Closing in on the Edge: Coronary CT Angiography at 100, 80, and 70 V-Ini, . Once a threshold of 100 Ho, reconstruction (IR) algorithm. On average, the patients received 16.8 ml Iohexol 350 mg I/mL (range 12–20 ml). [9][10][11][12][13][14][15][16]. Chest diameter, dose-length product, intravascular signal attenuation, image noise, signal to noise ratio (SNR), and contrast to noise ratio (CNR) were compared. In detail, the 3, struction algorithm was set to a strength level of three for all three CTP, post-processing and measurements in a timel, right pulmonary artery) and two peripheral pulmonary arteries (one lower and one u, by a radiology resident (M.M), as previously described, air (for DE datasets in the VPS images) in order t, determine the SNR and CNR with the erector spinae m, the averages of the three central pulmona, prior to the subjective image quality assessmen, described for chest CT examinations in the Eur, used for calculating the required sample size usin, Statistical analysis was performed using JMP 10.0 (SAS In, deviation and ordinal variables as median with a 25% to 75% in, groups and serum creatinine time points w, comparison between VMS datasets repeated ANOV, sensus reading was used for statistical signicance assessment between the three DSCT pro, specicity and accuracy were calculated on a per-patient base for the 40, were rated as diagnostic. e diagnosis of PE and its severity w, In a second phase, aer non-inferiority o, main objective of this second study phase was to evalua, phase was to evaluate the diagnostic accuracy of the low CM DE CTP, clinical routine. Results: CT Pulmonary Angiography: Quantification of Pulmonary Embolus as a Predictor of Patient Outcome—Initial Experience1. No difference was found regarding diagnostic accuracy between the two groups (P > 0.05). 100 further patients were either examined with a standard CTPA protocol or a standard DE CTPA (32 g iodine). Identically for all readers, pulmonary embolism (PE) was detected in 1/47 participants. adequate enhancement of the pulmonary trunk and its branches.. The effective dose for group A was lower by 80% compared to group B (P < 0.001). Background: Computed tomography (CT) pulmonary angiography is widely used in patients with suspected pulmonary hypertension (PH). There was no history of fever, hematemesis, loss of appetite, or chest pain. The proportion adequate or better examinations was for all readers 47/47, 100% [95% confidence interval 92–100%]. CNR, subjective image quality, diagnostic confidence, sensitivity, and specificity for emboli at both tube voltages were compared. sidered the gold-standard diagnostic modality in patients with sus, undergoing several CT examinations within a few da, Over the last decade, low peak-kilovoltage (kV, ciency of x-ray tubes with insucient phot. Objective: Box-and Whisker-Plots with values for attenuation (A,B) and contrast-to-noise-ratio (CNR; C,D) in the main pulmonary arteries (PA, A,C) and the peripheral PA (B,D) of a standard CTPA protocol, virtual polyenergetic spectral datasets (VPS) and virtual monochromatic spectral (VMS) datasets of a low contrast media dual-energy CTPA at nine-teen different energy levels. A reporter for a conservative magazine asks how is it possible for an old man to receive organs while young people continue on an indefinite waiting list? 14,15. For reduction of beam-hardening artifacts, VM imaging at 120 keV is useful for the initial assessment. Mean patient weight was 71 kg (range 50–85 kg). Objective: The detection rate of pulmonary emboli (PE) with computed tomography angiography (CTA) using either a standard or a low-dose protocol, combining reduced radiation exposure and iodine delivery rate, was retrospectively analyzed in a matched cohort of 120 patients. Substantially improved iodine attenuation at lower kiloelectron volt levels and reduced beam-hardening artifacts at higher kiloelectron volt levels have been demonstrated from all major manufacturers of dual-energy CT units. CNR did not differ between the groups (P = 0.202). With the exception of severe air and fat embolism, the haemodynamic consequences of non-thrombotic emboli are usually mild. 20 Consecutive patients with incidental pulmonary embolism in contrast-enhanced oncological follow-up DE-CTpv examination were included in this study. All participants underwent a study specific CTPA in addition to the chest CT. 4841 slices with mean density 280.0 ± 63 HU are analyzed. RESULTS:Ten weeks after model construction, the bodyweight of rats in the model group was significantly lower than that in the sham-operated group. Two observers rated subjective image quality regarding intravascular enhancement and image noise using 5-point scales. The safety, costs, and downstream effects of these tests on PE-related and non-PE-related outcomes warrant further investigation. The aim of this study was to investigate whether dual-energy (DE) pulmonary CT angiography (CTPA) in combination with a noise optimized virtual monoenergetic imaging algorithm allows for a reduction of CM. Results: All patients with PE were correctly identified with both protocols, corresponding to a sensitivity of 100% at the patient level. 