Dual-energy CT lung perfusion characteristics in pulmonary arterial hypertension (PAH) and pulmonary veno-occlusive disease and/or pulmonary capillary hemangiomatosis (PVOD/PCH): preliminary experience in 63 patients.

Background: In the stratification of potential causes of PH, current guidelines recommend performing V/Q lung scintigraphy to screen for CTEPH. The recognition of CTEPH is based on the identification of lung segments or sub-segments without perfusion but preserved ventilation. The presence of mismatched perfusion defects has also been described in a small proportion of idiopathic pulmonary arterial hypertension (PAH) and pulmonary veno-occlusive disease and/or pulmonary capillary hemangiomatosis (PVOD/PCH).

Quantification of Antifibrillarin (anti-U3 RNP) Antibodies: A New Insight for Patients with Systemic Sclerosis.

Background: The detection of additional autoantibodies is of great concern in systemic sclerosis (SSc) when those included in the ACR/EULAR classification are negative. In this context, the interest of antifibrillarin (anti-U3RNP) autoantibodies (AFAs) in the routine evaluation of SSc remains unclear. We aimed to assess the relevance of AFAs and their clinical association in SSc patients.

Machine Learning and Deep Neural Network Applications in the Thorax: Pulmonary Embolism, Chronic Thromboembolic Pulmonary Hypertension, Aorta, and Chronic Obstructive Pulmonary Disease.

The radiologic community is rapidly integrating a revolution that has not fully entered daily practice. It necessitates a close collaboration between computer scientists and radiologists to move from concepts to practical applications. This article reviews the current littérature on machine learning and deep neural network applications in the field of pulmonary embolism, chronic thromboembolic pulmonary hypertension, aorta, and chronic obstructive pulmonary disease.

Cerebrospinal Fluid and Cerebral Blood Flows in Idiopathic Intracranial Hypertension.

Objectives: Cerebrospinal fluid (CSF) and blood flows have a strong relationship during a cardiac cycle. Idiopathic intracranial hypertension (IIH) is a pathology that seems to present hemodynamic and hydrodynamic disturbance. The aim of this study was to establish CSF and blood interaction in IIH.

Manipulation of host membranes by the bacterial pathogens Listeria, Francisella, Shigella and Yersinia.

Bacterial pathogens display an impressive arsenal of molecular mechanisms that allow survival in diverse host niches. Subversion of plasma membrane and cytoskeletal functions are common themes associated to infection by both extracellular and intracellular pathogens. Moreover, intracellular pathogens modify the structure/stability of their membrane-bound compartments and escape degradation from phagocytic or autophagic pathways.

Imaging the heart-lung relationships during a chest computed tomography examination: is electrocardiographic gating the only option?

Before the advent of fast-scanning multidetector-row computed tomography (CT) technology, thoracic CT studies were exclusively used for the morphologic assessment of thoracic organs, as the concurrent examination of the heart was hampered by image degradation from cardiac motion artifacts. The introduction of fast rotation speed and dedicated cardiac reconstruction algorithms has opened new possibilities for chest imaging, starting with the possibility to integrate cardiac morphologic and functional information into a diagnostic CT scan of the chest. Initiated with 16-slice multidetector-row CT, this concept of integrating morphology and function has been further simplified with 64-slice CT scanners, thus allowing radiologists to provide vital information in the management of patients with a wide variety of acute or chronic respiratory disorders.

Lung perfusion with dual-energy multi-detector row CT: can it help recognize ground glass opacities of vascular origin?

Rationale And Objectives: The aim of this study was to evaluate whether the spectral characterization of the iodine content of lung microcirculation could help identify ground-glass opacity (GGO) of vascular origin.

Materials And Methods: Thirty-five consecutive patients with GGO of bronchioloalveolar (group 1; n = 24) and vascular (group 2; n = 11) origin underwent dual-energy multi-detector computed tomographic angiography of the chest using a standard injection protocol. For each patient, two radiologists evaluated by consensus the presence, location, and extent of GGO on diagnostic computed tomographic scans (ie, contiguous 1-mm-thick averaged images from both tubes) and characteristics of the corresponding areas on perfusion scans.

Nonmassive acute pulmonary embolism: evaluation of the impact of pulmonary arterial wall distensibility on the assessment of the CT obstruction score.

Purpose: To evaluate the impact of pulmonary arterial wall distensibility on the assessment of a computed tomography (CT) score in patients with nonmassive pulmonary embolism (PE) (ie, Mastora score).

