共查询到20条相似文献,搜索用时 15 毫秒
1.
Bernhard Bischoff Felix G. Meinel Alessandra Del Prete Maximilian F. Reiser Hans-Christoph Becker 《European journal of radiology》2013
Background
Coronary CT angiography (CCTA) is usually performed during breath holding to reduce motion artifacts caused by respiration. However, some patients are not able to follow the breathing commands adequately due to deafness, hearing impairment, agitation or pulmonary diseases. The aim of this study was to evaluate the potential of high-pitch CCTA in free breathing patients when compared to breath holding patients.Methods
In this study we evaluated 40 patients (20 free breathing and 20 breath holding patients) with a heart rate of 60 bpm or below referred for CCTA who were examined on a 2nd generation dual-source CT system. Image quality of each coronary artery segment was rated using a 4-point grading scale (1: non diagnostic–4: excellent).Results
Mean heart rate during image acquisition was 52 ±5 bpm in both groups. There was no significant difference in mean image quality, slightly favoring image acquisition during breath holding (mean image quality score 3.76 ± 0.32 in breath holding patients vs. 3.61 ± 0.45 in free breathing patients; p = 0.411). Due to a smaller amount of injected contrast medium, there was a trend for signal intensity to be slightly lower in free breathing patients, but this was not statistically significant (435 ± 123 HU vs. 473 ± 117 HU; p = 0.648).Conclusion
In patients with a low heart rate who are not able to hold their breath adequately, CCTA can also be acquired during free breathing without substantial loss of image quality when using a high pitch scan mode in 2nd generation dual-source CT. 相似文献2.
Maksymilian P. Opolski Cezary Kepka Stephan Achenbach Jerzy Pregowski Mariusz Kruk Adam D. Staruch Jacek Kadziela Witold Ruzyllo Adam Witkowski 《European journal of radiology》2014
Objective
To determine the application of advanced coronary computed tomography angiography (CCTA) plaque analysis for predicting invasive fractional flow reserve (FFR) in intermediate coronary lesions.Methods
Sixty-one patients with 71 single intermediate coronary lesions (≥50–80% stenosis) on CCTA prospectively underwent coronary angiography and FFR. Advanced anatomical and morphometric plaque analysis was performed based on CCTA data set to determine optimal criteria for significant flow impairment. A significant stenosis was defined as FFR ≤ 0.80.Results
FFR averaged 0.85 ± 0.09, and 19 lesions (27%) were functionally significant. FFR correlated with minimum lumen area (MLA) (r = 0.456, p < 0.001), minimum lumen diameter (MLD) (r = 0.326, p = 0.006), reference lumen diameter (RLD) (r = 0.245, p = 0.039), plaque burden (r = −0.313, p = 0.008), lumen area stenosis (r = −0.305, p = 0.01), lesion length (r = −0.692, p < 0.001), and plaque volume (r = −0.668, p < 0.001). There was no relationship between FFR and CCTA morphometric plaque parameters. By multivariate analysis the independent predictors of FFR were lesion length (beta = −0.581, p < 0.001), MLA (beta = 0.360, p = 0.041), and RLD (beta = −0.255, p = 0.036). The optimal cutoffs for lesion length, MLA, MLD, RLD, and lumen area stenosis were >18.5 mm, ≤3.0 mm2, ≤2.1 mm, ≤3.2 mm, and >69%, respectively (max. sensitivity: 100% for MLA, max. specificity: 79% for lumen area stenosis).Conclusions
CCTA predictors for FFR support the mathematical relationship between stenosis pressure drop and coronary flow. CCTA could prove to be a useful rule-out test for significant hemodynamic effects of intermediate coronary stenoses. 相似文献3.
