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Objective:To investigate the effects of total-body PET/CT imaging with short acquisition time on image quality and lesion detectability in lungs and parenchymal organs.Methods:Sixty patients (31 males, 29 females, age (61.1±11.8) years) with pulmonary nodules (PN) and 53 patients (29 males, 24 females, age (56.7±17.2) years) with parenchymal organ lesions (POL) who underwent total-body PET/CT imaging in the First Affiliated Hospital of Shandong First Medical University between October 2021 and April 2022 were retrospectively analyzed. The acquisition time with PET was 600 s, and the reconstructed images were divided into 6 groups based on different duration (30, 60, 120, 180, 300 and 600 s), namely G30, G60, G120, G180, G300 and G600 groups. The subjective analysis was carried out with the 5-point Likert scale in 3 aspects: the overall impression of image quality, noise, and lesion conspicuity. The objective analysis indicators included the SUV mean of the mediastinal blood pool (MBP); the SUV mean, standard deviation (SD) and signal-to-noise ratio (SNR) of the liver; SUV max and target-to-background ratio (TBR) of the lesions. Differences of the indicators among 6 groups were analyzed by Friedman test with Bonferroni correction. G600 served as the reference for the other 5 groups to test their lesion detectability. Results:The subjective image quality of different groups for PN and that of G120, G180, G300 groups for POL could meet the needs of clinical diagnosis in terms of the overall image quality, noise, and lesion conspicuity (all scores>3). There was no significant difference in the SUV mean of MBP among different time groups (median for PN: 1.52-1.56, median for POL: 1.35-1.47; χ2 values: 10.23, 11.02, both P>0.05). Difference was not found in SUV mean of the liver either (median for PN: 2.51-2.56, median for POL: 2.33-2.40; χ2 values: 8.35, 8.93, both P>0.05). The liver SD significantly increased along with the shortened acquisition time ( χ2 values: 400.99, 400.00, both P<0.001; z values: from -16.90 to -3.15, all P<0.003). The SNR significantly decreased along with the shortened acquisition time ( χ2 values: 397.32, 400.00, both P<0.001; z values: 2.98-16.90, all P<0.003). The SUV max (median for PN: 3.55-4.01, median for POL: 5.77-6.08; χ2 values: 8.58, 3.02, both P>0.05) and TBR (median for PN: 2.42-2.81, median for POL: 2.36-2.45; χ2 values: 9.83, 3.69, both P>0.05) of lesion were not significantly different among 6 groups. Taking G600 group as a reference, the lesion detection rates were 100% in G30 group and other 4 groups for PN (81/81) and in G120, G180, G300 groups for POL (80/80). Conclusion:Total-body PET/CT imaging with acquisition time of 30 s for lungs and that with acquisition time of 120 s for parenchymal organs are feasible for clinical use, with the PET image quality and lesion detectability maintained.
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Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease accompanied by cholestasis, with the histological feature of non-purulent cholangitis. This article briefly describes the advantages and limitations of the traditional pathological staging systems such as Rubin stage, Scheuer stage, and Ludwig stage and the latest Nakanuma stage. Among them, Nakanuma stage refines the histological grading and staging standards to reduce the chance of missed diagnosis due to sampling errors, thus providing more adequate diagnostic and prognostic information for the clinic. A combination of new and traditional staging systems can provide guidance to the diagnosis, treatment, and research of PBC.
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Objective:To explore the evolution of imaging findings on dynamic chest high resolution CT(HRCT) in patients with mild COVID-19.Methods:The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 common type and 1 mild) were enrolled in the group, including 14 males and 11 females, with age of (42±12) years and hospital stay of (19±5) days. The basic images and dynamic images of HRCT were analyzed and compared by the radiologists.Results:The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lacked specificity. There were no significant abnormalities on chest CT of one mild patient. HRCT findings of the common type were as follows: (1) the distribution of the lesions: most of the multiple lesions involved both lungs (19 cases), with average of 3 (3±1) lobes, located in the peripheral pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); with the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5th (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days.Conclusions:Dynamic chest HRCT can monitor the basic evolution process of the disease in patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.