Materials And Methods: The arterial wall distensibility of five central pulmonary arteries (pulmonary artery trunk, right and left main pulmonary arteries, right and left interlobar pulmonary arteries) was studied on ECG-gated CT angiographic studies of the chest in 15 patients with no pulmonary arterial hypertension (group 1; mean pulmonary artery pressure: 17.2 mm Hg) and 9 patients with nonmassive PE (group 2), using 2D reconstructions at every 10% of the R-R interval.

Computer-aided detection of acute pulmonary embolism with 64-slice multi-detector row computed tomography: impact of the scanning conditions and overall image quality in the detection of peripheral clots.

Purpose: To evaluate the performance of a computer-aided detection (CAD) system for diagnosing peripheral acute pulmonary embolism (PE) with a 64-slice multi-detector row computed tomography (CT).

Materials And Methods: Two radiologists investigated the accuracy of a software aimed at detecting peripheral clots (PECAD prototype, version 7; Siemens Medical Systems, Forchheim, Germany) by applying this tool for the analysis of the pulmonary arterial bed of 74 CT angiograms obtained with 64-slice dual-source CT (Definition; Siemens Medical Systems). These cases were retrospectively selected from a database of CT studies performed on the same CT unit, with a similar collimation (64 x 0.

Assessment of lobar perfusion in smokers according to the presence and severity of emphysema: preliminary experience with dual-energy CT angiography.

The purpose of the study was to assess pulmonary perfusion on a lobar level in smokers using dual-energy computed tomography (CT). Forty-seven smokers and ten non-smokers underwent a dual-energy multi-detector CT angiogram of the chest that allowed automatic quantification of emphysema and determination of the iodine content at the level of the microcirculation (i.e.

Lung perfusion with dual-energy multidetector-row CT (MDCT): feasibility for the evaluation of acute pulmonary embolism in 117 consecutive patients.

Rationale And Objectives: To investigate the accuracy of dual-energy computed tomography in the depiction of perfusion defects in patients with acute pulmonary embolism (PE).

Materials And Methods: One hundred seventeen consecutive patients with clinical suspicion of acute PE underwent dual-energy multidetector computed tomographic (CT) angiography of the chest with a standard injection protocol. Two radiologists evaluated, by consensus, the presence of endoluminal clots on (1) transverse "diagnostic" scans (contiguous 1-mm-thick averaged images from tubes A and B) and (2) lung perfusion scans.

Thoracic applications of dual-source CT technology.

Among the various imaging modalities available, CT has remained over time the core imaging technique for the evaluation of respiratory disorders. The recent advent of dual-source CT offers innovative approaches to investigate thoracic diseases, based on the use of one or two tubes as well as single or dual energy to scan the entire thorax. Two major options can be used in clinical practice with promising results.

Screening for coronary artery disease in respiratory patients: comparison of single- and dual-source CT in patients with a heart rate above 70 bpm.

To evaluate the assessibility of coronary arteries in respiratory patients with high heart rates. This study was based on the comparative analysis of two paired populations of 54 patients with a heart rate >70 bpm evaluated with dual-source (group 1) and single-source (group 2) CT. The mean heart rate was 89.

Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography.

The purpose of this study was to determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis.

Pulmonary arteriovenous malformation treated with embolotherapy: systemic collateral supply at multidetector CT angiography after 2-20-year follow-up.

Purpose: To retrospectively evaluate frequency of systemic arterial collateral supply to treated pulmonary arteriovenous malformations (PAVMs) in long-term follow-up with multi-detector row helical computed tomography (CT).

Materials And Methods: Institutional review board approval was obtained, with waiver of informed consent. Thirty-two patients (19 male, 13 female; mean age, 43 years) underwent follow-up multi-detector row helical CT angiography of the chest (collimation, 16x0.

MDCT of right ventricular function: impact of methodologic approach in estimation of right ventricular ejection fraction, part 2.

Objective: The purpose of this study was to evaluate the impact of the methodologic approach for MDCT estimation of right ventricular ejection fraction (RVEF).

Materials And Methods: In 49 consecutive patients (30 men, 19 women; mean age, 59 years) known to have or suspected of having right ventricular (RV) dysfunction secondary to pulmonary disease, 16-MDCT of the heart was performed after standard CT angiographic examination of the entire thorax, with determination of RVEF by two reviewers who had limited experience in cardiac CT. The reconstruction windows were determined using the ECG tracing (reviewer 1) or using transverse test images obtained in 5% steps through the entire R-R interval showing the largest and smallest RV cavity areas (reviewer 2).