Karsten Beiderwellen Benedikt Gomez Christian Buchbender Verena Hartung Thorsten D. Poeppel Felix Nensa Hilmar Kuehl Andreas Bockisch Thomas C. Lauenstein 《European journal of radiology》2013
Objectives
To assess the value of PET/MRI with [18F]-FDG using a whole body protocol for the depiction and characterization of liver lesions in comparison to PET/CT.Methods
70 patients (31 women, 39 men) with solid tumors underwent [18F]-FDG PET/CT and followed by an additional PET/MRI using an integrated scanner. Two readers rated the datasets (PET/CT; PET/MRI) regarding conspicuity of hepatic lesions (4-point ordinal scale) and diagnostic confidence (5-point ordinal scale). Median scores for lesion conspicuity and diagnostic confidence were compared using Wilcoxon's rank sum test. Prior examinations, histopathology and clinical follow-up (116 ± 54 days) served as standard of reference.Results
36 of 70 (51%) patients showed liver lesions. Using PET/CT and PET/MRI all patients with liver metastases could correctly be identified. A total of 97 lesions were found (malignant n = 26; benign n = 71). For lesion conspicuity significantly higher scores were obtained for PET/MRI in comparison to PET/CT (p < 0.001). Significantly better performance for diagnostic confidence was observed in PET/MRI, both for malignant as for benign lesions (p < 0.001).Conclusions
PET/MRI, even in the setting of a whole body approach, provides higher lesion conspicuity and diagnostic confidence compared to PET/CT and may therefore evolve as an attractive alternative in oncologic imaging. 相似文献4.
Christopher Herzog J. Matthias Kerl Salvatore De Rosa Tuna Tekin Eike Boehme Sven Liem Miriam Scheuchenzuber He-Ri Kim Ralf W. Bauer Justin R. Silverman Peter L. Zwerner Hanns Ackermann Thomas J. Vogl U. Joseph Schoepf 《European journal of radiology》2013
Purpose
To assess the influence of experience and training on the proficiency in coronary CT angiography (CCTA) interpretation of practitioners with different levels of experience.Methods and materials
Nine radiologist and cardiologist observers with varying prior CCTA experience ranging from novice to expert independently analyzed two case series of 50 catheter-correlated CCTA studies for coronary artery stenosis (0%, ≤49%, 50–74%, 75–99%, or 100%). Results of the first case series were unblinded and presented along with catheter angiography results to each reader before proceeding to the second series. Diagnostic accuracy on a per-segment basis was compared for all readers and both case series, respectively.Results
Correlation coefficients between CCTA and catheter angiography initially ranged between good (r = 0.87) and poor (r = 0.26), depending on reader experience, and significantly (p < 0.05) improved in the second case series (range: r = 0.42 to r = 0.91). Diagnostic accuracy was significantly (p < 0.05) higher for more experienced readers (range: 96.5–97.8%) as compared to less experienced observers (range: 90.7–93.6%). After completion of the second case series for less experienced readers sensitivity and PPV significantly (p < 0.05) improved (range: 62.7–67.8%/51.4–84.1%), but still remained significantly (p < 0.05) lower as compared to more experienced observers (range: 89.8–93.3%/80.6–93.3%).Conclusion
The level of experience appears to be a strong determinant of proficiency in CCTA interpretation. Limited one-time training improves proficiency in novice readers, but not to clinically satisfactory levels. 相似文献5.
Background
Patients who present to the emergency department (ED) complaining of acute chest pain are of clinical concern because a small percentage will have acute coronary syndrome (ACS). The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend hospitalization for patients with a low-to-intermediate risk of ACS who have initial negative ECG and enzyme test results. A negative coronary CT angiography (CCTA) during the triage has a very high negative predictive value for ruling out ACS decreasing the length of hospital stay. Recent techniques e.g. ASiR in CCTA should be used to decrease the radiation dose as low as possible.Objective
The aim of this study is to evaluate the role of low radiation dose CCTA with ASiR in triage of low-risk patients with acute chest pain in emergency department. A negative CCTA early in the workup may enable a shorter length of stay.Subjects and methods
We studied 54 selected patients (55.6% men; mean age 48 ± 6 years) with chest pain who were awaiting hospital admission to rule out ACS despite the absence of diagnostic ECG changes and normal cardiac enzymes on ED presentation. Patients underwent CCTA before hospital admission. Afterward, patients received standard clinical care (SCC). ER physicians involved in the patient’s care were blinded to the results of CCTA. An expert panel established the presence or absence of ACS based on AHA guidelines. The CCTA images were evaluated for the presence of significant coronary artery stenosis (diameter reduction >50%) and were used to make a triage decision.Results
Four patients (7.4%) with chest pain had at least one significant coronary stenosis on CCTA (sensitivity 100%, specificity 96%, accuracy 96.3%, positive predictive value (PPV) 66.7% and negative predictive value (NPV) 100%). Significant coronary stenosis was excluded in 48 of the 54 patients by CCTA (88.9%), potentially saving about 71.6% of unnecessary hospital admission hours.Conclusion
CCTA based detection of significant coronary stenosis has potential role to decrease the length of hospital stay , without reducing appropriate patient care, in low risk patients with acute chest pain. CCTA should be done with lowest radiation possible using recent techniques. 相似文献6.