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Objective DSA and/or surgery was used as a control to evaluate the image quality, radiation dose and diagnostic efficacy of 70 kV combined with low contrast agent dose and 80 kV dual-source CT scanning of coronary artery. Methods Between Apr, 2012 and Apr, 2017, a total of 150 consecutive pediatrics with suspected or confirmed coronary arterial diseases underwent DSCTCA, and the patients were randomly divided into 3 groups by different scanning protocols. Group A (n=50): 80 kV with 1.5 ml/kg contrast agent;Group B (n=50): 70 kV with 1.5 ml/kg contrast agent;Group C (n=50): 70 kV with 1.0 ml/kg contrast agent. ANOVA was used to compare the differences of subjective coronary arteries image quality between the three groups; The t-test was used to compare the difference in effective radiation dose between the 70 kV group and the 80 kV group; The surgery and/or angiography results were used as gold standard to evaluate the diagnostic efficacy of the three groups. Results All patients underwent DSCTCA successfully and satisfactory diagnostic images were gained . The mean scores of subjective image quality of coronary artery were 3.5±0.7, 3.4±0.6, 3.7±0.8, respectively. There was no significant difference between the 3 groups (F=2.042, P=0.133). The diagnostic accuracy of the three groups for coronary artery disease was 100%, as the surgical and/or angiographic results were used as gold standard. The effective radiation doses in 80 kV group (A group) and the 70 kV group (B+C group) were (0.49 ± 0.04) and (0.30 ± 0.03) mSv, respectively, with a statistically significant difference (t=4.037, P=0.001). Conclusions DSCTCA can better display and diagnose pediatric coronary artery lesions with 70 kV tube voltage combined with low contrast agent, and has a high diagnostic accuracy. It is a reliable method for diagnosing pediatric coronary artery disease.
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Objective To compare the accuracy, image quality and radiation dose between prospective ECG?gated sequential and high?pitch acquisition on 128?slice dual?source CT (DSCT) angiography in infants and children with congenital heart disease (CHD). Methods Ninety?two children with CHD from October 2011 to February 2013 were prospectively enrolled and assigned into two groups according to random number table. Forty?six patients underwent DSCT angiography with sequential mode, and the other 46 patients were examined with high?pitch mode. With surgical and/or DSA results as the standard, the diagnostic accuracy and sensitivity of the two groups for the intracardiac structures, extracadiac and coronary artery anomalies were evaluated, and the comparison was analyzed by Fisher exact test. A 5?grade scoring system was used to interpret the image quality of intracardiac structures, great vessels and the proximal and middle segments of coronary arteries. Interobserver agreement on grades of image quality was assessed by Kappa statistics. The image quality scores were compared using the Mann?Whitney U test. The Student t test or the Mann?Whitney U test was used to analyze the differences between the two groups regarding to patients' age, weight , heat rate, CT attenuation, image noise and SNR in the ascending aorta and the pulmonary trunk as well as radiation dose. Results All 92 patients successfully underwent DSCT angiography. The diagnostic accuracies of intracardiac anomalies by high?pitch group and sequential group were 95.65%(88/92) and 99.28%(274/276), showed significant difference between the two groups (P0.05) .There was no significant difference in the diagnostic accuracy and sensitivity of extracadiac anomalies between the two groups (P>0.05). The diagnostic accuracies of coronary artery anomalies by high?pitch group and sequential group were 93.48%(43/46) and 100.00%(46/46), showed no significant difference between the two groups (P>0.05), but there was significant difference in the sensitivity of coronary artery anomalies (50.00%(3/6) , 100.00% (11/11)) (P0.05). The median image quality scores of intracardiac structures and proximal and middle segments of coronary arteries respectively by high?pitch group were 4.00 and 3.00, and 5.00 and 4.00 respectively by sequential group. The image quality of intracardiac structures (U=594.500, P<0.05) and proximal and middle segments of coronary arteries (U=397.500, P<0.05) was significantly better in the sequential group than that in the high?pitch group. There was no significant difference between the two groups in CT attenuation, noise and SNR of the ascending aorta and pulmonary trunk. The mean effective doses of the high?pitch group and the sequential group were(0.27±0.11)and(0.39±0.17)mSv, and showed significant difference between the two groups (t=4.316, P<0.05). Conclusions Both sequential and high?pitch mode of 128?slice DSCT angiography provide high accuracy for the assessment of CHD in infants and children, while the high?pitch mode, though with some image quality declined, shows further significantly lower radiation dose.
