Nila Joyce Akhtar

Cleveland State University, Cleveland, Ohio, United States

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Publications (4)1.83 Total impact

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    ABSTRACT: The expanding imaging capabilities of multidetector computed tomography (MDCT) have made it an important part of the preoperative assessment of the cardiac surgery patient. Ever decreasing imaging times, superior spatial resolution, and the 3-dimensional capabilities of MDCT improve diagnosis and enhance surgical planning. Understanding the imaging advantages of MDCT enable improved outcomes in this important patient population.
    Radiologic Clinics of North America 01/2010; 48(1):117-39. DOI:10.1016/j.rcl.2009.09.002 · 1.83 Impact Factor
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    ABSTRACT: PURPOSE While MRI and echocardiography have enabled functional and anatomical evaluation in the infant with congenital heart dsease, these procedures often require prolonged sedation , and the three dimensional evaluation of extracardiac structures can be limited. We report our experience with low dose CT evaluation in infants with complex congenital heart disease with Dual Source CT. METHOD AND MATERIALS Over the period of 2008-2009, we evaluated 27 patients under I year of age (1 day to 1 year, mean age, 56 days) with a low dose CT protocol. .Most common diagnoses included hypoplastic left heart syndrome (HLHS) in 10 patients, transposition of the great arteries (TGA) in 3 patients and Tetralogy of Fallot (TOF) in 3 patients. All patients were imaged with Dual Source CT (Siemens Definition).with temporal resolution 0.83ms, slice thickness 1mm and reconstruction interval of 0.5 mm. Heart rates ranged from 80-145 BPM.Patients were imaged using either a 80 or100 kV tube current.. Dose modulation (Care Dose) was performed in all patients with effective mAs dose ranges of10-15 mAs.. Infants were imaged with retrospective ECG gating utilizing Min Dose, an EKG pulsing technique which reduces radiation dose to 4% of maximum dose during the systolic phases.. Radiation doses were calculated using mSv=DLPx0.017.Estimated radiation dose measurements for each patient were established for standard non ECG gated pediatric chest protocol: utilizing 120kv and 40 mAs.Statisical analysis was performed using a paired t test. RESULTS CT scans were diagnostic in all patients. Functional evaluation of ventricular function and vascular stenosis were possible in all patients The mean .radiation dose for the 27 patients was 0.17 mSv. (dose ranges 0.051mSv-0.408 mSv) Estimated doses using the standard non gated pediatric protocol was 0.37 mSv (dose ranges 0.56 -1.412 mSv). This difference was statistically significant (p<.009) CONCLUSION The improved temporal resolution of Dual Source CT enables dynamic evaluation and minimizes cardiacc despite very high heart rates. Reduction in kV,dose modulation and EKG pulsing techniques minimize cardiac motion while enabling significant dose reduction in infants and small children with congenital heart disease. CLINICAL RELEVANCE/APPLICATION Diual Source CT imaging enables accurate dynamic imaging of the infant with congenital heart disease,minimizing sedation and significantly reducing radiation dose.
    Radiological Society of North America 2009 Scientific Assembly and Annual Meeting; 12/2009
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    ABSTRACT: PURPOSE/AIM To present an expanded role of the Prospective ECG gated "step and shoot" technology in the evaluation of a wide variety of cardiovascular disease. To present techniques tooptimize dose reduction in Prospective ECG gated techniques CONTENT ORGANIZATION Content Organization A.Prospective vs Retrospective ECG gated CT: techniques and priciples B.Image optimization techniques for Propective ECG gated CT. C.Dose Reduction Rechniques with Prospective ECG gating techniques. D.Patient based CT protocols and Cinical Indications. E.Prospective ECG Gating for the chest pain "triple rule out" patient. F. Prosepective ECG gating for congenital and acquired aortic disease. G. Prospective ECG gating for the reoperative cardiac surgery patient. SUMMARY Prospective ECG gated techniques enable an expanded role for the diagnosis and management of the cardiac disease patient. This technique enables accurate diagnosis while effectively limiting radiation dose in a wide variety of clinical indications.
    Radiological Society of North America 2009 Scientific Assembly and Annual Meeting;
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    ABSTRACT: PURPOSE/AIM The purpose of this exhibit is to demonstrate the improved imaging capabilities of dual source CT in the diagnosis of mitral valve disease. Echocardiographic correlation will be presented to better illustrate the anatomic/imaging correlates of mitral valve disease. CONTENT ORGANIZATION Dual source CT has enabled significant improvement in the imaging evaluation of mitral valve disease. Demonstration of the normal mitral valve, papillary muscle and chordal anatomy will be discussed in this exhibit.CT findings in congenital and acquired mitral stenosis and mitral regurgitation will be demonstrated. Ischemic mitral valve disease, mitral valve prolapse and mitral valve pathology in the hypertrophic cardiomyopathies will be demonstrated with echocardographic correlation.. SUMMARY The improved temporal resolution made possible with dual source CT has enabled new insights in the CT detection of mitral valve disease. Correlation of echocardiography and dual source CT will enhance the radiologist's undersanding of the anatomic/pathologic relationships in mitral valve disease.
    Radiological Society of North America 2008 Scientific Assembly and Annual Meeting;