Nolz R Wibmer A Beitzke D Gentzsch S Willfort-Ehringer A Lammer J Thurnher M Schoder M 《European journal of radiology》2012,81(1):89-94
Purpose
To compare 64-multi-slice-CT angiography (64-MSCTA) to color-coded duplex sonography (CCDS) in the follow-up after carotid artery stenting (CAS).Methods
Thirty patients who had an MSCTA and CCDS examination prior and after CAS were included. Twelve closed-cell and 24 open-cell stents were implanted. Neointimal surface, in-stent-restenosis (ISR), stent expansion, and fracture were evaluated. In addition, the occurrence of atherosclerotic lesions leading to a > 50% stenosis in supraaortic vessels was assessed.Results
With MSCTA, >50% ISR was found in 5.6% of cases during a mean follow-up of 41.7 months. Comparing MSCTA and CCDS, grading of ISR and absolute diameters of neointimal surface correlated moderately (Spearman = 0.402, p = 0.015; Pearson = 0.404, p = 0.03). Assessment of the neointimal surface was significantly better with MSCTA (100% vs. 80.6%; p = 0.011). Stent expansion was significant, compared to the basic value, with both modalities and stent types (p < 0.001). Of 237 additionally assessed vessel segments, a > 50% stenosis was detected in 38 (16.0%) vessel segments. Findings were stable in 25 (10.5%) and progressed in 11 (4.6%) vessel segments. Five small intracranial aneurysms were detected in four (13.3%) patients. Of 21 incidental findings in 16 (51.6%) patients there was one with malignancy (4.8%).Conclusion
With regard to ISR and stent expansion, no significant difference was found, when MSCTA and CCDS were compared. CTA is quite applicable as a complementary imaging method for the follow-up of patients with carotid artery stents. Additional advantages are the detection of supraaortic vessel pathologies and incidental findings. 相似文献7.
Samir Zaki Kotb Amina Ahmed SultanGalal Magdy Elhawary Saher Ebrahim Taman 《The Egyptian Journal of Radiology and Nuclear Medicine》2014
Aim of the work
To assess the value of diffusion weighted MRI in the differentiation of benign and malignant bony tumors and tumor like lesions.Patients and methods
This study included 100 patients (66 males and 34 females). Their ages ranged between 4 and 65 years and the mean age was 31.3 years. The patients were referred to MRI unit from orthopedic surgery and radiotherapy departments and oncology center in Mansoura University hospital. These patients were selected on clinical bases indicating or suggesting presence of bony tumors or tumor-like lesions as a primary diagnosis (e.g. swelling or signs of inflammation). The commonest clinical presentations were pain (n = 71) and swelling (n = 61). Other presentations included limitation of movement (n = 20), back pain (n = 21) and fever (n = 20). More than one symptom may be present in one patient. Patients included in our study were classified according to the pathological and radiological criteria into three groups: Benign bone tumors (14 patients); malignant bone tumors (51 patients); tumor-like lesions (35 patients).Results
DWI with measurement of ADC values helped in the differentiation of benign and malignant bone tumors, as malignant bone tumors have mean ADC values less than (1.31 × 10−3) mm2/s; while benign bone tumors have mean ADC values 1.43 × 10−3 mm2/s. Also, mean ADC values helped in differentiating malignant from inflammatory bony lesions as well as cystic from solid bony lesions.Conclusion
DWI has been proven to be highly useful in the differentiation of benign, malignant bone tumors and tumor like bony lesions. Measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Moreover, measurement of ADC values can be used in the follow up of tumors and their response to therapy. 相似文献8.