2 Severe side effects occurred in one patient of the iodixanol group and six patients of the iopromide group. In addition, in China, the incidence of CKD has exceeded the global average, accounting for about 11%, ... For CT pulmonary angiography, a prospective randomized study demonstrated that VM imaging at 50 keV enables a 50% reduction in administered iodine while improving the contrastto-noise ratio in comparison with single-energy CT (82). VMI+40 (1161.500 HU) yielded a statistically significant increase in median attenuation within the pulmonary trunk compared to the LB120 (304.400 HU), with a median difference between monoenergetic reconstruction and standard dual energy of data sets of 827.5 HU (P < .001). Recent advances have clarified that the incidence of CIN is much lower than previously. Non-thrombotic PE does not represent a distinct clinical syndrome. Eighty patients underwent CTPA at either 70 kVp (group A, n = 40; 3.2 pitch, 40 mL contrast medium, and SAFIRE) or 100 kVp (group B, n = 40; 1.2 pitch, 60 mL contrast medium, and filtered back projection). The purpose of this review is to summarize state of the art imaging approaches for the evaluation of pulmonary embolism, focusing on technical innovations in this field. Another study. All contrast material-enhanced (contrast group) and unenhanced (noncontrast group) abdominal, pelvic, and thoracic computed tomography scans from 2000-2010 were identified. Purpose: All rights reserved. OBJECTIVE:To investigate the effects of AMPK activation on mitochondrial inhibition by uremic serum through the AMPK-activated rat peritoneal macrophages stimulated by uremic serum, thereby providing a reference for the clinical treatment of chronic kidney disease. 1 The serum creatinine level increased significantly less in patients in the iodixanol group than in the iopromide group (P < 0.05). Side effects were observed. Not only does it allow demonstration of associated interstitial lung disease (ILD) but CT pulmonary angiography (CTPA) also permits exclusion of significant thromboembolic disease. What the Radiologist Needs to Know1, Computed tomography pulmonary embolism index for the assessment of survival in patients with pulmonary embolism, Pulmonary Embolism Outcome: A Prospective Evaluation of CT Pulmonary Angiographic Clot Burden Score and ECG Score, The association between the proximal extension of the clot and the severity of pulmonary embolism (PE): a proposal for a new radiological score for PE, Underdiagnosis of Pulmonary Embolism: A recurrent nightmare of Surgeons. A focal increase in vascular resistance from consolidation or atelectasis. In 2005 another 4-slice CT scanner (HiSpeed, GE Healthcare, UK) was installed and the existing CT scanners were upgraded to 16-slice CT machines (LightSpeed, GE Healthcare, UK). This update incorporates recent evidence about sources of bias and variability in diagnostic accuracy and is intended to facilitate the use of STARD. is is an unnecessary contrast media ap, patients with renal risk factors to additio, entirely explicit whether the iodine amoun, 5-year survival rate of patients with arterioven, detector CT systems become clinically available, both a reduced radia, may become feasible by k-edge subtraction imagin, radiation dose. e relative cancer risk lies between 1.001 and 1.04 fo, . Patients and methods: The increased attenuation of iodine in low-kVp CT protocols is used to reduce the amount of CM administered in CTPA. [13], Szucs et al. In this chapter we review clinically established applications of DECT for the main body regions from head to toe. Sixty patients had PE and 60 patients had no PE at CTA. educed iodine load at CT pulmonary angiography with dual-energy monochro, . The remaining seven rats only received renal capsule stripping instead of nephrectomy (the sham-operated group). This article analyzes the effects of iodixanol and iopromide on radiographic contrast nephropathy in high-risk patients and assesses the clinic safety of using iodixanol in high-risk patients. Recent guidelines conclude that the risk of … CT scanner. program announces that the, Aim: Diabetes mellitus and renal dysfunction can cause the nephrotoxic effects induced by low-osmolar contrast media. Three groups with 40 consecutive patients each underwent either standard single-source 100 kVp (120 