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Objective To investigate the value of prospectively electrocardiogram (ECG)-triggered high-pitch coronary computed tomography angiography at 70 kV and 30 mL contrast medium with Stellar detector dual-source CT.Methods 60 patients with the BMI0.05).The CT attenuation of the 70 kV group were higher than that of the 100 kV group for all the segments(P 0.05).Compared with the 100 kV group,the radiation dose of the 70 kV group was reduced by 76.5% (A:0.19±0.023 mSv,B:0.81±0.101 mSv,P <0.01).Conclusion Using 70 kV with 30 mL contrast medium in Stellar detector dual-source CT coronary angiography for the patients with a normal BMI could obtain qualified diagnostic image with low radiation dose and contrast medium.
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Objective To evaluate feasibility and time efficiency of dual-source flash post-processing software (Bone Reading)for reconstruction of bronchial artery.Methods The imaging data of 70 patients with suspected bronchial artery dilatation who underwent bronchial artery-CTA were evaluated by 2 independent radiologists.First,the related contents of bronchial artery such as origination,number, type,route and lumen diameter were evaluated by multiple planar reconstruction (MPR),maximum intensity projection (MIP)and volume rendering technique (VRT).The results and process time were recorded.After a month,the post-processing software(Bone Reading)was used to evaluate the same contents.Results There was very good correlation between both readers for both reading methods without significant differences.There was significant difference of process time between with regular method and with Bone Reading (P<0.05)for both readers.Process time could be decreased by approximately 35%.Conclusion The application of CT software (Bone Reading)is feasible in the CTA of bronchial artery.This method may gain a significant time saving in comparison to regular method.
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Objective To explore the clinical usefulness of low-dose dual-source CT (DSCT) angiography in detecting coronary artery anomaly (CAA) in patients with complex congenital heart disease (CHD). Methods A total of 615 consecutive patients with complex CHD who underwent DSCT angiography between 2008 and 2012 were retrospectively reviewed. According to the ultrasonic results, a total of 312 patients with tetralogy of Fallot (n=176 cases) or double outlet right ventricle (n=72 cases) or pulmonary artery atresia (n=64 cases) were included. Scans were divided into 3 groups: retrospective electrocardiogram (ECG)-triggered spiral scanning in 75 cases, prospective ECG?triggered spiral scanning in 158 cases, and prospective ECG?triggered high?pitch spiral scanning in 79 cases. The subjective image quality was evaluated with a four?point scale by two radiologists. Radiation dose values were calculated. Interobserver agreement in subjective image quality grading was assessed by using Kappa statistics. The scanning groups were compared with the Kruskal?Wallis test. Results The incidence of CAA was 8.0 %(25/312). CAA was detected in 7.9%(14/176)patients with tetralogy of Fallot, 8.3%(6/72)patients with double outlet right ventricle, 7.8%(5/64)patients with pulmonary artery atresia. In 76%(19/25)of the patients, the anomalous vessels were crossing the right ventricular outflow tract (RVOT). Thirty of 312 CT examinations were nondiagnostic (9.6%). Two radiologists acquired good agreement (Kappa=0.72,P<0.01). The median subjective image quality score of three scan groups was 3 (range 1—4). The score in high?pitch spiral scanning group was significantly lower than those in other two groups (H=29.1,P<0.01). Retrospective ECG?triggered scans had a median dose of 1.19 mSv(range 0.52—3.29 mSv), prospectively ECG?triggered scans had a median dose of 0.51 mSv(range 0.27—2.13 mSv), and prospectively ECG?triggered high?pitch spiral scans had a median effective dose of 0.30 mSv(range 0.18—0.62 mSv). The difference between groups was statistically significant (H=160.0, P<0.01). Conclusions DSCT angiography is a reliable diagnostic method for the assessment of CAA with complex CHD and low?dose prospectively ECG?triggered DSCT scan is the best choice.