Claus Koelblinger Julia Fruehwald-Pallamar Klaus Kubin Mirja Wallner-Blazek Luc van den Hauwe Leonardo Macedo Stefan B. Puchner Majda M. Thurnher 《European journal of radiology》2013
Introduction
The purpose of this study was to evaluate MR imaging characteristics with conventional and advanced MR imaging techniques in patients with IIDL.Methods
MR images of the brain in 42 patients (20 male, 22 female) with suspected or known multiple sclerosis (MS) from four institutions were retrospectively analyzed. Lesions were classified into five different subtypes: (1) ring-like lesions; (2) Balo-like lesions; (3) diffuse infiltrating lesions; (4) megacystic lesions; and (5) unclassified lesions.The location, size, margins, and signal intensities on T1WI, T2WI, and diffusion-weighted images (DWI), and the ADC values/ratios for all lesions, as well as the contrast enhancement pattern, and the presence of edema, were recorded.Results
There were 30 ring-like, 10 Balo-like, 3 megacystic-like and 16 diffuse infiltrating-like lesions were detected. Three lesions were categorized as unclassified lesions.Of the 30 ring-like lesions, 23 were hypointense centrally with a hyperintense rim. The mean ADC, measured centrally, was 1.50 ± 0.41 × 10−3 mm2/s. The mean ADC in the non-enhancing layers of the Balo-like lesions was 2.29 ± 0.17 × 10−3 mm2/s, and the mean ADC in enhancing layers was 1.03 ± 0.30 × 10−3 mm2/s. Megacystic lesions had a mean ADC of 2.14 ± 0.26 × 10−3 mm2/s. Peripheral strong enhancement with high signal on DWI was present in all diffuse infiltrating lesions. Unclassified lesions showed a mean ADC of 1.43 ± 0.13 mm2/s.Conclusion
Restriction of diffusion will be seen in the outer layers of active inflammation/demyelination in Balo-like lesions, in the enhancing part of ring-like lesions, and at the periphery of infiltrative-type lesions. 相似文献9.
Qianwen Li Pengyu Li Zhuangzhi Su Xinyu Yao Yan Wang Chen Wang Xiangying Du Kuncheng Li 《European journal of radiology》2014
Purpose
To evaluate the effect of SnapShot Freeze (SSF) reconstruction at an intermediate heart-rate (HR) range (65–75 bpm) and compare this method with single-sector reconstruction and bi-sector reconstruction on segmental and vessel bases in retrospective coronary computed tomography angiography (CCTA).Materials and methods
Retrospective electrocardiogram-gated CCTA was performed on 37 consecutive patients with HR between 65 and 75 bpm using a 64-row CT scanner. Retrospective single-sector reconstruction, bi-sector reconstruction, and SSF were performed for each patient. Multi-phase single-sector reconstruction was performed to select the optimal phase. SSF and bi-sector images were also reconstructed at the optimal phase. The images were interpreted in an intent-to-diagnose fashion by two experienced readers using a 5-point scale, with 3 points as diagnostically acceptable. Image quality among the three reconstruction groups were compared on per-patient, per-vessel, and per-segment bases.Results
The average HR of the enrolled patients was 69.4 ± 2.7 bpm. A total of 111 vessels and 481 coronary segments were assessed. SSF provided significantly higher interpretability of the coronary segments than bi-sector reconstructions. The qualified and excellent rates of SSF (97.9% and 82.3%) were significantly higher than those of single-sector (92.9% and 66.3%) and bi-sector (90.9% and 64.7%) reconstructions. The image quality score (IQS) using SSF was also significantly higher than those of single-sector and bi-sector reconstructions both on per-patient and per-vessel bases. On per-segment analysis, IQS was improved in most segments (9/14).Conclusion
The SSF algorithm can provide acceptable diagnostic image quality in coronary CTA for patients with intermediate HR. 相似文献10.