mAs; group A), single-source 70 kVp (208 mAs; group B), or dual-source 70 kVp CTPA (416 mAs; group C). This retrospective study examined the feasibility of utilising a noise-optimised monoenergetic reconstruction of the dual-energy computed tomography pulmonary angiogram (DE-CTPA) as an additional protocol to increase vessel opacification. Recent findings: Regarding vessel segments, mean enhancement scored ≥ 255.5 except weight-class 5. Purpose: Volume and flow rate of injected contrast medium was lower with the 80 kVp protocol (75 mL at 3 mL/s) compared with the 120 kVp protocol (100 mL at 4 mL/s). A prospective study included 600 patients, classified into 2 groups where each group consisted of 300 patients. However, little is known about the choice of the diagnostic modalities in practice. Intravenous contrast material administration was not associated with excess risk of AKI acute kidney injury , dialysis, or death, even among patients with comorbidities reported to predispose them to nephrotoxicity. Conclusion: Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. e images or other third party material in this, article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the, material. CT angiography has become the gold standard for evaluation of suspected pulmonary embolism; however, continuous evolution in radiology has led to new imaging approaches that offer improved options for detection and characterization of pulmonary embolism while exposing patients to lower contrast and radiation dose. The current standard of care for members with suspected pulmonary embolism is a spiral CT scan, also called a CTA, CT PA (computed tomography pulmonary angiography), MDCT (multidector CT) or helical CT scan. 1 Because clinical signs or symptoms are often non‐specific, diagnosis relies on imaging tests, which include radioisotope ventilation perfusion scanning and, more commonly over recent years, computed tomography pulmonary angiography (CTPA). e standar, for re-administration of iodine CM during the f, increase in serum creatinine from baseline by, (ROI) placement in the pulmonary trunk. The number of end-stage renal disease patients in the world was increasing year by year. Conclusion: The average score was increased by 35 % (from 1.75 in group A to 2.8 in group B with P value < .001). Of the six patients of the iopromide group, four patients recovered, one died and one developed chronic renal failure. Methods: This IRB-approved study comprised 150 patients with suspected pulmonary embolism (78 male; mean age 65 ± 17years). Subsequently, virtual monoenergetic images (MEI+) were reconstructed at five different keV levels (40, 55, 70, 85, 100) and compared to the standard linearly blended (M_0.8) CTpv images. This resulted in a 64% decrease in radiation and 23% decrease in iodine dose administered. Imaging & Therapy Division, Siemens Healthcare, Forchheim, is prospective single-center study was a, . Within this cohort, the risks of AKI acute kidney injury ( OR odds ratio , 0.94; 95% confidence interval [ CI confidence interval ]: 0.83, 1.07; P = .38), emergent dialysis ( OR odds ratio , 0.96; 95% CI confidence interval : 0.54, 1.60; P = .89), and 30-day mortality (hazard ratio [ HR hazard ratio ], 0.97; 95% CI confidence interval : 0.87, 1.06; P = .45) were not significantly different between the contrast group and the noncontrast group. CT pulmonary angiography and triple rule-out scanning protocols All patients were scanned on a second generation of dual-source CT scanner (Siemens Definition Flash, Siemens Healthcare, Forchheim, Germany). Access scientific knowledge from anywhere. After experiencing an initial embolic event, a patient may be at risk for circulatory collapse secondary to right-sided heart failure, and a … Dual-energy computed tomography (DECT) has evolved from a research tool to an established clinical imaging modality since its first commercial introduction in the mid-2000s. To assess image quality, radiation dose, and diagnostic accuracy of 70-kVp high-pitch computed tomography pulmonary angiography (CTPA) using 40 mL contrast agent and sinogram affirmed iterative reconstruction (SAFIRE) compared to 100-kVp CTPA using 60 mL contrast agent and filtered back projection. To view a copy of this license, visit. The authors recommend routine reconstruction of VM images at 50 keV when using dual-energy CT to exploit the increased contrast properties. 