共查询到20条相似文献,搜索用时 0 毫秒
1.
2.
PURPOSE: To retrospectively evaluate whether intravenous furosemide, either alone or in addition to intravenous saline, improved depiction of the normal urinary collecting system at multi-detector row computed tomographic (CT) urography. MATERIALS AND METHODS: Institutional review board approval for review of patient images and medical records was obtained; informed consent was not required for this HIPAA-compliant study. Excretory phase images from multi-detector row CT urography in 87 patients (44 women, 43 men; age range, 21-83 years; mean, 53 years) were reviewed. Examinations were performed with, in addition to intravenous contrast medium, 250 mL of intravenous normal saline alone (n = 35), both 250 mL of normal saline and 10 mg of intravenous furosemide (n = 26), or 10 mg of furosemide alone (n = 26). Three readers, blinded to the imaging technique used, individually assigned opacification scores to each of six urinary collecting system segments. Urinary distention was assessed by one reader by measuring transverse widths of the proximal, middle, and distal ureteral segments. Mean opacification scores for each segment and mean ureteral width measurements for each technique were compared by using the Student t test. RESULTS: Mean opacification scores achieved with furosemide were significantly higher than those achieved with saline for the middle (P = .008) and distal (P < .001) ureteral segments. Similarly, mean ureteral widths were significantly higher with furosemide than with saline for the middle (P = .04) and distal segments (P = .01). There was no overall benefit of administering both saline and furosemide. CONCLUSION: To optimize opacification and distention of the normal urinary collecting system, contrast material-enhanced multi-detector row CT urography may be supplemented with intravenous furosemide alone. 相似文献
3.
The authors describe a computed radiographic system employed to generate and archive digital images in intravenous urography. For each exposure the system produces two digital images: the first (left image) simulates a conventional screen-film radiograph, the second (right image); enhances some spatial frequencies and emphasizes the margins of the structures. These images can be modified in their chief parameters and then printed by a laser-printer and archived on optical disks. Four experienced radiologists evaluated digital images with regard to some chief diagnostic parameters and, in 50 patients, they compared digital images with conventional screen-film radiographs and submitted the results to statistical analysis. For some of the chosen parameters, particularly for the evaluation of renal margins before and after contrast medium injection, digital images gave statistically better results than conventional films, while, no statistically significant different was observed for the other parameters. From the results of this preliminary study digital radiography was found to be useful in intravenous urography by reducing the patient's exposition dose, by always obtaining images of good quality, and by enhancing some particular features of the standard image; on the other hand there were many unsolved problems regarding the communicating and archiving system (PACS), because of the slowness of the image transfer procedure, difficulties in data transmission and complexity of referential procedures. 相似文献
4.
Curić J Vukelić-Marković M Marusić P Hrkać-Pustahija A Brkljacić B 《European radiology》2008,18(5):1065-1070
The purpose of the study was to evaluate and compare opacification of the renal collecting system and ureters detected by
computed tomographic urography (CTU) performed 20 min and 1 h after the ingestion of 1,000 ml of water. CTU was performed
on 89 patients (55 men, 34 women; age 28–77 years) and 168 collecting systems and ureters were evaluated. A 16-detector-row
scanner (Sensation 16, Siemens) was used; a two-phase protocol with a split bolus of contrast agent (total 120 ml) was applied.
A combined nephrographic-excretory phase was obtained 100 s after the second injection. Three-dimensional reconstructions
of the excretory phase were created and used to evaluate the degree of opacification of the collecting system and ureters.
In 44 patients, water was administered 20 min before examination, and in 45 patients, 1 h before examination. CTU performed
1 h after water ingestion demonstrated complete opacification of calices in 87.5%, of renal pelvis in 97.5%, of upper ureter
in 91.8% and of lower ureter in 87.5% of patients. CTU performed 20 min after water ingestion demonstrated complete opacification
of calices in 79.5%, of renal pelvis in 85%, of upper ureter in 62.5% and of lower ureter in 54.5% of patients. Complete opacification
of the proximal and distal ureter in the group with a 1-h delay was statistically higher (P < 0.01). CTU performed on the distended bladder, 1 h after the oral ingestion of water, enables excellent opacification of
collecting system, including distal ureters. 相似文献
5.
