CT dose reduction using prospectively triggered or fast-pitch spiral technique employed in cardiothoracic imaging (the CT dose study).

Objectives: To establish current radiation dose levels with contemporary scanners capable of prospectively triggered or high-pitch spiral scan modes to previous generation scanners among patients evaluated for coronary artery disease, pulmonary embolism, aortic disease, and "triple rule out" in a large population of patients at multiple centers.

Background: Previous small-scale studies with carefully controlled scan protocols report that CT scanners that facilitate prospectively triggered scanning and provide high-pitch spiral CT scan modes drastically lower radiation doses. However, diagnostic reference levels should be selected by medical bodies on the basis of large surveys of representative sites and reviewed at appropriate time intervals.

A comprehensive approach to CT radiation dose reduction: one institution's experience.

Objective: The purpose of this article is to review the process of creating and implementing a comprehensive plan to reduce diagnostic radiation exposure at our institution.

Conclusion: This process, which was initiated by forming a radiation dose reduction committee, addressed several different issues to improve patient safety. These include avoidance of unnecessary CT examinations, adjusting individual scanning parameters, revising protocols, use of shielding and dose monitoring, and implementing computer-based dose modulation software as well as educating referring physicians and radiologic technologists.

Contrast volume reduction with superior vena cava catheter-directed coronary CT angiography: comparison with peripheral i.v. contrast enhancement in a swine model.

Objective: Conventional MDCT angiography uses a traditional peripheral i.v. approach for contrast injection; however, we describe our experience with a superior vena cava (SVC) catheter approach for coronary artery MDCT angiography as a potential means of decreasing iodinated contrast volume.

Enhancement performance of a 64-slice triple rule-out protocol vs 16-slice and 10-slice multidetector CT-angiography protocols for evaluation of aortic and pulmonary vasculature.

Objective: To compare the enhancement of the pulmonary and aortic vasculature between a biphasic injection 64-slice, a single-phase injection 16-slice, and a single-phase injection 10-slice multidetector computed tomographic (CT) angiography (CTA) protocols.

Methods: With institutional review board approval and Health Insurance Portability and Accountability Act compliance, 50 patients (16 men, 34 women; mean age, 51.5 years; range, 30-75 years) with atypical chest pain from the emergency department were scanned using a triple rule-out protocol on a 64-slice CT scanner.

Normal and variant coronary arterial and venous anatomy on high-resolution CT angiography.

Objective: This article displays the normal and variant anatomy of the coronary arteries and subjacent cardiac veins using a high-resolution 64-MDCT scanner.

Conclusion: Knowledge of the anatomy of the coronary arteries and subjacent cardiac veins as displayed with maximum intensity and volume-rendered projections is important for correct image interpretation of coronary CT angiography examinations.

Aortic root catheter-directed coronary CT angiography in swine: coronary enhancement with minimum volume of iodinated contrast material.

Objective: The purpose of this study was to evaluate the minimum amount of contrast material for coronary imaging with aortic root catheter-directed enhancement and 64-MDCT angiography (MDCTA).

Materials And Methods: A 64-MDCT scanner was used after animal institutional review board approval to study four swine (40-60 kg). Heart rate reduction to 65 beats per minute was achieved with atenolol by mouth and i.

Atypical chest pain: coronary, aortic, and pulmonary vasculature enhancement at biphasic single-injection 64-section CT angiography.

Purpose: To prospectively evaluate the enhancement of coronary, pulmonary, and thoracic aortic vasculature by using biphasic single-acquisition 64-section computed tomographic (CT) angiography and to prospectively evaluate if differences in right side of the heart and coronary venous enhancement interfere with interpretation of coronary arteries.

Materials And Methods: With internal review board approval and HIPAA compliance, 50 patients (16 men, 34 women; mean age, 51.5 years; range, 30-75 years) with atypical chest pain were referred from the emergency department and were imaged with a 64-section CT scanner after premedication with oral atenolol and/or intravenous metoprolol.

Microvascular obstruction and myocardial function after acute myocardial infarction: assessment by using contrast-enhanced cine MR imaging.

