Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

PURPOSE: To evaluate the capability to detect acute coronary syndrome (ACS) by using non-electrocardiogram-gated parenchymal phase CT imaging. MATERIALS AND METHODS: Of 962 consecutive patients who underwent emergent coronary angiography for suspected ACS, 32 with ACS who underwent CT ≤24 h before angiography and 15 without ACS who underwent CT ≤24 h before or after angiography were included. Parenchymal phase was acquired at 100-s scan delay. The presence of a myocardial perfusion defect (MPD) on the left ventricle (a decrease of >20 HU) and its capability to detect ACS were evaluated. Results were compared with laboratory findings. RESULTS: MPD was detected in 29 of 32 ACSs. The sensitivity, specificity, and positive and negative predictive values were 91 % (29/32), 93 % (14/15), 97 % (29/30), and 82 % (14/17), respectively. The sensitivities of ST- and non-ST-elevation ACSs were 89 % (16/18) and 93 % (13/14), respectively, without significant difference (P > 0.99). Of the CT-detectable ACS, non-ST-elevation on the electrocardiogram and a normal creatine kinase-myocardial band were observed in 41 % (12/29) and 24 % (7/29), respectively. CONCLUSION: ACS is highly detectable even using conventional parenchymal phase CT imaging. Therefore, even when CT is non-gating, radiologists should carefully evaluate the heart to avoid overlooking ACS.

DOI： 10.1007/s11604-016-0527-5

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

PURPOSE: The aim of this study was to determine if lung perfusion blood volume (lung PBV) with non-occlusive pulmonary embolism (PE) differs quantitatively and visually from that with occlusive PE and to investigate if lung PBV with non-occlusive PE remains the same as that without PE. MATERIALS AND METHODS: Totally, 108 patients suspected of having acute PE underwent pulmonary dual-energy computed tomography angiography (DECTA) between April 2011 and January 2012. Presence of PE on DECTA was evaluated by one radiologist. Two radiologists visually evaluated the PE distribution (segmental or subsegmental) and its nature (occlusive or non-occlusive) on DECTA and classified perfusion in lung PBV as "decreased," "slightly decreased," and "preserved". Two radiologists used a lung PBV application to set a region of interest (ROI) in the center of the lesion and measured HU values of an iodine map. In the same slice as the ROI of the lesion and close to the lesion, another ROI was set in the normal perfusion area without PE, and HUs were measured. The proportion of lesions was compared between the occlusive and non-occlusive groups. HUs were compared among the occlusive, non-occlusive, and corresponding normal groups. RESULTS: Twenty-five patients had 80 segmental or subsegmental lesions. There were 37 and 43 lesions in the occlusive and non-occlusive groups, respectively. The proportion of decreased lesions was 73.0% (27/37) in the occlusive group, while that of preserved lesions in the non-occlusive group was 76.7% (33/43). There was a significant difference in the proportion of lesions (P<0.001) between the two groups. HUs of the iodine map were significantly higher in the non-occlusive group than in the occlusive group (33.8 ± 8.2 HU vs. 11.9 ± 6.1 HU, P<0.001). There was no significant difference in HUs for the entire lesion between the non-occlusive (33.8 ± 8.2 HU) and corresponding normal group (34.5 ± 6.8 HU; P=0.294). CONCLUSION: Iodine perfusion tended to be visually and quantitatively preserved in lungs with nonocclusive PE. Lung PBV is required to evaluate pulmonary blood flow.

DOI： 10.1016/j.ejrad.2014.08.015

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

PURPOSE: Our aim was to clarify the common site of deep venous thrombosis (DVT) in patients suspected of having pulmonary embolism using computed tomography pulmonary angiography with computed tomography venography (CTV). MATERIALS AND METHODS: We evaluated 215 patients. For all studies, 100 ml of 370 mg I/ml nonionic contrast material was administered. CTV were scanned with helical acquisition starting at 3 min in four-slice multidetector-row computed tomography (MDCT) or 5 min in 64-MDCT after the start of contrast material injection. The site of DVT was divided into iliac vein, femoral vein, popliteal vein, or calf vein. Calf vein was divided into muscular (soleal and gastrocnemius) and nonmuscular (anterior/posterior tibial and peroneal) veins. The 2 × 2 chi-square test was used. RESULTS: One hundred and thirty-seven patients showed DVT; the muscular calf vein was more prevalent than other veins (P < 0.01). CONCLUSIONS: Our study showed that the most common site of DVT was the muscular calf vein.

DOI： 10.1007/s11604-012-0059-6

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

RATIONALE AND OBJECTIVES: To evaluate reconstruction image quality at the systolic and diastolic cardiac phases and determine the optimal phase for reconstruction according to heart rate when using dual-source computed tomography (CT) with 75 ms temporal resolution. MATERIALS AND METHODS: We retrospectively reviewed the CT datasets of 35 patients with regular heartbeats who underwent coronary CT angiography. Images were reconstructed in 2% steps between 32 and 78% of the beat-to-beat interval. Two experienced radiologists determined the reconstruction interval with the fewest motion artifacts and the motion score of each vessel for the systolic and diastolic phases. Subgroup analysis was performed in patients having heart rates of <70, 70-80, and >80 beats per minute (bpm). RESULTS: In the subgroup with heart rates of <70 bpm, the diastolic phase reconstruction image quality was significantly better than for the systolic phase (P < .01). In the 70-80 bpm and >80 bpm subgroups, no significant difference was observed. In the diastolic phase, the image quality of the <70 bpm subgroup was significantly better than for the >80 bpm subgroup (P < .05). In all systolic phase subgroups and other diastolic phase subgroups, no significant difference was observed. CONCLUSIONS: Using a DSCT scanner with 75 ms temporal resolution, reconstruction at the diastolic phases should be used for patients with heart rates <70 bpm. For heart rates >70 bpm, larger studies are necessary to determine whether reconstruction at the systolic, diastolic, or both phases should be used.

DOI： 10.1016/j.acra.2011.01.012

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

PURPOSE: The aim of this study was to evaluate the relation between the sites of pulmonary embolism (PE) and deep vein thrombosis (DVT) by computed tomography pulmonary angiography (CTPA) and CT venography (CTV) of the pelvis and lower extremities. MATERIALS AND METHODS: We retrospectively reevaluated CTPA-CTV data sets for 227 consecutive patients suspected of having a PE. The PEs were divided into proximal (located at the lobar artery or proximal to it) and distal groups. DVTs were divided into proximal (located above the knee) and distal groups. Cohen's kappa statistic and chi-squared tests were performed. RESULTS: The incidence of PE was significantly higher in patients with a proximal DVT than with a distal DVT (P < 0.01). In patients with a proximal DVT, the incidence of proximal PE was significantly higher than that of distal PE (P < 0.05). In patients with a proximal DVT, the incidence of PE was significantly higher in patients with a right-side DVT than with a left-side DVT (P < 0.05). CONCLUSION: Proximal PEs were correlated with proximal DVTs. Patients with a proximal DVT tended to have a PE, especially with a right-proximal DVT. Hence, the presence of a right-proximal DVT has the potential for serious complications, and carefully diagnosis is required for PE and DVT.

DOI： 10.1007/s11604-010-0533-y

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/jmri.22370

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s11604-010-0428-y

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