Maksymilian P. Opolski Jerzy Pregowski Mariusz Kruk Adam D. Staruch Adam Witkowski Marcin Demkow Tomasz Hryniewiecki Piotr Michalek Witold Ruzyllo Cezary Kepka 《European journal of radiology》2014
Objective
To determine the prevalence, radiologic patterns and clinical characteristics of intra-atrial right coronary artery (IARCA) among adult coronary computed tomography angiography (CCTA) population.Methods
We included 9,284 consecutive subjects who underwent CCTA at a single high-volume center. The presence of IARCA including the number, length and diameter of IARCA segments with accompanying atherosclerosis and coronary anomalies were evaluated. Additionally, clinical characteristics and midterm follow-up of IARCA patients were recorded.Results
The IARCA prevalence was 0.15% (14/9,284) with 15 intra-atrial segments. The intra-atrial segment length ranged from 14 to 53 mm, and the mean diameter proximal to the entry site was 3.3 ± 0.7 mm. IARCA was more often associated with intramuscular course of the left anterior descending coronary artery (29% vs. 4%, p = 0.001) and anomalous origin of the left circumflex artery from the right aortic sinus (14% vs. 0.3%, p = 0.001) compared with non-IARCA cases. The majority of IARCA patients were women (86%) presenting with supraventricular arrhythmia (71%). Compared with computed tomographic population without IARCA, IARCA subjects were younger (60 ± 12 vs. 54 ± 14 years, p = 0.037) and more often women (51% vs. 86%, p = 0.013). At a mean of 20 months follow-up of IARCA patients there were no adverse cardiac events except for supraventricular tachycardia episodes occurring in 36% of subjects.Conclusions
IARCA occurs rarely and is often associated with additional coronary anomalies. The clinical profile of IARCA patients is most often represented by middle-aged women with supraventricular arrhythmia showing favorable midterm prognosis. 相似文献11.
Fabio Becce Anastasia Pomoni Emilie Uldry Nermin Halkic Pu Yan Reto Meuli Sabine Schmidt 《European journal of radiology》2014
Purpose
To report the diffusion-weighted MRI findings in alveolar echinococcosis (AE) of the liver and evaluate the potential role of apparent diffusion coefficients (ADCs) in the characterisation of lesions.Materials and methods
We retrospectively included 22 patients with 63 AE liver lesions (≥1 cm), examined with 3-T liver MRI, including a free-breathing diffusion-weighted single-shot echo-planar imaging sequence (b-values = 50, 300 and 600 s/mm2). Two radiologists jointly assessed the following lesion features: size, location, presence of cystic and/or solid components (according to Kodama's classification system), relative contrast enhancement, and calcifications (on CT). The ADCtotal, ADCmin and ADCmax were measured in each lesion and the surrounding liver parenchyma.Results
Three type 1, 19 type 2, 17 type 3, three type 4 and 21 type 5 lesions were identified. The mean (±SD) ADCtotal, ADCmin and ADCmax for all lesions were 1.73 ± 0.50, 0.76 ± 0.38 and 2.63 ± 0.76 × 10−3 mm2/s, respectively. The mean ADCtotal for type 1, type 2, type 3, type 4 and type 5 lesions were 1.97 ± 1.01, 1.76 ± 0.53, 1.73 ± 0.41, 1.15 ± 0.42 and 1.76 ± 0.44 × 10−3 mm2/s, respectively. No significant differences were found between the five lesion types, except for type 4 (p = 0.0363). There was a significant correlation between the presence of a solid component and low ADCmin (r = 0.39, p = 0.0016), whereas an inverse correlation was found between the relative contrast enhancement and ADCtotal (r = −0.34, p = 0.0072).Conclusion
The ADCs of AE lesions are relatively low compared to other cystic liver lesions, which may help in the differential diagnosis. Although ADCs are of little use to distinguish between the five lesion types, their low value reflects the underlying solid component. 相似文献12.