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Objective To investigate the effectiveness and feasibility of cardiovascular computed tomography angiography(CTA) in 128-slice DSCT with low tube voltage and low dosage contrast media in children with tetralogy of Fallot (TOF). Methods Forty patients with TOF were randomly divided into group A and group B by random number table method, patients in group A received a conventional scan with 80 kVp and contrast media of 1.2 ml/kg, patients in group B, 70 kVp and contrast media of 1.0 ml/kg were used. The injection time of the two groups were both fixed for 12 s. CT attenuation, image noise and signal-to-noise ratio (SNR) of ascending aorta, the main pulmonary artery, left ventricle and right ventricle were quantified. Radiation dose and volume of the contrast medium were recorded. Subjective image quality was assessed by two radiologists in consensus. The Student's t test was performed to analyse the differences between the two groups regarding CT attenuation, image noise, SNR, radiation dose and volume of the contrast medium. The image quality scores between the two groups were compared by using the Mann-Whitney U test. Results No significant difference was found in the attenuation, noise, SNR between the two groups in the same evaluated anatomic regions and no significant difference was found in the image quality. Effective dose (ED) was(0.17±0.05),(0.13±0.04)mSv respectively, there was significant reduction in group B than that in group A (t=2.48, P=0.019). The consumed iodine amount was(10.00±1.84),(8.29± 1.45) ml respectively, there was significant reduction between the two groups (t=2.89, P=0.007). Conclusions In children with TOF, the cardiovascular CTA with diagnostic quality can be adequately acquired with low tube voltage (70 kVp) and low concentration contrast media (1.0 ml/kg), there is significant reduction in radiation dose and contrast medium amount.
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ObjectiveTo investigate the value of prospective ECG-gated dual-source CT (DSCT)in the diagnosis of coarctation of aorta ( CoA ).MethodsSixteen patients clinically suspected of CoA underwent prospective ECG-gated DSCT angiography and color Doppler flow imaging (CDFI). The diagnostic accuracy of DSCT and CDFI were compared according to the results of operation or DSA.The nonparametric chi-square test was used for the statistics.ResultsSixteen patients were diagnosed as CoA by DSCT,4 were complicated with artial septal defect (ASD),9 with ventricular septal defect (VSD),1 with transposition of the great arteries,3 with dysplasia of aortic arch,7 with patent ductus arteriosus (PDA),1 with abnormal origin of the coronary artery, 1 with bronchus artery dilation. Fifteen patients were diagnosed as CoA by CDFI,1 was diagnosed as interruption of aortic arch. Four were complicated with ASD,9 with VSD,2 with bicuspid aortic valve (BAV),1 with transposition of the great arteries,2 with dysplasia of aortic arch,7 with PDA,1 with bronchus artery dilation.Abnormal origin of the coronary artery was not found.The diagnostic accuracy of DSCT and CDFI were 97.2% ( 140/144)and 97.9% (141/144)respectively,there was no significant difference (x2 =0.00,P > 0.05 ).The sensitivity of DSCT and CDFI were both 93.2% ( 41/44 ),the specificity were 99.0% (99/100) and 100.0% (100/100).The mean effective radiation dose was 0.42 mSv. Conclusion Prospective ECG-gated DSCT is a good imaging technique for the diagnosis of aortic coarctation in children.
