[Usefulness of the Principle of Selective Excitation Technique Non-electrocardiogramgated 3D-TOF Method in Lower-extremity MRA Using a Whole-body Coil].

PURPOSE: Generally, non-contrast, lower-extremity, magnetic resonance angiography (MRA) uses electrocardiography; thus, examination is difficult in patients who exhibit arrhythmia. However, the use of electrocardiography can be avoided by using the selective excitation technique in non-electrocardiogram-gated three-dimensional time-of-flight (TOF) (pNon-Gate) MRA. Therefore, patients who exhibit arrhythmia can be examined with pNon-Gate MRA. The purpose of this study was to assess the usefulness of pNon-Gate MRA by using a whole-body coil. METHODS: Images acquired using pNon-Gate MRA were compared with images acquired using electrocardiogram-gated two-dimensional TOF (Gate) MRA. Comparisons comprised visual evaluation, as well as comparisons of contrast-to-noise ratio and imaging time. RESULTS: In visual evaluation of the pelvic region, Gate MRA showed better results than pNon-Gate MRA. In terms of contrast-to-noise ratio, there were no significant differences in either region. Imaging time showed no significant differences between the two methods. However, it exceeded 30 minutes frequently for Gate MRA, but rarely for pNon-Gate MRA. CONCLUSIONS: pNon-Gate MRA is useful in patients with frequent arrhythmia and in those with difficulty in maintaining long-term postures. By using a whole-body coil, pNon-Gate MRA enables easier patient positioning and setting. Therefore, pNon-Gate MRA can be used in routine examinations.

[Study of X-ray Beam Quality and Contrast-to-Noise Ratio of Lung Nodules in Chest FPD Radiography: Monte Carlo Simulation Using Chest Model Phantom].

OBJECTIVES: Contrast-to-noise ratio (CNR) of four X-ray beams (90 kV with 0.15-mm Cu filter, 90 kV with 0.2-mm Cu filter, 120 kV without filter and 120 kV with 0.2-mm Cu filter) in CsI-flat panel detector (FPD) radiography for lung cancer diagnosis was investigated using Monte Carlo simulation. METHOD: Two billion photons were injected to the chest phantom model (width: 300 mm, length: 300 mm, thickness: 200 mm) with imitated lung nodules (10 mm diameter, CT value: +30 Hounsfield unit (HU), -375 HU, and -620 HU). Individual primary and secondary photon's process (absorption, scattering and penetration) in the phantom and CsI-detector was recorded by Monte Carlo simulation. CNR was calculated using primary and secondary absorbed photon's number in the CsI-detector. RESULTS: CNR of 90 kV X-ray beam with 0.15 mm and 0.2 mm Cu filters was higher to 120 kV X-ray beam because of higher primary object contrast and photon's contribution, and high photon's absorption to CsI. CONCLUSION: By Monte Carlo calculation, it was verified that 90 kV X-ray beam with 0.15 mm and 0.2 mm Cu filters yielded higher CNR to 120 kV X-ray beam.

[Optimal Beam Quality in Chest Radiography Using CsI-flat Panel Detector for Detection of Pulmonary Nodules].

OBJECTIVES: Optimal beam quality for detection of pulmonary nodules in digital chest radiography using CsI-flat panel detector (FPD) was investigated in consideration of image quality and patient dose. METHODS: The human chest phantom with inserted imitated nodules (diameter: 10 mm, CT value: +30 Hounsfield unit (HU), -375 HU, -620 HU) was used for the measurement of contrast-to-noise ratio (CNR) of imitated nodules by twenty beams arranged by five tube voltages and four filters. RESULTS: The CNR varies with X-ray tube voltage and added filter. CNR correlates weakly to the tube voltage, fairly to the effective energy in second-order polynomial and strongly to the quality index (effective energy divided X-ray tube voltage). In order to improve the CNR, the effective energy and the quality index are kept about 50 keV and more than 0.5, respectively, using an 80-100 kV beam with a copper filter. CONCLUSION: A 90 kV (2.5 mm Al inherent filtration) beam with a 0.15 mm copper filter and a 90 kV or 100 kV (2.5 mm Al inherent filtration) beam with a 0.2 mm copper filter are appropriate for chest radiography using CsI-FPD.

Effects of different fat-suppression methods on T1 values in dynamic contrast-enhanced magnetic resonance imaging: a phantom study.