MDCT of right ventricular function: comparison of right ventricular ejection fraction estimation and equilibrium radionuclide ventriculography, part 1.

Objective: The aim of this study was to calculate right ventricular ejection fraction by use of ECG-gated MDCT and to compare the results with those of equilibrium radionuclide ventriculography.

Subjects And Methods: Forty-nine consecutively examined patients (30 men, 19 women; mean age, 59 years) with known or suspected right ventricular dysfunction secondary to bronchopulmonary (n = 30) or pulmonary vascular (n = 19) disease underwent ECG-gated 16-MDCT angiography of the heart (rotation time, 0.42 second; 120 kV; 300 mAs; collimation, 12 x 0.

Coronary artery imaging during preoperative CT staging: preliminary experience with 64-slice multidetector CT in 99 consecutive patients.

The purpose of this study was to evaluate the clinical feasibility of coronary artery imaging during routine preoperative 64-slice MDCT scans of the chest. Ninety-nine consecutive patients in sinus rhythm underwent a biphasic multidetector-row spiral CT examination of the chest without the administration of beta-blockers, including an ECG-gated acquisition over the cardiac cavities, followed by a non-gated examination of the upper third of the thorax. Data were reconstructed to evaluate coronary arteries and to obtain presurgical staging of the underlying disease.

Coronary imaging quality in routine ECG-gated multidetector CT examinations of the entire thorax: preliminary experience with a 64-slice CT system in 133 patients.

To evaluate image quality in the assessment of the coronary arteries during routine ECG-gated multidetector CT (MDCT) of the chest. One hundred and thirty three patients in sinus rhythm underwent an ECG-gated CT angiographic examination of the entire chest without beta-blockers with a 64-slice CT system. In 127 patients (95%), it was possible to assess the coronary arteries partially or totally; coronary artery imaging failed in six patients (5%), leading to a detailed description of the coronary arteries in 127 patients.

Integrated cardio-thoracic imaging with ECG-Gated 64-slice multidetector-row CT: initial findings in 133 patients.

The purpose of this study was to investigate the possibility of assessing the underlying respiratory disease as well as cardiac function during ECG-gated CT angiography of the chest with 64-slice multidetector-row CT (MDCT). One hundred thirty-three consecutive patients in sinus rhythm with known or suspected ventricular dysfunction underwent an ECG-gated CT angiographic examination of the chest without beta-blockers using the following parameters: (1) collimation: 32 x 0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.

Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients.

The purpose of this study was to evaluate image quality of low-dose electrocardiogram (ECG)-gated multislice helical computed tomography (CT) angiograms of the chest. One hundred and five consecutive patients with a regular sinus rhythm (72 men; 33 women) underwent ECG-gated CT angiographic examination of the chest without administration of beta blockers using the following parameters: (a) collimation 32 x 0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.

Multi-detector row CT angiography of pulmonary circulation with gadolinium-based contrast agents: prospective evaluation in 60 patients.

Purpose: To prospectively evaluate gadolinium dose safety and effectiveness for 16-detector pulmonary computed tomographic (CT) angiography.

Materials And Methods: Ethics committee approval and informed consent were obtained. Sixty patients with contraindications to iodine underwent CT of the pulmonary circulation with 0.

Pulmonary arteriovenous malformations treated with embolotherapy: helical CT evaluation of long-term effectiveness after 2-21-year follow-up.

Purpose: To retrospectively evaluate the long-term results of transcatheter embolotherapy of pulmonary arteriovenous malformations (PAVMs) with helical computed tomography (CT).

Materials And Methods: Neither institutional review board approval nor patient consent was required for this retrospective study. Thirty-eight patients underwent follow-up helical chest CT 2-21 years after successful embolotherapy of 64 PAVMs.

Multi-detector row CT of hemoptysis.

Hemoptysis is symptomatic of a potentially life-threatening condition and warrants urgent and comprehensive evaluation of the lung parenchyma, airways, and thoracic vasculature. Multi-detector row computed tomographic (CT) angiography is a very useful noninvasive imaging modality for initial assessment of hemoptysis. The combined use of thin-section axial scans and more complex reformatted images allows clear depiction of the origins and trajectories of abnormally dilated systemic arteries that may be the source of hemorrhage and that may require embolization.