Nour-Eldin A. Nour-Eldin Mohammed Alsubhi Nagy N. Naguib Thomas Lehnert Ahmed Emam Martin Beeres Boris Bodelle Karen Koitka Thomas J. Vogl Volkmar Jacobi 《European journal of radiology》2014
Purpose
To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques.Materials and methods
Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant.Results
Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion's depth from the pleural surface (p = 0.021 and 0.018 in non-coaxial and coaxial groups respectively), increased distance of traversed lung in the needle track of more than 2.5 cm (p = 0.001 in both groups). Insignificant risk factors were patient's age, gender or emphysema in both groups (p value >0.1 in both groups). Concomitant incidence of pneumothorax was 32.3% (21/65) in non-coaxial group and 36.6% (26/71) in coaxial group. Pulmonary hemorrhage in the majority of cases was treated conservatively.Conclusion
Pulmonary hemorrhage complicating CT-guided core biopsy of pulmonary lesions, showed insignificant difference between coaxial and non-coaxial techniques. Significant risk factors of pulmonary hemorrhage included small and basal lesions, increased lesion's depth from pleural surface, increased length of aerated lung parenchyma crossed by biopsy needle and passing through vessels within the lung during puncture. 相似文献13.
Objective
In this research, patients who had pericardial lesions are imaged by either CT or MRI and the purpose of this paper is to discuss which imaging modality should be used in the assessment of patients with different pericardial diseases.Patients and methods
Thirty patients ranging in age between 3 months and 46 years diagnosed as having pericardial lesions by transthoracic echocardiography were prospectively studied. All patients were examined by history taking, chest X-ray, clinical examination, transthoracic echocardiography, Multidetector CT and/or magnetic resonance imaging.Result
Several types of lesions were identified including constrictive pericarditis (n = 10), pericardial simple effusion (n = 9), pericardial tumors (n = 5), pericardial abscess (n = 4), pericardial hemorrhage (n = 4) and one case of pericardial cyst. Three patients had combined lesions.Conclusion
CT and MR imaging should be used when findings at echocardiography are difficult to interpret, inconclusive or conflict with clinical findings. CT is better used for the assessment of postoperative cases while MRI is superior in detecting and diagnosing pericardiac masses and constrictive pericarditis.Also, because of radiation involving CT scan should be avoided in children if possible but has the advantage of fast imaging speed and often no need for sedation of patients and children. 相似文献14.
Objective
To assess the role of DWI and ADC in differentiating between benign and malignant breast lesions.Materials and methods
51 patients (age range 24–66 years; mean age 48 years) were included in our study. MRI was done using bilateral fat-suppressed T2- weighted fast spin-echo, STIR, axial T1-weighted fast spin-echo. DWI series were acquired using echo planar imaging pulse sequences incorporated with diffusion gradients and finally dynamic contrast enhancement study was done.Results
Sixty three lesions were detected in 51 patients included in our study. Twenty one lesions were malignant, three lesions were intermediate and twenty two lesions were fibroadenoma according to the final histopathological study and seventeen lesions were breast cysts. A total of 21 lesions showed lower ADC values than benign lesions and were in the range of 0.76–1.29 × 10−3 mm2/s and were diagnosed as malignant breast lesions. The sensitivity and specificity for DWI in the differentiating malignant from benign breast lesions were calculated and showed 95.4% and 97.5%, respectively.Conclusion
DWI is easy to obtain in short scan time and easy to evaluate, and ADC values can differentiate between benign and malignant breast lesions with high sensitivity and specificity. 相似文献15.
Objective
To assess feasibility of whole-body diffusion-weighted MRI (wbDWI) for very early evaluation of response to therapy in different lymphoma subtypes.Materials and methods
20 patients (10 male, 10 female; mean age 50.7 ± 16.1 ± 17.2 years) underwent wbDWI (calculation of apparent diffusion coefficient [ADC] with b = 0, 800 s/mm2) at baseline and within a median of 7 days after therapy onset. Lymphoma manifestations were evaluated with respect to changes in ADC and size at follow-up with up to six of the largest lesions per patient undergoing quantification. An increase in ADC as well as a decrease in size at follow-up was classified as responder, whereas neither change in ADC nor in size (or progression) was considered non-responder. Results were confirmed at interim measurements (after 3–4 chemotherapy cycles) and 6 months after treatment.Results
90 lymphoma lesions were analyzed. 18 patients were classified as responders and 2 as non-responder at FU (mean, 1 week). DWI results accurately (100%) correlated with the subsequent interim course of all lesions. mean baseline ADC was 0.79 ± 0.28 × 10−3 s/mm2. For responders mean follow-upADC increased by 64.6 ± 56.5% (p < 0.001) whereas lesions size decreased by mean 14.4 ± 13.3% (p < 0.001). In the non-responder, both values did not significantly change.In patients classified as responders six months after treatment, meanADC increase at FU was 70.3 ± 57.8% (p < 0.001) whereas mean size decrease vs. baseline was 15.8 ± 13.6% as compared to non-responders (22.4 ± 39.9%) and 5.4 ± 0.9%, respectively.Conclusion
wbDWI with ADC analysis represents a feasible diagnostic tool for very early response assessment in lymphoma patients enabling also prediction of long-term response. 相似文献16.
