-
[show abstract]
[hide abstract]
ABSTRACT: To determine the image quality and diagnostic performance of an optimized pulmonary computed tomography angiography (CTA) protocol in terms of radiation and contrast volume saving.
Seventy consecutive patients weighting ≤80 kg with clinical suspicion of pulmonary embolism (PE) were prospectively enrolled. Two pulmonary CTA protocols (group A: n = 35, 80 kV/60 ml; group B: n = 35, 100 kV/80 ml) were compared. The presence of PE, image quality parameters [contrast attenuation, contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR)] and effective radiation dose (mSv) were assessed.
PE was found in 11 patients (five of group A, six of group B). The total mean attenuation of the pulmonary arteries was significantly higher in group A (362.4 ± 100.2 HU) than in group B (262.4 ± 134.3 HU), whereas the CNR and SNR did not differ statistically (14.8 ± 7.4 and 16.3 ± 7.5 for group A and 12.5 ± 8.6 and 13.8 ± 9.1 for group B, respectively). The estimated effective radiation dose was significantly lower in group A (1.1 ± 0.7 mSv) than in group B (2.7 ± 1.2 mSv).
In individuals weighting ≤80 kg, the evaluated pulmonary CTA protocol allows similar image quality to be achieved as compared with the conventional pulmonary CTA protocol while reducing radiation exposure by 60% and contrast media volume by 25%.
Clinical radiology 06/2012; 67(9):833-9. · 1.65 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The replacement of conventional films and view boxes with digital images and computer monitors managed by PACS has clearly improved the diagnostic imaging workplace. The new setup has many advantages, including increased productivity brought about by decreased overall time required for image interpretation. On the other hand, the implementation of the digital workplace has increased the importance of factors like background lighting and the position of the chair, work table, mouse, keyboard, and monitor to prevent lesions that can disable the radiologist. The influence of these factors is often undervalued in the design and implementation of the radiological workplace. This article provides recommendations for the design of the radiological workplace based on ergonomics, which is the science that studies interactions among humans and other elements of a system.
Radiología 09/2011; 53(6):507-15.
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the potential usefulness of dual-source CT (DSCT) in the diagnostic work-up of inpatients with atypical chest pain of unknown etiology.
Forty-one consecutive inpatients (25 male, 16 female; mean age 55.6+/-17.39 years) with atypical chest pain underwent DSCT to determine the cause of pain. Images were acquired with retrospective ECG gating after the administration of 120ml of iodinated contrast medium at 4ml/s using the bolus tracking technique. Two readers analyzed the images in consensus.
DSCT was diagnostic in all patients. We detected pulmonary embolisms in five patients and aortic disease in two (one aortic ulcer and one sacular aneurysm). Anomalies of the coronary arteries were depicted in 15 patients, two of whom presented luminal stenosis >50%. Extracardiovascular findings at DSCT included pneumonia in eleven patients, sarcoidosis in one, and non-small cell lung carcinoma in one. Pleural effusion was detected in four patients and pericardial effusion in another four. No pathological findings were observed in 22% of subjects. Evolution was favorable in all patients. No patients were readmitted for persistent pain or new onset of acute chest pain during the follow-up period.
DSCT can rule out most life-threatening clinical conditions that cause chest pain and is useful in determining the cause of chest pain in inpatients.
Radiología 09/2009; 51(6):568-76.
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the effect of average heart rate on the quality of images of the coronary arteries and to determine the optimal reconstruction interval in nonselected patients undergoing DSCT coronary imaging.
We studied 28 consecutive subjects (26 men, 2 women; mean age 60+/-12 years) undergoing contrast-enhanced DSCT (Somatom Definition, Siemens) coronary angiography. Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers assessed the image quality of the whole coronary tree and of each coronary artery using a four-point scale (1: impossible to evaluate, 4: excellent quality).
Mean heart rate during scanning was 73.1+/-14.8 bpm (range, 49-107 bpm). In the best reconstruction interval, excellent diagnostic image quality (score 4) was achieved for 98.8% (83/84) of coronary arteries. Very good interobserver agreement was observed for image quality rating (kappa=0.77) and for selection of the optimal reconstruction interval (kappa=0.86). Mean image quality score for the whole coronary tree was 2.84+/-0.31. No significant correlation was found between the average heart rate and the mean quality scores (r=0.108). No significant differences were found in the quality of images of the coronary arteries in systolic and diastolic reconstructions in each patient.
DSCT makes it possible to obtain excellent coronary angiograms independent of the heart rate. Reconstructions can be obtained in either the diastolic or systolic phase without significant differences in image quality, even at high heart rates.
Radiología 04/2009; 51(4):376-84.