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Objective To explore the clinical value of prospective electrocardiography-triggering high-pitch spiral acquisition by dual-source CT (HP mode ) in children with congenital heart diseases (CHD).MethodsThirty-six patients ( mean age:0.67 years,range:1 month to 2 years and 6 months; 25 males;mean weight:7.7 kg)underwent prospective ECG-triggering high-pitch spiral acquisition.The dose length product (DLP) was recorded to calculate effective dose ( ED ).Two experienced radiologists made diagnosis and assessed the overall image quality by a five-point scale independently.The consistency of their judgment was determined by Kappa statistics.Surgeries were performed in 29 patients,and conventional cardiac angiography(CCA) was performed in 7 patients.The accuracy,sensitivity and specificity of HP mode were calculated based on the surgical or CCA findings.ResultsThe DLP was (5.12 ± 1.64) mGy.cm with a range of 2.4 mGy · cm to 9.2 mGy · cm and ED was (0.125 ± 0.027 ) mSv ranging from 0.078 mSv to 0.179 mSv.The average subjective image quality score was 4.2 ± 0.7.All images were diagnosable.Two radiologists made good agreement ( K =0.774,P < 0.05 ).The accuracy,sensitivity and specificity of HP mode were 98.9%,94.2% and 99.8%,respectively.ConclusionLow radiation dose with the accurate diagnosis of anomalies makes HP mode a new choice for children with CHD.
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Objective To explore the application of low-dose prospective ECG-triggering dualsource CT (DSCT) angiography in infants and children with Kawasaki disease (KD).MethodsNineteen children diagnosed of Kawasaki disease underwent low-dose prospective ECG- triggering DSCT angiography (DSCTA) with free breathing and transthoracic echocardiogram (TTE).The overall imaging quality was graded on a five-point scale. Interobserver agreement in subjective image quality grading was assessed by Kappa statistics.The location,number and size of the aneurysms and dilations were recorded and compared with those of TTE.Pearson correlation analysis was used to evaluate the agreement on measurements between DSCTA and TTE.The average effective dose of DSCTA in all 19 children was calculated.ResultsDSCTA was performed successfully in all 19 children.A total of 91.5 % (226/247) segments permitted visualization with diagnostic image quality. Fifteen patients were diagnosed with coronary artery lesions. A total of 28 aneurysms and 15 arterial aneurysmal dilations were detected by DSCTA,while 19 aneurysms and 13 arterial aneurysmal dilations were found by TTE.TTE failed to detect 9 aneurysms (2 in the distal right coronary artery,2 in the posterior descending artery,1 in the middle of left anterior descending artery,1 in the middle of left circumflex artery,2 in the distal of LCX and 1 in the obtuse marginal branch)and 2 arterial aneurysmal dilations (1 at the diagonal branch and 1 at obtuse marginal branch). The concordance of DSCTA and TTE in measurement of diameter and length of these aneurysms and aneurysmal dilatations are good (0.63 ± 0.20) and (0.58 ± 0.20) cm vs ( 1.49 ± 0.83 ) and ( 1.22 ± 0.66) cm ( r =0.989 and 0.965,P < 0.05 ).There was a good agreement on overall image quality ( Kappa =0.87 ). The mean effective dose was(0.24 ± 0.08) mSv.ConclusionProspective ECG-triggering DSCTA with very low effective radiation dose is safe,reliable and more sensitive than TTE on diagnosing of coronary artery lesions,especially in the distal lesions,in infants and children with KD.
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Objective To evaluate the application of prospective ECG-gated dual source CT (DSCT) in patients with acute chest pain, and compare it's image quality and radiation dose with those of retrospective ECG-gated spiral scan. Methods Thirty consecutive patients (Group A, average HR ≥85 bpm) with acute chest pain were scanned with prospective ECG-gated scan and another 30 consecutive patients (Group B, average HR ≥85 bpm)were analyzed by retrospective ECG-gated scan. Tube voltage and tube current were adapted by the BMI of patients. MPR, MIP, CPR and VR were used to display pulmonary arteries (PA), thoracic aorta and coronary arteries (CA). Image quality as well as radiation dose were assessed in 2 groups. Qualitative image quality was compared with chi-square test between the two groups,while quantitative image quality [the image noise ( IN ), signal-to-noise ratio ( SNR ) and contrast-to-noise ratio(CNR)] and radiation dose were evaluated with x2 test and Student's t test. Results The proportion of valid coronary segments for diagnosis were 379/385 ( 98. 44% ) and 390/396 ( 98.48% ) respectively in Group A and Group B with no significant difference(x2 =0. 002,P =0. 961 ). The IN [( 16. 23 ±5.75)vs ( 16. 31 ±3. 32) HU] ,SNR (26. 85 ±9. 94 vs 24. 78 ±9. 91 ) and CNR (20. 99 ±9. 31 vs 18. 65 ±8. 72)showed no significant differences between 2 groups ( t = 0. 069,0. 908 and 1. 224, P > 0. 05, respectively).The ED was on average ( 8. 37 ± 2. 69 ) mSv in Group A, whereas on average ( 20. 05 ± 5.52 ) mSv in Group B. There was a statistical difference between 2 groups ( t = 9. 401, P = 0. 000). Conclusion Low dose prospective ECG-gated DSCT angiography can show similar image quality as retrospective ECG-gated spiral scan with radiation dose.