6.
Compression CT urography: a comparison with IVU in the opacification of the collecting system and ureters 总被引:10,自引:0,他引:10
Heneghan JP Kim DH Leder RA DeLong D Nelson RC 《Journal of computer assisted tomography》2001,25(3):343-347
OBJECTIVE: The purpose of this study was to evaluate opacification of the collecting system and ureters using compression computed tomography (CT) urography compared with conventional intravenous urography (IVU). MATERIALS AND METHODS: Fifty consecutive patients underwent compression CT urography as part of a dedicated renal CT. A compression belt was applied prior to nephrographic phase imaging. Excretory phase scans were acquired through the kidneys 3 minutes post injection with the compression belt in place. The compression belt was then released, and scans were obtained through the ureters. Three independent readers then scored opacification of the collecting system and ureters on a scale of 0-2 (0 = no opacification, 1 = partial opacification, 2 = full opacification and distension). Fifty consecutive nonmatched IVUs were scored by segment by the same readers. Comparison of the two modalities was made using the Mann-Whitney U test. Interobserver agreement was assessed by the Kappa coefficient. RESULTS: CT demonstrated significantly better opacification (p < or = 0.02) of the upper and lower pole pelvicalyceal systems and midureters bilaterally. There was no difference in opacification of the proximal and distal ureters by CT compared with IVU. The Kappa coefficient was 0.53. CONCLUSIONS: Compression CT urography yields equal or better opacification of the collecting system and ureters when compared with IVU, and shows promise for the routine evaluation of the renal excretory system. 相似文献
7.
Multi-detector row CT urography: comparison of strategies for depicting the normal urinary collecting system 总被引:23,自引:0,他引:23
PURPOSE: To evaluate several protocols for depiction of the urinary collecting system with multi-detector row computed tomographic (CT) urography. MATERIALS AND METHODS: Fifty-one patients with hematuria or a suspicious renal mass underwent CT urography, during which thinly collimated (1-mm) pyelographic phase scanning was performed 8-10 minutes after contrast medium administration. Patients were examined while prone only (n = 17) and while both prone and supine (n = 17) after a 250-mL infusion of normal saline. Each collecting system and ureter was divided into six segments that were assigned opacification scores. All acquisition techniques were compared, and the highest-scoring technique was compared with that in 17 patients who underwent conventional intravenous urography (IVU). Three reconstruction techniques (transverse, coronal, and maximal intensity projection) were also compared. Stratified analysis was performed with the paired two-tailed Student t test to compare opacification scores for both the acquisition techniques and display methods, both individually and in all possible combinations. RESULTS: CT urography with supplemental saline administration, performed with the patient prone or supine, significantly improved mean opacification scores in the distal ureters (right, P =.004; left, P =.006). With this technique, CT urography produced a mean opacification score that was not significantly different from that with IVU in 11 of 12 segments and was significantly better than that with IVU in one of 12 segments (lower left ureter). Mean opacification scores obtained with transverse or coronal displays were equal to or higher than those obtained with maximum intensity projection reconstructions in all segments. CONCLUSION: CT urography with a multi-detector row scanner and supplemental infusion of normal saline reliably displays the opacified urinary collecting system. 相似文献
8.