Dynamic contrast-enhanced MRI may yield variable longitudinal-relaxation time (T1) values depending on the precision of the fat-suppression (FS) technique. This study aimed to investigate the influences of FS methods on T1 value measurements on phantoms containing test tubes filled with mixtures of five volumes of fat, six amounts of contrast agent, and water. Volumetric interpolated images were obtained using several FS methods and flip angles. T1 maps were created based on the variable flip angle approach. The T1 values of water obtained by point-resolved single-voxel spectroscopy (SVS) were used as reference values. Notably, FS methods were shown to have substantial effects on the measurement of T1 values. Among the tested FS methods, the Dixon (water) method produced T1 values most similar to SVS, which can be considered as a reference value for clinical practice.

Effectiveness of the new injection program 'saline test injection mode' for use power injector in pediatric contrast CT.

To improve the safety of the use of a power injector for pediatric contrast CT, we newly developed a saline test injection mode for a power injector and investigated its usefulness. We used an injection route and investigated the relationship of the injection pressure to the injection rate of saline and the contrast medium. From this relationship, we investigated it was possible to estimate the change of pressure injection of contrast medium from the pressure change of saline injection. The correlation between the saline test injection pressure and the contrast medium injection pressure was investigated in 64 clinical cases. The detection rate of side effects from the saline test injection was investigated in 473 patients. Regarding the correlation between the injection rate and pressure for both saline and contrast, the pressure rose as the rate increased. The contrast medium injection pressure could be estimated from the correlation observed with saline. The clinical data were obtained had a relationship similar to that with phantom data. The detection rate of side effects from the saline test injection was 4.4% in the clinical cases. In these cases, examinations were completed by re-establishing an injection route or administering hypnotics. Our results suggest that contrast medium pressure can be estimated from a saline test injection, thus aiding in prediction of the risk of injection abnormality. Reactions to injections could be observed in the present study, facilitating the prevention of examination failure. Countermeasures can be taken against the cause of the reaction, and the examination can be performed after confirming the absence of a reaction to injection. Therefore, a saline test injection may be useful in pediatric contrast CT.

Comparison of anti-scatter grids for digital imaging with use of a direct-conversion flat-panel detector.

Our purpose in this study was to establish a selection standard for anti-scatter grids for a direct conversion flat-panel detector (FPD) system. As indices for grid evaluation, we calculated the selectivity, Bucky factor, and the signal-to-noise ratio improvement factor (SIF) by measuring rates of scatter transmission, primary transmission, and total transmission (based on the digitally displayed measurement values of the FPD system), using 4 acrylic phantoms of different thicknesses. The results showed that the SIF was less than 1.0 when the phantom thickness was 5 cm. When the phantom thickness was 25 cm and the grid ratio was 16:1, the SIF was 1.505 and 1.518 (maximum value) at 90 and 120 kV, respectively. Compared with the grid ratio of 12:1, the SIF at the grid ratio 16:1 was improved by 6.1% at 90 kV, and by 7.0% at 120 kV. In a direct-conversion FPD system, the grid ratio of 16:1 is considered adequate for eliminating the scattered-radiation effect when much scattered radiation is present, such as with a thick imaged object or a high X-ray tube voltage.

Structural noise from automatic exposure control device and its relationship to X-ray tube voltage used for calibration of a flat-panel detector system.

In flat-panel detector (FPD) systems, the ion-chamber dosimeters used for automatic exposure control (AEC), which are placed between the detector and the source, should not affect clinical images because of FPD gain correction, but can sometimes still introduce fixed-pattern noise. In this study, we investigated whether such artifacts were caused by structural noise from the AEC detector on the basis of the noise power spectrum (NPS) and the mean square error (MSE) of FPD images taken at various tube voltages either with or without the AEC detector. When the NPS was measured without the AEC detector, the NPS did not increase in the low special-frequency band at all radiation qualities tested, irrespective of X-ray calibration tube voltages. However, when the NPS was measured while the AEC detector was used, the NPS increased in the low special-frequency band at all radiation qualities when the X-ray calibration tube voltages were at low levels. Similarly, the MSE increased when the X-ray calibration tube voltages were at low levels. From these results, artifacts in the AEC detector appear to be suppressed when a radiation quality of approximately 90 kV is used at four different standardized radiations quality (RQA3, RQA5, RQA7, and RQA9).

Small bowel perforation from a thermal burn caused by contact with the end of a laparoscope during ovarian cystectomy.

Although laparoscopic surgery now replaces many gynecologic laparotomy procedures, serious complications unique to laparoscopy may occur, including vascular or bowel injury. In most cases of bowel injury during laparoscopy, the laparoscopic instruments that cause injury are the trocar, Veress needle, grasping forceps or scissors, electrocoagulator, or laser. We report a rare case of small bowel perforation after a thermal burn caused by contact with the end of the scope during laparoscopic ovarian cystectomy. Burns and perforations of the small bowel during laparoscopy are rare complications preventable by familiarity with the physical properties of the laparoscopic instruments.