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Objective To explore the clinical value of dual-energy CT angiography (DE-CTA) in the diagnosis of carotid cavernous fistula. Methods Fourteen patients suspected of carotid cavernous fistula underwent DE-CTA between Dec. 2008 and Feb. 2010. Image post-processing of DE-CTA was performed with the dedicated software to obtain bone-removal and non bone-removal images. Four experienced radiologists evaluated image quality of DE-CTA, the number, location and size of fistulae and dilation of cerebral veins. The bone-removal and non bone-removal images were compared for displaying of fistulae and other related lesions. Kappa test was used to test the consistency of image quality evaluation between two radiologists. The sizes of fistulae were measured with bone-removal DE-CTA images and non bone-removal DE-CTA images respectively and their results were compared by using student's t-test and the correlation test. Results Twenty-eight intracranial internal carotid arteries of 14 patients showed acceptable image quality. Fourteen cases were diagnosed as carotid cavernous fistula with both bone-removal and non boneremoval DE-CTA images. Two patients presented with bilateral lesions, while 7 patients presented with left lesions and 5 patients had right lesions. Totally, sixteen fistulae lesions were detected in 14 patients. The mean size of fistulae was (0. 36 ±0. 10) mm by bone-removal images, whereas (0. 35 ±0. 11 ) mm by non bone-removal images. There was no significant difference between the two methods ( t = 0. 29, P > 0. 05 ),and good correlation was found between the two methods ( r = 0. 97, P <0.05). Thirteen dilated cerebral veins in 8 cases were found by bone-removal images versus 9 dilated cerebral veins in 6 cases by non boneremoval images. Conclusions Image post-processing of DE-CTA is a simple and useful method to identify carotid cavernous fistula. DE-CTA is also useful for therapeutic planning.
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Objective To explore the optimal reconstruction windows in patients with heart rate (HR) over 91 (beats per minute) bpm, and to explore the feasibility of prospective ECG-gated DSCT coronary angiography.Methods Two hundred and thirty-two patients[body mass index (BMI):23-25 kg/m2, with stable HR, and average HR ≥91 bpm]with suspected or known coronary artery disease underwent retrospective ECG-gated DSCT coronary angiography.They were divided into 3 groups (A-C) according to the average HR of scanning.Images were reconstructed from 29% to 80% of the R-R interval in 3% increments.Two independent readers assessed the overall image quality by a five-point scale and determined the optimal reconstruction windows of each coronary segment and the ranges.Coronary arteries were segmented according to the guideline of the American Heart Association (AHA).The degree of interobserver agreement was determined by Kappa statistics.Results Three thousand three hundred and fortythree segments were considered to have diagnostic image quality in 232 patients.The ranges of optimal reconstruction windows of images were concentrated on 81%-61% and 51%-31%.In group A(91-95 bpm), there were 1183 segments in 83 patients, and the according proportions were 5.49%, 94.51%,respectively; In group B(96-100 bpm), there were 986 segments in 68 patients, and the according proportions were 0.20%, 99.80%, respectively; In group C(≥ 101 bpm), there were 1174 segments in 81 patients, and the according proportions were 0.17%, 99.83%, respectively.The optimal construction windows in 3274 segments out of 3343 segments in 232 patients were concentrated in 41%, ranged from 51%-31%.The image quality assessment in 3343 segments in 232 patients have a high inter-observe agreement (Kappa=0.883,P <0.05).Conclusion The optimal reconstruction windows of patients with stable HR(≥91 bpm) was concentrated in 41%, ranged from 51%-31%.When nothing except the window of data acquisition is considered, the prospective ECC,-gated DSCT coronary angingraphy can be used in patients with stable HR(≥91 bpm).