Shaowei Zheng Yue DongYanwei Miao Ailian LiuXin Zhang Bin WangYing Ge Yijun LiuShaowu Wang 《European journal of radiology》2014
Purpose
To assess the reliability of dual-energy CT (DECT) spectral imaging for the differentiation of bone metastases (BMs) from Schmorl's nodes (SNs) in the vertebrae of cancer patients.Materials and methods
In this retrospective study, 102 cancer patients who underwent DECT (GE spectral CT Discovery CT750 HD scanner) had 110 low density vertebral lesions. Each lesion was characterized as a BM or SN, based on the typical MRI or SPECT/PET-CT findings as well as size and number change in the 6 months follow-up. The means of 140 kVp polychromatic CT values, 40–140 keV monochromatic CT values, slopes (k) of the spectral curves, bone(water) and water(bone) densities of BMs and SNs were measured and compared with independent-samples t-test. The difference values of the two lesions and their respective normal bone tissue were calculated (normal density − lesion density) and compared using independent-samples t-test. ROC curves were used to compare the diagnostic efficacies of these measures in the identification of SNs and BMs.Results
110 lesions consisting of 69 BMs and 41 SNs were identified. The spectral curve patterns and slopes for BMs and SNs were different (p < 0.05). The water(bone) density of BMs (1009.02 ± 59.25 mg/cm3) was higher than that of SNs (892.00 ± 83.65 mg/cm3) (p < 0.01) while the bone(water) density (43.57 ± 50.87 mg/cm3) was lower than that of SNs (174.60 ± 94.61 mg/cm3) (p < 0.01). The 40 keV CT value, k, bone(water) density and water(bone) density had a higher diagnostic efficacy for differentiating the two lesions than polychromatic CT value (p < 0.05).Conclusions
Dual-energy CT imaging is accurate enough for identification of osteolytic metastases and Schmorl's nodes. 相似文献17.
Joachim Böttcher Andreas Hansch Alexander Pfeil Peter Schmidt Ansgar Malich Albrecht Schneeweiss Martin H. Maurer Florian Streitparth Ulf K. Teichgräber Diane M. Renz 《European journal of radiology》2013
Objective
To compare the diagnostic efficacy of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) vs. multidetector computed tomography (MDCT) for the detection and classification of focal liver lesions, differentiated also for lesion entity and size; a separate analysis of pre- and postcontrast images as well as T2-weighted MRI sequences of focal and exclusively solid lesions was integrated.Methods
Twenty-nine patients with 130 focal liver lesions underwent MDCT (64-detector-row; contrast medium iopromide; native, arterial, portalvenous, venous phase) and MRI (1.5-T; dynamic and tissue-specific phase 20 min after application of Gd-EOB-DTPA). Hepatic lesions were verified against a standard of reference (SOR). CT and MR images were independently analysed by four blinded radiologists on an ordinal 6-point-scale, determining lesion classification and diagnostic confidence.Results
Among 130 lesions, 68 were classified as malignant and 62 as benign by SOR. The detection of malignant and benign lesions differed significantly between combined and postcontrast MRI vs. MDCT; overall detection rate was 91.5% for combined MRI and 80.4% for combined MDCT (p < 0.05). Considering all four readers together, combined MDCT achieved sensitivity of 66.2%, specificity of 79.0%, and diagnostic accuracy of 72.3%; combined MRI reached superior diagnostic efficacy: sensitivity 86.8%, specificity 94.4%, accuracy 90.4% (p < 0.05). Differentiated for lesion size, in particular lesions <20 mm revealed diagnostic benefit by MRI. Postcontrast MRI also achieved higher overall sensitivity, specificity, and accuracy compared to postcontrast MDCT for focal and exclusively solid liver lesions (p < 0.05).Conclusion
Combined and postcontrast Gd-EOB-DTPA-enhanced MRI provided significantly higher overall detection rate and diagnostic accuracy, including low inter-observer variability, compared to MDCT in a single centre study. 相似文献18.