Zähringer M Hesselmann V Schulte O Kamm KF Braun W Haupt G Krug B Lackner K 《AJR. American journal of roentgenology》2003,181(4):931-937
OBJECTIVE: The purpose of the study was to examine the possibilities for reducing radiation exposure in uroradiology using digital flat-panel silicon X-ray detector radiography. We compared the subjectively determined image quality of abdominal radiographs and urograms obtained on a digital flat-panel detector radiography system with those obtained on a computed radiography system. SUBJECTS AND METHODS. Fifty patients who had a clinical indication for urography underwent unenhanced abdominal imaging that was alternately performed using flat-panel silicon X-ray detector radiography or computed radiography. For patients who required a second radiograph with contrast medium, the examination modality was changed to avoid exposing the patients to excess radiation. The images obtained on flat-panel X-ray detector radiography were obtained at half the radiation dose of the images obtained on computed radiography (800 speed vs 400 speed). The resulting 50 pairs of images were interpreted by four independent observers who rated the detectability of structures of bone and the efferent urinary tract relevant to diagnosis and compared the image quality. RESULTS: At half the radiation dose, digital flat-panel X-ray detector radiography provided equivalent image quality of the liver and spleen, lumbar vertebrae 2 and 5, pelvis, and psoas margin on abdominal radiographs. The image quality obtained with digital flat-panel X-ray detector radiography of the kidneys, the hollow cavities of the upper efferent urinary tract, and the urinary bladder was judged to be statistically better than those obtained with computed radiography. CONCLUSION: With half the exposure dose of computed radiography, the flat-panel X-ray detector produced urograms with an image quality equivalent to or better than computed radiography. 相似文献
9.
10.
11.
摘要目的回顾性分析在双源CT中采用新兴锡过滤板技术虚拟消除对比剂后与泌尿系结石检出有关的特征。材料与方法此项研究已获制度伦理委员会批准,并无需知情同意书。152例病人接受了普通CT平扫及排泄期双源CT尿路成像[140kV和80kV(n=44),或140kV和100kV(n=108),140kV锡过滤板置入]检查。 相似文献
12.
13.
HASTE MRI versus chest radiography in the detection of pulmonary nodules: comparison with MDCT. 总被引:7,自引:0,他引:7
Florian M Vogt Christoph U Herborn Peter Hunold Thomas C Lauenstein Tobias Schr?der J?rg F Debatin J?rg Barkhausen 《AJR. American journal of roentgenology》2004,183(1):71-78
OBJECTIVE: The purpose of our study was to compare the diagnostic accuracy of an ultrafast ECG-triggered black blood-prepared HASTE sequence with chest radiography for the detection of pulmonary nodules. SUBJECTS AND METHODS. Sixty-four patients with various primary malignancies who had undergone radiography and MDCT of the chest also underwent ECG-triggered black blood-prepared HASTE MRI of the lung. MR images and radiographs were interpreted separately. The number, location, and size of detected lesions were recorded, and each hemithorax was classified as affected or not affected on the basis of a grade reflecting the conspicuity of nodular involvement. Sensitivity, specificity, and positive and negative predictive values for the detection of pulmonary nodules with diameters of 5 mm or larger were determined, using MDCT findings as the standard of reference. Lesions with diameters smaller than 5 mm were not evaluated. Additional lesion-by-lesion comparisons between MDCT and MRI findings were performed. RESULTS: MDCT confirmed pulmonary lesions in 32 patients, whereas HASTE MRI revealed lesions in 30 patients and chest radiography, in 19 patients. MDCT revealed 226 nodules in 32 patients, whereas MRI HASTE revealed 227 lesions in 30 patients. Conspicuity scale-based sensitivity and specificity for chest radiography were 55.8% and 92.4%, respectively, whereas HASTE MRI had a sensitivity of 93.0% and a specificity of 96.2%. Positive and negative predictive values for chest radiography were 80% and 79.3%, respectively, and for HASTE MRI, 93.0% and 96.2%, respectively. The sensitivity of HASTE MRI increased with lesion size, ranging from 94.9% for nodules between 5 and 10 mm in diameter to 100% for lesions exceeding 3 cm in diameter. CONCLUSION: ECG-triggered black blood-prepared HASTE MRI is reliable for detecting pulmonary nodules exceeding 5 mm and has proven significantly more accurate than conventional chest radiography. The technique appears useful as an adjunct to MRI of the heart, great vessels, or chest, potentially increasing the diagnostic yield of MRI examinations. 相似文献
14.