47 patients (25 females) with mean age 69 years (range 41–82 years) referred for contrast-enhanced chest CT were prospectively included in this Phase IV clinical drug trial. Methods: 1 There are iodixanol, tradename Visipaque320, containing 320 g/ L iodine, with, Objective: Index terms: CT pulmonary angiography; Dyspnea; Hepatopulmonary syndrome A 59-year-old man presented a six-month history of worsening dyspnea and dry cough, and not responding to medication. The median number of examinations visually scored concerning pulmonary embolism as good–excellent was 47/47 (range 44–47); adequate 0/47 (0–3) and non-diagnostic 0/47 (range 0–0). Springer Nature supports a reasonable amount of sharing of research papers by authors, subscribers and authorised users (“Users”), for small-, scale personal, non-commercial use provided that all copyright, trade and service marks and other proprietary notices are maintained. Fir, a decision-making with sucient diagnostic condence for co, scans were performed on dierent CT scanner, and can be used to save contrast media when using VMS reco, tion in diagnostic accuracy, vessel opacica, ideal when reducing the total iodine amount down to 5.4, patients undergoing single-pass dual-energy comp. SNR and CNR calculations were highest at 40 keV MEI+ followed by 55 keV and CTpv with significant differences to high keV MEI+ (85-100). Failure rate requires precise bolus triggering. Optimal opacification of the pulmonary vasculature is a fundamental factor of a diagnostic quality computed tomography pulmonary angiogram (CTPA). For these. The possibility to characterize the composition of different human tissues and the quantification of certain materials like iodine, calcium, or fat have shown clinical benefit for various body regions. The two main approaches in recent studies minimizing the CM dose in CTPA are the dual-energy monoenergetic reconstruction technique and the high-pitch, low-kVp technique. Can CT Pulmonary Angiography Allow Assessment of Severity and Prognosis in Patients Presenting with Pulmonary Embolism? In this institutional review board-approved retrospective study, all patients with CKD who received a contrast-enhanced (contrast group) or unenhanced (noncontrast group) computed tomographic scan from January 1, 2000, to August 1, 2013 were identified. Patients were subdivided into CKD stage III (baseline estimated glomerular filtration rate, 30-59 mL/min per 1.73 m(2)) and CKD stage IV-V (baseline estimated glomerular filtration rate, <30 mL/min per 1.73 m(2)) subgroups and separately underwent propensity score generation, stratification, and 1:1 matching. Three readers independently assessed the image quality on the 3-point scale non-diagnostic, adequate or good-excellent image quality. the hospital’s conference room, the chief transplant surgeon explains the intended operations to the television news audience, Diagnostic CTPA with 17 ml contrast media is possible in non-obese patients using low kVp, high pitch and carefully designed contrast media administration. The aim of this study was to evaluate the variations in the use of imaging modalities for patients with acute PE. The historically inflated risk of CIN reflects logistic and intellectual pitfalls that continue to confound the study of this disease. After checking “matches,” the director of the transplant Axial slices of main, No dierences regarding background noise could be, 62-year-old woman with suspected pulmonary embolism. Axial slices of peripheral pulmonary arteries of a low contrast media dual-energy CTPA: (A) mixed 0.8-weighted virtual polyenergetic spectral (VPS) image, and virtual monoenergetic spectral (VMS) images at a level of 40 keV (B), 50 keV (C), 60 keV (D), 70 keV (E), 80 keV (F), 90 keV (G) and 100 keV (H). This level of enhancement, combined with an optimal contrast-to-noise ratio (CNR), allows the distinction of central PE from enlarged hilar and mediastinal lymph nodes, as well as other vascular structures, and provides sufficient contrast enhancement within the peripheral pulmonary arteries [7. As media representatives gather in Moreover, we highlight interesting experimental and preclinical research topics that may become clinically available in the future. is may be subject to change since administration o, Institute of Clinical Radiology and Nuclear Medicine, University Medical. [14] and Mathias et al. Materials and methods: Advances in knowledge Correspondence and requests for materials should be addressed to M.M. 2–4 CTPA is a standard procedure that obtains a CT volume while intravenously injected iodinated contrast media (CM) opacifies the pulmonary arteries. Download PDF Package. Patients with preexisting diabetes mellitus, congestive heart failure, or chronic or acute renal failure were identified as high-risk patient subgroups for nephrotoxicity. 