Impact of various iodine concentrations of iohexol and iodixanol contrast media on image reconstruction techniques in a vascular-specific contrast media phantom: quantitative and qualitative image quality assessment.

PURPOSE: The aim of our study is to investigate the impact of iodine quantification on image reconstruction when employing a vascular-specific contrast media phantom with varying iodine concentrations. MATERIALS AND METHODS: A 30-cm phantom simulating arterial and venous blood vessel diameters was manufactured. Small (9 mm) and medium (12 mm) cylinders contained iodine concentrations from 10 to 100% while large (21 mm) cylinders were in quartiles from 25 to 100% diluted in blood equivalent medium. Each phantom was filled with either iohexol 350 mgI/mL (Group A) or iodixanol 320 mgI/mL (Group B) and then scanned separately. For each group, tube potential (80-140 kVp) and current (50-400 mAs) were changed and all image series were reconstructed with filtered back projection (FBP), hybrid-based iterative reconstruction (HBIR) and model-based iterative reconstruction (MBIR). Mean opacification was measured in all groups. All data were compared employing an independent t test and Pearson's correlation. Visual grading characteristic (VGC) and Cohens' kappa analyses were performed. RESULTS: At 80 kVp, mean opacification using HBIR was significantly higher in Group B (2165 ± 1108 HU) than in Group A (2040 ± 1036 HU) (p < 0.009). At 140 kVp, MBIR and HBIR were greater in Group A (1704 ± 1033 HU and 1685 ± 1023 HU) versus Group B (1567 ± 1036 HU and 1567 ± 1034 HU) (p < 0.022). CNR using FBP, HBIR and MBIR was higher in Group B (46 ± 42 HU, 70 ± 163 HU and 83 ± 74 HU, respectively) than in Group A (43 ± 39 HU, 174 ± 130 HU and 80 ± 65 HU, respectively) (p < 0.0001-0.035). Qualitative image analysis demonstrated no difference in Cohen's kappa analysis. VGC was higher in Group A at all image reconstruction groups. CONCLUSION: Iohexol outperforms iodixanol in observer performance when assessing image reconstruction techniques and iodine concentrations in a vascular-specific contrast media phantom.

Contrast Media Delivery in the Assessment of Anomalous Left Coronary Artery From the Pulmonary Artery.

BACKGROUND: A patient with a history of mitral valve prolapse and regurgitation that was corrected with a mitral ring repair 15 years earlier received a diagnosis of anomalous left coronary artery arising from the pulmonary artery and underwent repair. DISCUSSION: Coronary computed tomography angiography (CTA) was employed to image the patient before surgical intervention. Synchronizing contrast media administration to opacify the right coronary artery in the arterial phase and the left coronary artery in the venous phase required a test-bolus approach. CONCLUSION: Matching compromised cardiovascular dynamics with patient-specific contrast media administration protocols was improved considerably with the use of a test-bolus technique during electrocardiography-gated coronary CTA.

Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists.

Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications.

Price of isotropy in multidetector CT.

Recent advances in multidetector computed tomography (CT) have made isotropic data acquisition feasible for nearly every application. The benefits of routine use of isotropic data for image display and interpretation have been described in the literature and at educational conferences. However, there is usually a trade-off in the form of an increased radiation dose to the patient. The parameters that affect the radiation dose vary considerably in accordance with the CT scanner design, and those variations determine the cost in dose increase relative to the voxel size. The detector configuration and beam collimation (narrow or wide) used for a particular acquisition also affect the voxel size and the relationship between spatial resolution and the radiation dose. By closely comparing the quality of multidetector CT images obtained with different detector configurations on scanners with four, 16, 40, and 64 channels and the estimated radiation exposure incurred with each option, radiologists may achieve an understanding of the relationship between radiation dose and voxel size. This understanding, in turn, may help balance the need for diagnostic image quality against the concern for patient safety.