15.
16.
Simulated pulmonary nodules: detection with dual-energy digital versus conventional radiography 总被引:9,自引:0,他引:9
Niklason LT; Hickey NM; Chakraborty DP; Sabbagh EA; Yester MV; Fraser RG; Barnes GT 《Radiology》1986,160(3):589-593
Performance of a prototype dual-energy digital chest radiography unit in detecting calcified and noncalcified simulated pulmonary nodules was compared with that of a highly optimized, conventional system. Nodules ranging in size (0.5, 1.0, and 1.6 cm), in number (five to 11), and in calcium content (0-25 mg) were superimposed over the lungs of a frozen, unembalmed, human chest phantom. For each technique, six observers examined 50 posteroanterior projections with different randomized nodule locations. Detection consisted of locating and assigning a level of confidence to each perceived nodular opacity. The resulting plots of the true-positive fraction versus the mean number of false-positive calls per projection indicate that for both calcified and noncalcified nodules, the digital unit performed significantly better (P less than .01). 相似文献
17.
18.
Choi D Choo SW Lim JH Lee SJ Do YS Choo IW 《Journal of computer assisted tomography》2001,25(2):218-224
PURPOSE: The purpose of this study was to ascertain the cause of opacification of the portal veins during CT hepatic arteriography (CTHA). METHOD: A total of 155 consecutive patients with hepatocellular carcinoma were evaluated with CTHA as preoperative staging. The opacification of the portal veins during CTHA was categorized as opacification of the main portal vein, right or left branches of the main portal vein (generalized), and segmental or subsegmental portal veins (localized). Hepatic angiography was compared and possible causes were evaluated. RESULTS: One hundred eight (70%) of 155 patients showed intrahepatic portal vein opacification at CTHA: generalized in 60 patients (39%) and localized in 48 patients (31%). Intrahepatic causes were arterioportal shunts due to hepatocellular carcinoma in 20 (19% of 108 patients), previous liver biopsy in 9 (8%), and portal vein thrombosis in 4 (4%). Extrahepatic cause was counted in 57 cases (53%) and was due to inflow of contrast material via nonmesenteric portal circulation through the gastric antrum, duodenum, and/or pancreas. CONCLUSION: Intrahepatic portal veins are frequently opacified during CTHA, and the causes were arterioportal shunts through hepatocellular carcinoma, postbiopsy shunt, portal vein thrombosis, and inflow of contrast material via the nonmesenteric portal circulation. 相似文献
19.
20.
Direct digital radiography versus storage phosphor radiography in the detection of wrist fractures 总被引:6,自引:0,他引:6
Peer S Neitzel U Giacomuzzi SM Pechlaner S Künzel KH Peer R Gassner E Steingruber I Gaber O Jaschke W 《Clinical radiology》2002,57(4):258-262
AIM: To define the value of digital radiography with a clinical flat panel detector system for evaluation of wrist fractures in comparison with state of the art storage phosphor radiography. MATERIAL AND METHODS: Hard copy images of 26 fractured wrist specimens were acquired with the same exposure dose on a state of the art storage phosphor radiography system and a clinical flat panel detector. Image features like cortical bone surface, trabecular bone, soft tissues and fracture delineation were independently analysed by 4 observers using a standardised protocol. Image quality ratings were evaluated with an analysis of variance (ANOVA). RESULTS: Flat panel detector radiographs were rated superior with respect to cortical and trabecular bone representation as well as fracture evaluation, while storage phosphor radiographs produced better soft tissue detail. CONCLUSION: In some of the observed image quality aspects, the performance of caesium iodide/amorphous silicon flat panel detector exceeds state of the art storage phosphor radiography. This makes it well suited for skeletal imaging particularly in trauma as seen in the detection of wrist fractures. 相似文献