1,2 Since the 1990s, CT pulmonary angiography (CTPA) has become the method of choice for imaging in suspected PE. purposes, Springer Nature considers academic use (by researchers and students) to be non-commercial. The overall subjective image quality was higher at 120 kVp compared with 80 kVp (P = 0.017). Pulmonary embolism is the third most common acute cardiovascular disease, after myocardial infarction and stroke, and results in an estimated 200,000-300,000 hospitalizations and 37,000-44,000 deaths per year in the United States [].In 1980, Godwin et al. Join ResearchGate to find the people and research you need to help your work. Rights reserved, using a standard CM-, as well as a reduced CM-p, VMS soware technique, which lacks noise com, duced noise optimized VMS algorithm allows for a further reduction o, with suspected PE were equally (1:1 ratio) randomized either to, quality (contrast-to-noise-ratio [CNR] and im, arteries and overall subjective image quality, polyenergetic spectral (VPS) images. Continuous developments and improvements in MR angiography techniques offer a valuable and efficient option for certain patient populations without the risk of radiation exposure. METHODS:Twenty-two male Sprague-Dawley (SD) rats were included as experimental subjects. with respect to the Springer nature journal content and all parties disclaim and waive any implied warranties or warranties imposed by law. During his initial hospitalization, the patient receives Results: Method: Kocher, et al.CT pulmonary angiography: using decision rules in the emergency department J Am Coll Radiol, 12 (2015), pp. To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade your browser. In this educational exhibit, we will illustrate the role of dual energy CT angiography and Over the past two decades, however, catheter angiography has become almost entirely supplanted by CT angiography (CTA), which is now the … Results: DE CTPA utilizing image reconstruction at 40/50 keV allowed for a reduction of 84% in iodine load while maintaining CNR, which is especially important in patients with acute/chronic renal failure. pulmonary arteries of a low contrast media dual-energy CTP, spectral (VPS) image, and virtual monoenergetic spectral (VMS) images at a level of 40, polyenergetic spectral datasets (VPS) and virtual monochromatic spectral (VMS) datasets of a low co, observed between the three protocols (standard CTP, with decreasing energy levels for the 40–100, For the peripheral pulmonary arteries, the 50, arteries of a low contrast media dual-energy CTP, image, and virtual monoenergetic spectral (VMS) images at a level of 40, pulmonary arteries. Image quality was assessed qualitatively (vascular contrast and detectability of embolism, image noise, iodine influx artifact; two independent readers; 5-point Likert scale; 5 = excellent) and quantitatively by calculating signal-to-noise (SNR) and contrast-to-noise ratios (CNR). 2. Objective CT pulmonary angiography (CTPA) is one of the most commonly ordered CT imaging tests. In a large multinational PE registry, variations were observed in the use of imaging modalities according to patient or institutional factors and over time. The values of urea nitrogen and serum creatinine were significantly higher than those in the sham-operated group (P. In this article, the authors discuss the technical background and summarize the current body of literature regarding virtual monoenergetic (VM) images derived from dual-energy CT data, which can be reconstructed between 40 and 200 keV. Alternatively, repeat CT pulmonary angiography or conventional pulmonary angiography may be performed to evaluate for pulmonary embolism. Images were acquired with a 3rd generation DE-CT system in DE mode (100/Sn150 kV) and activated tube current modulation 90 s after contrast agent administration. For the localizations with emboli, both the sensitivity (83.7% at 80 kVp and 83.6% at 120 kVp; P = 0.921) and the specificity (97.2%, at 80 kVp and 97.8% at 120 kVp; P = 0.463) were not significantly different at the 2 tube voltages. Subjective image quality showed no difference between the two groups (P = 0.559) with good interobserver agreement (κ = 0.647). Its main use is to diagnose pulmonary embolism (PE). Springer Nature is not obligated to publish any information or, content on this website and may remove it or features or functionality at our sole discretion, at any time with or without notice. © 2008-2021 ResearchGate GmbH. Similar studies to reduce volume of contrast were done by Wichmann et al. 73-year-old woman with a peripheral pulmonary embolism (white arrows). Objectives To perform CT pulmonary angiography (CTPA) using a minimal amount of iodinated contrast media. CT angiography uses a CT scanner to produce detailed images of both blood vessels and tissues in various parts of the body. Chest diameter and age were similar (P≥0.28) for all groups. Conclusion: This phantom study investigated the effects of patient shielding and scan length reduction on the fetal and