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ObjectiveTo explore the value of low-dose gated dual-source CT(DSCT)in the diagnosis of interrupted aortic.arch.MethodsNine pediatric patients performed DSCT angiography and color Doppler flow imaging(CDFI)in the thoracic aorta and heart.All patients were operated.ResultsDSCT examination was finished in all patients with interrupted aortic arch.Nine patients were associated with ventricular septal defect(VSD),8 patients with patent ductus arteriosus(PDA),2 with bronchus artery dilation and 3 with abnormal origin of the coronary artery.Seven patients were diagnosed as interrupted aortic arch by CDFI,2 patients were diagnosed as truncus arteriosus and coarctation of the aorta respectively.All VSDs and PDAs were detected by CDFI.The diagnostic accuracy of DSCT and CDFI were 94.12%(32/34)and 82.35(28/34)respectively.Conclusion DSCT is a valuable imaging method for the diagnosis of pediatric interrupted aortic arch.
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Objective To study the application of 64-slice spiral CT coronary artery angiography in children.Methods 21 pediatric patients were undergone 64-slice spiral CT coronary artery angiography.6 of 21 patients underwent selective coronary artery angiography.All patients underwent echocadiogram.Results 12 patients were showed having abnormal coronary artery,including double openings at right coronary artery in 3,RCA an LCX origin together from right aortic sinus in 2,LAD and right coronary artery trunk origin together from right aortic sinus in 2 and LAD and LCX origin directively from left aortic sinus respectively in 2,left coronary artery trunk origin from pulmonary artery trunk in 1 case,normal origin of coronary artery but their branches to be tortuous and expansive in 1 case,left coronary artery trunk closed up and right coronary artery to be tortuous in 1 case.Coronary artery simple or multiple tumor-like dilation in 6 cases with Kawasaki disease,3 patients with normal CT coronary artery angiography.In comparing with DSA,the accuracy of 64-SCT in diagnosis pediatric coronary artery disease was 100%.Conclusion As a minimally invasive examination,64-SCT coronary angiography is a valuable method to detect and diagnose the pediatric coronary artery diseases.
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Objective To explore the clinical application of dual-soure CT(DSCT) in coronary artery.Methods 51 patients suspected with coronary artery disease underwent both DSCT coronary arteriography and selective coronary angiography(CAG), the DSCTA results were compared with that of CAG.Results DSCT coronary arteriography in 51 patients at any heart rate was successful.Coronary artery branches and part sub-branches were clearly displayed by DSCT angiography.Stenosis or obstruction of 166 coronary artery branchs in 51 patients were showed ,of them,150 branches were confirmed by CAG. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DSCTA were 100%, 90%, 90.4%, 100% and 94.8% respectively.Conclusion DSCT is a valuable method in detecting the diseases of coronary artery with lower dose. The accuracy of the DSCT is approximate to the CAG.
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Objective To explore the clinical value of 64-slice spiral CT in the diagnosis of congenital cardiopathy.Methods 64-slice spiral CT angiographic date of 20 cases with congenital cardiopathy were analyzed retrospectively in comparison with the ECG and surgical results.Results 4 cases of atrial septal defect,6 cases of ventricular septal defect,7 cases of tetralogy of Fallots,2 cases of patent ductus arteriosus,1 case of right cardiac ventricle double exit in company with ventricular septal defect,1 case of coarctation of aorta and 1 case of interruption of aortic arch were showed by 64-slice spiral CT angiography.Six cases were showed having abnormal coronary artery.Pulmonary arteries of 7 cases were showed straitness in some extent.One atrial septal defect(3 mm) and one ventricular septal defect(2 mm) were missed.The accuracy of diagnosis is 90.00%.Conclusion 64-slice spiral CT heart angiography is an important examination in diagnosing congenital cardiopathy.