Mohamed Fouad Sherif Faten Mohamed Salem Magdy A. Almahallawy Ahmad Mohamed Abd Algawad Qanet M. Hammad 《The Egyptian Journal of Radiology and Nuclear Medicine》2014
Purpose
This study aims to evaluate the role of MR spectroscopy in the detection of recurrent glioma and differentiation from post radiation injury.Patients and methods
32 patients (20 males and 12 females) complaining of different neurological symptoms were enrolled prospectively in this study between September 2011 and December 2013. These patients were selected on the basis that they were known patients with pathologically proved glioma who underwent radiotherapy. All patients underwent standard MRI examination and MR spectroscopy.Results
This study included 32 patients, twenty four patients (75%) proved histologically to be of recurrent glioma (group I) and 8 cases (25%) diagnosed as post radiation injury (group II). Peri-tumoral infiltration was present in 18 cases (56.25%) of recurrent glioma. Significantly increased Cho/Cr and Cho/NAA ratios were observed in neoplastic (n = 24) compared with non-neoplastic lesions (n = 8). Presence of lactate and lipid yielded correct classification as neoplastic and non-neoplastic lesions.Conclusion
Magnetic resonance spectroscopy is a useful tool for the detection of recurrent glioma and differentiation from post radiation injury. 相似文献19.
Mert Köroğlu Mehmet Çallıoğlu Hüseyin Naim Eriş Mustafa Kayan Meltem Çetin Mahmut Yener Cemil Gürses Bekir Erol Barış Türkbey Ayşe Eda Parlak Okan Akhan 《European journal of radiology》2012
Objective
Purpose of this study is to assess sonographic changes and clinical response in different subgroups of Baker's cyst patients with knee osteoarthritis after a single session of ultrasound-guided percutaneous aspiration and corticosteroid injection.Materials and methods
Thirty-two knee osteoarthritis patients (46–85 years, mean 58.97 ± 9.88) with symptomatic Baker's cyst diagnosed at ultrasonography were included in the study. To determine the grade of the symptoms, Visual Analogue Scale was applied. The patients were grouped in two, as simple (n = 24) and complex (n = 8) Baker's cyst. Thirty-two ultrasound-guided cyst aspirations concomitant 1 ml betamethasone injection (24 simple, 8 complex subgroups) were performed. Patients were followed clinically as well as via ultrasonography for 6 months after procedures.Results
A significant decrease in volume of the Baker's cysts after percutaneous treatment was accompanied by a significant clinical improvement. Moreover, the volume reduction of Baker's cyst after the treatment was significantly correlated with the clinical improvement (Pearson correlation coefficient = 0.542, p = 0.001). All 6 Baker's cysts relapsed at ultrasonography were complex type. Furthermore, a comparison of patients with simple Baker's cysts and those with complex Baker's cysts demonstrated no significant change in Visual Analogue Scale scores between two groups (p = 0.061, Mann–Whitney U). No complications (minor or major) occurred secondary to percutaneous treatment.Conclusion
Baker's cysts can be grouped as simple and complex groups via ultrasonography prior to the treatment. Cyst aspiration with ultrasound-guided corticosteroid injection yields clinical improvement and cyst volume reduction in all subgroups of patients with Baker's cyst secondary to knee osteoarthritis. 相似文献20.
Enas A. Abdel-Gawad Osama A. Khalil Sara M. Ragaee 《The Egyptian Journal of Radiology and Nuclear Medicine》2014