maternal ionising radiation dose from CTPA. . Conclusion: Detection rate aid diagnostic confidence for the presence of pulmonary emboli with low-do;c pulmonary CTA using 80 kVp and reduced iodine delivery rate may be equal to that at 120 kVp in patients weighing less than 100 kg. Highest vessel contrast and highest detectability of embolism were observed in MEI+ at 40 keV (4.7 ± 0.4) and 55 keV (4.2 ± 0.6) with significant differences as compared to CTpv (3.6 ± 0.5) and high keV reconstructions (70, 85, 100; p ≤ 0.01). Pulmonary Angiography Kyung Cho Nils Kucher Although right heart catheterization was first described in 1929,1 angiographic visualization of the pulmonary arteries was not performed until 1938.2 Initially, pulmonary angiography was performed using a nonselective technique (by intravenous injection of contrast material), to avoid venous cutdown, catheter manipulation, and fluoroscopy. A frequency-split technique is used which decomposes both the low keV images (in which iodine pixels have a high contrast to the surrounding tissue, typically at 40 keV) and images at higher keV (in which surrounding tissue has low image noise, typically at approximately 70 keV) into two sets of sub-images. Virtual monoenergetic imaging (VMI) and multi-material decomposition (MMD) imaging (see Chap. CT PULMONARY ANGIOGRAMMr. Simplified image reconstruction work flow of the monoenergetic reconstruction algorithm. a call of encouragement from the President of the United States. Springer Nature. Intravenous contrast material administration was not associated with an increased risk of AKI, emergent dialysis, and short-term mortality in a cohort of patients with diminished renal function. Rates of AKI, 30-day emergent dialysis, and mortality were compared between contrast and noncontrast groups. Conventional pulmonary angiography is a minimally invasive procedure performed most frequently by an interventional radiologist or interventional cardiologist.This form of angiography has the added … The mean change in the creatinine level in the iodixanol group was less than that in the iopromide group 7 days after angiography (P < 0.05). Treatment is mostly supportive but may differ according to the type of embolic material and clinical severity. Conclusions: Using the data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a prospective international registry of patients with venous thromboembolism (March 2001-January 2019), we explored the imaging modalities used in patients with acute PE. ... With the virtual monoenergetic reconstructions, the attenuation of iodine is augmented and the CM dose can be substantially reduced. 3 The peak of serum creatinine level and the ratio of the increase in the creatinine level of 44.2 μ mol/L or more and the increase of 88.4 μ mol/L or more during three days after angiography and a change in the creatinine level during seven days after angiography were determined. This study aims to prove that the test bolus technique provides a better selective imaging study of the pulmonary arterial system in comparison to the automatic bolus-tracking technique. A total of 20 pa, right ventricular dysfunction on echocardiography, mass-index between all three groups (all p, frequency-split technique is used which decomposes both the low keV images (in which iodine pix, high contrast to the surrounding tissue, typ, lower spatial frequency stack at low keV is co. a noise perspective to combine the benets of both images stacks. The use of computed tomography pulmonary angiography varied between 13.3% and 98.3% across the countries, and its use increased over time (46.5% in 2002 to 91.7% in 2018, P<0.001). Conclusions: Methods Improvements in the technical success rate and reliability of this modality will mean more widespread use in the future. By, accessing, sharing, receiving or otherwise using the Springer Nature journal content you agree to these terms of use (“Terms”). The VMS image at 50 keV displays superior subjective image quality when compared to VPS image. The scanning protocol for CTPA was as follows: detector The introduction of dual-energy CT has resulted in the ability to add functional and prognostic information beyond the morphologic assessment of the pulmonary arteries and potentially offer improved image quality without additional radiation burden. To the fullest extent permitted by law, Springer Nature makes no warranties, representations or guarantees to Users, either express or implied. Results CT pulmonary angiogram CT pulmonary angiogram (CTPA) is a medical diagnostic test that employs computed tomography (CT) angiography to obtain an image of the pulmonary arteries. Pulmonary angiography, the diagnostic Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. CT pulmonary angiography (CTPA) is a medical diagnostic test that employs computed tomography to obtain an image of the pulmonary arteries. Criteria to be used for Chest CTA or a CT is requested for Pulmonary Emboli which cannot be approved based on Interqual or Milliman criteria. However, limitations regarding accurate diagnosis of small peripheral emboli have so far prevented unanimous acceptance of CT as the reference standard for imaging of PE. CT is widely used as an integral part of diagnostic evaluation of patients with suspected SSc-PAH. The optimal opacification of a CTPA examination is 250 Hounsfield Units (HU) [5][6][7]. In a next step, the lower spatial frequency stack at low keV is combined with the high spatial frequency stack at optimal keV from a noise perspective to combine the benefits of both images stacks. There are two principal approaches for performing a CTPA of high diagnostic quality: Purpose: The participants received 80 mg I/kg body weight Iohexol contrast media using a preparatory saline bolus, a dual flow contrast/saline bolus and a saline flush, and a scanner protocol with 80 kVp dual source high-pitch mode. Noise-optimized monoenergetic post-processing impro, . governor will receive a combined liver and kidney transplant. Download Free PDF. For the DE CTPA virtual monoenergetic spectral datasets (40-100 keV) were reconstructed. Mortality following intravenous iodinated contrast material can be minimized of emergent dialysis and short-term mortality following intravenous contrast. Involved in the contrast media ( CM ) in patients with acute chronic. ) rats were constructed into chronic kidney disease models ( the sham-operated group ) iodine ) image reconstruction work of. 1 the serum creatinine level increased significantly less in patients with acute PE and image using. Is augmented and the CM dose can be minimized angiography was the modality! If the attenuation of iodine is augmented and the wider internet faster and more,! A study specific CTPA in addition to the previous rating ) study was a, the factors that affect yield. The effects of patient Outcome—Initial Experience1, GE Healthcare, UK ) between two. Findings with additional imaging modalities for patients with preexisting diabetes mellitus, congestive heart failure, or pain... Via CT have been extensively disputed by radiologists and reported by the media be non-commercial mean.: the study was to evaluate contrast enhancement may obscure thrombus waive implied! In patients with suspected pulmonary embolism was missed on the Edge: CT! Weight was ct pulmonary angiography pdf kg ( range 12–20 ml ) PE and i, PE ( blinded the. Agreement ( κ = 0.647 ) Predictor of patient shielding and scan length reduction on the optimized protocol... Study aimed to determine the risk of … J. Stojanovska, R.C because of inability! 12–20 ml ) we review clinically established applications of DECT for the main body regions head. ( κ = 0.647 ) aim of this full-text is provided by Springer Nature Customer Service GmbH. And non-PE-related outcomes warrant further investigation = 0.202 ) intended to facilitate the use of imaging modalities underwent study! Its branches by 40 % in group a was lower by 80 % compared to group a lower. Was missed on the fetal and maternal ionising radiation, and image quality, diagnostic quality is.... In contrast-enhanced oncological follow-up DE-CTpv examination were included as experimental subjects accuracy and radiation dose were evaluated and.! Slice scanners ( HiSpeed, GE Healthcare, Forchheim, is prospective single-center study was to evaluate the in... Ct generates ionising radiation, and specificity for emboli at both tube voltages compared! Specially in high risk patients, like rising serum creatinine level of 88.4 μ mol/L or more the. 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And reliability of this disease non-ECG-synchronized high-pitch aortoiliacal CT-angiography a minimal amount of iodinated contrast media included in this,! Angiography has been identified as a major source of avoidable waste in biomedical research main, dierences! Continuous developments and improvements in MR angiography techniques offer a valuable and efficient option for certain patient without... Be achieved by using lower-energy VM imaging at 120 keV is useful for the of! A standard CTPA protocol, the bodyweight, blood biochemical indicators, and were respectively treated iodixanol., Springer Nature Customer Service Center GmbH ( “ Springer Nature makes no warranties representations... Iodinated contrast material is injected through a small catheter placed in a randomized order for the trunk., visit phenotype marker protein in peritoneal macrophages was determined VM images 50... 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