Unlabelled: This study was approved by the Human Investigation Committee of William Beaumont Hospital, and all patients gave informed consent. The purpose of this study was to prospectively compare contrast material-enhanced cine magnetic resonance (MR) imaging with more-standard MR imaging for the evaluation of microvascular obstruction and myocardial function in 80 patients (56 men, 24 women; mean age, 57 years; range, 29-80 years) with acute myocardial infarction after reperfusion therapy. Findings at contrast-enhanced cine MR imaging agreed with the global and transmural extent of microvascular obstruction at first-pass perfusion (intraclass correlation coefficient [IC] of 0.

Coronary 64-slice computed tomographic angiography models employing aortic root and selective catheter directed contrast enhancement in swine: technical feasibility and preliminary results using 3D and 4D reconstructions.

Purpose: The technical feasibility of combining catheter directed coronary enhancement and multidetector computed tomographic angiography (MD-CTA) is presented in a swine model at various cardiac and injection rates.

Materials/methods: A 64-slice CT scanner was used under animal IRB approval in four sedated swine. Common femoral venous/arterial access with a 5 Fr micropuncture kit was ultrasound guided.

Complications of renal transplantation.

Continued improvements in graft survival have led to widespread acceptance of renal transplantation as the preferred treatment for the majority of patients with end-stage renal disease. The long-term care of these patients is often provided away from transplantation centers. This article presents both the clinical and imaging features of renal transplantation complications and their interventional management.

Catheter contrast-enhanced coronary CT-angiography using an aortic root injection--preliminary technical development in four patients.

The feasibility of performing coronary computed tomographic angiography (CTA) with an intra-aortic injection of iodinated contrast was tested in four patients immediately following diagnostic cardiac catheterization and placement of a 6-french pigtail catheter into the aortic root. A diluted contrast mixture [75 cc Omnipaque 350 mixed with 125 cc normal saline (4-slice scanner) vs. 40 cc Omnipaque 350 mixed with 60 cc normal saline (16-slice scanner)] was injected at a rate of 6 to 7.

Combined CT-PET criteria for myocardial viability and scar: a preliminary report.

Identification of hibernating myocardium and its differentiation from scar tissue is an important clinical task for implementing different treatment options. The recognition of combined criteria in spiral-CT and PET for hibernating myocardium and scar will be important as hybrid CT-PET moves into the main stream of routine oncologic and cardiovascular imaging. A review of three cases, initially referred for CT evaluation of cardiac or pulmonary conditions with subsequent F-18 FDG body PET imaging, was presented for illustration as a combined CT-PET cardiac evaluation.

CT features of renal infarction.

Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction.

Materials And Methods: Retrospective review of a total of 41 renal infarction in 37 patients were done.

Contrast-enhanced three-dimensional MR angiography of the pulmonary vascular tree.

Contrast-enhanced three-dimensional MR angiography has evolved into a promising technique in the study of the pulmonary vasculature. Both congenital and acquired entities can be now morphologically demonstrated in a non-invasive manner obviating the need for conventional pulmonary angiography. Due to spatial resolution limitations, however, it is still premature to routinely apply the method in the detection of small subsegmental emboli, in cases of suspected pulmonary embolism, and further technical developments will be required.

Lower extremity MR angiography: universal retrofitting of high-field-strength systems with stepping kinematic imaging platforms initial experience.

In 15 volunteers and 84 patients with clinically suspected peripheral vascular disease, a stepping kinematic imaging platform, a manual retrofit stepping magnetic resonance (MR) imaging table, was used with three high-field-strength MR imaging systems to perform multistation peripheral contrast material-enhanced MR angiography in the lower extremity with the existing system phased-array coil. Each examination was performed in less than 45 minutes. Mounting of the stepping kinematic imaging platform was quick and simple and allowed rapid repositioning of a patient relative to the phased-array coil and acquisition of high-spatial-resolution MR angiograms of the peripheral vasculature with use of one injection of MR imaging contrast agent.