectively developmental dysplasia of the hip (DDH) screening of children within 36 months. METHODS: Newborn infants underwent initial DDH screening at First Affiliated Hospital, Zhengzhou University from September 2011 to May 2013. The examinations included double hip function, abduction test and Ortolani/Barlow test. After initial DDH screening, suspected and abnormal infants were transferred to our department for re-screening. And clinical physical examinations, type B ultrasound or radiological imaging were performed for confirmation or elimination. RESULTS: A total of 10 428 children were DDH screened. And 1 260 children were examined with ultrasound and 346 suspected and abnormal children (445 hips) were transferred for further assessments. Among them, 33 children (49 hips) were positive with Ortolani or Barlow test, 61 children (88 hips) had dysplasia of hip and 48 children (14 boys, 34 girls) (69 hips) received a final diagnosis of DDH. Left (n = 52) and right hip (n = 17) were involved with a disease incidence of DDH at 0.46%. CONCLUSIONS: Ultrasonic examination is both simple and cost-effective for DDH screening of children within 6 months. And meticulous medical examinations and imaging studies are effective DDH screening for children from 6 to 36 months.

Material decomposition images generated from spectral CT: detectability of urinary calculi and influencing factors.

RATIONALE AND OBJECTIVES: To evaluate the detectability of urinary calculi on material decomposition (MD) images generated from spectral computed tomography (CT) and identify the influencing factors. MATERIALS AND METHODS: Forty-six patients were examined with true nonenhanced (TNE) CT and spectral CT urography in the excretory phase. The contrast medium was removed from excretory phase images using water-based (WB) and calcium-based (CaB) MD analysis. The sensitivity for detection on WB and CaB images was evaluated using TNE results as the reference standard. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) on MD images were evaluated. Using logistic regression, the influences of image noise, attenuation, stone size, and patient's body mass index (BMI) were assessed. Threshold values with maximal sensitivity and specificity were calculated by means of receiver operating characteristic analyses. RESULTS: One hundred thirty-six calculi were detected on TNE images; 98 calculi were identified on WB images (sensitivity, 72.06%) and 101 calculi on CaB images (sensitivity, 74.26%). Sensitivities were 76.92% for the 3-5-mm stones and 84.51% for the 5-mm or larger stones on both WB and CaB images but reduced to 46.15% on WB images and 53.85% on CaB images for small calculi (<3 mm). Compared to WB images, CaB images showed lower image noise, higher SNR but similar CNR. Larger stone sizes (both >2.71 mm on WB and CaB) and greater CT attenuation (>280 Hounsfield units [HU] on WB, >215 HU on CaB) of the urinary stones were significantly associated with higher stone visibility rates on WB and CaB images (P ≤ .003). Image noise and BMI showed no impact on the stone detection. CONCLUSIONS: MD images generated from spectral CT showed good reliability for the detection of large (>2.71 mm) and hyperattenuating (>280 HU on WB, >215 HU on CaB) urinary calculi.

Optimizing contrast medium injection protocol individually with body weight for high-pitch prospective ECG-triggering coronary CT angiography.

To individually optimize contrast medium protocol for high-pitch prospective ECG-triggering coronary CT angiography using body weight. Ninety patients undergoing high-pitch coronary CT angiography were randomly assigned to 3 contrast medium injection protocols with bolus tracking technique: Group A, 0.7 ml CM per kg patient weight (ml/kg); Group B, 0.6 ml/kg; Group C, 0.5 ml/kg. Each group had 30 patients. The CT values of superior vena cava (SVC), pulmonary artery (PA), ascending aorta (AA), left atrium (LA), left ventricle (LV), left main artery (LM) and proximal segment of right coronary artery (RCA) were measured. The image quality of coronary artery was evaluated on per-segment basis using a 4-point scale (1-excellent, 4-non-diagnosis). The CT value was not significantly different on AA (p = 0.735), LM (p = 0.764), and proximal segment of RCA (p = 0.991). The CT value was significantly different on SVC, PA, LA and LV (all p < 0.05). The mean image quality score was 1.6 ± 0.1, 1.6 ± 0.1 and 1.6 ± 0.1 (p = 0.217). The volume of CM was 47 ± 8, 44 ± 8 and 36 ± 6 ml for 3 groups (p < 0.001). The effective radiation dose was 0.88 ± 0.04, 0.87 ± 0.06, and 0.85 ± 0.07 mSv for 3 groups. Contrast medium could be reduced to 0.5 ml/kg for high-pitch coronary CT angiography without compromising diagnostic image quality, which associated ~50 % reduction of total contrast volume compared with standard contrast protocol with test bolus technique.